Effect of Consuming Food Cooked in Iron Utensils on Iron Status in Children With Iron Deficiency Anemia (IDA)
Condition: Iron Deficiency Anemia
MeSH terms: Anemia; Anemia, Iron-Deficiency; Iron Deficiencies; Deficiency Diseases
Study type: Interventional

Summary: 
      Iron deficiency is a common problem in the world and more so in the developing countries with
      a prevalence of 64 % (using WHO cut-off values of Hb <11.0 g/dl) among children, 9-36 months
      of age. The Pediatric population is especially vulnerable to iron deficiency anemia due to
      low intake of iron rich foods, rapid growth with high demand and losses of iron from body
      especially with the commonly found worm infestations in children. Mild to moderate iron
      deficiency is widely prevalent in children and can have several implications including
      failure to thrive, poor scholastic performance, repeated infections etc. Dietary measures
      along with therapeutic measures are recommended to combat Iron Deficiency Anemia (IDA).
      However, iron rich foods alone cannot be relied upon as a sole step to counter IDA. The
      utensil in which the food is cooked plays a major role in determining the final iron content
      of food. Several studies have documented that most of the foods (90%) contained significantly
      more iron when cooked in iron utensils depending on the acidity, moisture content, and
      cooking time of food.The daily dietary intake could vary from 11 to 6 mg of iron if iron
      utensil was used for cooking [3].

      Food cooked in Aluminum (Al) utensils has a higher Al content which can be detrimental to
      healthy individuals and particularly to patients with chronic renal failure.In healthy
      persons, diseases of central nervous system, as well as of hematopoeitic system, skeletal
      system and respiratory system are described due to excess of Aluminium consumption. Aluminium
      utensils have fast replaced iron cooking pots from Indian kitchens, hence a study to know the
      effectiveness of iron cooking pot as a measure to combat IDA is necessary.

      Studies have shown the utility of cooking food in iron utensil in prevention of IDA but the
      investigators did not come across a study to document the use of this modality in treatment
      of IDA in children. Since the investigators anticipate that the improvement of iron status
      will be a gradual process, so the investigators decided to evaluate the utility of cooking
      food in iron utensils on iron status in children with non-severe IDA (Hb% < cutoff point for
      age but > 5 gm %.

      To test the following hypothesis "use of iron utensils for cooking food will result in
      improvement in iron status in Pediatric patients with nonsevere Iron Deficiency Anemia."
    

Detailed description: 
      Dietary advice and iron therapy are considered the cornerstones of treating a patient with
      non-severe IDA. The foods that are rich in Iron include meat and poultry products, egg, green
      leafy vegetables, jaggery, dry fruits etc. Iron in food is of two types viz. haem iron and
      non haem iron. Haem Iron has excellent bioavailability but the bioavailability of the
      non-haem Iron in the food stuffs is considerably affected by the presence of substances like
      phosphates, phytates, tannins and fibres. On the other hand, Ascorbic acid, sugars and other
      acidic substances in the food enhance the iron absorption. The bulk of food consumed by a
      child is too less to provide him with therapeutic amounts of iron form diet alone. In the
      developing countries, the child is quite unlikely to get poultry products and meat as a
      source of haem Iron. If in this situation, the child is provided with food cooked in Iron
      utensil, then it provides additional Iron to meet the increased demand. This will not only be
      cost effective but it will also alter the cooking practices and thereby have a long term
      effect on the iron status of the entire family. Thus it will treat the IDA in the index case
      and will also benefit other family members who may be having borderline or overt iron
      deficiency. This cost effective measure if incorporated in the health policy of the country
      will certainly have widespread positive implications on the health of the general population.
    

Intervention name(s): iron cooking pot
Intervention type(s): Other
Intervention description(s): the mother was instructed to cook the family food in the iron cooking pot for the study period (60 days) as frequently in the day as possible.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: iron deficiency anemia; dietary intervention; To evaluate a cheap and sustainable dietary intervention to improve the iron status of the entire family of the index case of non-severe iron deficiency anemia.