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Anitha S, Tsusaka TW, Givens DI, Kane-Potaka J, Botha R, Sulaiman NLB, Upadhyay S, Vetriventhan M, Rajendran A, Parasannanavar DJ, Longvah T, Subramaniam K, Bhandari RK. Does millet consumption contribute to raising blood hemoglobin levels compared to regular refined staples?: a systematic review and meta-analysis. Front Nutr 2024; 11:1305394. [PMID: 38419846 PMCID: PMC10900984 DOI: 10.3389/fnut.2024.1305394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/18/2024] [Indexed: 03/02/2024] Open
Abstract
Millets are recognized for their health and nutritional values, and the United Nations declared 2023 the International Year of Millets. Among the several health and nutritional benefits of millets, their impact on hemoglobin concentration is important since anemia is a major public health issue in many countries. To investigate the effect of millet (including sorghum) consumption on hemoglobin concentration in the blood, a systematic review and meta-analysis were conducted. Thirteen published studies featuring randomized control trials involving 590 individuals in the intervention group and 549 control individuals were eligible for the meta-analysis. The difference-in-differences analysis revealed highly significant (p < 0.01) positive effects of millet consumption on hemoglobin concentration, with an effect size of +0.68 standardized mean difference units. The change in hemoglobin concentration observed in the intervention group was +13.6%, which is statistically significant (p < 0.0005), compared to that in the control group, which was +4.8% and not statistically significant (p = 0.1362). In four studies, the consumption of millets in the intervention group demonstrated a change from mild anemia to normal status among children, whereas there was no change in the control group. The findings provide evidence that the consumption of millets can improve blood hemoglobin concentration, likely resulting from increased iron intake. Further research is needed involving the assessment of iron content and bioavailability to better understand the effect variation among millet types and the mechanisms involved.
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Affiliation(s)
- Seetha Anitha
- Asia-Pacific Association of Agricultural Research Institutions (APAARI), Bangkok, Thailand
- International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), Patancheru, India
| | | | - D Ian Givens
- Institute of Food, Nutrition, and Health, University of Reading, Reading, United Kingdom
| | | | | | | | - Shweta Upadhyay
- Asia-Pacific Association of Agricultural Research Institutions (APAARI), Bangkok, Thailand
| | - Mani Vetriventhan
- International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), Patancheru, India
| | | | | | | | - Kowsalya Subramaniam
- Avinashilingam Institute for Home Science and Higher Education for Women, Coimbatore, Tamil Nadu, India
| | - Raj Kumar Bhandari
- National Technical Board of Nutrition, Government of India (GoI), Mumbai, India
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Anitha S, Kane-Potaka J, Botha R, Givens DI, Sulaiman NLB, Upadhyay S, Vetriventhan M, Tsusaka TW, Parasannanavar DJ, Longvah T, Rajendran A, Subramaniam K, Bhandari RK. Millets Can Have a Major Impact on Improving Iron Status, Hemoglobin Level, and in Reducing Iron Deficiency Anemia-A Systematic Review and Meta-Analysis. Front Nutr 2021; 8:725529. [PMID: 34722606 PMCID: PMC8551390 DOI: 10.3389/fnut.2021.725529] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 09/03/2021] [Indexed: 11/13/2022] Open
Abstract
The prevalence of iron deficiency anemia is highest among low and middle-income countries. Millets, including sorghum, are a traditional staple in many of these countries and are known to be rich in iron. However, a wide variation in the iron composition of millets has been reported, which needs to be understood in consonance with its bioavailability and roles in reducing anemia. This systematic review and meta-analysis were carried out to analyze the scientific evidence on the bioavailability of iron in different types of millets, processing, and the impact of millet-based food on iron status and anemia. The results indicated that iron levels in the millets used to study iron bioavailability (both in vivo and in vitro) and efficacy varied with the type and variety from 2 mg/100 g to 8 mg/100 g. However, not all the efficacy studies indicated the iron levels in the millets. There were 30 research studies, including 22 human interventions and 8 in vitro studies, included in the meta-analysis which all discussed various outcomes such as hemoglobin level, serum ferritin level, and absorbed iron. The studies included finger millet, pearl millet, teff and sorghum, or a mixture of millets. The results of 19 studies conducted on anaemic individuals showed that there was a significant (p < 0.01) increase in hemoglobin levels by 13.2% following regular consumption (21 days to 4.5 years) of millets either as a meal or drink compared with regular diets where there was only 2.7% increase. Seven studies on adolescents showed increases in hemoglobin levels from 10.8 ± 1.4 (moderate anemia) to 12.2 ± 1.5 g/dl (normal). Two studies conducted on humans demonstrated that consumption of a pearl millet-based meal significantly increased the bioavailable iron (p < 0.01), with the percentage of bioavailability being 7.5 ± 1.6, and provided bioavailable iron of 1 ± 0.4 mg. Four studies conducted on humans showed significant increases in ferritin level (p < 0.05) up to 54.7%. Eight in-vitro studies showed that traditional processing methods such as fermentation and germination can improve bioavailable iron significantly (p < 0.01) by 3.4 and 2.2 times and contributed to 143 and 95% of the physiological requirement of women, respectively. Overall, this study showed that millets can reduce iron deficiency anemia.
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Affiliation(s)
- Seetha Anitha
- Smart Food Initiative, International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), Patancheru, India
| | - Joanna Kane-Potaka
- Smart Food Initiative, International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), Patancheru, India
| | - Rosemary Botha
- Development Strategy and Governance Division, International Food Policy Research Institute (IFPRI), Lilongwe, Malawi
| | - D Ian Givens
- Institute of Food, Nutrition and Health, University of Reading, Reading, United Kingdom
| | | | | | - Mani Vetriventhan
- Smart Food Initiative, International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), Patancheru, India
| | - Takuji W Tsusaka
- Ostrom Center for Advanced Studies on Natural Resources Governance, Asian Institute of Technology, Pathumthani, Thailand
| | | | | | | | - Kowsalya Subramaniam
- Food Science and Nutrition, Avinashilingam Institute for Home Science and Higher Education for Women, Coimbatore, India
| | - Raj Kumar Bhandari
- National Technical Board of Nutrition, Government of India (GoI), New Delhi, India
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