American Journal of Health Research

Submit a Manuscript

Publishing with us to make your research visible to the widest possible audience.

Propose a Special Issue

Building a community of authors and readers to discuss the latest research and develop new ideas.

Review Article |

Efficacy of Iron-Fortification in Complementary Feeding for Prevention of Iron Deficiency Anemia in Children of Bangladesh

Iron deficiency anemia is a worldwide public health issue, and the best cost-effective prophylactic technique is to fortify foods with iron. The right mix of iron form and food carrier, as well as the dietary context in which it is consumed, are critical. It raises the chances of preterm birth and a low birth weight baby. IDA slows development affects cognitive function and lowers physical activity in youngsters. It also increases the risk of death and morbidity in women. Dietary iron requirement, socioeconomic level, and illness condition are all important considerations. Disease management methods, dietary variety, supplementation, and iron fortification in food have all been used to combat IDA. Iron fortification of food is now thought of as a long-term and sustainable option. For a fortification program to be successful, the combination of iron fortificants and food vehicles must be secure, well-tolerated, and consumed by the target population. Additionally, it shouldn't have a detrimental effect on the stability and acceptability of the final product. This article provides a comprehensive summary of the current state of iron deficiency in women and children in Bangladesh. This research also discusses the efficacy and current issues with existing intervention strategies. Interventions to prevent iron deficiency should take precedence in high-risk groups. However, there is a risk of negative side effects, and the long-term benefits are questionable. Although significant progress has been achieved and a variety of methodologies and treatments are being supported, significant issues including coverage, quality, and compliance still exist. The results show that iron deficiency and anemia continue to be major problems in Bangladesh, despite the fact that current intervention programs have had some success in addressing severe deficiencies. More well-integrated strategies are required to support present therapeutic initiatives. New treatment and prevention strategies for specific iron deficiencies and anemia are also offered.

Iron Deficiency, Complementary Feeding, Anemia, Bioavailability, Management

APA Style

Chowdhury Arzu, M., Azim, A., Shahab Uddin, M., Das, D., Islam, S., et al. (2023). Efficacy of Iron-Fortification in Complementary Feeding for Prevention of Iron Deficiency Anemia in Children of Bangladesh. American Journal of Health Research, 11(6), 149-157. https://doi.org/10.11648/j.ajhr.20231106.11

ACS Style

Chowdhury Arzu, M.; Azim, A.; Shahab Uddin, M.; Das, D.; Islam, S., et al. Efficacy of Iron-Fortification in Complementary Feeding for Prevention of Iron Deficiency Anemia in Children of Bangladesh. Am. J. Health Res. 2023, 11(6), 149-157. doi: 10.11648/j.ajhr.20231106.11

AMA Style

Chowdhury Arzu M, Azim A, Shahab Uddin M, Das D, Islam S, et al. Efficacy of Iron-Fortification in Complementary Feeding for Prevention of Iron Deficiency Anemia in Children of Bangladesh. Am J Health Res. 2023;11(6):149-157. doi: 10.11648/j.ajhr.20231106.11

