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Meta-Analysis
. 2014 Mar;17(3):579-86.
doi: 10.1017/S1368980013000062. Epub 2013 Feb 7.

Impact of iron-fortified foods on Hb concentration in children (<10 years): a systematic review and meta-analysis of randomized controlled trials

Ramesh Athe  1 , M Vishnu Vardhana Rao  1 , K Madhavan Nair  2
Affiliations
Meta-Analysis

Impact of iron-fortified foods on Hb concentration in children (<10 years): a systematic review and meta-analysis of randomized controlled trials

Ramesh Athe et al. Public Health Nutr. 2014 Mar.

Abstract

Objective: To combine evidence from randomized controlled trials to assess the effect of Fe-fortified foods on mean Hb concentration in children (<10 years).

Design: We conducted a meta-analysis of randomized, controlled, Fe-fortified feeding trials that evaluated Hb concentration. The weighted mean difference was calculated for net changes in Hb by using random-effects models. Meta-regression and covariate analyses were performed to explore the influence of confounders on the net pooled effect.

Setting: Trials were identified through a systematic search of PubMed, the Cochrane Library and secondary references.

Subjects: Eighteen studies covering 5142 participants were identified. The duration of feeding of fortified foods ranged from 6 to 12 months in these studies.

Results: Eighteen studies were included and evaluated in the meta-analysis. The overall pooled estimate of Hb concentration showed a significant increase in the fortification group compared with the control group (weighted mean difference = 5·09 g/l; 95% CI 3·23, 6·95 g/l; I 2 = 90%, τ 2 = 18·37, P < 0·0001). Meta-regression analysis indicated that duration of feeding was positively related to the effect size (regression coefficient = 0·368; 95% CI 0·005, 0·731; P < 0·05). The net pooled effect size after removing the confounders was 4·74 (95% CI 3·08, 6·40) g/l.

Conclusions: We observed an association between intake of Fe-fortified foods and Hb concentration in children aged <10 years. Fe-fortified foods could be an effective strategy for reducing Fe-deficiency anaemia in children.

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Figures

Fig. 1
Fig. 1
Flow diagram for inclusion in the present meta-analysis of randomized controlled trials assessing the effect of iron-fortified foods on mean Hb concentration in children (<10 years)
Fig. 2
Fig. 2
Forest plot: effect of iron fortification on mean difference in Hb concentration in comparison with no intervention or placebo control in children (<10 years). Random-effects meta-analysis of weighted mean difference (WMD; and 95 % CI) on Hb concentration with iron-fortified food intervention compared with control group. The sizes of data markers indicate the weight of each study in the analysis. Horizontal lines represent 95 % CI. Blob indicates best estimate and diamond indicates the summary estimate of the WMD
Fig. 3
Fig. 3
Funnel plot of all individual studies in the meta-analysis. Studies that evaluated the effect of iron fortification on Hb concentration in children (<10 years) were plotted with their weighted mean difference (WMD) on the x-axis and the corresponding standard error of the WMD along the y-axis
See this image and copyright information in PMC

References

    1. World Health Organization (2008) Worldwide Prevalence of Anaemia 1993–2005. Geneva: WHO.
    1. Brown K, Dewey K & Allen L (1998) Complementary Feeding of Young Children in Developing Countries. A Review of Current Scientific Knowledge. Geneva: WHO.
    1. Le HT, Brouwer ID, Verhoef H et al. (2007) Anemia and intestinal parasite infection in school children in rural Vietnam. Asia Pac J Clin Nutr 16, 716–723. - PubMed
    1. Neumann CG, Bwibo NO, Murphy SP et al. (2003) Animal source foods improve dietary quality, micronutrient status, growth and cognitive function in Kenyan school children: background, study design and baseline findings. J Nutr 133, 11 Suppl. 2, 3941S–3949S. - PubMed
    1. Sivakumar B, Nair KM, Sreeramulu D et al. (2006) Effect of micronutrient supplement on health and nutritional status of school children: biochemical status. Nutrition 22, 1 Suppl., S15–S25. - PubMed

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