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A Functional Food for the Prevention of Iron-deficiency Anemia

This study has been completed.
Information provided by:
Manchester Metropolitan University Identifier:
First received: January 22, 2010
Last updated: July 29, 2014
Last verified: July 2010

It has been estimated that 1 in 2 women expecting a baby will be diagnosed with iron deficiency. In turn iron deficiency can affect the health and wellbeing or both mother and child. Studies show that low iron stores prior to conception and low iron intakes during pregnancy may both be contributing to this problem. Although dietary supplements may be one solution, research indicates that daily compliance is low (Nguyen et al., 2008). Furthermore, prescribed iron supplements may result in uncomfortable side-effects, including constipation (Wulff & Ekstrom, 2003).

It is been observed in Ethiopia that iron deficiency anemia is lower than average; a finding that has been attributed to regular "Teff" consumption (Gies et al., 2003). Teff (Eragrostis tef) is a staple food usually consumed in the form of Enjera (flat bread prepared using a range of cereals). Research has shown that Teff is a rich source of iron that is easily absorbed by the body.

Although it is believed that regular Teff consumption may prevent to onset of iron deficiency anemia there is no research to support this. Therefore, the aim of the present study is to es-tablish whether incorporating Teff into the daily diet may be one way to improve blood profile and prevent the onset of iron deficiency anemia in expectant mothers. Study findings will demonstrate whether Teff may be an alternative source of iron that can be easily incorporated into the daily diet of both pregnant mothers and the lay public.

Condition Intervention Phase
Other: Control bread
Other: Teff Bread
Phase 1

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double Blind (Participant, Investigator)
Primary Purpose: Prevention
Official Title: Teff (Eragrostis Tef) as a Functional Food for the Prevention of Pregnancy Iron-deficiency Anemia

Resource links provided by NLM:

Further study details as provided by Manchester Metropolitan University:

Primary Outcome Measures:
  • To develop Teff bread that is rich in iron (per slice). [ Time Frame: 2 years ]
  • To establish whether iron from Teff is bioavailable. [ Time Frame: 2 years ]
  • To conclude whether daily Teff consumption prevents iron-deficiency anemia in pregnancy. [ Time Frame: 2 years ]

Secondary Outcome Measures:
  • To use a range of different biomarkers to determine iron status. [ Time Frame: 2 years ]
  • To compare dietary intakes of iron and iron status between the Teff/control group. [ Time Frame: 2 years ]

Enrollment: 55
Study Start Date: October 2009
Study Completion Date: July 2011
Primary Completion Date: July 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Placebo Comparator: Control
Control bread
Other: Control bread
Control bread
Other Name: Low-iron bread
Active Comparator: Teff bread
Teff bread
Other: Teff Bread
Teff bread
Other Name: High-iron bread

Detailed Description:

Rationale Iron deficiency anemia is considered to be one of the most prevalent forms of malnutrition in Europe (Stoltzfus, 2003 & Hercberg et al., 2001). Pregnant mothers are particularly susceptible to the onset of iron deficiency anemia (Daily & Wylie, 2008). It has been estimated that 1 in 2 pregnant women will be diagnosed with iron deficiency (Scholl, 2005). During pregnancy maternal plasma volume expands, increasing iron requirements (Scholl et al., 2000) whilst dietary intakes generally remain unchanged (Milman, 2006). Physiologically, intestinal iron absorption may increase during pregnancy but only after iron depletion has already commenced (Milman, 2006). Research strongly suggests that pregnant women are not meeting dietary guidelines for iron (Derbyshire et al., 2009).

A Sheffield (UK) study has reported that pregnant women consume around 10.2mg of iron per day (Mouratidou et al., 2006). Another investigation undertaken in a London population found that expectant mothers had a mean intake of 10.7mg iron per day (Rees et al., 2005). A further study investigating the diet of educated, Caucasian pregnant mothers reported similar figures (Derbyshire et al., 2006). Diets deficient in iron during gestation may subsequently affect infant health, in both the short and longer term (Scholl & Reilly, 2000). Iron deficiencies in pregnancy have been linked to preterm deliveries, reduced infant birth weight, length and iron stores (Daily & Wylie, 2008). Low iron stores during periods of infant brain growth may permanently impede cognitive development (Lozoff, 2007 & Lozoff & Georgieff, 2006).

Teff (Eragrostis tef) is a staple food consumed in northern, western and central Ethiopia; usually in the form of Enjera (flat bread prepared using a range of cereals, including Eragrostis tef) (Umeta et al., 2005). Research has shown that Teff is a rich source of bioavailable iron which may be attributed to its low phytate content. Bread made with Tef enjera contains around 30mg of iron per 100g and up to 35mg when the food is fermented (Umeta et al., 2005). The iron content dramatically exceeds that of common Western foods (Corn flakes 7.9mg, boiled brown rice, 0.5mg and brown bread, 2.2mg, all per 100g consumed) (FSA, 2006). Furthermore, studies have shown that the prevalence of pregnancy iron deficiency anemia is relatively low in Ethiopia (Gies et al., 2003) which may be attributed to Eragrostis tef forming a staple part of the diet (Haidar et al., 1999).

Incorporation of Teff into the daily diet of expectant mothers may help to reduce the incidence of iron-deficiency anemia. Research shows that women do not adhere to taking large tablet supplements (Nguyen et al., 2008). Teff may therefore provide an alternative source of dietary iron that can be easily incorporated into the daily diet of both pregnant mothers and the lay public.


Ages Eligible for Study:   18 Years to 40 Years   (Adult)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • Caucasian
  • Primiparous
  • Singleton pregnancy (wk 20 to wk 30)
  • Non smokers
  • Pre pregnancy BMI between 19.8 and 26
  • Healthy, free from iron metabolism disorders (pregnancy induced hypertension
  • Not taking medicines known to influence iron status
  • Not taking iron supplements (multivitamins will be accounted for)
  • Free from gastrointestinal disorders
  • No allergies

Exclusion Criteria:

  • Pregnancy haemoglobin concentrations are not within the normal range (below 70g/l or over 160g/l)
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Please refer to this study by its identifier: NCT01055431

United Kingdom
Manchester Food Research Centre, Manchester Metropolitan University
Manchester, United Kingdom, M14 6HR
Sponsors and Collaborators
Manchester Metropolitan University
Principal Investigator: Dr Emma J Derbyshire Manchester Metropolitan University
  More Information

Additional Information:
Responsible Party: Dr Emma Derbyshire, Manchester Metropolitan University Identifier: NCT01055431     History of Changes
Other Study ID Numbers: 09/H1013/69
Study First Received: January 22, 2010
Last Updated: July 29, 2014

Keywords provided by Manchester Metropolitan University:
functional foods
child bearing

Additional relevant MeSH terms:
Anemia, Iron-Deficiency
Hematologic Diseases
Anemia, Hypochromic
Iron Metabolism Disorders
Metabolic Diseases
Trace Elements
Growth Substances
Physiological Effects of Drugs processed this record on May 25, 2017