Abstract:
Background: Childhood anemia affects more than 40% of under-five children in Ethiopia, where iron supplementation has achieved limited success and locally grounded, sustainable strategies are needed. Red teff (Eragrostis tef) is an iron-rich, gluten-free staple crop. We evaluated whether a red teff porridge improves hemoglobin in anemic children and quantified its cost and over animal-source iron foods.
Methods: In a self-controlled pre–post feeding trial in East Gojjam Zone, Ethiopia, anemic children received home-prepared red teff porridge providing about 77 mg iron per day for 60 days. The primary outcome, the change in hemoglobin, was analyzed with covariate-adjusted models (n = 32 after excluding one implausible value), with covariates selected by cross-validated LASSO. The cost, protein content and Greenhouse-Gas Emissions (GHGE) of red teff were compared with beef, lamb and egg per milligram of absorbed iron and per gram of protein, with substitution and sensitivity analyses.
Results: Hemoglobin increased by 2.65 g/dL (95% CI 1.94, 3.37; p < 0.001), an effect robust to adjustment for measured covariates (child age, sex, study site and dietary diversity). To deliver one milligram of absorbed iron, red teff cost and emitted two to three orders of magnitude less than beef, lamb or egg, and was also the cheapest and lowest-emitting source per gram of protein; replacing 1 kg of red meat with teff avoided 38–97 kg CO2-equivalent. The advantage held across all sensitivity analyses.
Conclusions: Red teff porridge significantly improved hemoglobin and supplies iron and protein at a small fraction of the cost and carbon of animal-source foods, supporting it as a low-cost, low-carbon and locally acceptable strategy against childhood anemia.
Keywords: Anemia, Red teff, Hemoglobin. Environmental Health