Copyright © 2023 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Abbasi, S., & Azari, S. (2011). The efficiency of novel iron microencapsulation techniques: Fortification of milk. International Journal of Food Science and Technology, 46 (9), 1927-1933.
2. Aly, S. S., Fayed, H. M., Ismail, A. M., & Hakeem, G. L. A. (2018). Assessment of peripheral blood lymphocyte subsets in children with iron deficiency anemia. BMC Pediatrics, 18 (1), 49.
3. Au, A. P., & Reddy, M. B. (2018). Caco-2 cells can Be used to assess human iron bioavailability from a semipurified meal. Journal of Nutrition, 130 (5), 1329.
4. Balk, J., Connorton, J. M., Wan, Y., Lovegrove, A., Moore, K. L., Uauy, C., et al. (2019). Improving wheat as a source of iron and zinc for global nutrition. Nutrition Bulletin, 44 (1), 53-59.
5. Benotti, P. N., Wood, G. C., Still, C. D., Gerhard, G. S., Rolston, D. D., & Bistrian, B. R. (2019). Metabolic surgery and iron homeostasis. Obesity Reviews, 20 (4), 612-620.
6. Blanco-Rojo, R., Pérez-Granados, A. M., Toxqui, L., González-Vizcayno, C., Delgado, M. A., & Vaquero, M. P. (2011). Efficacy of a microencapsulated iron pyrophosphatefortified fruit juice: A randomised, double-blind, placebo-controlled study in Spanish iron-deficient women. British Journal of Nutrition, 105 (11), 1652-1659.
7. Blanco-Rojo, R., & Vaquero, M. P. (2019). Iron bioavailability from food fortification to precision nutrition. A review. Innovative Food Science & Emerging Technologies, 51, 126-138.
8. Cengiz, A., Kahyaoglu, T., Schroen, K., & Berton-Carabin, C. (2019). Oxidative stability of emulsions fortified with iron: The role of liposomal phospholipids. Journal of the Science of Food and Agriculture.
9. Cercamondi, C. I., Duchateau, G. S. M. J. E., Harika, R. K., Van Den Berg, R., Murray, P., Koppenol, W. P., et al. (2016). Sodium pyrophosphate enhances iron bioavailability from bouillon cubes fortified with ferric pyrophosphate. British Journal of Nutrition, 116 (3), 496-503.
10. Abbaspour, N., R. Hurrell, and R. Kelishadi. 2014. Review on iron and its importance for human health. Journal of Research in Medical Sciences 19 (2): 164-74.
11. Abdel Moety, G. A. F., A. M. Ali, R. Fouad, W. Ramadan, D. S. Belal, and H. M. Haggag. 2017. Amino acid chelated iron versus an iron salt in the treatment of iron deficiency anemia with pregnancy: A randomized controlled study. European Journal of Obstetrics & Gynecology and Reproductive Biology 210: 242-6.
12. Akhtar, S., T. Ismail, S. Atukorala, and N. Arlappa. 2013. Micronutrient deficiencies in South Asia - Current status and strategies. Trends in Food Science & Technology 31 (1): 55-6.
13. Al Hasan, S. M., M. Hassan, S. Saha, M. Islam, M. Billah, and S. Islam. 2016. Dietary phytate intake inhibits the bioavailability of iron and calcium in the diets of pregnant women in rural Bangladesh: A cross-sectional study. BMC Nutrition 2 (1): 1-10.
14. Anderson, G. J., and D. M. Frazer. 2017. Current understanding of iron homeostasis. The American Journal of Clinical Nutrition 106 (6): 1559S-66S.
15. Araujo, J. A., M. Zhang, and F. Yin. 2012. Heme oxygenase-1, oxidation, inflammation, and atherosclerosis. Frontiers in Pharmacology 3: 119-7.
16. Anjum, F. M., and Walker, C. E. 2000. Grain, flour, and bread-making properties of eight Pakistani hard white spring wheat cultivars grown at three different locations for two years. Int. J. Food Sc. Tech., 35: 407-416.
17. Arroyave, G., and Dary, O. 1996. Manual for sugar fortification with vitamin A, Part 1: Guidelines for the development, implementation, monitoring, and evaluation of a vitamin A sugar fortification program. USA: OMNI/USAID, Arlington, 1996.
18. Bonkovsky, H. L., Ponka, P., Bacon, B. R., Drysdale, J., Grace, N. D., and Tavill, A. S. 1996. An update on iron metabolism: summary of the fifth international conference on disorders of iron metabolism. Hepatology, 24: 718-729.
19. Bothwell, T. H., and Charlton, R. 1981. Iron deficiency in women. Int. Nutr. Anemia Consultative Group (INACG), Washington DC.
20. Brooker, S., Peshu, N., Warn, P. A., Mosobo, M., Guyatt, H. L., Marsh, K., and Snow, R. W. 1999. The epidemiology of hookworm infection and its contribution to anemia among pre-school children on the Kenyan Coast. Trans. Royal Soc. Trop. Med. Hygiene, 93: 240-246.
21. Brune, M., Rossander-Hulten, L., Hallberg, L., Gleerup, A., and Sandberg, E. 1992. Iron absorption from bread in humans: Inhibiting effects of Cereal fiber, phytate, and inositol phosphate with different numbers of phosphate groups. J. Nutr., 122: 442-449.
22. Hurrell, R. F., and Cook, J. D. 1990. Strategies of iron fortification of foods. Trends in Food Sci. Technol., 9: 56-61.
23. Hurrell, R. F., Juillerat, M. A., Reddy, M. B., Lynch, S. R., Dassenko, S. A., and Cook, J. D. 1992. Soy protein, phytate, and iron absorption in man. Am. J. Clin. Nutr. 56: 573-578.
24. Hurrell, R. F. 1997. Preventing iron deficiency through food fortification. Nutr. Rev., 55: 210-222.
25. Hurrell, R. F. 2002. How to ensure adequate iron absorption from iron-fortified food. Nutr. Rev., 60: 7S-15S.
26. Ioannou, G. N., Dominitz, J. A., Heagerty, P. J., and Kowdley, K. V. 2004. The effect of alcohol consumption on the prevalence of iron overload, iron deficiency, and iron deficiency anemia. Gastroenterology, 126: 1293-1301.
