The Efficacy of Consuming Iron-Fortified Lentils on Body Iron (Fe) Status in Bangladeshi Adolescent Girls: A Sustainable, Food-Based Solution to Iron Deficiency

Abstract

ObjectivesIron deficiency (ID) and iron deficiency anaemia (IDA) remain a public health concern among women and girls globally, and have numerous impacts on health, nutrition and socioeconomic status. Our objective was to investigate the efficacy of consuming iron-fortified lentils on iron status among rural Bangladeshi adolescent girls. MethodsIn this community-based, double-blind, cluster-randomized controlled trial, girls (13.5 ± 2.0 years) were randomly assigned to three groups that received 1)cooked iron-fortified lentils (160 ppm Fe NaFeEDTA per kg of lentils); 2)cooked non-iron-fortified lentils; or 3)no lentils (usual intake group). We served 200 g of cooked lentils using a local daal recipe on five days/week, for 4 months. Iron status (sFer, sTfR, and Hgb) was assessed at baseline, 2 and 4 months. All analyses were adjusted for inflammation. ResultsThere were no differences in baseline iron status among the three groups. sFer significantly increased by 21.9% (+5.7 μg/L, p < 0.001; 95% CI: 1.7, 9.5 μg/L) from baseline to 4 months in the iron-fortified lentil group, compared to a decline in sFer observed in the non-iron fortified lentil (53.3 vs. 38.6 μg/L, p < 0.01) and no lentil groups (53.6 vs. 39.5 μg/L, p < 0.01). Examining overall changes in iron status over 4 months, we observed maintenance in the iron-fortified group from baseline, compared to a decline in the other groups. ConclusionsWe observed improvement in and maintenance of iron status in a population vulnerable to ID and IDA who consumed iron-fortified lentils for 4 months. Additionally, girls who consumed iron-fortified lentils had a 60% lower chance of developing clinical and subclinical ID (sFer < 15, 15–30 μg/L), and a 70% lower chance of developing sub-clinical IDA (sFer 15–30 μg/L + Hgb < 12 g/dL) compared to those who did not. Funding SourcesGlobal Institute for Food Security.