Vitamin C-rich guava consumed with mungbean dal reduces anemia and increases hemoglobin but not iron stores: A randomized controlled trial of food-to-food fortification in Indian children

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cg.authorship.typesCGIAR single centreen
cg.authorship.typesCGIAR and advanced research instituteen
cg.authorship.typesCGIAR and developing country instituteen
cg.contributor.affiliationWageningen University & Researchen
cg.contributor.affiliationChaudhary Charan Singh Haryana Agriculture Universityen
cg.contributor.affiliationSwiss Federal Institute of Technologyen
cg.contributor.affiliationSwiss Distance University for Applied Sciencesen
cg.contributor.affiliationUniversity of Applied Sciences of South Switzerlanden
cg.contributor.affiliationSt. John's National Academy of Health Sciencesen
cg.contributor.affiliationUniversity of Oxforden
cg.contributor.affiliationInternational Food Policy Research Instituteen
cg.contributor.donorMinistry of Science and Technology, Indiaen
cg.contributor.donorNutricia Research Foundationen
cg.contributor.donorWageningen University & Researchen
cg.coverage.countryIndia
cg.coverage.iso3166-alpha2IN
cg.coverage.regionAsia
cg.coverage.regionSouthern Asia
cg.creator.identifierInge Brouwer: 0000-0002-2554-7227
cg.howPublishedFormally Publisheden
cg.identifier.doihttps://doi.org/10.1016/j.tjnut.2024.10.042en
cg.identifier.projectIFPRI - Nutrition, Diets, and Health Unit
cg.identifier.publicationRankA Plus
cg.isijournalISI Journalen
cg.issn0022-3166en
cg.issue12en
cg.journalJournal of Nutritionen
cg.reviewStatusPeer Reviewen
cg.subject.actionAreaSystems Transformation
cg.subject.impactAreaNutrition, health and food security
cg.subject.sdgSDG 2 - Zero hungeren
cg.volume154en
dc.contributor.authorRani, Varshaen
dc.contributor.authorMoretti, Diegoen
dc.contributor.authorKhetarpaul, Neelamen
dc.contributor.authorThankachan, Prashanthen
dc.contributor.authorZimmermann, Michael B.en
dc.contributor.authorMelse-Boonstra, Alidaen
dc.contributor.authorBrouwer, Inge D.en
dc.date.accessioned2024-11-18T21:13:44Zen
dc.date.available2024-11-18T21:13:44Zen
dc.identifier.urihttps://hdl.handle.net/10568/159903
dc.titleVitamin C-rich guava consumed with mungbean dal reduces anemia and increases hemoglobin but not iron stores: A randomized controlled trial of food-to-food fortification in Indian childrenen
dcterms.abstractBackground Adding vitamin C-rich fruit to staples containing iron could be an effective strategy to improve iron bioavailability and thereby reduce iron-deficiency anemia in children. Objectives We aimed to assess the effect of consuming a mungbean-based meal with or without guava fruit on body iron stores, hemoglobin concentration, and anemia of children as part of a school feeding program. Methods We conducted a 7-mo randomized, controlled trial with 6- to 10-y-old school children (n = 200; 46% anemic, 71% iron-deficient) from a rural community in Haryana, North India. Children were assigned to 2 treatment groups to daily receive either a meal of mungbean dal only (3.0 mg iron; vitamin C:iron molar ratio ∼0.5:1), or mungbean dal with fresh guava (3.2 mg iron; ∼170 mg vitamin C; molar ratio ∼18:1). Meals were served every school day under supervision. The primary outcome was body iron stores, whereas concentrations of hemoglobin and other iron indicators were secondary outcomes. Results Daily consumption of mungbean dal along with guava did not result in an overall improvement of body iron stores [mean treatment effect: 0.65 mg/kg body weight; 95% confidence interval (CI): −0.34, 1.63; P = 0.197]. However, compared with children who consumed mungbean dal only, children in the guava group showed a larger increase in hemoglobin concentration (3.7 g/L; 95% CI: 1.6, 5.6; P = 0.001), and a larger drop in the prevalence of anemia (−51%; 95% CIs: −74, −10; P = 0.022) and iron-deficiency anemia (−56%, 95% CI: −83, 13; P = 0.087). These effects were more pronounced in children who were iron deficient at study start. Conclusions Addition of guava to a mungbean-based meal containing a moderate amount of iron increased hemoglobin and reduced anemia but did not provide enough additional absorbed iron to also increase body iron stores. Food-to-food fortification by inclusion of vitamin C-rich fruits in iron-containing school meals may help alleviate the burden of anemia in children.en
dcterms.accessRightsOpen Access
dcterms.audienceAcademicsen
dcterms.available2024-10-30
dcterms.bibliographicCitationRani, Varsha; Moretti, Diego; Khetarpaul, Neelam; Thankachan, Prashanth; Zimmermann, Michael B.; Melse-Boonstra, Alida; and Brouwer, Inge D. 2024. Vitamin C-rich guava consumed with mungbean dal reduces anemia and increases hemoglobin but not iron stores: A randomized controlled trial of food-to-food fortification in Indian children. Journal of Nutrition 154(12): 3740-3748. https://doi.org/10.1016/j.tjnut.2024.10.042en
dcterms.extent3740-3748en
dcterms.issued2024-12
dcterms.languageen
dcterms.licenseCC-BY-4.0
dcterms.publisherElsevier BVen
dcterms.subjectascorbic aciden
dcterms.subjectguavasen
dcterms.subjectanaemiaen
dcterms.subjecthealthen
dcterms.subjecthaemoglobinen
dcterms.subjectironen
dcterms.subjectrandomized controlled trialsen
dcterms.subjectfood fortificationen
dcterms.subjectnutrient improvementen
dcterms.subjectschool feedingen
dcterms.subjectchildrenen
dcterms.typeJournal Article

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