27. Jackson, L. S., and Lee, K. 1991. Microencapsulated iron for food fortification. J. Food Sci., 56: 1047-1050.
28. Radlowski EC, Johnson RW. Perinatal iron deficiency and neurocognitive development. Front Hum Neurosci 2013; 7: 585.
29. Pasricha SR, Drakesmith H, Black J, et al. Control of iron deficiency anemia in low- and middle-income countries. Blood 2013; 121: 2607-2617.
30. Eden AN, Sandoval C. Iron deficiency in infants and toddlers in the United States. Pediatr Hematol Oncol 2012; 29: 704-709.
31. Andersson O, Hellstrom-Westas L, Andersson D. Effects of delayed compared with early umbilical cord clamping on maternal postpartum hemorrhage and cord blood gas sampling: a randomized trial. Acta Obstet Gynecol Scand 2013; 92: 567-574.
32. Duley L, Batey N. Optimal timing of umbilical cord clamping for term and preterm babies. Early Hum Dev 2013; 89: 905-908.
33. Upadhyay A, Gothwal S, Parihar R. Effect of umbilical cord milking in term and near-term infants: randomized control trial. Am J Obstet Gynecol 2013; 208: 120; e121-126.
34. Erickson-Owens DA, Mercer JS, Oh W. Umbilical cord milking in term infants delivered by cesarean section: a randomized controlled trial. J Perinatol 2012; 32: 580-584.
35. Domellof M, Braegger C, Campoy C. Iron requirements of infants and toddlers. J Pediatr Gastroenterol Nutr 2014; 58: 119-129.
36. Taylor TA, Kennedy KA. Randomized trial of iron supplementation versus routine iron intake in VLBW iMiller SM. Iron supplementation in premature infants using the zinc protoporphyrin to heme ratio: short- and long-term outcomes. J Perinatol 2013; 33: 712-716 infants. Pediatrics 2013; 131: e433-e438.
37. Abdullah K, Kendzerska T, Shah P, et al. Efficacy of oral iron therapy in improving the developmental outcome of preschool children with nonanaemic iron deficiency: a systematic review. Public Health Nutr 2013; 16: 1497-1506.
38. Thompson J, Biggs BA, Pasricha SR. Effects of daily iron supplementation in 2- to 5-year-old children: systematic review and meta-analysis. Pediatrics 2013; 131: 739-753.
39. Low M, Farrell A, Biggs BA, Pasricha SR. Effects of daily iron supplementation in primary-school-aged children: systematic review and meta-analysis of randomized controlled trials. CMAJ 2013; 185: E791-E802.
40. Zhang L, Kleiman-Weiner M, Luo R, et al. Multiple micronutrient supplementation reduces anemia and anxiety in rural China’s elementary school children. J Nutr 2013; 143: 640-647.
41. United Nations Children’s Fund, Micronutrient Initiative (2004) Vitamin and Mineral Deficiency: A Global Progress Report. Ottawa, Canada: Micronutrient Initiative.
42. World Health Organization, The United Nations Children’s Fund (UNICEF), International Council for the Control of Iodine Deficiency Disorders (ICCIDD) (2007) Assessment of Iodine Deficiency Disorders and Monitoring their Elimination: A Guide for Programme Managers. Geneva: WHO.
43. National Institute of Population Research and Training (NIPORT), Mitra and Associates, ICF International (2015) Bangladesh Demographic and Health Survey Report 2014: Key Indicators. Dhaka, Bangladesh and Rockville, MD: NIPORT, Mitra and Associates, and ICF International.
44. Merrill RD, Labrique AB, Shamim AA, et al. (2010) Elevated and variable groundwater iron in rural northwestern Bangladesh. J Water Health 8, 818-825.
45. Hallberg L (1991) Bioavailability of dietary iron in man. Ann Rev Nutr 1, 123-147.
46. Merrill RD, Shamim AA, Ali H, et al. (2011) Iron status of women is associated with the iron concentration of potable groundwater in rural Bangladesh. J Nutr 141, 944-949.
47. Merrill RD, Shamim AA, Ali H, et al. (2012) High prevalence of anemia with lack of iron deficiency among women in rural Bangladesh: a role for thalassemia and iron in groundwater. Asia Pac J Clin Nutr 21, 416-424.
48. International Centre for Diarrhoeal Diseases Research, Bangladesh (ICDDR, B), Global Alliance for Improved Nutrition (GAIN), The United Nations Children’s Fund (UNICEF) (2013) The National Micronutrients Status Survey 2011-12. Dhaka, Bangladesh: International Centre for Diarrhoeal Diseases Research, Bangladesh.
49. Institute of Public Health Nutrition (IPHN), Helen Keller International (HKI) (1985) Bangladesh Nutritional Blindness Study 1982-83. Dhaka, Bangladesh: IPHN and HKI.
50. Rahman S, Ahmed T, Rahman AS, et al. (2016) Determinants of iron status and Hb in the Bangladesh population: the role of groundwater iron. Public Health Nutr 19, 1862-1874.
51. Dreyfuss ML, Stoltzfus RJ, Shrestha JB, et al. (2000) Hookworm, malaria, and vitamin A deficiency contribute to anemia and iron deficiency among pregnant women in the plains of Nepal. J Nutr 130, 2527–2536.
52. Jansson LT, Kling S & Dallman PH (1986) Anemia in children with acute infection seen in a primary care pediatric outpatient clinic. Paediatr Infect Dis 5, 424-427.
53. Linpisarn S, Tienboon P, Promtet N, et al. (1996) Iron deficiency and anemia in children with a high prevalence of haemoglobinopathies: implications for screening. Int J Epidemiol 25, 1262-1266.
54. Ruth Blanco-Rojo, M. Pilar Vaquero: Iron bioavailability from food fortification to precision nutrition. A review: https://doi.org/10.1016/j.ifset.2018.04.015
55. Irene Murgia, Paolo Arosio, Delia Tarantino, Carlo Suave: Biofortification for combating ‘Hidden Hunger: https://doi.org/10.1016/j.tplants.2011.10.003