Cognitive Performance in Indian School-Going Adolescents Is Positively Affected by Consumption of Iron-Biofortified Pearl Millet: A 6-Month Randomized Controlled Efficacy Trial
Open accessAbstract
Background Iron deficiency remains the most prevalent micronutrient deficiency globally, but few studies have examined how iron status relates to cognition in adolescents. Iron biofortification of staple food crops is being scaled up, yet it is unknown whether consuming biofortified crops can benefit cognition.Objective Our objective was to determine the efficacy of iron-biofortified pearl millet in improving attention and memory in Indian school-going adolescents.Methods A double-blind, randomized, intervention study was conducted in 140 Indian boys and girls, aged 12-16 y, who were assigned to consume iron-biofortified [Fe = 86 parts per million (ppm)] or conventional (Fe = 21-52 ppm) pearl millet. Hemoglobin, ferritin, and transferrin receptor (TfR) were measured and body iron (BI) was calculated at baseline and after 4 and 6 mo. Five measures of cognitive function were obtained at baseline and 6 mo: simple reaction time (SRT), Go/No-Go (GNG) task, Attentional Network Task (ANT), Composite Face Effect (CFE) task, and Cued Recognition Task (CRT). Intention-to-treat analysis was used.Results Daily iron intake from pearl millet was higher in those consuming biofortified compared with conventional pearl millet (19.6 compared with 4.8 mg/d). Effects on ferritin, TfR, and BI at 4 mo, and on TfR at 6 mo (all P < 0.05), indicated efficacy of biofortified pearl millet over conventional pearl millet in improving iron status. Compared with conventional pearl millet, the consumption of biofortified pearl millet resulted in greater improvement in attention (SRT, GNG, and ANT) and memory (CFE and CRT). Reaction time decreased twice as much from 0 to 6 mo in those consuming biofortified compared with conventional pearl millet on attention tasks (SRT: -123 compared with -63 ms; GNG: -67 compared with -30 ms; ANT double cue: -74 compared with -32 ms; all P < 0.01).Conclusion Consuming iron-biofortified pearl millet improves iron status and some measures of cognitive performance in Indian adolescents. This trial was registered at http://www.clinicaltrials.gov as NCT02152150.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In 140 Indian adolescents aged 12-16 years who consumed for 6 months a biofortified iron-rich millet compared with conventional millet, attention and memory performance increased significantly, and ferritin level increased vs placebo (30 vs 22 μg/L).
“attention and memory performance increased significantly in 140 Indian adolescents aged 12–16 years who consumed for 6 months a biofortified iron-rich millet compared with conventional millet, which increased their ferritin level vs. placebo (30 vs. 22 µg/L) [206].”
From Vitamins and Minerals for Energy, Fatigue and Cognition: A Narrative Review of the Biochemical and Clinical Evidence (2020) · cites this paper as [206]
Cites
Testing the efficiency and independence of attentional networks
Fan, J., McCandliss, B. D., Sommer, T., Raz, A., & Posner, M. I. (2002) · Journal of Cognitive Neuroscience · doi:10.1162/089892902317361886 · Cited by 3,717 · see citing works
DMDX: A Windows display program with millisecond accuracy
Forster, K. I., & Forster, J. C. (2003) · Behavior Research Methods, Instruments, & Computers · doi:10.3758/bf03195503 · Cited by 2,775 · see citing works
A systematic analysis of global anemia burden from 1990 to 2010.
