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

Iron-deficiency anemia in young working women can
be reduced by increasing the consumption of cerealbased
fermented foods or gooseberry juice at the
workplace
Tara Gopaldas
Abstract
This efficacy trial for both employers and employees
(young working women 18 to 23 years of age) was undertaken
to determine whether culturally acceptable dietary
changes in lunches in the workplace and at home could
bring about a behavioral change and improvement in
their iron-deficiency anemia status. Maximum weight
was given to increasing consumption of iddli, a popular
cereal-based-fermented food, or of gooseberry juice. Four
small factories were selected in periurban Bangalore,
with a sample of 302 women. The 180-day interventions
were supervised at the workplace. In unit 1 (72 women),
the intervention consisted of iddli four times a week
plus information, education, and communication (IEC)
related to iron-deficiency anemia. Unit 2 (80 women)
received 20 ml of gooseberry juice (containing 40 mg of
vitamin C) three times a week plus IEC once a month.
Women in unit 3 (70 women), the positive control,
received 400 mg albendazole once plus ferrous sulfate
tablets (60 mg elemental iron) two times a week. No IEC
was given. Unit 4 (70 women) served as the negative
control and received no intervention. The pre-post impact
measures were dietary and nutrient intake, knowledge
and practice, and hemoglobin status. In units 1, 2,
and 3, the hemoglobin status of the women improved
significantly from 11.10 to 12.30 g/dl, 11.20 to 12.70 g/dl,
and 11.50 to 13.00 g/dl, respectively. In unit 4 there was
no change: the values were 10.90 g/dl before and after
intervention. The results show that the type of workplace
lunch was of greater significance than IEC. Knowledge
gains were impressive, but behavioral change was not
sustained. It was concluded that the hemoglobin levels of
the workers can easily be improved by cost-effective workplace
lunches that also lead to better employer–employee
relations.
The author is affiliated with Tara Consultancy Services in
Bangalore, India.
Mention of the names of firms and commercial products
does not imply endorsement by the United Nations University.
Introduction
The population of young working women (18 to 23
years of age) in most of India’s cities and towns is a
phenomenon of this millennium. Women are working
more than ever before for economic reasons.
Iron-deficiency anemia is highly prevalent in this
group because most come from low-income-group
families. Iron-deficiency anemia has clear effects on
physical work capacity [1–3] and cognition [4, 5].
This workplace-lunch with an information-educationcommunication
(IEC) study was designed to increase
the bioavailability of everyday foodstuffs by simple
dietary changes. The emphasis was on cereals, which
are consumed in large quantities. Fermentation of
cereal-pulse batter is well accepted in South India,
where the present study was conducted from 1998 to
2000. Fermentation of such batters reduces the inhibitory
action of phytate-iron, thus making the iron more
bioavailable. Gooseberry juice, a well-known dietary
iron enhancer because of its vitamin C content, was
offered along with IEC at the workplace.
Methods
Experimental design
Details of the interventions are set out in table 1. There
were 302 subjects in the four selected units. The aims,
objectives, and scope of work and collaboration were
fully explained to the owners and managers, and they
gave full cooperation. All of the workers agreed to the
medical examination and the hemoglobin measurements.
Signed agreements for the various tests were
also obtained from the management.
Visiting homes and making inventories of food
shopping, cooking, and eating habits
Thirty representative homes of the women were visited
94 Food and Nutrition Bulletin, vol. 23, no. 1 © 2002, The United Nations University.