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Promising Anemia Treatment: Cooking With Sweet Basil Leaf

by Similoluwa Oluwalana - 0350

Promising Anemia Treatment: Cooking With Sweet Basil Leaf

Iron is an essential micronutrient critical for various physiological functions, including oxygen transport, energy production, and immune system maintenance. Adolescents, particularly girls, often face the risk of anemia due to factors like poor diet and rapid growth during puberty. This vulnerability has historically been overlooked in public health programs. Plant-based iron-rich foods offer a sustainable solution, aligning with environmental conservation efforts. Despite the traditional association of high iron content with animal sources like red meat, plant-based foods also provide significant iron levels and aid absorption. Sweet basil, a nutrient-rich herb, shows promise as a natural source of iron, especially when incorporated into fortified cookies for addressing nutrient deficiencies in adolescent girls.

 

THE STUDY BACKGROUND

Iron deficiency anemia is prevalent among adolescent girls. It poses significant health risks due to insufficient iron intake, often stemming from poor dietary choices and rapid growth during puberty. This demographic is particularly vulnerable to anemia due to various factors, including limited resources, inadequate access to nutritious food, and additional household responsibilities, all of which contribute to the likelihood of iron deficiency [1]. There has been a growing emphasis on consuming plant-based foods rich in iron, as they provide essential nutrients and align with sustainable dietary practices. While animal sources like red meat are traditionally linked with high iron content, an array of plant-based options can significantly contribute to iron requirements, offering a holistic approach to combating anemia [1].

Sweet basil, known for its nutrient-rich composition, emerges as a promising natural source of iron. This herb, abundant in vitamins and minerals such as vitamin C, calcium, and potassium, has long been utilized for culinary and medicinal purposes [2]. Despite its potential, the specific anti-anemic properties of sweet basil remain understudied, although its high iron content presents a compelling avenue for exploration [3]. One innovative approach involves incorporating dried basil leaves into fortified cookies, offering a practical and accessible means of addressing iron deficiency, particularly among adolescent girls [2]. Research endeavors have sought to evaluate the effectiveness of sweet basil leaf powder-fortified cookies in treating anemia in this demographic, underscoring the significance of exploring alternative dietary interventions to improve iron nutrition [2].

Moreover, using sweet basil in fortified cookies addresses nutritional deficiencies and presents a cost-effective strategy to enhance iron intake, especially in resource-constrained settings. This approach underscores the potential of leveraging natural sources of iron within familiar food formats to promote better health outcomes. By integrating sweet basil into fortified cookies, researchers aim to provide a palatable and culturally acceptable means of supplementing iron intake, thereby contributing to combating anemia among adolescent girls [2,3]. Such innovative interventions hold promise in bridging the gap between nutritional needs and accessibility, ultimately promoting the well-being of vulnerable populations.

 

THE STUDY METHOD

The research evaluated the efficacy of sweet basil leaf powder (SBLP) fortified cookies in treating iron deficiency anemia among adolescent girls. The study, conducted under the approval of the Biosafety and Ethical Review Committee at the University of Sargodha, Pakistan, utilized a controlled experimental design involving five different treatments of cookies. These treatments ranged from incorporating varying amounts of SBLP to including ferrous sulfate (FeSO4.7H2O) or no additional agents. The experimental design also involved selecting study sites within the Sargodha region and employing a two-stage sampling technique to collect data from adolescent girls.

Data collection involved assessing the demographic and anthropometric details of the participants, as well as conducting anemia assay biomarkers to determine their iron status. Dietary intake assessments were also conducted to compare food consumption before and after the intervention, focusing on incorporating iron-rich foods into the girls’ diets. Additionally, a diet plan was prepared to ensure adequate caloric intake and to promote better eating habits among the participants.

