Egg Powder Fortification of Tom Brown Significantly Improves Hemoglobin and Ferritin and Reduces Inflammation Among School-Aged Children in Ghana: A Randomized Controlled Trial
Joe Dare Nyefene, Felix Mills-Robertson, Isaac Amoah, Charles Apprey, Christopher EdehBackground:
Anemia and micronutrient deficiencies remain major public health concerns among children in Ghana. Nutrient-rich food fortification offers a promising strategy to improve iron status and reduce inflammation. This study evaluated the effect of a 24-week egg powder–fortified Tom Brown meal on hemoglobin (Hb), serum ferritin, and C-reactive protein (CRP) levels among school-aged children in the Wa Municipality.
Methods:
A randomized controlled trial was conducted with 136 children aged 5 to 12 years. Children in the intervention group received egg powder–fortified Tom Brown 3 days/week for 24 weeks, while the control group consumed unfortified Tom Brown. The Shapiro–Wilk test (
Results:
After the 24-week intervention, hemoglobin levels increased from 11.81 ± 0.83 to 14.67 ± 0.93 g/dl (P < .001; d = 2.602) in the intervention group, while in the control group, hemoglobin levels increased from 11.43 ± 0.85 to 12.53 ± 0.54 g/dl (P > .051; d = 0.519). Ferritin levels increased from 14.32 ± 2.07 to 18.87 ± 3.82 ng/ml (P < .001; d = 2.640) in the intervention group, compared to an increase from 12.24 ± 2.72 to 15.10 ± 2.11 ng/ml (P > .052; d = 0.699) in the control group. In contrast, CRP levels decreased from 5.87 ± 1.67 to 3.93 ± 0.99 mg/l (P < .001; d = −1.542) in the intervention group, while in the control group, CRP levels decreased from 4.97 ± 1.148 to 3.911 ± 0.93 mg/l (P > .052; d = −0.719).
Conclusion:
The 24-week egg powder–fortified Tom Brown intervention resulted in substantial improvements in hemoglobin and iron stores and a marked reduction in inflammation in school-aged children. The findings revealed that fortifying and integrating affordable, locally acceptable foods into school-based feeding programs can be a high-impact, scalable public health intervention for reducing anemia and micronutrient deficiencies in resource-limited settings.