1“There is no anaemia in Bolivia.” In the 1990s, this quote from a Unicef report caught the attention of Orstom, who had just completed a research programme on anaemia in Togo. An epidemiological study was launched, showing that 40% to 60% of Bolivians were actually anaemic and suffered from iron deficiency. If their haemoglobin level is high, it is primarily because they live at a high altitude, which introduces a bias in the diagnosis of anaemia.

Preparation of therapeutic food for the treatment of malnutrition, Vietnam.

2A comparative trial was undertaken, whereby Bolivian children were given iron every day or every week, in a pill or in an iron-fortified traditional beverage made from grain. Results suggested that the weekly taking of pills was as effective as their daily intake, which is however the treatment recommended by the WHO to this day. In addition, the fortified beverage had the same impact as the pills. Sold by a local producer, this beverage was not as successful as expected, due to the lack of an information campaign targeting the population.

3In 1998, the team continued their research in Vietnam. Several trials were initiated on infants and pregnant women, with new types of supplement. Results showed that a weekly intake of iron/folic acid started two months prior to conception and maintained during pregnancy had a greater impact, in terms of birth weight, than daily supplementation.

••• From Bolivia to Cambodia, fortified local products are used to combat micronutrient deficiencies •••

4Researchers subsequently tested an iron-fortified nuoc-mâm and demonstrated that its consumption under actual conditions within the population helped eliminate iron deficiency within one year. Building on this result, they created and assessed the impact of food supplements for infants and young children based on local products, first in Vietnam and later in Cambodia, with a fish paste that is, very much appreciated in this country.

Sale of fortified nuoc-mâm, Vietnam.

“Combating micronutrient deficiencies in pregnant women and young children is the only way to put an end to the generational cycle of malnutrition. The work done by IRD and the National Institute of Nutrition in Vietnam showed that it is possible to tackle this issue in a relatively short time, and was used as a model for other Asian countries.” 
Professor Le Danh Tuyen, director of the National Institute of Nutrition, Vietnam