Open Access Subscription Access
Open Access Subscription Access
Can Iron and Folic Acid-IFA and Ca & Vitamin D Supplementation in Pregnancy be Fitted into Habitual Pattern of Three Meals A Day?
In India prevalence of anaemia and vitamin D deficiency in pregnancy are widespread. National programmes recommend that two tablets of iron and folic acid (IFA) and two tablets of calcium and vitamin D (Ca & Vit D) to be given every day from second trimester till delivery. To minimize the side effects and increase compliance, it is advised that each tablet should be taken after a meal. Most households follow a three meal pattern. A study was taken up to find out how IFA and Ca & Vit D supplementations can be fitted into the habitual three meal pattern. A short term crossover supplementation study was carried out on 38 pregnant women to assess side effects following consumption after lunch of one or two tablets containing 500mg elemental calcium (as calcium carbonate) and 250 IU vitamin D or 60 mg of elemental iron as ferrous sulphate. Prevalence of side effects was higher in women who received iron supplements as compared to Ca & Vit D supplements. Taking two tablets of Ca & Vit D together after meal was associated with significantly higher prevalence of side effects as compared to taking one tablet after meal. Taking two tablets of iron together after meal was not associated with any significant increase in prevalence of side effects as compared to one tablet. Giving two tablets of iron together after one meal and giving one tablet of calcium and vitamin after two meals is feasible option for providing two tablets each of iron and Ca & Vit D to pregnant women who habitually follow a three meal pattern.
Iron Folic Acid Supplementation, Calcium and Vitamin D Supplementation, Pregnancy, Side Effects Following Supplementation.
- World Health Organization (2015). The global prevalence of anaemia in 2011. Available from: http://www.who.int/nutrition/publications/micronutrients/global_prevalence_anaemia_2011/en/, accessed on October 10, 2018.
- Menon, M.K.K. Observations on anaemia in pregnancy. Proceeding of Nutrition Society of India, Vol. II. Hyderabad: National Institute of Nutrition; 1968, 1-18.
- Ministry of Health and Family Welfare (MOHFW). Prophylaxis against nutritional anaemia among mothers and children. Technical Information, MCH No. 1. New Delhi: Government of India; 1970.
- MoHFW (1989) Report of the meeting on Prevention and control of nutritional anaemias Government of India and UNICEF New Delhi.
- MoHFW (2013). Guidelines for Control of Iron Deficiency Anaemia. Available from: http://www.pbnrhm.org/docs/iron_plus_guidelines.pdf, accessed on September 23, 2017.
- Kalaivani, K. and Ramachandran, P. Time trends in prevalence of anaemia in pregnancy. The Ind. J. Med. Res., 2018, 147, 268-277.
- MoHFW (2018). Anemia Mukt Bharat. Intensified National Iron Plus Initiative (I-NIPI): Operational Guidelines for Programme Managers. April, 2018.
- Sachan, A., Gupta, R., Das, V., Agarwal, A., Awasthi, P. K. and Bhatia, V. High prevalence of vitamin D deficiency among pregnant women and their new-borns in northern India. The Am. J. Clin. Nutr., 2005, 81, 1060-1064.
- Balasubramanian, S. and Ganesh, R. Vitamin D deficiency in exclusively breast-fed infants. Ind. J. Med. Res., 2008, 127, 250-255.
- Jain, V., Gupta, N., Kalaivani, M., Jain, A., Sinha, A. and Agarwal, R. Vitamin D deficiency in healthy breastfed term infants at 3 months and their mothers in India: seasonal variation and determinants. The Ind. J. Med. Res., 2011, 133, 267-273.
- Harinarayan, C.V. Vitamin D deficiency in sun drenched India–Can D-lightful sunlight be a respite?- Sunlight D lemma. Proceedings of the Indian National Science Academy, 2018, 84, 923-935.
- MOHFW (2014) National Guidelines for calcium supplementation during pregnancy and lactation. http://www.nrhmhp.gov.in/sites/default/files/files/NG_calcium.pdf Accessed on 21.07.2019.
- ICMR (1989) Report of the evaluation of national anaemia prophylaxis programme -ICMR task force study, ICMR New Delhi.
- Koenig, M., Tussing-Humphreys, L., Day, J., Cadwell, B. and Nemeth, E. Hepcidin and iron homeostasis during pregnancy. Nutr., 2014, 6, 3062-3083.
- Moretti, D., Goede, J.S., Zeder, C., Jiskra, M., Chatzinakou, V., Tjalsma, H. and Zimmermann, M. B. Oral iron supplements increase hepcidin and decrease iron absorption from daily or twice-daily doses in iron-depleted young women. Blood, 2015, 126, 1981-1989.
- Stoffel, N.U., Cercamondi, C.I., Brittenham, G., Zeder, C., Geurts-Moespot, A.J., Swinkels, D.W., Moretti, D. and Zimmermann, M.B. Iron absorption from oral iron supplements given on consecutive versus alternate days and as single morning doses versus twice-daily split dosing in iron-depleted women: two open-label, randomised controlled trials. The Lancet Haematol., 2017, 4, e524-e533.
Abstract Views: 70
PDF Views: 1