Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-21T15:38:39.908Z Has data issue: false hasContentIssue false

Haematological response to haem iron or ferrous sulphate mixed with refried black beans in moderately anaemic Guatemalan pre-school children

Published online by Cambridge University Press:  02 January 2007

K Schümann*
Affiliation:
Institute for the Physiology of Nutrition, Hochfeldweg 2, D-85350 Freising-Weihenstephan, Germany
ME Romero-Abal
Affiliation:
Center for Studies of Sensory Impairment, Ageing and Metabolism (CeSSIAM), Guatemala City, Guatemala
A Mäurer
Affiliation:
Fraunhofer Institute for Process Engineering and Packaging, Freising, Germany
T Luck
Affiliation:
Fraunhofer Institute for Process Engineering and Packaging, Freising, Germany
J Beard
Affiliation:
The Pennsylvania State University, University Park, PA, USA
L Murray-Kolb
Affiliation:
The Pennsylvania State University, University Park, PA, USA
J Bulux
Affiliation:
Center for Studies of Sensory Impairment, Ageing and Metabolism (CeSSIAM), Guatemala City, Guatemala
I Mena
Affiliation:
Center for Studies of Sensory Impairment, Ageing and Metabolism (CeSSIAM), Guatemala City, Guatemala
NW Solomons
Affiliation:
Center for Studies of Sensory Impairment, Ageing and Metabolism (CeSSIAM), Guatemala City, Guatemala
*
*Corresponding author: Email K.Schuemann@lrz.uni.muenchen.de
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective

Combating iron deficiency in toddlers with iron-fortified food has proved difficult in countries with phytate-rich diets. For this purpose, a new haem iron preparation was developed. The study compared changes in iron status after administration of refried beans with beans fortified with a haem iron preparation or ferrous sulphate (FeSO4).

Design

In a masked, stratified-randomised intervention trial, children received five 156-g cans of refried black beans per week for 10 consecutive weeks. The beans-only (control), FeSO4 and haem iron groups were offered a cumulative dose of 155 mg, 1625 mg and 1700 mg of iron from the bean intervention, respectively. Haemoglobin (Hb) and ferritin concentrations were determined at baseline and after 5 and 10 weeks. Compliance was examined weekly.

Setting

A low-income community in Guatemala City.

Subjects

One hundred and ten children aged 12–36 months with initial Hb values between 100 and 115 g l−1.

Results

The cumulative intake of beans was approximately 80% of that offered, signifying an additional ~1300 mg of either haem or inorganic iron in the corresponding treatment groups over 10 weeks. Hb concentrations increased by the order of 7.3–11.4 g l-1 during the intervention, but without significant differences across treatments. Average ferritin concentrations were unaffected by treatment assignment. However, post hoc analysis by subgroups of initial high ferritin and initial low ferritin found the Hb increments after 10 weeks in the haem iron group (13.1±7.7 g l−1) to be significantly greater than the respective increases (6.8±11.2 and 6.4±8.5 g l−1) in the inorganic iron and beans-only groups.

Conclusions

Canned refried beans are a candidate vehicle for fortificant iron. Given the improved colour and organoleptic properties imparted by haem iron added to refried beans, its additional potential for benefiting the iron status of consumers with iron deficiency may recommend it over FeSO4.

