Iron Deficiency Anemia Clinical Trial
Official title:
Randomized Controlled Trial to Study the Effect of Consuming Food Cooked in Iron Utensils on Iron Status in Children With Iron Deficiency Anemia (IDA)
Iron deficiency is a common problem in the world and more so in the developing countries
with a prevalence of 64 % (using WHO cut-off values of Hb <11.0 g/dl) among children, 9-36
months of age. The Pediatric population is especially vulnerable to iron deficiency anemia
due to low intake of iron rich foods, rapid growth with high demand and losses of iron from
body especially with the commonly found worm infestations in children. Mild to moderate iron
deficiency is widely prevalent in children and can have several implications including
failure to thrive, poor scholastic performance, repeated infections etc. Dietary measures
along with therapeutic measures are recommended to combat Iron Deficiency Anemia (IDA).
However, iron rich foods alone cannot be relied upon as a sole step to counter IDA. The
utensil in which the food is cooked plays a major role in determining the final iron content
of food. Several studies have documented that most of the foods (90%) contained
significantly more iron when cooked in iron utensils depending on the acidity, moisture
content, and cooking time of food.The daily dietary intake could vary from 11 to 6 mg of
iron if iron utensil was used for cooking [3].
Food cooked in Aluminum (Al) utensils has a higher Al content which can be detrimental to
healthy individuals and particularly to patients with chronic renal failure.In healthy
persons, diseases of central nervous system, as well as of hematopoeitic system, skeletal
system and respiratory system are described due to excess of Aluminium consumption.
Aluminium utensils have fast replaced iron cooking pots from Indian kitchens, hence a study
to know the effectiveness of iron cooking pot as a measure to combat IDA is necessary.
Studies have shown the utility of cooking food in iron utensil in prevention of IDA but the
investigators did not come across a study to document the use of this modality in treatment
of IDA in children. Since the investigators anticipate that the improvement of iron status
will be a gradual process, so the investigators decided to evaluate the utility of cooking
food in iron utensils on iron status in children with non-severe IDA (Hb% < cutoff point for
age but > 5 gm %.
To test the following hypothesis "use of iron utensils for cooking food will result in
improvement in iron status in Pediatric patients with nonsevere Iron Deficiency Anemia."
Dietary advice and iron therapy are considered the cornerstones of treating a patient with non-severe IDA. The foods that are rich in Iron include meat and poultry products, egg, green leafy vegetables, jaggery, dry fruits etc. Iron in food is of two types viz. haem iron and non haem iron. Haem Iron has excellent bioavailability but the bioavailability of the non-haem Iron in the food stuffs is considerably affected by the presence of substances like phosphates, phytates, tannins and fibres. On the other hand, Ascorbic acid, sugars and other acidic substances in the food enhance the iron absorption. The bulk of food consumed by a child is too less to provide him with therapeutic amounts of iron form diet alone. In the developing countries, the child is quite unlikely to get poultry products and meat as a source of haem Iron. If in this situation, the child is provided with food cooked in Iron utensil, then it provides additional Iron to meet the increased demand. This will not only be cost effective but it will also alter the cooking practices and thereby have a long term effect on the iron status of the entire family. Thus it will treat the IDA in the index case and will also benefit other family members who may be having borderline or overt iron deficiency. This cost effective measure if incorporated in the health policy of the country will certainly have widespread positive implications on the health of the general population. ;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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