The use of sugar fortified with iron tris-glycinate chelate in the prevention of iron deficiency anemia in preschool children

Abstract

In the present work, the effectiveness of consumption for 6 months of iron fortified sugar in the prevention or control of iron deficiency anemia was evaluated in 93 children (10-48 months old) attending a day care center in São Paulo, Brazil. Each child consumed 20 g of fortified sugar per day for 5 days a week in orange juice during breakfast. Two levels of fortification were tested using iron tris-glycinate chelate as the source of iron. Level one sugar contained 10 mg of iron/kg of sugar, and level 2, 100 mg of iron/kg. The children were assigned to either of the two groups. The first group (n = 42) received level 1 sugar, and those of group two (n = 52) received level 2 sugar. The daily iron intake corresponded to 2 and 20% of the RDA. At the end of the 6 months trial period, significant increases in weight/height ratio was observed in both groups. In the group consuming level 1 fortified sugar the mean change in hemoglobin concentration was 0.4 g/dL (from 11.3 grams to 11.7 g/dL), and in the group consuming level two fortified sugar the mean hemoglobin increase was also 0.4 g/dL (from 11.6 to 12.0 g/dL). Both changes were highly significant (p < 0.001). When only the anemic children were considered (32/93), the increment of hemoglobin was 1.4 g/dL. In anemic children there was a significant increase in the levels of serum ferritin. The increase was more notorious in group 2 children. We verified that the acceptability of the iron-fortified sugar was excellent. There were no detectable changes in the organoleptic characteristics of the fortified sugar as compared with unfortified sugar. No differences in response were observed between the two groups indicating that probably the lower level of iron was absorbed more efficiently that the higher level. The iron tris-glycinate chelate was very well tolerated with no side effects registered. It was concluded that even with low iron levels, the consumption of iron fortified sugar is an effective, low cost intervention for the control and prevention of iron deficiency anemia in preschool children.