Type
Research Article
Copyright
Copyright © The Authors 2005

References

1Yip, R. Iron deficiency. Contemporary scientific issues and international programmatic approaches. Journal of Nutrition 1994; 124: 1479S–90S.CrossRefGoogle ScholarPubMed
2Walter, T, De Andraca, I, Chadud, P, Peralas, CG. Iron deficiency anemia: adverse effects on infant psychomotor development. Pediatrics 1989; 84: 717.CrossRefGoogle ScholarPubMed
3Lozoff, B, Jimenez, E, Wolf, AW. Long-term developmental outcome of infant mental development scores. New England Journal of Medicine 1991; 325: 687–93.CrossRefGoogle Scholar
4Pollitt, E. The developmental and probabilistic nature of the functional consequences of iron-deficiency anemia in children. Journal of Nutrition 2001; 131: 669S–75S.CrossRefGoogle ScholarPubMed
5Viteri, FE, Guzman, MA. Haematological status of the Central American population: prevalence of individuals with haemoglobin levels below ‘normal’. British Journal of Haematology 1972; 23: 723–33.CrossRefGoogle ScholarPubMed
6Ruz, M, Rosas, A, Bulux, J, Guerrero, A-M, Lopez, CY, Molina, S, et al. Haematological status of school children in two regions of Guatemala: relevance of normal standards. International Journal of Food Sciences and Nutrition 1992; 43: 8995.CrossRefGoogle Scholar
7Romero-Abal, ME, Bulux, J, Mendoza, I, Grazioso, C, Solomons, NW. Hematological status of preschool and school children in rural and urban areas of Guatemala. Food and Nutrition Bulletin 1995; 16: 60–6.CrossRefGoogle Scholar
8Ministerio de, Salud. Inquesta Nacional de Micronutrientes. Guatemala City: United Nations Children's Fund/Institute of Nutrition of Central America and Panama/Ministerio de Salud, 1996.Google Scholar
9Viteri, FE, Alvarez, E, Batrez, R, Torún, B, Pineda, O, Mejía, LA, et al. Fortification of sugar with iron sodium ethylenediamino-tetraacetate (FeNaEDTA) improves iron status in semirural Guatemalan populations. American Journal of Clinical Nutrition 1995; 61: 1153–63.CrossRefGoogle ScholarPubMed
10Hallberg, L. Bioavailability of dietary iron in man. Annual Review of Nutrition 1981; 1: 123–47.CrossRefGoogle ScholarPubMed
11Monsen, EL, Hallberg, L, Layrisse, M, Hegsted, DM, Cook, JD, Merz, W, et al. Estimation of available dietary Fe. American Journal of Clinical Nutrition 1978; 31: 134–41.CrossRefGoogle Scholar
12Hallberg, L, Brune, M, Erlandsson, M, Sandberg, AS, Rossander-Hulten, L. Calcium: effect of different amounts on nonheme- and heme-iron absorption in humans. American Journal of Clinical Nutrition 1991; 53: 112–9.CrossRefGoogle ScholarPubMed
13Cook, JD, Dassenko, SA, Whittaker, P. Calcium supplementation: effects on iron absorption. American Journal of Clinical Nutrition 1991; 53: 106–11.CrossRefGoogle ScholarPubMed
14Asenjo, JA, Amar, M, Cartegena, N, King, J, Hiche, E, Stekel, A. Use of bovine heme iron concentrate in the fortification of biscuits. Journal of Food Science 1985; 50: 795–9.CrossRefGoogle Scholar
15Calvo, E, Hertrampf, E, Pablo, S, Amar, M, Stekel, A. Haemoglobin-fortified cereal: an alternative weaning food with high iron bioavailability. European Journal of Clinical Nutrition 1989; 43: 237–43.Google ScholarPubMed
16Hertrampf, E, Olivares, M, Pizarro, F, Olivares, M, Llanguno, S, Letelier, A, et al. Haemoglobin fortified cereal: a source of available Fe in breast-fed infants. European Journal of Clinical Nutrition 1990; 44: 793–8.Google ScholarPubMed
17Walter, T, Hertrampf, E, Pizarro, R, Olivares, M, Llaguno, S, Letelier, A, et al. Effect of bovine-hemoglobin-fortified cookies on iron status of schoolchildren. A nationwide program in Chile. American Journal of Clinical Nutrition 1993; 57: 190–4.CrossRefGoogle ScholarPubMed
18Martínez-García, C, López-Martínez, G, Roz-Berruezo, G, Vidal-Guevara, ML, Abellán-Ballesta, P. Use of heme iron concentrate in the fortification of weaning foods. Journal of Agricultural and Food Chemistry 2000; 48: 2930–6.CrossRefGoogle Scholar
19Martínez, C, Fox, T, Eagles, J, Fairweather-Tait, SJ. Evaluation of iron bioavailability in infant weaning foods fortified with haem concentrate. Journal of Pediatric Gastroenterology and Nutrition 1998; 27: 419–29.CrossRefGoogle ScholarPubMed
