Iron-deficiency Clinical Trial
Official title:
An Absorption Study in Young Women to Evaluate the Effect of Polyphenols on Iron Absorption From Ragi (Finger Millet) Using the Iron Isotopic Method
In India, one of the fast growing countries, 53% of all women have anaemia as per the National Family Health Survey. A recently published study on the burden of disease in India concluded that the burden of Iron deficiency anaemia (IDA) is 3 times higher than the average globally for other geographies at a similar level of development, and that women are disproportionately affected. Finger Millet (Eleusine coracana), more commonly known as Ragi, is a type of a millet crop grown in India, is considerably rich in minerals and its micronutrient density is higher than that of the world's major cereal grains: rice and wheat. Ragi also contains different antinutrients such as phytates and polyphenols, which have been known to have an inhibiting effect on the absorption of iron. On an average, white finger millet contains 0.04-0.09% polyphenols and brown varieties have 0.08-3.47%. The dark variety of ragi is the most widely consumed type. The white ragi is the lesser consumed type. However, the levels of polyphenols, which inhibit the absorption of iron, are ten times lower in the white ragi as compared to the dark ragi. Thus, it is important to evaluate the extent of inhibition of the polyphenols on the iron absorption. This information would be beneficial for policy making and promotion of cultivation of the type of ragi that could be most effective for the consumers
Finger Millet (Eleusine coracana), more commonly known as Ragi, is a type of a millet crop
grown in India, including other countries especially in East Africa. Ragi has been perceived
as a potential "super cereal" by the United States National Academies being one of the most
nutritious among all major cereals. From the nutritional perspective, finger millet is
considerably rich in minerals and its micronutrient density is higher than that of the
world's major cereal grains: rice and wheat .
Millets (Ragi or finger millet and Jowar or sorghum) were consumed by 59% of rural and 28% of
urban population in Karnataka. Ragi consumption was seen predominantly in south Karnataka
with 27% of rural and 17% of urban population reporting consumption.
Ragi is the richest source of calcium among cereals with up to 10-fold higher calcium content
than brown rice, wheat or maize and three times than that of milk. It is also rich in iron
and fiber, making this crop more nutritive as compared to other most commonly used cereals.
Finger millet is enriched in the essential amino acids like lysine and methionine which are
important in human health and growth but remain absent from most other plant foods . In
addition, it also contains useful amounts of the two polyunsaturated fatty acids- linoleic
acid and α-linolenic acid , metabolized products of which facilitate normal development of
the central nervous system. Despite the well-documented health benefits of finger millet,
only a limited progress has been made in context to its nutraceutical applications as
functional food. Although, it may have remained underutilized by the general population due
to either unawareness or apprehension, its immense potential for enhancing the nutritional
and therapeutic attributes by acting as functional food cannot be ignored.
Ragi also contains different antinutrients such as phytates and polyphenols, which have been
known to have an inhibiting effect on the absorption of iron. On an average, white finger
millet contains 0.04-0.09% polyphenols and brown varieties have 0.08-3.47% . It was found
that found proto-catechuic acid (45.0 mg/100 g) is the major free phenolic acid in ragi. In
another study of total phenolic compounds in finger millet, it was found to have 85% benzoic
acid derivatives (gallic acid, protocatechuic acid, p-hydroxybenzoic acid, vanillic acid,
syringic acid) while rest of the fraction were either cinnamic acid derivatives (ferulic
acid, trans-cinnamic acid, p-coumaric acid, caffeic acid, sinapic acid) or flavonoids
(quercetin, Proanthocyanidins like condensed tannins) . Among bound phenloic acids, ferulic
and p-coumaric acid are the major fractions and account for 64-96 and 50-99% of total ferulic
and p-coumaric acid content of finger millet grains, respectively.
The dark variety of ragi is the most widely consumed type. The white ragi is the lesser
consumed type. However, the levels of polyphenols, which inhibit the absorption of iron, are
ten times lower in the white ragi as compared to the dark ragi. Thus, it is important to
evaluate the extent of inhibition of the polyphenols on the iron absorption. This information
would be beneficial for policy making and promotion of cultivation of the type of ragi that
could be most effective for the consumers
The study duration will be 26 days from the first day of the first meal administration till
the last blood withdrawal . For each appointment, the participants will spend about 30
minutes at the Human Nutrition Laboratory at ETH Zurich, between 7 and 9 am for breakfast
meal consisting of pancakes made out of the ragi. the white ragi meal and the black ragi meal
will be extrinsically labelled with isotopes 57 Fe and 58 Fe respectively. The participants
will consume the ragi meal as breakfast. The first type of ragi meal will be given for 5
consecutive days,. They will have a weekend break of two days (during which they will resume
their usual eating habits). After that, they will consume the second test meal as breakfast
for another five consecutive days. Thus, there will be 10 meals in total. The breakfast meals
will be consumed between 7 and 9 am together with a glass of 300 mL bottled water after which
they have to wait another 3 hours before they can consume anything. The procedure will remain
the same for all the days. Participants will always be asked to fast the day before coming
for the feeding, that is, no food intake after 8 pm and no beverage intake after midnight the
evening before. On day of screening, day 1 and the end point day 26 of the study, blood
samples will be collected after an overnight fast for the determination of Hb, PF, CRP and
isotopic ratio
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