title: Micronized ferric pyrophosphate supplied through extruded rice kernels improves body iron stores in children: a double-blind, randomized, placebo-controlled midday meal feeding trial in Indian schoolchildren.
abstract: BACKGROUND
  Micronized ferric pyrophosphate (MFPP) in extruded rice kernels mixed in a rice-based meal could be an effective strategy for improving iron status of children in India.
  
  
  OBJECTIVE
  The objective was to determine the impact of MFPP supplied through extruded rice kernels in a rice-based meal on iron status of children participating in the midday meal (MDM) scheme in India.
  
  
  METHODS
  The sensory characteristics of cooked rice containing MFPP in extruded rice kernels, in vitro availability, and loss of iron during cooking from a typical MDM consisting of 125 g rice (dry weight) containing 19 mg Fe [fortified rice (FR); normal rice mixed with Ultra Rice (extruded kernels containing MFPP of ∼3.14-μm mean particle size)] in comparison with unfortified rice (UFR) were tested. A double-blind, 8-mo, placebo-controlled trial was conducted in 5-11-y-old schoolchildren (n = 140) who were randomly assigned to receive either an FR-MDM or a UFR-MDM. Average consumption amounts of the MDM, height, weight, hemoglobin, ferritin, and C-reactive protein were measured at baseline and at 8 mo.
  
  
  RESULTS
  The sensory qualities of cooked FR and UFR were similar. The in vitro iron availability from FR-MDM (1.3%) was significantly (P < 0.05) lower than that from UFR-MDM (3.3%). Providing FR-MDM to the schoolchildren for 8 mo improved ferritin significantly (P < 0.001), by 8.2 ± 2.10 μg/L. However, the increase in hemoglobin was similar between groups (FR: 0.99 ± 0.10 g/dL; UFR: 1.15 ± 0.10 g/dL), which suggests that other factors beyond additional iron intake had a large influence on hemoglobin concentration. The prevalence of iron deficiency decreased significantly (P < 0.05) in the FR group (33-14%) and increased marginally in the UFR group (31-37%). The prevalence of anemia and iron deficiency anemia was similar between groups at baseline and at 8 mo.
  
  
  CONCLUSIONS
  Regular intake of 19 mg Fe/d in MFPP supplied through extruded rice kernels improves iron stores and reduces iron deficiency among schoolchildren in India.
authors.affiliation: Division of Community Studies, National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, India.
authors.forename: Madhari S
authors.initials: MS
authors.lastname: Radhika
authors.forename: Krishnapillai M
authors.initials: KM
authors.lastname: Nair
authors.forename: Rachakulla Hari
authors.initials: RH
authors.lastname: Kumar
authors.forename: Mendu Vishnuvardhana
authors.initials: MV
authors.lastname: Rao
authors.forename: Punjal
authors.initials: P
authors.lastname: Ravinder
authors.forename: Chitty Gal
authors.initials: CG
authors.lastname: Reddy
authors.forename: Ginnela N V
authors.initials: GN
authors.lastname: Brahmam
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000188:drug therapy*; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D011756:Diphosphates / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D005293:Ferritins / Q000097:blood; D005527:Food, Fortified; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007194:India; D007501:Iron / Q000008:administration & dosage*; D008297:Male; D012275:Oryza; D010919:Placebos; D012424:Rural Population; D012574:Schools; D018709:Statistics, Nonparametric
chemical_list: D011756:Diphosphates; D006454:Hemoglobins; D010919:Placebos; D002097:C-Reactive Protein; D005293:Ferritins; D007501:Iron; C049051:ferric pyrophosphate