Alternate strategies for improving iron nutrition: lessons from recent research

Strategies such as dietary diversification and food fortification have yielded significant results in controlling iron deficiency anaemia in developed countries. Reducing the prevalence of iron deficiency anaemia in developing countries is still a matter of importance. The major factors responsible for iron deficiency anaemia in the vulnerable segments of developing countries are reduced intake and poor bioavailability of dietary iron. Dietary diversification and food-based approaches pose considerable challenges before they can be implemented on a wide scale. Anaemia control programmes based on the administration of prophylactic doses of iron and folic acid tablets have been widely implemented. As the programmes were not effective in countries such as India, the dosage of iron was increased. The role of excess iron in causing intestinal oxidative stress has drawn attention to other approaches of iron supplementation. Prophylactic administration of iron along with antioxidants like vitamins E and C or foods rich in these vitamins is one such strategy. To reduce the intestinal oxidative stress, intermittent supplementation of iron is being considered. The potential benefits and shortcomings of these approaches are reviewed.