Effect of iron-fortified candies on the iron status of children aged 4-6 y in East Jakarta, Indonesia

Background: Iron deficiency anemia is the most prevalent nutrition problem in young children. One possible strategy to prevent iron deficiency anemia in this population group is the fortification of affordable food. Objective: This study was designed to assess whether iron-fortified candies can improve iron status and are acceptable to children aged 4-6 y. Design: A double-blind, placebo-controlled intervention study was conducted in Jakarta, Indonesia. The children were randomly assigned to 1 of 2 treatment groups: a fortified group (n = 57) and a placebo group (n = 60). Every week for 12 wk, 30 g (10 pieces) candy was given to the children. The candy given to the fortified group contained 1 mg elemental Fe/g and very small amounts of other vitamins and minerals. Results: The hemoglobin concentration of the fortified group increased by 10.2 g/L (95% CI: 8.3, 12 g/L) whereas that of the placebo group increased by 4.0 g/L (2.0, 6.0 g/L; P < 0.001). Anemia prevalence decreased from 50.9% at the start of the intervention to 8.8% after 12 wk of intervention in the fortified group (P < 0.001) and from 43.3% to 26.7% in the placebo group (P < 0.05). After 12 wk of intervention, the serum ferritin concentration was 71% higher than at baseline in the fortified group and 28% higher in the placebo group (P < 0.001). Acceptability of the iron-fortified candies was good. The per capita cost of the supplement was approximately US$0.96-1.20 for the 12 wk of intervention. Conclusion: Iron-fortified candies were effective for improving the iron status of young children and might be an affordable way to combat iron deficiency in children of low-to-middle income groups.