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Randomized Controlled Trial
. 2021 Aug;60(5):2617-2629.
doi: 10.1007/s00394-020-02447-2. Epub 2020 Dec 23.

Can the supplementary consumption of baobab (Adansonia digitata L.) fruit pulp improve the hemoglobin levels and iron status of schoolchildren in Kenya? Findings of a randomized controlled intervention trial

Esther Charlotte Evang  1 , Tsige-Yohannes Habte  1 , Willis Omondi Owino  2 , Michael Bernhardt Krawinkel  3
Affiliations
Randomized Controlled Trial

Can the supplementary consumption of baobab (Adansonia digitata L.) fruit pulp improve the hemoglobin levels and iron status of schoolchildren in Kenya? Findings of a randomized controlled intervention trial

Esther Charlotte Evang et al. Eur J Nutr. 2021 Aug.

Abstract

Purpose: In the rural Kenyan diet, the bioavailability of iron is low and predisposes the population to iron deficiency. Fruit pulp of the indigenous baobab tree contains significant amounts of vitamin C, which enhances non-heme iron bioavailability. We studied the impact of baobab fruit pulp (BFP) consumption on the hemoglobin (Hb) and iron status of Kenyan schoolchildren.

Methods: The single-blind randomized controlled intervention trial was implemented daily among apparently healthy schoolchildren aged 6-12 years with hemoglobin level < 12.2 g/dl. For 12 weeks, children in the intervention group (n = 29) received a drink with BFP, while the control group (n = 29) received an isoenergy drink without BFP. At baseline and endline, blood samples were taken.

Results: The development of hemoglobin, ferritin (FER) and soluble transferrin receptor (sTfR) did not differ significantly between the intervention and control groups. However, in the intervention group, Hb levels improved slightly (2.2%), while they decreased slightly (1.2%) in the control group. Levels of geometric means of sTfR remained almost unchanged (0.7%) in the intervention group and slightly worsened (2.7%) in the control group. In both the groups, geometric mean of FER levels decreased, yet to a smaller extent in the intervention (17.3%) than in the control (26.0%) group.

Conclusion: Even though no significant effects of BFP could be detected in this study, the identification of products such as BFP remains pertinent to help improve non-heme iron absorption in the most vulnerable populations.

Keywords: Anemia; Baobab; Bioavailability; Kenya; Schoolchildren.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Consort flow diagram of the Baobab Nutrition Intervention Study. MUAC: mid-upper arm circumference
Fig. 2
Fig. 2
Median intake of energy, vitamin C and iron at t1, t2 and t3 of the intervention (n = 29) and control (n = 29) group. *Significant differences between intervention and control group (p < 0.05)
Fig. 3
Fig. 3
Changes in hemoglobin and iron status from baseline to endline; independent t test was applied for difference in development between intervention and control group. a Mean development of Hb with non-significant differences between intervention and control group. b Development of geometric mean of FER and with non-significant difference of LN(FER) development between intervention and control group. c Development of geometric mean of sTfR with non-significant difference between development of LN(sTfR) in the intervention and control group. Hb: hemoglobin, FER: ferritin adjusted, sTfR: soluble transferrin receptor
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