Testing the efficacy of the Lucky Iron Fish® in reversing iron deficiency anemia in rural, impoverished regions of Guatemala

Abstract

# Background According to the World Health Organization (WHO), the most common nutrient-related cause of anemia is a lack of dietary iron (iron deficiency anemia, IDA). In regions of the world where populations are at greatest risk for IDA, barriers make screening and subsequent treatment challenging. Thus, IDA remains one of the most common, yet treatable, nutrition-related health problems in developing countries. A new approach to IDA remediation, called Lucky Iron Fish^®^ (LIF) (Lucky Iron Fish, Guelph, Canada), overcomes many of these challenges. When placed into a pot of boiling, acidified water for 10 minutes, the LIF releases iron into the cooking water. Subsequently, the food absorbs the iron from the iron-enriched water, increasing the overall iron content of the meal. The purpose of this 52-week longitudinal study, conducted in rural, underserved regions of Guatemala, was to determine whether or not iron status improved after 12 months of using a LIF for meal preparation. # Methods Of the 302 people screened for IDA, 145 (48.0%) met the WHO standards for IDA. Heads of households were instructed how to prepare meals using a LIF. Subjects were asked to consume at least one meal/d prepared with a LIF and to return 1 year later to have their iron status retested. # Results A total of 56 (38.6%) subjects returned after 52 weeks to have their iron status retested. A paired t test showed that mean differences in both hematocrit and hemoglobin values were significantly higher at week 52 (*P*\<0.001 for both) compared to baseline. A total of 45 (80.3%) subjects were no longer anemic at week 52, with a mean difference (follow-up being higher than baseline) in hemoglobin of 1.28 (19.6% improvement) and a mean difference in hematocrit of 3.8 (28.5% improvement). # Conclusions The results of this study suggests that regular use of a LIF for meal preparation offers a safe and effective means to reverse IDA in high risk populations that lack the access and financial resources to purchase iron-rich foods or dietary supplements.