Kassebaum, N., Jasrasaria, R., Naghavi, M., Wulf, S., Johns, N., Lozano, R., Regan, M., Weatherall, D., Chou, D. P., Eisele, T., et al. (2014) · Blood · doi:10.1182/blood-2013-06-508325 · Cited by 2,019 · see citing works
Biofortification: A New Tool to Reduce Micronutrient Malnutrition
Bouis, H. E., Hotz, C. S., McClafferty, B., Meenakshi, J. V., & Pfeiffer, W. (2011) · Food and Nutrition Bulletin · doi:10.1177/15648265110321s105 · Cited by 934 · see citing works
The quantitative assessment of body iron
Cook, J. D., Flowers, C. H., & Skikne, B. (2003) · Blood · doi:10.1182/blood-2002-10-3071 · Cited by 771 · see citing works
The Influence of Exercise on Cognitive Abilities
Gómez‐Pinilla, F., & Hillman, C. H. (2012) · Comprehensive physiology · doi:10.1002/cphy.c110063 · Cited by 683 · see citing works
Bruner, A. B., Joffe, A., DUGGAN, A. K., Casella, J. F., & Brandt, J. (1996) · The Lancet · doi:10.1016/s0140-6736(96)02341-0 · Cited by 632 · see citing works
Global Burden of Disease Pediatrics Collaboration, Kyu, H. H., Pinho, C., Wagner, J. A., Brown, J. C., Bertozzi-Villa, A., Charlson, F. J., Coffeng, L. E., Dandona, L., Erskine, H. E., et al. (2016) · JAMA Pediatrics · doi:10.1001/jamapediatrics.2015.4276 · Cited by 618 · see citing works
Petry, N., Olofin, I. O., Hurrell, R. F., Boy, E., Wirth, J. P., Moursi, M., Angel, M. D., & Rohner, F. (2016) · Nutrients · doi:10.3390/nu8110693 · Cited by 497 · see citing works
Self-citationEriksen, C. W. (1995) · Visual Cognition · doi:10.1080/13506289508401726 · Cited by 412 · see citing works
Iron treatment normalizes cognitive functioning in young women
Murray-Kolb, L. E., & Beard, J. L. (2007) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/85.3.778 · Cited by 373 · see citing works
Iron and mechanisms of emotional behavior
Kim, J., & Wessling‐Resnick, M. (2014) · The Journal of Nutritional Biochemistry · doi:10.1016/j.jnutbio.2014.07.003 · Cited by 314 · see citing works
Falkingham, M., Abdelhamid, A. S., Curtis, P. J., Fairweather‐Tait, S. J., Dye, L., & Hooper, L. (2010) · Nutrition Journal · doi:10.1186/1475-2891-9-4 · Cited by 282 · see citing works
Sheehan, P. J., Sweeny, K., Rasmussen, B., Wils, A., Friedman, H. S., Mahon, J., Patton, G. C., Sawyer, S. M., Howard, E. J., Symons, J., et al. (2017) · The Lancet · doi:10.1016/s0140-6736(17)30872-3 · Cited by 256 · see citing works
Changes in the adolescent brain and the pathophysiology of psychotic disorders
Keshavan, M. S., Giedd, J. N., Lau, J. Y. F., Lewis, D. A., & Paus, T. (2014) · The Lancet Psychiatry · doi:10.1016/s2215-0366(14)00081-9 · Cited by 247 · see citing works
Putative biological mechanisms of the effect of iron deficiency on brain biochemistry and behavior
Youdim, M. B. H., Ben‐Shachar, D., & Yehuda, S. (1989) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/50.3.607 · Cited by 238 · see citing works
Haas, J. D., Luna, S., Lung’aho, M., Wenger, M. J., Murray‐Kolb, L. E., Beebe, S., Gahutu, J. B., & Egli, I. M. (2016) · Journal of Nutrition · doi:10.3945/jn.115.224741 · Cited by 223 · see citing works
Self-citationWISC-IV Clinical Use and Interpretation : Scientist-Practitioner Perspectives
Prifetera, A., & Saklofske, D. (2004) · Cited by 213 · see citing works
A Randomized Trial of Iron-Biofortified Pearl Millet in School Children in India ,
Finkelstein, J. L., Mehta, S., Udipi, S. A., Ghugre, P. S., Luna, S., Wenger, M. J., Murray‐Kolb, L. E., Przybyszewski, E. M., & Haas, J. D. (2015) · Journal of Nutrition · doi:10.3945/jn.114.208009 · Cited by 184 · see citing works
Self-citationIron deficiency and child and maternal health
Murray‐Kolb, L. E., & Beard, J. L. (2009) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.2008.26692d · Cited by 176 · see citing works
Self-citationInterventions to Improve Adolescent Nutrition: A Systematic Review and Meta-Analysis
Salam, R. A., Hooda, M., Das, J. K., Arshad, A., Lassi, Z. S., Middleton, P., & Bhutta, Z. A. (2016) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2016.06.022 · Cited by 176 · see citing works
Pasricha, S.-R., Low, M., Thompson, J., Farrell, A., & De-Regil, L.-M. (2014) · The Journal of Nutrition · doi:10.3945/jn.113.189589 · Cited by 158 · see citing works
Vasconcelos, M. W., Gruissem, W., & Bhullar, N. K. (2016) · Current Opinion in Biotechnology · doi:10.1016/j.copbio.2016.10.001 · Cited by 135 · see citing works
Determination of Zinc Status in Humans: Which Indicator Should We Use?
