Efficacy of iron-fortified rice in reducing anemia among schoolchildren in the Philippines

Background: Iron deficiency anemia (IDA) in the Philippines is a serious public health problem. Fortifying rice offers a great opportunity to control IDA. However, information on other types of fortificants that can be used is scarce. Objective: To compare the effects of two types of iron fortificants in rice in improving the hematological status of schoolchildren. Design: 180 randomly selected 6-to 9-year-old anemic children were randomly allocated to three groups in a double-blinded manner: One group received iron-enriched rice (IER) with extruded iron premix rice (IPR) using ferrous sulfate as fortificant (ExFeSO(4)); the second group received IER with extruded IPR using micronized dispersible ferric pyrophosphate (ExFeP80); and the third group received non-fortified rice (Control). These were administered daily for 5 days a week for 6 months. Blood samples were collected at baseline after 3 and 6 months. Results: At baseline, one child in the ExFeP80 group was suffering from IDA; at 3 months, no IDA was found in any groups; while at 6 months, one child in the ExFeP80 developed IDA. The baseline prevalence of anemia in all groups, which was 100%, was significantly reduced to 51%, 54%, and 63% in the ExFeSO(4), ExFeP80 and Control groups respectively. After 6 months, further significant reductions were observed in the ExFeSO(4) (38%) and ExFeP80 (33%) but remained at 63% in the Control group. Greater, significant increases were also observed in plasma ferritin in the fortified groups than in the Control group from baseline to 6 months. The predictors of change in hemoglobin (Hb) and plasma ferritin were group allocation and basal values. Conclusion: The consumption of rice fortified with FeP80 using extrusion technology has similar effects as that of FeSO4 in reducing the prevalence of IDA among schoolchildren.