156 Am J C/in Nuir 1989;49: 156-61. Printed in USA. © 1989 American Society for Clinical Nutrition Fortification of curry powder with NaFe(1 1 1 )EDTA in an iron- deficient population: initial survey of iron status1’2 Daynia E Ballot, A Patrick MacPhail, Thomas H Bothwell, Mary Gillooly, and Fatima G Mayet ABSTRACT A survey of iron status was conducted in 984 volunteers (404 males and 580 females) from an Fe-deficient population before an Fe-fortification trial. Hemoglobin, percentage saturation of transferrin, and serum ferritin were used to assess Fe status and to calculate body Fe stores. Almost 30% of males and 60% of females had evidence of Fe defi- ciency. The distribution of body Fe stores for both males and females was shifted to the left compared with a population in the United States. In females 24% had Fe-deficiency anemia, 13% Fe-deficient erythropoiesis, and 16% depleted stores. Multiple regression analysis failed to show any relationship in women between age, parity, and duration of menses and measure- ments of Fe status. In males Fe deficiency was more frequent for those < 18 y and alcohol abusers had increased serum ferritin and calculated body Fe compared with nondrinkers. Am J Clin Nutr 1 989;49: 156-61. KEY WORDS Iron fortification, iron status, Fe(l 1 1)EDTA, iron stores Introduction Nutritional iron deficiency is common especially in developing countries. Its prevalence tends to be greatest in populations subsisting on diets containing little meat, fish, and poultry and large amounts ofcereals or legumes (1). Although the total Fe content ofsuch diets is usually adequate, inhibitors in the foodstuffs limit the bioavail- ability of the Fe. The problem of nutritional Fe defi- ciency can be addressed by supplementation, in which hematinics are supplied in tablet form to affected mdi- viduals, or by fortification, in which Fe in a readily ab- sorbable form is added to a foodstuff commonly con- sumed by the whole population. The choice of approach is determined by the prevalence and severity of the Fe deficiency (2). The Indian population of Durban was previously shown to have a high prevalence of nutritional Fe defi- ciency. Mayet (3) found evidence ofFe deficiency in 20% of males and 33% of females. In a later study MacPhail et al (4) reported Fe-deficiency anemia (IDA) in 14% of reproductive females in the same population with a fur- ther 26% having depleted Fe stores and another 8% Fe- deficient erythropoiesis (IDE). This population would therefore be expected to benefit from an Fe-fortification program because Fe deficiency of moderate degree affects all segments ofthe population. On this basis a rep- resentative sample was chosen for a pilot fortification program to evaluate the potential benefit of fortification to the whole Indian population. Before commencing the pilot fortification program an assessment ofthe Fe nutri- tion ofthe target population was undertaken to establish the prevalence and severity ofFe deficiency and to docu- ment the occurrence of factors such as disease and drug usage that might affect Fe balance (4). The results of this initial survey form the base line against which the find- ings in the fortification trial were assessed (5). Subjects and methods Subjects The study was approved by the Human Ethics Committee ofthe University ofthe Witwatersrand. Indian volunteers, 984 from 264 families, were recruited from a subeconomic housing area in Chatsworth near Durban. There were 404 males and 580 females in the study. Informed consent was obtained from each subject by an Indian nursing sister. Children aged < 10 y were excluded from the study because it was anticipated that there might be problems in obtaining the repeated blood sam- ples needed for the trial. A history ofdiseases, drug usage, and alcohol intake and demographic data were obtained from each subject by the Indian nursing sister. I From the Joint University/MRC Iron and Red Cell Metabolism Unit, Department of Medicine, University of the Witwatersrand, Jo- hannesburg and the Department of Medicine, University of Natal, Durban, South Africa. 2 Address reprint requests to TH Bothwell, Department of Medi- cine, University of the Witwatersrand, Medical School, York Road, Parktown 2193, South Africa. Received October 20, 1987. Accepted for publication January 27, 1988. by guest on July 10, 2011 www.ajcn.org Downloaded from