Long-Term Effectiveness of Iron Fortified Fish Sauce in Controlling Iron Deficiency Anemia in Vietnam

Background: Iron deficiency anemia (IDA) is the public health problem in Vietnam. One cost-effective strategy for controlling of IDA is the fortification of Fish sauce (FS).

Objective: To investigate the long-term effect of iron fortified FS in iron status of women of reproductive age (WRA).

Design: A double blind intervention for 18 months (T18). The villages in two communes were randomly divided into a Control (Group C-199 subjects) and a Fortified (Group F-189 subject). Families were randomly selected and provided with the FS daily. Group C received unfortified FS and in Group F received fortified with 0.5 mg Fe/ml (7.5 mg additional Fe/day). Iron status was assessed by measuring hemoglobin (Hb), serum ferritin (SF), and transferrin receptor (TfR) in venous blood at baseline (T0), at 18 mo. (T18) of intervention and after stopping the intervention for 18 mo. (T36).

Results: At T0, there were no significant differences between the C and F groups in Hb, SF, TfR, or body iron stores (TfR/SF ratio). There were no significant changes in any of these indicators in the Group C by the time. At T18 prevalence of anemia had reduced (T0=25.5%; T18=8.2%) and IDA (T0=21.4%; T18=5.1%) significantly in Group F, but at T36 the prevalence of anemia (20.4%) and IDA (17.3%) had increased again.

Conclusions: The daily consumption of iron fortified FS significantly improved iron status in WRA, but in order to sustain the effect, it should be regularly and long-term.