Effectiveness of Amaranth Grain Flatbread Compared to Maize Bread for Iron Deficiency Anemia among Pregnant Women: Findings from a Cluster Randomized Controlled Trial in Southern Ethiopia
Notice bibliographique
Résumé
Background/Objectives: Maternal anemia remains a critical public health issue in Ethiopia, with iron deficiency anemia (IDA) being the most prevalent form, primarily due to low dietary iron intake and poor bioavailability from cereal-based diets. Despite the widespread cultivation of nutrient-rich amaranth in Ethiopia, its role in improving maternal iron status remains understudied. To address this gap, we conducted a cluster-randomized controlled trial to evaluate the effectiveness of amaranth grain flatbread consumption, compared to maize bread consumption, on hemoglobin concentration and IDA among pregnant women in southern Ethiopia. Methods: We conducted a six-month, community-based, parallel-group, cluster-randomized controlled trial involving 306 pregnant women with anemia (mild or moderate) to evaluate the effectiveness of locally prepared amaranth grain flatbread in enhancing hemoglobin concentration and reducing IDA, compared to the standard maize bread. At the end of the intervention, hemoglobin levels were measured, and IDA was assessed using World Health Organization (WHO) defined cutoffs of serum ferritin levels. Multilevel linear and modified Poisson regression models were used to estimate adjusted effects, accounting for confounders and community-level clustering. All analyses were conducted following the intention-to-treat principle. Results: The loss to follow-up rate was similar between the amaranth and maize groups (4.6% vs. 3.9%). In the unadjusted analysis, the mean hemoglobin concentration was higher in the amaranth group (12.39 g/dL, 95% CI: 12.17–12.61) compared to the maize group (10.17 g/dL, 95% CI: 9.95–10.39). The proportion of IDA was also lower in the amaranth group (26.71% [95% CI: 20.14–34.49] vs. 65.98% [95% CI: 57.93–73.21]). After adjusting for potential confounders (due to baseline differences after randomization) and clustering, pregnant women who received amaranth grain flatbread had higher hemoglobin levels (adjusted β = 2.67 g/dL; 95% CI: 2.41–2.90) and a 53% lower risk of IDA compared to those in the maize group (adjusted risk ratio = 0.47; 95% CI: 0.26–0.84). No serious adverse events were reported in either group. Conclusion: Consumption of amaranth grain flatbread during pregnancy improved hemoglobin levels and reduced IDA compared to maize-based diets. These findings highlight the potential of locally available, nutrient-dense foods, such as amaranth, to address maternal iron deficiency among pregnant women with mild or moderate anemia in resource-limited settings. Trial registration number: NCT06536153
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,005 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,003 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».