20Valdez, C, Mazariegos, M, Grazioso, CF, Solomons, NW. Prevalence of apparent and inapparent infections in preschool children in a peri-urban community. International Child Health 1996; 7: 4353.Google Scholar
21Dewey, KG, Romero-Abal, ME, Quan de Serrano, J, Bulux, J, Peerson, JM, Engle, P, et al. Effects of discontinuing coffee on iron status of anemic Guatemalan toddlers. A randomized intervention study. American Journal of Clinical Nutrition 1997; 66: 168–76.CrossRefGoogle ScholarPubMed
22Grazioso, C, Isalgue, M, Ramirez, I, Ruz, M, Zepeda, E, Solomons, NW. The effect of zinc supplementation on parasitic reinfestation of Guatemalan school children. American Journal of Clinical Nutrition 1993; 57: 673–8.CrossRefGoogle Scholar
23Dallman, PR. Manifestations of iron deficiency. Seminars in Hematology 1982; 19: 1930.Google ScholarPubMed
24Grantham-McGregor, S, Ani, C. A review of studies on the effect of iron deficiency on cognitive development in children. Journal of Nutrition 2001; 131: 649S–68S.CrossRefGoogle ScholarPubMed
25Mäurer, A, Schümann, K. Abattoir blood used in foods: an example of nutrition–environment interaction. SCN News 2000; 21: 32–3.Google Scholar
26Schultink, W, Gross, R, Gliwitzki, M, Karyadi, D, Matulessi, P. Effect of daily vs. twice weekly iron supplementation in Indonesian preschool children with low iron status. American Journal of Clinical Nutrition 1995; 61: 111–5.CrossRefGoogle ScholarPubMed
27Krause, V, Solomons, NW, Tucker, KL, Lopez, CY, Ruz, M, Kuhnlein, KV. Rural–urban variation in the calcium, iron, zinc and copper content of tortilla and the intake of these minerals from tortilla by women in Guatemala. Ecology of Food and Nutrition 1992; 28: 289–97.CrossRefGoogle Scholar
28Belizán, J, Villar, J. The relationship between calcium intake and edema-, proteinuria-, and hypertension-gestosis: an hypothesis. American Journal of Clinical Nutrition 1980; 51: 2202–10.CrossRefGoogle Scholar
29Hallberg, L, Rossander-Hulten, L, Brune, M, Gleerup, A. Inhibition of haem-iron absorption in man by calcium. British Journal of Nutrition 1993; 69: 533–40.CrossRefGoogle Scholar
30Abrams, SA. Using stable isotopes to assess mineral absorption and utilization by children. American Journal of Clinical Nutrition 1999; 70: 955–64.CrossRefGoogle ScholarPubMed
31Hillman, RS, Finch, CA. Drugs effective in iron-deficiency and other hypochromic anemias. In: Goodman Gilman, A, Goodman, LS, Rall, TW, Murad, F, eds. The Pharmacological Basis of Therapeutics, 7th ed. New York: MacMillan Publishing Company, 1985; 1308–22.Google Scholar
32Morris, SS, Ruel, MT, Cohen, RJ, Dewey, KG, de la Briere, B, Hassan, MN. Precision, accuracy, and reliability of hemoglobin assessment with use of capillary blood. American Journal of Clinical Nutrition 1999; 69: 1243–8.CrossRefGoogle ScholarPubMed
33Zlotkin, S, Arthur, P, Yeboah, K, Yeung, G. Treatment of anemia with microencapsulated ferrous fumarate plus ascorbic acid supplied as sprinkles to complementary (weaning) foods. American Journal of Clinical Nutrition 1994; 74: 791–5.CrossRefGoogle Scholar
34Straubli Asobayire, F, Adou, P, Davidsson, L, Cook, JD, Hurrell, RF. Prevalence of iron deficiency with and without concurrent anemia in population groups with high prevalences of malaria and other infections: a study in Côte d'Ivoire. American Journal of Clinical Nutrition 2001; 74: 776–82.CrossRefGoogle ScholarPubMed
35Allen, LH, Rosado, JL, Casterline, JE, Lopez, P, Munoz, E, Garcia, OP, et al. Lack of hemoglobin response to iron supplementation in anemic Mexican preschoolers with multiple micronutrient deficiencies. American Journal of Clinical Nutrition 2000; 71: 1485–94.CrossRefGoogle ScholarPubMed
36Linneweh, F. Morphologische und funktionelle Entwicklung des Kindes. In: Joppich, G, ed. Lehrbuch der Kinderheilk-unde, 22nd ed. Stuttgart: Gustav Fischer Verlag, 1971; 1–17.Google Scholar
37Forth, W, Rummel, W. Pharmakotherapie des Eisenmangels. In: Forth, W, Henschler, D, Rummel, W, Förstermann, U, Starke, K, eds. Pharmakologie und Toxikologie, 8th ed. München: Urban and Fisher, 2001; 739–50.Google Scholar
38Walters, GO, Miller, FM, Worwood, M. Serum ferritin concentration and iron stores in normal subjects. Journal of Clinical Pathology 1973; 26: 770–2.CrossRefGoogle ScholarPubMed