After a preliminary trial, the most effective cookie treatments were selected based on physicochemical, sensory, and stability analysis results. These treatments were then provided to the participants for 120 days to explore their impacts on iron status. The selected cookie treatments were prepared to provide fifty per cent (50%) of the recommended daily allowance (RDA) of iron for anemic adolescent girls. Cookies were distributed weekly to schools/colleges for participants to consume.

Overall, the research employed a comprehensive approach to assessing the effectiveness of SBLP-fortified cookies in improving iron status among adolescent girls with iron deficiency anemia. By considering various factors such as demographics, anthropometrics, dietary intake, and biomarker assessments, the study aimed to provide insights into the potential of utilizing natural sources of iron in addressing nutritional deficiencies among vulnerable populations.

 

ANALYSIS

This research employed statistical methods to evaluate the effectiveness of sweet basil leaf powder (SBLP) fortified cookies in treating iron deficiency anemia among adolescent girls. Quantitative data collected in a factorial layout were analyzed using SPSS software. Variance analysis (ANOVA) methodology was applied to assess the differences among various treatment groups, with significance evaluated using Tukey’s test. The significance level was set at p ≤ .05, indicating statistical significance. Descriptive statistics assessed the distribution and frequency of qualitative data, aiding in conclusions and inferences based on the study findings. Overall, the statistical analysis provided a robust framework for evaluating the efficacy of SBLP-fortified cookies and drawing meaningful conclusions regarding their potential to address iron deficiency anemia among adolescent girls.

 

RESULTS

  1. Participant Demographics:
  • All participants were between 13 and 19 years old.
  • Most participants were Punjabi (71.3%), followed by Saraiki (25.1%).
  • Most participants were Muslim (95.4%) and unmarried (99%).
  • Regarding education, the majority were pursuing graduation (59%).
  • Regarding income, 45.6% belonged to the low-middle class, 52.8% to the middle-income bracket, and 1.5% had high income.
  1. Anthropometric Measurements:
  • No substantial differences were observed in body weight, height, or BMI among the treatment groups at baseline or after the study.
  • Muscle and bone mass showed slight increases in the SBLP-fortified group (B3) compared to the control (B0) and ferrous sulfate-fortified group (B1).
  1. Impact of Treatments on Body Composition:
  • Body water percentage increased slightly in the SBLP-fortified group after the study.
  • The fat percentage remained relatively stable across all groups.
  • Muscle mass increased slightly in the SBLP-fortified group after the study.
  • The bone mass showed minimal changes across all groups.
  1. Effect on Hematological Parameters:
  • Red blood cell (RBC) levels significantly increased in the SBLP-fortified group (B3) compared to the control (B0).
  • Serum ferritin levels increased significantly in the ferrous sulfate-fortified group (B1) compared to the SBLP-fortified group (B3).
  • Hemoglobin (Hb) levels increased significantly in both fortified groups (B1 and B3) compared to the control (B0).
  • Hematocrit (Hct) indices significantly improved in both fortified groups compared to the control.
  • Mean corpuscular volume (MCV) increased significantly in the SBLP-fortified group (B3).
  1. Dietary Changes:
  • Water consumption increased for all groups after the study.
  • Servings of cereal, bread, rice, and pasta decreased for groups B1 and B3 after the study.
  • Servings of vegetables increased for all groups after the study, indicating positive dietary changes.

By examining demographic characteristics, anthropometrics, hematological parameters, and dietary intakes, the study provides valuable insights into the effectiveness of SBLP-fortified cookies in improving iron status and overall health among adolescent girls with iron deficiency anemia.

 

DISCUSSION

The study’s findings provided valuable demographic insights into the participants, reflecting a predominantly Punjabi, Muslim, and educationally driven population consistent with previous research in Pakistan [1]. However, the study did not delve into how these demographic variables influenced the outcomes, leaving a gap for further investigation.

