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Randomized controlled trial of iron-fortified drinking water in preschool children

Francisco Plácido Nogueira Arcanjo1, Olga Maria Silverio Amancio, Josefina Aparecida Pellegrini Braga

  • 1Rua Botucatu 703, 04023-062, São Paulo-SP, BRASIL. omsamancio.dped@epm.br

Journal of the American College of Nutrition
|August 4, 2010
PubMed

Insights

Fortified drinking water with 7.5 mg of iron per liter effectively reduced anemia in preschoolers. This intervention improved hemoglobin levels, showing significant benefits for public health in young children.

Area of Science:

  • Public Health Nutrition
  • Pediatric Hematology
  • Micronutrient Fortification

Background:

  • Iron deficiency anemia is a significant global health concern, particularly in preschool-aged children.
  • Preschoolers often have inadequate iron intake, leading to suboptimal hemoglobin and hematocrit levels.
  • Fortified foods and beverages are a common strategy to combat micronutrient deficiencies.

Purpose of the Study:

  • To assess the impact of different iron concentrations in drinking water on hemoglobin and hematocrit in preschoolers.
  • To determine the optimal iron fortification level for improving iron status in young children.
  • To evaluate the efficacy of iron-fortified water in reducing anemia prevalence.

Main Methods:

  • A double-blind, randomized cluster clinical trial involving 4 state-run schools with children aged 2-5 years.
  • Four groups received drinking water fortified with ferrous sulfate at 5 mg/L (Group A), 7.5 mg/L (Group B), 10 mg/L (Group C), or a placebo (Group D) for 4 months.
  • Hemoglobin and hematocrit levels were measured before and after the intervention period.

Main Results:

  • All groups showed a reduction in anemia prevalence post-intervention, with Group B (7.5 mg Fe/L) exhibiting the most significant decrease (48.3%).
  • Hemoglobin levels in Groups B (11.5 g/dL) and C (11.4 g/dL) were statistically similar, though water consumption was lower in Group C.
  • No significant difference in hemoglobin was observed between Group A (5 mg Fe/L) and the control Group D (11.0 g/dL), indicating limited efficacy at this lower concentration.

Conclusions:

  • Drinking water fortified with 7.5 mg of elemental iron per liter demonstrated superior adherence and effectiveness in increasing hemoglobin levels.
  • This iron concentration led to a notable reduction in the prevalence of anemia among preschool children.
  • Iron fortification of drinking water at 7.5 mg/L is a viable strategy for improving iron status in preschoolers.
Abstract

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