TABLE 2.
Efficacy studies with rice fortified with MGFP or MDFP (SunActive iron) and monitored with a combination of iron status parameters1
| Reference, country | Subjects2 | Duration | Fortified food3 | Additional iron4 | Inflammation5 | Impact6 |
|---|---|---|---|---|---|---|
| MGFP | ||||||
| Moretti et al. (21), India | 184 children aged 6–13 y, 2 groups | 7 mo | Hot extruded premix rice | 17 mg/d | Inflammation excluded | SF and BIS increased, TfR decreased, ID (80%–25%) and IDA (30%–15%) decreased |
| Beinner et al. (23), Brazil7 | 175 infants aged 6–24 mo, 2 groups | 5 mo | Cold extruded premix rice | 23 mg/d | Inflammation excluded | SF increased, ID decreased (65%–25%) |
| Radhika et al. (22), India | 140 children aged 5–11 y, 2 groups | 8 mo | Cold extruded premix rice | 16 mg/d | Inflammation excluded | SF increased, ID decreased (33%–14%) |
| Thankachan et al. (24), India | 258 children aged 6–12 y, 3 groups | 6 mo | Hot extruded premix rice8 | 8 mg/d | Inflammation excluded | No change in SF, TfR, ZPP, or Hb |
| Hussain et al. (25), India | 222 children aged 5–8 y, 6 groups | 6 mo | Hot extruded premix rice | 7 mg/d | Not measured | SF increased, ID decreased (82%-26%) |
| Perignon et al. (26), Cambodia8 | 2440 children aged 6–16 y, 5 groups | 6 mo | Hot and cold extruded premix rice | 7.4–10.5 mg/d | >40% | No change in Hb and BIS, SF and TfR increased |
| MDFP | ||||||
| Hotz et al. (30), Mexico | 201 women aged 18–49 y, 2 groups | 6 mo | Cold extruded premix rice | 13 mg/d | Not measured | PF and BIS increased, TfR decreased, ID (33%–23%) and anemia (21%–4%) decreased |
| Angeles-Agdeppa et al. (29), Philippines | 180 children aged 6–9 y, 3 groups | 6 mo | Cold extruded premix rice | 9 mg/d | Not measured | PF increased, anemia decreased (100%–33%) |
BIS, body iron stores; CRP, C-reactive protein; Hb, hemoglobin; ID, iron deficiency; IDA, iron deficiency anemia; MDFP, micronized dispersible ferric pyrophosphate; MGFP, micronized ground ferric pyrophosphate; PF, plasma ferritin; SF, serum ferritin; TfR, transferrin receptor; ZPP, zinc protoporphyrin.
All studies were randomized and placebo controlled with approximately the same number of subjects in each group. Subjects aged 6 mo–16 y were of both sexes.
Iron-fortified rice is produced by mixing regular nonfortified rice grains with iron-fortified premix rice grains manufactured from fortified rice flour by hot (70–110°C) or cold (30–40°C) extrusion (19).
The additional iron consumed per day over the study duration was calculated by dividing the combined amount of iron consumed on test days (excluding weekend days and school holidays if the test meal was not consumed) by the total number of days in the study duration.
Inflammation based on CRP, or on CRP plus α-1-acid-glycoprotein [Perignon et al. (26)].
Reported increases or decreases of iron status parameters relative to control were statistically significant (at least P < 0.05). More precision on the statistical significance is given in the text. No change in iron status parameters is reported when differences relative to control were P > 0.05.
Not placebo controlled; iron-fortified rice was compared with ferrous sulfate drops (10 mg Fe) with similar impact.
Premix rice with multimicronutrients.