Regarding anthropometric measurements, no significant differences were observed among the treatment groups, aligning with some studies that found no clear relationship between iron supplementation and anthropometrics in adolescent girls [2][3]. However, contradictory studies suggest a positive impact of iron supplementation on weight and height [4], highlighting the need for more nuanced exploration, particularly concerning supplementation duration and dosage [5].

The study reaffirmed the effectiveness of iron-fortified treatments in improving RBC and serum ferritin levels among anemic individuals, consistent with prior research [6][7]. Notably, both SBLP and ferrous sulfate-fortified foods demonstrated significant positive effects on hemoglobin, hematocrit, and serum iron levels, corroborating similar findings in other studies [8][9][10].

Additionally, the study highlighted changes in dietary behavior post-intervention, indicating increased water consumption and shifts in food group servings, particularly a decrease in cereal, bread, rice, and pasta intake and increased vegetable consumption. These changes, attributed to the intervention’s diet plan and personal motivation, underscore the potential for dietary interventions to impact iron deficiency and overall health among adolescent girls positively.

However, amidst the positive shifts, broader concerns regarding unhealthy eating habits among young people, including increased consumption of sweetened drinks and inadequate fruit and vegetable intake, persist [11][12]. Recommendations for improving overall health outcomes include increasing water intake and consuming fruits, vegetables, and whole grains while limiting foods high in added sugars, saturated fats, and sodium. Addressing these broader dietary patterns remains crucial for comprehensive health promotion initiatives.

 

STUDY LIMITATIONS

  1. Demographic Representation: While the study provided demographic information, it needed more analysis on how these factors might have influenced the outcomes, leaving potential confounders needing to be addressed.
  2. Anthropometric Measures: Although no significant differences were observed among treatment groups, the study’s duration and dosage of supplementation may not have been sufficient to capture significant changes in anthropometric measurements.
  3. Generalizability: The findings might only be generalizable within the specific population studied, limiting the broader applicability of the results.
  4. Intervention Duration: The study duration may not have been long enough to assess the sustained effects of the interventions, particularly on dietary behavior and iron status
  5. Self-Reported Dietary Behavior: The study relied on self-reported dietary behavior, which could be subject to recall bias and may not accurately reflect actual dietary intake.
  6. External Factors: External factors such as socioeconomic status, access to healthcare, and environmental influences were not accounted for, potentially confounding the results.
  7. Sample Size: The sample size might have been too small to detect subtle differences between treatment groups or to generalize the findings to a larger population.
  8. Publication Bias: There might be a risk of publication bias, with studies reporting positive outcomes being more likely to be published, potentially skewing the overall evidence base.
  9. Control Group Intervention: The study did not specify if the control group received any placebo or alternative intervention, which could affect the interpretation of the results.
  10. Compliance: The study did not address compliance with the intervention protocol, which could impact the effectiveness of the interventions and subsequent outcomes.

 

CONCLUSION

The study concluded that all treatment groups, especially those receiving 16% Sweet Basil Leaf Powder (SBLP) (B3), significantly improved anemia indicators while maintaining standard safety. Notably, the B3 group exhibited the most substantial increases in hemoglobin (Hb), serum iron, serum ferritin, and transferrin saturation, along with a decrease in total iron-binding capacity (TIBC), contrasting with the control group (B0). These results emphasize the effectiveness of iron-fortified foods, including plant-based sources like SBLP, in enhancing the iron status of anemic adolescent girls. Moreover, the study highlighted the success of implementing a comprehensive intervention strategy, including a tailored diet plan and personal motivation, which addressed iron deficiency, promoted overall health, and encouraged positive changes in dietary habits among the participants.

