Anemia Clinical Trial
Official title:
Teff (Eragrostis Tef) as a Functional Food for the Prevention of Pregnancy Iron-deficiency Anemia
It has been estimated that 1 in 2 women expecting a baby will be diagnosed with iron
deficiency. In turn iron deficiency can affect the health and wellbeing or both mother and
child. Studies show that low iron stores prior to conception and low iron intakes during
pregnancy may both be contributing to this problem. Although dietary supplements may be one
solution, research indicates that daily compliance is low (Nguyen et al., 2008).
Furthermore, prescribed iron supplements may result in uncomfortable side-effects, including
constipation (Wulff & Ekstrom, 2003).
It is been observed in Ethiopia that iron deficiency anemia is lower than average; a finding
that has been attributed to regular "Teff" consumption (Gies et al., 2003). Teff (Eragrostis
tef) is a staple food usually consumed in the form of Enjera (flat bread prepared using a
range of cereals). Research has shown that Teff is a rich source of iron that is easily
absorbed by the body.
Although it is believed that regular Teff consumption may prevent to onset of iron
deficiency anemia there is no research to support this. Therefore, the aim of the present
study is to es-tablish whether incorporating Teff into the daily diet may be one way to
improve blood profile and prevent the onset of iron deficiency anemia in expectant mothers.
Study findings will demonstrate whether Teff may be an alternative source of iron that can
be easily incorporated into the daily diet of both pregnant mothers and the lay public.
Rationale Iron deficiency anemia is considered to be one of the most prevalent forms of
malnutrition in Europe (Stoltzfus, 2003 & Hercberg et al., 2001). Pregnant mothers are
particularly susceptible to the onset of iron deficiency anemia (Daily & Wylie, 2008). It
has been estimated that 1 in 2 pregnant women will be diagnosed with iron deficiency
(Scholl, 2005). During pregnancy maternal plasma volume expands, increasing iron
requirements (Scholl et al., 2000) whilst dietary intakes generally remain unchanged
(Milman, 2006). Physiologically, intestinal iron absorption may increase during pregnancy
but only after iron depletion has already commenced (Milman, 2006). Research strongly
suggests that pregnant women are not meeting dietary guidelines for iron (Derbyshire et al.,
2009).
A Sheffield (UK) study has reported that pregnant women consume around 10.2mg of iron per
day (Mouratidou et al., 2006). Another investigation undertaken in a London population found
that expectant mothers had a mean intake of 10.7mg iron per day (Rees et al., 2005). A
further study investigating the diet of educated, Caucasian pregnant mothers reported
similar figures (Derbyshire et al., 2006). Diets deficient in iron during gestation may
subsequently affect infant health, in both the short and longer term (Scholl & Reilly,
2000). Iron deficiencies in pregnancy have been linked to preterm deliveries, reduced infant
birth weight, length and iron stores (Daily & Wylie, 2008). Low iron stores during periods
of infant brain growth may permanently impede cognitive development (Lozoff, 2007 & Lozoff &
Georgieff, 2006).
Teff (Eragrostis tef) is a staple food consumed in northern, western and central Ethiopia;
usually in the form of Enjera (flat bread prepared using a range of cereals, including
Eragrostis tef) (Umeta et al., 2005). Research has shown that Teff is a rich source of
bioavailable iron which may be attributed to its low phytate content. Bread made with Tef
enjera contains around 30mg of iron per 100g and up to 35mg when the food is fermented
(Umeta et al., 2005). The iron content dramatically exceeds that of common Western foods
(Corn flakes 7.9mg, boiled brown rice, 0.5mg and brown bread, 2.2mg, all per 100g consumed)
(FSA, 2006). Furthermore, studies have shown that the prevalence of pregnancy iron
deficiency anemia is relatively low in Ethiopia (Gies et al., 2003) which may be attributed
to Eragrostis tef forming a staple part of the diet (Haidar et al., 1999).
Incorporation of Teff into the daily diet of expectant mothers may help to reduce the
incidence of iron-deficiency anemia. Research shows that women do not adhere to taking large
tablet supplements (Nguyen et al., 2008). Teff may therefore provide an alternative source
of dietary iron that can be easily incorporated into the daily diet of both pregnant mothers
and the lay public.
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Allocation: Randomized, Endpoint Classification: Bio-availability Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Prevention
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