title: Randomized placebo-controlled trial of guava juice as a source of ascorbic acid to reduce iron deficiency in Tarahumara indigenous schoolchildren of northern Mexico.
abstract: OBJECTIVE
  Assess the efficacy of a 10-week consumption of guava juice on the iron status of children with mild iron deficiency anemia.
  
  
  METHODS
  Ninety-five boarding school children aged 6-9 years identified as anemic were randomly allocated to receive 300 mL of natural guava juice containing ∼200 mg of ascorbic acid (AA) or placebo (guava-flavored juice free of AA) with the main meal (5 d/wk). Information about dietary intake was collected at weeks 3, 5, and 7 at school and household levels. Changes in hemoglobin (Hb) and plasma ferritin (PF) among the subsample iron deficient at baseline (n = 33) were the main outcomes.
  
  
  RESULTS
  Iron and phytic acid intakes at school and at home did not differ between groups. Baseline Hb and PF were 11.9 ± 0.5 g/dL and 8.2 ± 3.6 ng/mL for the guava, and 11.4 ± 1.1 g/dL and 7.4 ± 4.6 ng/mL for the placebo group (Hb: p = 0.08; PF: p = 0.31); at week 10 of the study, corresponding values were 13.1 ± 0.9 g/dL and 17.9 ± 10.3 ng/mL (n = 16), and 12.3 ± 1.3 g/dL and 15.4 ± 5.8 ng/mL (n = 12) (Hb: p = 0.05; PF: p = 0.21). With analysis of variance (ANOVA) for repeated measures, the guava group had 0.64 g/dL higher Hb (CI(95), 0.18-1.11; p = 0.01) and 2.47 ng/mL higher PF (CI(95), -1.04 to 5.98; p = 0.12) compared with the placebo group.
  
  
  CONCLUSIONS
  Guava juice providing 200 mg AA at one meal on each school day had a marginal effect on Hb and PF concentrations in children consuming high-phytate diets fortified with iron.
authors: Mexican Institute of Social Security, Clinical Epidemiology Research Unit, Chihuahua, México. jmonarrez@hotmail.com
authors: Joel
authors: J
authors: Monárrez-Espino
authors: Mardia
authors: M
authors: López-Alarcón
authors: Ted
authors: T
authors: Greiner
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000178:diet therapy* / Q000453:epidemiology*; D001205:Ascorbic Acid / Q000008:administration & dosage*; D001628:Beverages; D002648:Child; D004032:Diet; D002149:Energy Intake; D005260:Female; D005293:Ferritins / Q000097:blood / Q000172:deficiency; D006454:Hemoglobins / Q000032:analysis / Q000172:deficiency; D006801:Humans; D007407:Interviews as Topic; D019266:Iron, Dietary / Q000008:administration & dosage; D008297:Male; D008800:Mexico / Q000453:epidemiology; D009752:Nutritional Status; D010833:Phytic Acid; D031647:Psidium; D011795:Surveys and Questionnaires
chemical_list: D006454:Hemoglobins; D019266:Iron, Dietary; D010833:Phytic Acid; D005293:Ferritins; D001205:Ascorbic Acid