Wieringa, F. T., Dijkhuizen, M. A., Fiorentino, M., et al. (2015) · Nutrients · doi:10.3390/nu7053252 · Cited by 126 · see citing works
Murray‐Kolb, L. E., Wenger, M. J., Scott, S., Rhoten, S. E., Lung’aho, M., & Haas, J. D. (2017) · Journal of Nutrition · doi:10.3945/jn.117.255356 · Cited by 84 · see citing works
Self-citationMurray‐Kolb, L. E. (2013) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/mco.0b013e3283653ef8 · Cited by 64 · see citing works
Self-citationAhankari, A. S., Myles, P. R., Fogarty, A., et al. (2016) · Public Health · doi:10.1016/j.puhe.2016.07.010 · Cited by 63 · see citing works
Bouhouch, R., El-Fadeli, S., Andersson, M., Aboussad, A., Chabaa, L., Zeder, C., Kippler, M. J., Baumgartner, J., Sedki, A., & Zimmermann, M. B. (2016) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.115.129346 · Cited by 44 · see citing works
Intrusive effects of semantic information on visual selective attention
Malcolm, G. L., Rattinger, M., & Shomstein, S. (2016) · Attention Perception & Psychophysics · doi:10.3758/s13414-016-1156-x · Cited by 38 · see citing works
Scott, S., Souza, M. J. D., Koehler, K., & Murray‐Kolb, L. E. (2016) · Journal of Nutrition · doi:10.3945/jn.116.240192 · Cited by 34 · see citing works
Self-citationWenger, M. J., Murray‐Kolb, L. E., Nevins, J. E. H., Venkatramanan, S., Reinhart, G. A., Wesley, A. S., & Haas, J. D. (2017) · Journal of Nutrition · doi:10.3945/jn.117.251587 · Cited by 33 · see citing works
Self-citationWenger, M. J., Negash, S., Petersen, R. C., & Petersen, L. (2009) · Journal of Mathematical Psychology · doi:10.1016/j.jmp.2009.04.012 · Cited by 32 · see citing works
Self-citationKashyap, P., & Gopaldas, T. (1987) · Nutrition Research · doi:10.1016/s0271-5317(87)80037-4 · Cited by 23 · see citing works
Lambert, A. J., Knaggs, K., Scragg, R. K. R., Metcalf, P., & Schaaf, D. (2002) · ResearchSpace (University of Auckland) · Cited by 13 · see citing works
Rahman, M. T. (2011) · Springer eBooks · doi:10.1007/978-0-387-92271-3_149 · Cited by 1 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Tardy, A.-L., Pouteau, E., Marquez, D., Yilmaz, C., & Scholey, A. (2020) · Nutrients · doi:10.3390/nu12010228 · Cited by 541 · see citing works
- Authors
- Scott, S. P., Murray-Kolb, L. E., Wenger, M. J., Udipi, S. A., Ghugre, P. S., Boy, E., & Haas, J. D.
- Affiliations
- Pennsylvania State University (US)
- Cornell University (US)
- Shreemati Nathibai Damodar Thackersey Women's University (IN)
- International Food Policy Research Institute (US)
- Venue
- The Journal of Nutrition
- Publisher
- Elsevier BV
- Published
- 2018-09
- Volume
- 148
- Issue
- 9
- Pages
- 1462-1471
- ISSN
- 0022-3166 (ISSN-L)
- OpenAlex
- W2884063131
- Cited by
- 103
- References
- 35
- Citations by year
- 2026: 8 · 2025: 9 · 2024: 16 · 2023: 18 · 2022: 24 · 2021: 15 · 2020: 9 · 2019: 4
- FWCI
- 5.02
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Nutrition (publishedVersion)
- PubMed (publishedVersion)
- IFPRI E-brary (International Food Policy Research Institute) (submittedVersion)
- CGSPace A Repository of Agricultural Research Outputs (Consultative Group for International Agricultural Research) (submittedVersion)
- International Food Policy Research Institute (International Food Policy Research Institute) (submittedVersion)
- Funders
- HarvestPlus/International Food Policy Research Institute
- Consultative Group on International Agricultural Research/Agriculture for Nutrition and Health (2011H8247.COR, 2011H8212.PSU, 2011H8249.SNDT, 2012H8276.UO)
- Topics
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Life Sciences › Agricultural and Biological Sciences › Plant Science › Plant Micronutrient Interactions and Effects
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Keywords
- iron biofortification, pearl millet, iron deficiency, cognitive performance, attention, memory, adolescents, iron status, ferritin, transferrin receptor, body iron, reaction time, go/no-go task, staple crops, India, school-going children, micronutrient deficiency
- MeSH terms
- Iron Deficiencies, Adolescent, Attention, Child, Cognition, Double-Blind Method, Female, Ferritins, Food, Fortified, Hemoglobins, Humans, India, Iron, Male, Memory, Nutritional Status, Receptors, Transferrin, Students, Anemia, Iron-Deficiency, Pennisetum
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
