Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/107072
Citations
Scopus Web of Science® Altmetric
?
?
Type: Journal article
Title: Randomized controlled trial assessing the efficacy of a reusable fish-shaped iron ingot to increase hemoglobin concentration in anemic, rural Cambodian women
Author: Rappaport, A.
Whitfield, K.
Chapman, G.
Yada, R.
Kheang, K.
Louise, J.
Summerlee, A.
Armstrong, G.
Green, T.
Citation: American Journal of Clinical Nutrition, 2017; 106(2):667-674
Publisher: American Society for Nutrition
Issue Date: 2017
ISSN: 0002-9165
1938-3207
Statement of
Responsibility: 
Aviva I Rappaport, Kyly C Whitfield, Gwen E Chapman, Rickey Y Yada, Khin Meng Kheang, Jennie Louise, Alastair J Summerlee, Gavin R Armstrong, and Timothy J Green
Abstract: Background: Anemia affects 45% of women of childbearing age in Cambodia. Iron supplementation is recommended in populations in which anemia prevalence is high. However, there are issues of cost, distribution, and adherence. A potential alternative is a reusable fish-shaped iron ingot, which, when added to the cooking pot, leaches iron into the fluid in which it is prepared.Objective: We sought to determine whether there was a difference in hemoglobin concentrations in rural Cambodian anemic women (aged 18-49 y) who cooked with the iron ingot or consumed a daily iron supplement compared with a control after 1 y.Design: In Preah Vihear, 340 women with mild or moderate anemia were randomly assigned to 1) an iron-ingot group, 2) an iron-supplement (18 mg/d) group, or 3) a nonplacebo control group. A venous blood sample was taken at baseline and at 6 and 12 mo. Blood was analyzed for hemoglobin, serum ferritin, and serum transferrin receptor. Hemoglobin electrophoresis was used to detect structural hemoglobin variants.Results: Anemia prevalence was 44% with the use of a portable hemoglobinometer during screening. At baseline, prevalence of iron deficiency was 9% on the basis of a low serum ferritin concentration. There was no significant difference in mean hemoglobin concentrations between the iron-ingot group (115 g/L; 95% CI: 113, 118 g/L; P = 0.850) or iron-supplement group (115 g/L; 95% CI: 113, 117 g/L; P = 0.998) compared with the control group (115 g/L; 95% CI: 113, 117 g/L) at 12 mo. Serum ferritin was significantly higher in the iron-supplement group (73 μg/L; 95% CI: 64, 82 μg/L; P = 0.002) than in the control group at 6 mo; however, this significance was not maintained at 12 mo (73 μg/L; 95% CI: 58, 91 μg/L; P = 0.176).Conclusions: Neither the iron ingot nor iron supplements increased hemoglobin concentrations in this population at 6 or 12 mo. We do not recommend the use of the fish-shaped iron ingot in Cambodia or in countries where the prevalence of iron deficiency is low and genetic hemoglobin disorders are high. This trial was registered at clinicaltrials.gov as NCT02341586.
Keywords: anemia; Cambodia; hemoglobin; inflammation; iron deficiency; iron ingot; Lucky Iron Fish; randomized controlled trial; serum ferritin; women of reproductive age
Description: First published online June 14, 2017
Rights: © 2017 American Society for Nutrition
RMID: 0030071610
DOI: 10.3945/ajcn.117.152785
Appears in Collections:Public Health publications

Files in This Item:
There are no files associated with this item.


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.