IRON FORTIFICATION OF RICE: The Philippine Experience

Background. In the Philippines, iron deficiency anemia (IDA) remains as a serious public health problem across population groups. Fortifying staple foods offers a great opportunity to control micronutrient deficiencies. However, technological problems like the choice of technology and suitable fortificant should be critically considered. Objectives. The first phase of the study was to evaluate the stability of iron-fortified premix rice (IPR) and iron-fortified rice (IFR) using coating and extrusion technologies. The second phase was to assess the efficacy of two types of iron fortificants using extrusion technology in improving the hematological status of school-age children. Design. To produce the IFR, the extruded IPR was blended with ordinary rice at a ratio of 1:100, while the coated IPR was blended with ordinary rice at a ratio of 1:200. Ferrous sulfate (FeSO4) and micronized dispersible ferric pyrophosphate (MDFP) were used as fortificants. The color, bulk density, moisture, iron, and microbiological contents, and the presence or absence of infestation on IPR and IFR were analyzed during storage using standard methods of determination. For the efficacy study, 180 anemic children participated in a double-masked- randomized controlled trial. Group1 received IFR with extruded IPR using ferrous sulfate as fortificant (ExFeSO4); Group 2 received IFR with extruded IPR using micronized Ferric pyrophosphate as fortificant (ExFeP80); and Group 3 received unfortified rice (control). A low iron-content dish was served together with the rice as lunch for 5 days a week for 120 days under a supervised regimen. Hemoglobin, plasma ferritin, CrP, plasma retinol, weight, height, and food intake were assessed at baseline, after 3 months, and at 6 months. Results. Technological study revealed that the color, appearance, odor, taste, texture, deliciousness and general acceptability of cooked IFR were similar with that of the unfortified rice. However, on the 6th and 10th month of storage, the color of both unfortified and IFR became slightly darker. In general, the use of extrusion technology for the preparation of the IPR resulted to higher level of iron in the cooked IFR than in the coated IFR. Ferrous sulfate and MDFP, can be used to fortify rice to meet the targeted iron content of 600 mg/100g sample for IPR, 6 mg/100g sample for uncooked IFR, and 2 mg/100 samples for cooked IFR. Assessing the effects of IFR revealed that at 3 months, the prevalence of anemia had significantly been reduced from 100% at baseline to 51%, 54% and 63% in the ExFeSO4, ExFeP80 and control groups, respectively. At 6 months, further significant reductions were observed in the fortified groups: ExFeSO4 (38%) and ExFeP80 (33%). The control group had remained at 63%. The predictors of hemoglobin and plasma ferritin levels were: type of fortificant, initial Hb and initial plasma ferritin values. Conclusion. Extrusion technology is more suitable than coating technology to fortify rice with FeSO4 or MDFP because of higher iron retention. This is an effective strategy to reduce the prevalence of IDA among school-age children.

Keywords: Extrusion, ferrous sulfate, micronized dispersible ferric pyrophosphate, iron-fortified rice, anemia, school-aged children.

Contact information: imelda_agdeppa@yahoo.com

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