Impact of multiple micronutrient supplementation ("sprinkles") on iron deficiency anemia in Bedouin Arab and Jewish infants.

BACKGROUND: A high prevalence of iron deficiency anemia persists in Bedouin Arab and Jewish pediatric populations in southern Israel. OBJECTIVES: To compare the effect of daily use of the micronutrient supplementation (MMS), "Sprinkles," a powdered formulation of iron, vitamins A and C, folic acid and zinc, with liquid iron and vitamins A and D on iron deficiency at 12 months of age. METHODS: The 621 eligible Bedouin and Jewish infants in the study were assigned to the MMS and control arms and received supplementations from age 6 to 12 months. We examined the change in hemoglobin, hematocrit, mean cell volume, red blood cell distribution, serum ferritin and transferrin saturation. In addition, we used the high Iron Deficiency Index (IDI) if two or more of the above six parameters showed abnormal levels. RESULTS: Rates of anemia decreased significantly over the 6 month period, from 58.8% to 40.6% among Bedouin infants (P = 0.037) and from 40.6 to 15.8% among Jewish infants (P = 0.017). In Bedouin infants the prevalence of high IDI decreased significantly from 79.2% to 67.4% (P = 0.010) in the MMS group, but there was no change in the controls. Among Jewish infants, the high IDI prevalence decreased from 67% to 55.6% with no statistically significant difference in the two study arms. In the multivariate analysis in Bedouin infants MMS use was associated with a reduced risk of 67% in high IDI at age 12 months as compared to controls (P = 0.001). Fewer side effects in the intervention groups in both ethnic populations were reported. CONCLUSIONS: MMS fortification of home food can be recommended as an effective and safe method for preventing iron deficiency anemia at 12 months of age.

Differences in food intake and disparity in obesity rates between adult Jews and Bedouins in southern Israel.

OBJECTIVE: The goal of this study was to compare eating patterns of Jews and Muslim Bedouins and investigate possible dietary causes for discrepancy in obesity rates. METHODS: We pooled two surveys that included data from 793 Jews and 169 Bedouins aged 35-64years recruited from 1998 through 2003 in southern Israel. For the Jewish sample, we used a proportional geographic cluster random sample of persons aged > or = 35 years. For the Bedouins, a convenience sample of 519 participants was used. Participants were interviewed at home, using modified 24-hour food questionnaires with additional questions regarding health and eating habits. RESULTS: The Jewish group was older and better educated than were the Bedouins. The Bedouins had a higher age-adjusted body mass index than did the Jews (P = .03), and the rate of obesity was higher among Bedouins than Jews (27.9% vs 20.0%, respectively). Compared to Jewish men, Bedouin men reported lower intake of fat, cholesterol, total saturated fat, and protein and fat as a percentage of total energy, but they reported higher intake of carbohydrates, fiber, and carbohydrates as a percentage of total energy. Bedouin women reported lower intake of total saturated fat, percentage of protein and fat, and higher intake of carbohydrates and fiber than did Jewish women. CONCLUSION: The Bedouin population is adapting Western eating patterns that appear to be associated with increased obesity. To address this problem, culturally sensitive intervention programs will have to be developed.