F&N Bulletin Vol 23 No 1b - United Nations University

104 T. Gopaldas
as compared with 1.50 g/dl in the group receiving
gooseberry juice. All dietary sources of vitamin C are
very expensive and beyond the economic reach of our
subjects.
Enhancers such as ascorbic acid form soluble or
chelated complexes with iron that prevent the iron
from precipitating or polymerizing. Ascorbic acid
also reduces ferric iron to ferrous iron at pH values
greater than 3, such as are found in the duodenum
and small intestine. Apparently ascorbic acid is doserelated
and can act even in the presence of inhibitors
[25]. Although the consumption of lime and lime juice
did increase at the household level, it is a matter of
conjecture whether the level of ascorbic acid would
have been sufficient to have resulted in a mean increase
in hemoglobin of 1.50 g/dl in the working woman
population.
Ethiopian children who were given food cooked in
iron pots had an increase in hemoglobin of 1.7 g/dl
over a 12-month intervention period, a significantly
higher value than the increase of 0.4 g/dl in children
given food cooked in aluminum pots [26]. The subjects
in our study rejected outright the idea of replacing
aluminum cooking utensils with iron ones because
food cooked rapidly in aluminum pots and the pots
were easy to clean and easy to maintain. Pressure
cookers were made of aluminum. In unit 2, 75% of
the working women were intrigued by our IEC poster
advising them to put an iron key into the lentil soup
as it cooked and had tried to do so a few times at
their homes. However, the men in the household
objected strongly, stating that the food tasted “strange”
and “bad.”
Conclusions
Employers should be first targeted and informed about
the concept of a workplace lunch plus IEC. Behavioral
change will be immediate or not at all.
Concrete dietary or medicinal interventions at the
workplace, if given free of cost, appear to give the best
results as far as reduction in iron-deficiency anemia
is concerned.
The young working woman, especially if she is
unmarried, has very real constraints of money and
time, and has no control over her kitchen.
Both the employer and the employee need organizational
and managerial help to implement and sustain
such a program.
The employees appreciate the IEC and implement
the dietary recommendations to the extent possible.
However, their time and economic constraints are the
real limitations to total behavioral change or sustainability.
In urban India, aluminum cooking utensils have
come to stay. Hence, iron woks will not be used.
Although the intervention with fermented food
(iddli) did not increase the mean hemoglobin levels
(1.20 g/dl) as much as the gooseberry juice or the
medicinal supplementation interventions (1.50 g/dl),
it was the food-based iddli intervention that was most
appreciated.
Enhancing the hemoglobin levels of young working
women makes good economic sense. Such a strategy
brings about good labor relations apart from the
established rewards of greater productivity, better
reproductive health, better cognition, and an all-round
better working atmosphere.
Acknowledgments
This paper is part of a larger research study entitled
“An information-education-communication (IEC)
project for working girls (18–23 years) on cultural
dietary practices to increase the iron content of their
everyday diets” funded by the Thrasher Research Fund
(Contract 03001-0), Salt Lake City, Utah, USA, from
1 May 1998 to 30 April 2000. I thank all my research
colleagues, particularly Dr. Arati Singh, the project
coordinator. I am also thankful to the managers of the
four study units and the 302 female employees who
took part in this study.
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