A study to establish whether food-based approaches can improve serum iron levels in child-bearing aged women.

BACKGROUND: Iron-deficiency anaemia is particularly prevalent in pregnancy. The present study aimed to determine whether functional bread containing teff flour (i.e. naturally rich in iron) could be an alternative way of improving iron status. However, before testing whether its consumption can improve pregnancy iron status, the bio-availability of iron was determined in a sample of nonpregnant women. METHODS: Fifty-eight women (20-50 years) were recruited from the University. Blood samples were taken at baseline to assess iron status and participants were screened to account for other factors affecting iron status. Twenty-four participants (haemoglobin 9.5-14.0g dL(-1) ) were recruited to take part in the intervention and allocated to five groups: (i) control bread (CB); (ii) teff bread (TB); (iii) TB+level 1 phytase (TB+P1); (iv) TB+level 2 phytase (TB+P2); or (v) a supplement containing 10 mg of ferrous sulphate. Venous blood samples were taken before the intervention and after 180-210min, aiming to determine changes in serum iron. RESULTS: Consuming three or four slices of TB provided statistically significantly more iron (7.6mg) than CB (5.1mg) (P<0.001). Because participants were fasted, serum iron levels declined in all bread groups (average -1.5µm), although the smallest reduction was observed in the TB+P2 group (-0.3 µm). The area-under-the-curve from baseline to 210min was lower in the TB+P2 (-78.8µmol min L(-1) ) group compared to the other bread interventions, indicating higher levels of iron absorption in this group. CONCLUSIONS: The results obtained in the present study show that TB consumption may help to maintain serum iron levels, especially when phytase is added. The findings from the study also demonstrate there may be potential to further improve the bio-availability of iron from non-haem food sources.

A randomized trial investigating an iron-rich bread as a prophylaxis against iron deficiency in pregnancy.

The iron-rich bread (2.2 mg iron per 50 g slice) used in the study was developed using Eragrostis tef flour, naturally rich in iron. Iron deficiency is prevalent in pregnancy and compliance with supplements can be low. In this double-blind, randomized trial 34 Caucasian, primiparous antenatal patients were randomized to receive intervention bread or a placebo for 6 weeks. Women consumed on an average of 2.3 slices per day, providing a total of 5.0 mg iron. Using World Health Organisation (2001) haemoglobin cut-offs, 12% of participants eating the iron-rich bread were iron deficient by the end of the study compared with 27% in the control group. For other markers of iron status, these were improved in the placebo versus the treatment group. For example, a significant decline in serum iron and transferrin saturation was not observed in this group. Findings demonstrate that other modes of delivery, i.e. food fortification, may be needed to generate 'physiological effects', or further measures are taken to improve intervention compliance.