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Iron fortification reduces blood lead levels in children: a randomized, double‐blind, controlled trial in Bangalore, India
Author(s) -
Zimmermann Michael Bruce,
Muthayya Sumithra,
Moretti Diego,
Kurpad Anura,
Hurrell Richard
Publication year - 2006
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.20.4.a131
Subject(s) - lead poisoning , medicine , iron deficiency , hemoglobin , meal , fortification , lead (geology) , randomized controlled trial , zoology , blood lead level , iron status , anemia , lead exposure , physiology , gastroenterology , food science , chemistry , biology , cats , paleontology , psychiatry
Background Both chronic lead poisoning and iron deficiency can permanently impair neurocognitive development. Methods A randomized, double‐blind, controlled school‐based feeding trial was done in 5–9 y‐old iron‐deficient children (n=134) with a high prevalence of lead poisoning. They were dewormed and fed 6 d/wk for 16 wk either an iron‐fortified rice meal (≈15 mg mg iron/day) or an identical control meal without added iron. Feeding was directly supervised and compliance monitored. Hemoglobin, iron status, and blood lead concentrations were measured at baseline and after 16 wk. Results The prevalence of iron deficiency was significantly reduced in the iron group (from 68% to 19%) compared to the control (72% to 51%) (p<0.01). There was a significant decrease in median (range) blood lead concentration (μg/dl) in the iron group (from 12.1 (3.2–26.8) at baseline to 8.1 (3.7–22.9) at 16 wk) compared to the control group (from 12.0 (2.8–25.5) at baseline to 10.2 (4.4–22.3) at 16 wk) (p<0.02). The prevalence of blood lead levels ≥10 μg/dl was 65% and 68% in the iron and control groups at baseline, and fell to 29% and 55%, respectively, at 16 wks (p<0.001). Conclusions Our findings suggest providing iron in a fortified food to lead‐exposed children may reduce chronic lead intoxication. Iron fortification could be an effective and sustainable strategy to accompany environmental lead abatement.