Title: Efficacy of NaFeEDTA fortified wheat flour on improving anaemia and iron status in school children


July 2007 and May 2008


St John’s Research Institute, St John’s Medical College, Bangalore


Department of Biotechnology, Government of India


Dr. Sumithra Muthayya, Dr. Anura V Kurpad, Dr. Chittaranjan S Yajnik, Dr. Siddhivinayak Hirve, Dr. Prashanth Thankachan


Iron deficiency anaemia is a major public health problem worldwide. Fortification of wheat flour with NaFeEDTA is a highly bioavailable compound could be an effective strategy to tackle the iron deficiency anaemia worldwide.

Aim/s and objectives:

To Evaluate the efficacy of NaFeEDTA-fortified whole wheat flour in reducing iron deficiency, improving iron stores and cognitive performance in children

Research Methods/Study Design:

Randomized, double-blind, controlled efficacy trial was conducted at 2 sites, Karnataka and Maharashtra states, India. At each site,  200 iron deficient (serum ferritin concentration < 15 µg/L) children, with or without anaemia, were randomized to receive a meal made of whole wheat atta flour containing either 10 mg Fe as NaFeEDTA (iron-fortified group) or no added iron (control group) for 6 days/week for a period of 7 months. Children, aged 6-15 years, were recruited from Government and Government-aided schools located in Karnataka and Maharashtra after obtaining informed consent from their parents and oral assent from the children. Concentrations of hemoglobin, serum ferritin (SF), serum transferrin receptor (TfR), zinc protoporphyrin (ZnPP) and C-reactive protein (CRP) were measured at baseline and after 3.5 and 7 months.

Study population/ Sample size:

Study was conducted on Urban Bangalore and Rural Vadu population. 200 children from each site were recruited for the study.


Over 7 months, the prevalence of Iron deficiency and Iron Deficiency Anaemia significantly decreased from 62 to 22 % and 18 to 9 %, respectively, in the iron-fortified group. Time x treatment interactions were significant for Haemoglobin, Serum Ferritin and total body iron (all P<0.001). Body iron stores improved considerably in the iron group when compared to the controls (4.1 vs. 1.5 mg/kg body weight; P<0.001). In sensory tests, the NAFeEDTA fortified flour could not be differentiated from unfortified flour. No significant differences between the groups were found in any of the cognitive tests.

List of Publication, if any:

  • J Nutr. 2012 Nov;142(11):1997-2003. doi: 10.3945/jn.111.155135. Epub 2012 Sep 26. Iron fortification of whole wheat flour reduces iron deficiency and iron deficiency anemia and increases body iron stores in Indian school-aged children. Muthayya S, Thankachan P, Hirve S, Amalrajan V, Thomas T, Lubree H, Agarwal D, Srinivasan K, Hurrell RF, Yajnik CS, Kurpad AV.Source Division of Nutrition, St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, India. 


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