title: Leaf concentrate as an alternative to iron and folic acid supplements for anaemic adolescent girls: a randomised controlled trial in India.
abstract: OBJECTIVE
  Despite public health campaigns based on Fe and folic acid supplements, Fe-deficiency anaemia remains highly prevalent among women in India. We investigated leaf concentrate as an alternative to Fe and folic acid supplements for treating anaemia in adolescent girls.
  
  
  METHODS
  Randomised controlled two-arm trial over 3 months: one group received daily Fe and folic acid (IFA; 60 mg Fe, 500 microg folic acid); the other daily leaf concentrate (LC; 5 mg Fe, 13 microg folic acid). Hb concentration, mean cell volume, serum Fe, serum ferritin and total Fe-binding capacity were measured pre- and post-intervention.
  
  
  METHODS
  Jaipur, India.
  
  
  METHODS
  One hundred and two adolescent girls aged 14-18 years.
  
  
  RESULTS
  Of the 102 girls randomized to the two arms of the trial, four (3.9 %) were severely anaemic (Hb < 7 g/dl), twenty-eight (27.5 %) were moderately anaemic (Hb > or = 7 g/dl, <10 g/dl) and seventy (68.6 %) were mildly anaemic (Hb > or = 10 g/dl, <12 g/dl). In the IFA group, eleven girls (20.4 %) withdrew due to side-effects, compared with one girl (2.1 %) in the LC group (P = 0.005). Total losses to follow-up were 14/54 in the IFA group and 2/48 in the LC group. At the end of the trial, none of the eighty-six remaining girls were severely anaemic, nine (10.5 %) were moderately anaemic and twenty-six (30.2 %) were mildly anaemic; fifty-one (59.3 %) had normal Hb levels (> or = 12 g/dl). After adjustment for baseline values, LC was as effective as IFA in improving serum Fe parameters and treating anaemia.
  
  
  CONCLUSIONS
  Leaf concentrate is an effective, and more palatable, alternative to Fe and folic acid supplements for treating anaemia in adolescent girls.
authors.affiliation: Department of Foods and Nutrition, International College for Girls, Jaipur, India.
authors.forename: Swati
authors.initials: S
authors.lastname: Vyas
authors.forename: Simon M
authors.initials: SM
authors.lastname: Collin
authors.forename: Eric
authors.initials: E
authors.lastname: Bertin
authors.forename: Glyn J
authors.initials: GJ
authors.lastname: Davys
authors.forename: Beena
authors.initials: B
authors.lastname: Mathur
mesh_terms: D000293:Adolescent; D017195:Adolescent Nutritional Physiological Phenomena; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007194:India / Q000453:epidemiology; D019266:Iron, Dietary / Q000627:therapeutic use*; D000455:Medicago sativa / Q000737:chemistry*; D008517:Phytotherapy; D010936:Plant Extracts / Q000627:therapeutic use*; D018515:Plant Leaves / Q000737:chemistry; D015995:Prevalence; D016896:Treatment Outcome
chemical_list: D006454:Hemoglobins; D019266:Iron, Dietary; D010936:Plant Extracts; D005492:Folic Acid