Physical work capacity of young underprivileged school girls: Impact of daily vs intermittent iron-folic acid supplementation – A randomized controlled trial.

Objectives: To assess impact of daily and intermittent iron-folate (IFA) supplementation on physical work capacity of underprivileged schoolgirls in Vadodara. Design: Randomized controlled trial. Setting: Municipal Primary schools. Participants: Schoolgirls (n=163) in the age group of 9-13 years. Intervention: Three randomly selected schools were given IFA tablets (100 mg elemental iron + 0.5 mg folic acid) either once weekly or twice weekly or daily for one year. The fourth was the control school. Outcome Measures: Hemoglobin, modified Harvard's Step test for physical work capacity. Results: All three IFA supplemented groups showed significant improvement in number of steps climbed and recovery time compared to controls; with impact being relatively better in girls with higher Hb gain (>1 g/dL) vs. lower Hb gain. Similarly, higher the frequency of dosing better was the impact- it being the best in daily IFA group. Twice weekly IFA was as good as daily IFA under conditions of good compliance. Conclusion: Twice weekly IFA supplementation is comparable to daily IFA in terms of beneficial effects on physical work capacity in young girls.

Deleterious functional impact of anemia on young adolescent school girls.

Iron deficiency anemia during adolescence may reduce physical work capacity and cognitive function. OBJECTIVES: To assess the physical work capacity and cognition of underprivileged anemic schoolgirls in Vadodara in early adolescence as compared to their non-anemic counterparts. DESIGN: Prior to initiating anemia control interventions, schoolgirls in early adolescence were studied with regard to their hemoglobin status, physical work capacity and cognitive functions. SETTING: Schoolgirls from four municipal primary schools in the age of 9 - 14 years were studied. METHODS: In four Primary Municipal schools, hemoglobin of subjects was assessed using standard methods; physical work capacity using Modified Harvards Step test and cognitive functions using selected tests from the modified Wechsler Intelligence Scale for Children (WISC), suitably adapted for this group (n = 230). RESULTS: The mean hemoglobin was 11.32 g/dL, and anemia prevalence: 67%. A higher number of steps were climbed and a shorter time was taken to revert to the basal pulse rate (recovery time) by non-anemic girls compared to anemic girls (P < 0.001). Significantly lower scores in digit span and visual memory test were seen in anemic compared to non-anemic girls. The adverse impact of anemia remained after controlling for undernutrition (BMI). CONCLUSION: Anemia is likely to adversely affect physical work capacity and cognition in young adolescent girls undergoing pubertal development. Further research should be conducted in both school and community based settings to cover non-school going children.