Abstract
Iron deficiency anemia (IDA) is more common in South Asian countries including India, Bangladesh and Pakistan than anywhere else in the world. During infancy and early childhood, IDA is associated with impaired psycho-motor development and cognitive function that may be irreversible. As a consequence, there is a growing awareness that IDA is one of many factors impeding socio-economic prosperity of developing nations. The combination of unacceptably high prevalence rates and inadequate preventative programs highlights the need for new effective sustainable strategies to control IDA. The burden of iron deficiency can be reduced by taking a more holistic approach that would include promotion of healthy weaning practices and use of appropriate complementary foods, together with improving the nutritional value of such foods. There is an increasing body of peer-reviewed literature to support the contention that “micronutrient Sprinkles” is an effective strategy to improve the nutritional value of home-prepared complementary foods and thus to reduce the burden of iron deficiency among children. By combining data from recently conducted randomised control trials, Sprinkles were shown to be as efficacious as iron drops for treating childhood anemia. The iron in Sprinkles is well absorbed, and Sprinkles are easy to use and well accepted by young children and their caregivers. Integrated into existing public health programs, Sprinkles has the potential to improve the effectiveness of such programs.
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References
UNICEF. Delivering essential micronutrients: Iron. Available at: http://www.Unicef.org/nutrition/index_iron.html (Accessed on August 1,2004)
Grantham-McGregor S, Ani C. A review of studies on the effect of iron deficiency on cognitive development in children.J Nutr 2001; 131: 649S-666S; discussion 666S–668S.
Schauer C, Zlotkin S. Home fortification with micronutrient sprinkles-a new approach for the prevention and treatment of nutritional anemias.Pediatr Chil Health 2003; 8: 87–90.
MI/UNICEF. Vitamin and mineral deficiency. A global progress report. 2004
Proceedings from the national workshop on methodologies for assessment of vitamin A deficiency, iron deficiency anemia and iodine deficiency disorders, New Delhi, September 13–15, 2004. All India Institute of Medical Sciences, India, 2004.
Zlotkin SH, Ste-Marie M, Kopelman H, Jones A, Actam J. The prevalence of iron depletion and iron-deficiency anaemia in a randomly selected group of infants from four Canadian cities.Nutr Research 1996; 16: 729–733.
National Family Health Survey-2 (NFHS-2)- India 1998–99. Key findings: Anemia among women and children. Mumbai, International Institute for Population Sciences, 2000; chapter 7. Available at: http://www.nfhsindia.org/data/india/ indch7.pdf (Accessed on September 1,2004)
UNICEF/Bangladesh Bureau of Statistics. Report on anaemia prevalence survey of urban Bangladesh and the rural Chittagong Hill Tracts 2003. May 2004.
Gibson RS, Ferguson EL, Lehrfeld J. Complementary foods for infant feeding in developing countries: their nutrient adequacy and improvement.Eur J Clin Nutr 1998; 52: 764–770.
WHO. Complementary feeding of young children in developing countries: A review of current scientific knowledge. Geneva: World Health Organization, 1998.
Bhutta ZA. Iron and zinc intake from complementary foods: some issues from Pakistan.Pediatrics 2000; 106: 1295–1297.
Dewey KG, Brown KH. Update on technical issues concerning complementary feeding of young children in developing countries and implications for intervention programs.Food Nutr Bull 2003; 24: 5–28.
Horton S, Ross J. The economic of iron deficiency.J Food Policy 2003; 28: 51–75.
Kapil US. Technical consultation on “Strategies for Prevention and Control of Iron Deficiency Anemia amongst under three children in India.Indian Pediatr 2002; 39: 640–647.
Nestel P, Alnwick D. Iron/multi-micronutrient supplements for young children. Summary and conclusions of consultation held at UNICEF, Copenhagen, August 19–20, 1996. Washington, DC: International Life Sciences Institute, 1997.
INACG. Efficacy and effectiveness of interventions to control iron deficiency and iron deficiency anemia. International Nutritional Anemia Consultative Group. Washington, DC: International Life Sciences Institute, 2004.
Galloway R, McGuire J. Determinants of compliance with iron supplementation: supplies, side effects, or psychology?Soc Sci Med 1994; 39: 381–390.
WHO. Iron deficiency anemia assessment, prevention and control: a guide to programme managers. Geneva: World Health Organization, 2001.
National guidelines on infant and young child feeding. Ministry of Human Resources Development, Department of Women and Child Development Food and Nutrition Board. Government of India, 2004. Department of Women and Child Development Food and Nutrition Board
WHO. Malnutrition. The global picture. Geneva: World Health Organization, 2000.
Zlotkin S, Arthur P, Antwi KY, Yeung G. Treatment of anemia with microencapsulated ferrous fumarate plus ascorbic acid supplied as sprinkles to complementary (weaning) foods.Am J Clin Nutr 2001; 74: 791–795.
Zlotkin S, Antwi KY, Schauer C, Yeung G. Use of microencapsulated iron(II) fumarate sprinkles to prevent recurrence of anaemia in infants and young children at high risk.Bull World Health Organ 2003; 81: 108–115.
Zlotkin S, Arthur P, Schauer C, Antwi KY, Yeung G, Piekarz A. Home-fortification with iron and zinc sprinkles or iron sprinkles alone successfully treats anemia in infants and young children.J Nutr 2003; 133: 1075–1080.
Hyder SMZ, Zlotkin SH, Haseen F, Zeng L. Efficacy of daily versus weekly home fortification of weaning foods with Sprinkles among infants and young children in Bangladesh. Dhaka: National workshop on home fortification of weaning food with sprinkles: a new strategy to control iron deficiency anaemia among infants and young children, BRAC/IPHN/ MI/HSC, 2004.
Tondeur MC, Schauer C, Christofides A, Asante KP, Newton S, Serfass RE, Zlotkin SH. Determination of iron absorption from intrinsically labeled microencapsulated ferrous fumarate (sprinkles) in infants with different iron and hematologic status by using a dual-stable-isotope method.AJCN 2004 (In press).
Zlotkin S, Christofides A, Schauer C, Asante KP, Owusu-Agyei S. Home fortification using sprinkles containing 12.5 mg of iron successfully treats anemia in Ghanaian infants and young children.FASEB J 2004; 343.2.
Zlotkin S, Schauer C, Christofides A, Sharieff W, Hyder SMZ. Micronutrient Sprinkles to control childhood anemia: addressing an unresolved global problem through innovation, focused research and partnerships.PLOS 2004 (In press).
Christofides A, Zlotkin S, Schauer C. Impact of micronutrient sprinkles for the treatment and prevention of iron deficiency in Canadian first nations and Inuit infants 4–18 months old.FASEB J 2003; 17A;S1102.
Chan M, Zlotkin S, Yin SA, Sharieff W, Schauer C. The role of microencapsulated ferrous fumarate sprinkles in improving iron status and cognitive ability in preschool children in Northern China. Abstract, International Nutritional Anemia Consultative Group (2003) INACG Symposium. February 6, 2003, Marrakech Morocco, pp42. ILSI Research Foundation, Washington, DC.
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Zlotkin, S.H., Christofides, A.L., Hyder, S.M.Z. et al. Controlling iron deficiency anemia through the use of home-fortified complementary foods. Indian J Pediatr 71, 1015–1019 (2004). https://doi.org/10.1007/BF02828118
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DOI: https://doi.org/10.1007/BF02828118