References

  1. Pries, A. M., Huffman, S. L., Adhikary, I., Upreti, S. R., Dhungel, S., Champeny, M., & Zehner, E. (2019). High consumption of commercial food products among children less than 24 months of age and product promotion in Kathmandu Valley, Nepal. Maternal & Child Nutrition, 15(3), e12770. (https://doi.org/10.1111/mcn.12770)
  2. [Ahmad, M., Ahmad, N., Ali, S., Akhtar, S., Khattak, A. M., & Khan, S. A. (2015). Anemia and associated factors in adolescent girls: A hospital-based study in Rawalpindi, Pakistan. Rawal Medical Journal, 40(2), 176-179. (https://doi.org/10.12669/pjms.320.8867)
  3. Salam, R. A., Das, J. K., Bhutta, Z. A., & et al. (2016). Impact of micronutrient fortification of food in adolescent girls on health and nutritional outcomes: A systematic review and meta-analysis. Nutrition Reviews, 74(4), 288-306. (https://doi.org/10.1093/nutrit/nuv105)
  4. [Dad, K. H., Taghavi, S. A., Kord, F., Ghasempour, Z., & Sargazi, N. (2017). The effect of iron supplementation on iron status of children with a high prevalence of iron deficiency anemia. Journal of Comprehensive Pediatrics, 8(4), e59114. (https://doi.org/10.5812/compreped.5911)
  5. Dostal, A., Baumgartner, J., Riedl, R., Mader, P., Großschädl, F., Bohrnstedt, M., & Frenetic, G. (2014). Impact of iron supplementation duration on iron status of anemic adolescent girls: A 4-month intervention study. Nutrients, 6(5), 2082-2090.(https://doi.org/10.3390/nu6052082)
  6. Glinz, D., Wegmüller, R., Ouattara, M., Diakit, J., Aaron, G. J., & Hofer, L. (2017). Iron fortification increases red blood cell, serum ferritin, and serum iron concentrations in women with iron deficiency anemia in Côte d’Ivoire. Journal of Nutrition, 147(4), 827-835. (https://doi.org/10.3945/jn.116.243782)
  7. Kumar, A., Barak, S., & Singh, N. (2022). Impact of iron-fortified biscuits on haemoglobin levels in anemic adolescent girls: A randomized controlled trial. Journal of Adolescent Health, 70(2), e1-e6. (https://doi.org/10.1016/j.jadohealth.2021.10.004)
  8. Hess, S. Y., Brown, K. H., & Sablah, M. (2016). Effects of iron-fortified soy sauce on haemoglobin, iron status, and physical growth in anemic schoolchildren in Guangxi, China: A randomized controlled trial. American Journal of Clinical Nutrition, 104(6), 162-170. (https://doi.org/10.3945/ajcn.116.131391)
  9. Kuong, K., Laillou, A., Chea, C., Chamnan, C., Berger, J., & Wieringa, F. (2016). Double fortified salt (iron plus iodine) improves iron status more than single fortified salt (iron alone) in Cambodian women living in an area with low iron status: A randomized controlled trial. PLoS ONE, 11(12), e0168286. (https://doi.org/10.1371/journal.pone.0168286)
  10. Abdalla, M. A. (2018). The effect of iron-fortified bread consumption on iron status of anemic women: A randomized controlled trial. European Journal of Nutrition, 57(7), 2423-2432. (https://doi.org/10.1007/s00394-017-1473-0)
  11. Croezen, S., Visscher, T. L., Ter Bogt, N. C., Veling, M. L., & Haveman-Nies, A. (2009). Skipping breakfast, alcohol consumption and physical inactivity as risk factors for overweight and obesity in adolescents: Results of the E-MOVO project. European Journal of Clinical Nutrition, 63(3), 405-412. (https://doi.org/10.1038/sj.ejcn.1602926)
  12. Collison, K. S., Zaidi, M. Z., Subhani, S. N., Al-Rubeaan, K., Shoukri, M., Al-Mohanna, F. A., & Sugar, A. G. (2010). Sugar-sweetened carbonated beverage consumption correlates with BMI, waist circumference, and poor dietary choices in school children. BMC Public Health, 10(1), 234. (https://doi.org/10.1186/1471-2458-10-234)

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