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Iron deficiency is the most common of all nutritional deficiencies. It impairs the mental development of up to 60% of children aged 6–24 months in the developing world.
SUPPER FOR SCIENCE 300 religious sisters in 11 convents around Manila are taking part in a trial to determine the health benefits of a new strain of iron-enriched rice
photo by: Lingkod Sayo/IRRI
Severe iron deficiency causes the deaths of an estimated 50,000 women in pregnancy and childbirth each year. It is estimated that in severely affected areas, the subsequent loss of productivity in the workforce through iron deficiency may account for a loss of up to 2% of gross domestic product (GDP) in the worst-affected countries.
Among ADB’s developing member countries, an estimated 22,000 women die in India each year because of severe anemia during childbirth. In Afghanistan, 65% of children under the age of five are severely iron deficient. In the Philippines, morethan 35% of women aged 15–49 are iron deficient, and more than 500 die during pregnancy and childbirth each year as a result, according to the United Nations Children’s Fund (UNICEF) in 2004.
For many years, governments and public health nutrition specialists—from donor organizations to community health clinics—have struggled to find effective and sustainable ways to address this pervasive problem. Iron tablets are a possible solution but require an ongoing supply and can cause uncomfortable (but harmless) side effects.
In the long term, ensuring adequate iron intake through food is seen as the best solution. In most populations, the best sources of iron in the food supply are meat products, but these are relatively expensive and thus rarely consumed by the poor.
But imagine if the rice so extensively eaten by the poor across Asia was naturally bred and selected for high iron content.
To many researchers and health specialists, this has been a long dreamed of development in fighting micronutrient deficiencies—and now ADB’s support to a global effort to improve the nutrient quality of rice is helping make this a reality.
POOR DIET In India
alone, an estimated 22,000 women die each year as a result of severe anemia during childbirth
photo by: Matthew Westfall
In collaboration with the International Food Policy Research Institute (IFPRI) and the International Rice Research Institute (IRRI), ADB has supported the work of plant breeders at IRRI to identify rice crop varieties that have a naturally occurring high level of iron and to selectively breed these to enhance that iron content while also maintaining crop productivity and consumer acceptance. The latter is important to ensure that any newly developed varieties maintain farmers’ incomes; otherwise, farmers cannot be expected to adopt and grow the new varieties for the benefit of consumers.
After screening more than 1,600 varieties, a new strain (IR68144) was developed that had an iron content of 10 parts per million. This is approximately four to five times more iron (after processing and cooking) than most varieties currently consumed in the Philippines. But does this translate into improved iron status in the consumer?
To test this, a trial was planned with more than 300 religious sisters in 11 convents around Manila. With her full agreement, each sister was randomly assigned to receive either regular (low iron) rice or the new high-iron variety. The sisters and the research team were not told what they were receiving during the trial. The sisters represented an ideal population for such a study because their food is cooked in a common kitchen and consumed in a common dining room, so the distribution and consumption of different rice varieties can be carefully monitored.
The same women who consumed the high-iron rice on average also increased their body iron by 10%
The sisters’ iron status as indicated by hemoglobin and other biochemical indicators of iron status was measured before the trial began, halfway (4.5 months), and at the conclusion (9 months). Women remaining—or newly—iron-deficient at the end of the trial were given iron supplements to ensure this deficiency was quickly corrected.
The trial concluded in September 2003 and, so far, the analysis of data indicate the results have been positive. Among the women who were iron-deficient but not yet anemic at the start of the trial, total body iron reserves improved significantly. The women who consumed the high-iron rice ingested about 20% more iron per day than those who consumed the regular rice. The same women who consumed the high-iron rice on average also increased their body iron by 10%, while the women consuming control rice actually lost 6% of their body iron. The greatest increases in body iron were seen in the women who consumed the most iron from biofortified rice.
These are preliminary results and analysis is ongoing . The research team is preparing papers for submission to scientific journals and results will be presented at conferences for discussion and deliberation. Most importantly though—for ADB, IFPRI, and IRRI—they indicate that there is good reason to keep pursuing this work.
The next step is to conduct trials on the effect and use of high-iron rice in a community setting and look at the effect on children’s iron status. A study is planned in Bangladesh in 2004–2005.
ADB’s involvement in this work started in 2000 under the leadership of Joseph Hunt, ADB Senior Health and Nutrition Specialist (now retired). Due to ADB’s commitment to the concept of biofortified crops for improving the nutritional status of the poor, there have been significant developments in the field.
In October 2003, the Bill and Melinda Gates Foundation committed $25 million to IFPRI’s HarvestPlus program that will work to develop crops with enhanced nutrient status: not just with iron but also with vitamin A and zinc and in other key staple crops on which the poor around the world depend (wheat, maize, beans, cassava, and sweet potato).
Improving iron status in Asia’s poor populations will directly serve global efforts to meet the Millennium Development Goal (MDG) 5 on improving maternal health and contribute to achieving the MDG Goal 4 on reducing child mortality. For sustained, effective solutions, a continuing, concerted effort is required from a diverse range of people including plant breeders, nutritionists, multidisciplinary research teams, donors, and affected communities.
The prospect of helping children reach their full intellectual potential and women survive the most basic and important process of childbirth makes this effort more than worthwhile.
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