Effect of Multiple Micronutrient Fortified Bread Consumption on Iron Deficiency Anemia in Women of Reproductive Age

NCT ID: NCT05103709

Last Updated: 2021-11-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

351 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-08-03

Study Completion Date

2022-02-28

Brief Summary

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The project aims to assess if consuming two slices of multi-fortified bread daily for 120 days is effective in reducing iron deficiency anemia in women of reproductive age through a three-arm randomized trial.

Detailed Description

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Iron deficiency anemia (IDA) continues to be a public health priority in Peru and the world. The prevalence of the condition is high in women of reproductive age regardless of geographic area and socioeconomic status. Fortification of staple foods is recognized as a cost-effective strategy to reverse iron deficiency. In Peru, iron fortification of wheat flour and derived products is mandatory, but to date its effect on the IDA has not been evaluated. In recent years, evidence has been generated on the positive effect of zinc, vitamin A and vitamin B12 supplementation on hemoglobin (Hb) levels. This project is a three-arm randomized clinical trial that seeks to evaluate the effect of consuming two slices of bread fortified with a multivitamin premix (iron, folic acid, vitamin A, vitamin B12 and zinc) daily on iron deficiency anemia in non-pregnant women of reproductive age. As a control, one group will receive standard bread fortified according to Peruvian legislation and a third group will not receive treatment.

Conditions

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Iron Deficiency Anemia

Keywords

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iron deficiency anemia hemoglobin iron status hematological parameters

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors
Masking will be mixed. Since the third arm will not receive product of any kind it is not possible to mask the volunteers assigned to this group. The packaging of the products will be neutral to blind the volunteers in the groups that will receive products. The investigators will be blinded to randomization at all times.

Study Groups

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MULTI-FORTIFIED

The product to be evaluated is bread made from wheat flour fortified according to Peruvian national standards \[Riboflavin (0.18 mg), niacin (2.25 mg), thiamine (0.18 mg), folic acid (60ug), iron (4.2 mg)\] and a previtamin mix \[Vitamin A (240 ug), Vitamin b12 (0.72 ug), zinc (5.25 mg) per daily serving\]. Participants will receive 2 slices of bread a day for 120 days. It is supplied by Panificadora Bimbo del Peru S.A.

Group Type EXPERIMENTAL

MULTI-FORTIFIED

Intervention Type OTHER

Treatment with multifortified bread for 120 days

FORTIFIED

The active comparator is bread fortified according to Peruvian national standards \[Riboflavin (0.18 mg), niacin (2.25 mg), thiamine (0.18 mg), folic acid (60ug), iron (4.2 mg)\]. Participants will receive 2 slices of bread a day for 120 days. It is supplied by Panificadora Bimbo del Peru S.A.

Group Type ACTIVE_COMPARATOR

FORTIFIED

Intervention Type OTHER

Treatment with standard bread, fortified according to current Peruvian guidelines for 120 days

CONTROL

The control group will be followed for 120 days. No product will be provided.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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MULTI-FORTIFIED

Treatment with multifortified bread for 120 days

Intervention Type OTHER

FORTIFIED

Treatment with standard bread, fortified according to current Peruvian guidelines for 120 days

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Ferritin levels \< 13 ng/ml,
* Hemoglobin levels between 8 g/dL and 11.9 g/dL,
* No plans to move during the duration of the study,
* Commitment not to become pregnant during the duration of the study,
* Signed informed consent.

Exclusion Criteria

* Pregnancy,
* Amenorrhea not related to pregnancy,
* Breastfeeding,
* Chronic diseases (active TB, HIV, cancer, asthma, liver disease, coronary heart disease, chronic renal disease),
* Hemoglobin levels \< 8 g/dL,
* Bleeding in the 3 months prior to recruitment,
* Smoking,
* Inability to sign informed consent,
* Consumption of nutritional supplements.
Minimum Eligible Age

18 Years

Maximum Eligible Age

35 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Universidad Peruana Cayetano Heredia

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Centro de Salud Global

Tumbes, , Peru

Site Status RECRUITING

Countries

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Peru

Central Contacts

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Dulce E Alarcon Yaquetto, MSc

Role: CONTACT

Phone: +51 935401217

Email: [email protected]

Facility Contacts

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Percy M VĂ­lchez-Barreto, BSc

Role: primary

References

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Suchdev PS, Jefferds MED, Ota E, da Silva Lopes K, De-Regil LM. Home fortification of foods with multiple micronutrient powders for health and nutrition in children under two years of age. Cochrane Database Syst Rev. 2020 Feb 28;2(2):CD008959. doi: 10.1002/14651858.CD008959.pub3.

Reference Type BACKGROUND
PMID: 32107773 (View on PubMed)

Eichler K, Hess S, Twerenbold C, Sabatier M, Meier F, Wieser S. Health effects of micronutrient fortified dairy products and cereal food for children and adolescents: A systematic review. PLoS One. 2019 Jan 23;14(1):e0210899. doi: 10.1371/journal.pone.0210899. eCollection 2019.

Reference Type BACKGROUND
PMID: 30673769 (View on PubMed)

Gera T, Sachdev HS, Boy E. Effect of iron-fortified foods on hematologic and biological outcomes: systematic review of randomized controlled trials. Am J Clin Nutr. 2012 Aug;96(2):309-24. doi: 10.3945/ajcn.111.031500. Epub 2012 Jul 3.

Reference Type BACKGROUND
PMID: 22760566 (View on PubMed)

Finkelstein JL, Mehta S, Villalpando S, Mundo-Rosas V, Luna SV, Rahn M, Shamah-Levy T, Beebe SE, Haas JD. A Randomized Feeding Trial of Iron-Biofortified Beans on School Children in Mexico. Nutrients. 2019 Feb 12;11(2):381. doi: 10.3390/nu11020381.

Reference Type BACKGROUND
PMID: 30759887 (View on PubMed)

Alarcon-Yaquetto DE, Rueda-Torres L, Bailon N, Barreto PV, Malaga G. Accuracy of HemoCue301 portable hemoglobin analyzer for anemia screening in capillary blood from women of reproductive age in a deprived region of Northern Peru: An on-field study. PLoS One. 2023 Nov 14;18(11):e0293984. doi: 10.1371/journal.pone.0293984. eCollection 2023.

Reference Type DERIVED
PMID: 37963155 (View on PubMed)

Other Identifiers

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SIDISI 204220

Identifier Type: -

Identifier Source: org_study_id