Simulation of the effect of maize porridge fortified with grain amaranth or micronutrient powder containing NaFeEDTA on iron intake and status in Kenyan children.

OBJECTIVE: Simulating the probable impact of grain amaranth and highly absorbable, low-Fe micronutrient powder (MNP) on Fe status in a potential target population is an essential step in choosing and developing an appropriate actual intervention.

DESIGN: We simulated the potential effect of fortifying maize porridge with grain amaranth or MNP on the prevalence of inadequate Fe intake and Fe deficiency using data from two cross-sectional surveys. In the first survey (2008), dietary intake data were collected by two 24 h recalls (n 197). Biochemical data (n 70) were collected in the second survey (2010). A simulation with daily consumption for 80 d of non-fortified maize porridge (60 g of maize flour), amaranth-enriched porridge (80 g of grain amaranth–maize flour, 70:30 ratio) or maize porridge fortified with MNP (2.5mg Fe as NaFeEDTA) was done.

SETTING: Mwingi District, Kenya.

SUBJECTS: Pre-school children aged 12–23 months.

RESULTS: Prevalence of anaemia, Fe deficiency and Fe-deficiency anaemia was 49 %, 46% and 24 %, respectively. Consumption of non-fortified, amaranth-enriched and MNP-fortified maize porridge was estimated to provide a median daily Fe intake of 8.6 mg, 17.5mg and 11.1 mg, respectively. The prevalence of inadequate Fe intake was reduced to 35% in the amaranth-enriched porridge group and 45% in the MNP-fortified porridge group, while ferritin concentration was increased in both (by 1.82 (95% CI 1.42, 2.34) mg/l and 1.80 (95% CI 1.40, 2.31) μg/l, respectively; P,0.005) compared with the non-fortified maize porridge group, resulting in a decreased prevalence of Fe deficiency (27 %) in the two fortification groups.

CONCLUSIONS: Addition of grain amaranth or low-Fe MNP to maize-based porridge has potential to improve Fe intake and status in pre-school children.