Improving the iron status of school children through a school noon meal programme with meals prepared using a multiple micronutrient–fortified salt in Tamil Nadu, India

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Author : Malavika Vinod Kumar, Juergen Erhardt
Keyword : multiple micronutrient–fortified salt, school meals, transferrin receptor, total body iron stores, iron defi- ciency
DOI : 10.6133/apjcn.202009_29(3).0017
Issue : Asia Pac J Clin Nutr 2020;29(3):577-583
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Abstract

Background and Objectives: To improve the iron status of school children through noon meals prepared using a multiple micronutrient–fortified salt. Methods and Study Design: Children from a randomly selected school who consumed (intervention) and did not consume (reference) a noon meal prepared using a multiple micronutri- ent–fortified salt were studied over 1 year. A pre–post-test design for children aged 5–17years in reference (n=100) and intervention (n=128) groups was used. Levels of serum ferritin, soluble transferrin receptor (sTfR), alpha glycoprotein (AGP), and C-reactive protein (CRP) were assessed at baseline and at 1 year. In a subsample, urinary iodine was assessed. Results: sTfR decreased in the intervention group (−0.80 mg/L) but increased in the reference group (0.47 mg/L) at 1 year (p=0.0001).Body iron stores (BIS) increased in the intervention group (0.09 mg/kg body weight) and decreased (−0.58 mg/kg body weight) in the reference group at 1 year (p=0.028).These findings indicate an increase in iron deficiency in the reference group and a decrease in the intervention group. However, no changes in serum ferritin and urinary iodine were observed in either group or between groups. Con- clusions: Iron status can be improved in schoolchildren in Tamil Nadu by increasing the amount of micronutri- ents in the fortified salt used for preparing noon-time school meals.

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