Sustainability of the effects of medicinal iron and iron rich food supplementation on haemoglobin, intelligence quotient and growth of school aged girls

Abstract

Anaemia in school aged girls is an important but neglected issue. Since iron supplementation programmes have had little reported success in reducing anaemia, interest is turning to food based approaches that have higher potential for achieving far reaching benefits. The purpose of the study was to observe sustainability of the effect of iron and food supplementation on haemoglobin (Hb), intelligence quotient (IQ) and growth of the subjects. At baseline, estimation of haemoglobin (Hb), red cell indices, serum iron, total iron binding capacity, serum transferrin saturation and serum ferritin was done. IQ, weight and height were measured using standard procedures. Anaemic subjectswere divided into three groups, viz., (i) twice weekly supplementation of iron folic acid syrup (53 mg iron/week); (ii) daily supplementation of 4 niger seed and defatted soyaflour biscuits plus 2 lemons (45 mg iron/week) and (iii) control. Non anaemic group(NAC) was not intervened. Endline data was collected after 120 days. Follow up for Hb, IQ, weight and height was done 4 months after cessation of supplementation. The prevalence of anaemia was 77% in the study population; 46% subjects had mild anaemia and 32% had moderate anaemia. Iron status was lower in anaemic subjects (p<0.001).Iron supplementation was more effective in raising Hb and building iron stores than iron rich food supplementation. Iron supplementation improved IQ but did not bring about catch up of anaemics to non anaemics. Iron rich food supplementation was better than medicinal iron in promoting growth in anaemic girls. The impact of iron rich food supplementation on Hb, IQ and growth sustained for 4 months while that of medicinal iron did not. Effects of food supplementation are sustainable for 4 months, therefore, this strategy holds more potential to control anaemia, in school aged girls.