Effectiveness of nutrition education, iron supplementation or both on iron status in children

Abstract

Objective: A community-based, randomized trial was designed to compare the effect of nutrition education and/or iron supplementation (weekly) on iron status of children in an urban slum in Delhi.

Methods: Four hundred and fifty one children, 9-36 months of age and their caretakers (mothers), assigned to one of the following groups were included in the cohort. Group 1, nutrition education. Group 2, supplementation (with 20 mg elemental iron). Group 3, nutrition education with supplementation (with 20 mg elemental iron) and Group 4, control given placebo. The intervention program was of four months duration, with a treatment phase of 8 wk followed by 8 wk of no treatment.

Results: Post intervention, at 8 wk and at 16 wk, the hemoglobin change in the nutrition education, supplementation, nutrition education with supplementation and control groups was 2.9, 1.9, 3.8 and -5.9%, respectively and 2.1, -1.9, 0 and -9.3%, respectively (as compared to initial values). There was no significant effect of any of the intervention at 8 weeks. At 16 wk, there was significant positive effect of nutrition education group (p less than 0.05). The percent change in serum ferritin value at 16 wk in the nutrition education, supplementation, nutrition education with supplementation and control groups was 5.7, -2.3, -3.4 and -40%, respectively. Serum ferritin values were significantly higher for the nutrition education group (p < 0.001) as compared to the control. At 16 wk, the nutrition education group mothers showed significantly higher nutrition knowledge and the dietary iron intake of children was significantly higher than their control group counterparts (p < 0.0001).

Conclusion: The study suggests that nutrition education did have a positive effect on the iron status possibly by improving the dietary iron intake.