Millets Can Have a Major Impact on Improving Iron Status, Hemoglobin Level, and in Reducing Iron Deficiency Anemia–A Systematic Review and Meta-Analysis

Anitha, S and Kane-Potaka, J and Botha, R and Givens, D. I and Sulaiman, N L B and Upadhyay, S and Vetriventhan, M and Tsusaka, T W. and Parasannanavar, D J. and Longvah, T and Rajendran, A and Subramaniam, K and Bhandari, R K (2021) Millets Can Have a Major Impact on Improving Iron Status, Hemoglobin Level, and in Reducing Iron Deficiency Anemia–A Systematic Review and Meta-Analysis. Frontiers in Nutrition (TSI), 8 (725529). ISSN 2296-861X

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The prevalence of iron deficiency anemia is highest among low and middle-income countries. Millets, including sorghum, are a traditional staple in many of these countries and are known to be rich in iron. However, a wide variation in the iron composition of millets has been reported, which needs to be understood in consonance with its bioavailability and roles in reducing anemia. This systematic review and meta-analysis were carried out to analyze the scientific evidence on the bioavailability of iron in different types of millets, processing, and the impact of millet-based food on iron status and anemia. The results indicated that iron levels in the millets used to study iron bioavailability (both in vivo and in vitro) and efficacy varied with the type and variety from 2 mg/100 g to 8 mg/100 g. However, not all the efficacy studies indicated the iron levels in the millets. There were 30 research studies, including 22 human interventions and 8 in vitro studies, included in the meta-analysis which all discussed various outcomes such as hemoglobin level, serum ferritin level, and absorbed iron. The studies included finger millet, pearl millet, teff and sorghum, or a mixture of millets. The results of 19 studies conducted on anaemic individuals showed that there was a significant (p < 0.01) increase in hemoglobin levels by 13.2% following regular consumption (21 days to 4.5 years) of millets either as a meal or drink compared with regular diets where there was only 2.7% increase. Seven studies on adolescents showed increases in hemoglobin levels from 10.8 ± 1.4 (moderate anemia) to 12.2 ± 1.5 g/dl (normal). Two studies conducted on humans demonstrated that consumption of a pearl millet-based meal significantly increased the bioavailable iron (p < 0.01), with the percentage of bioavailability being 7.5± 1.6, and provided bioavailable iron of 1 ± 0.4 mg. Four studies conducted on humans showed significant increases in ferritin level (p < 0.05) up to 54.7%. Eight in-vitro studies showed that traditional processing methods such as fermentation and germination can improve bioavailable iron significantly (p < 0.01) by 3.4 and 2.2 times and contributed to 143 and 95% of the physiological requirement of women, respectively. Overall, this study showed that millets can reduce iron deficiency anemia.

Item Type: Article
Divisions: Strategic Marketing and Communication
Uncontrolled Keywords: Iron status, hemoglobin level, millets, sorghum, meta-analysis
Subjects: Others > Smart Foods
Mandate crops > Millets
Depositing User: Mr Ramesh MNR
Date Deposited: 15 Jun 2022 08:17
Last Modified: 12 Jul 2022 13:15
Official URL:
Funders: This research was supported financially by the Smart Food endowment fund.
Acknowledgement: The authors acknowledge Joycelyn M. Boiteau, Division of Nutritional Sciences, Cornell University, Tata-Cornell Institute for Agriculture and Nutrition, the United States for reviewing the case and her valuable inputs that contributed significantly to the quality of the study. Thanks are also due to Dr Colin I Cercamondi, Dr Julia Finkelstein, Dr Jere Haas (Project Investigator of the pearl millet trial) and Mr Amy Fothergill (doctoral student at Cornell University), who provided the data from their studies to support the meta-analysis of iron absorption and hemoglobin levels. Dr Waswa Judith confirmed the usage of finger millet in her study, which is highly appreciated. The authors acknowledge Ms Sitaraman Smitha, ICRISAT, for editing the manuscript.
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