Effect of a dietary iron education programme on iron status and intelligence quotient score among schoolchildren in Phatthalung province, southern Thailand

Introduction: The aim of the study was to determine the effect of a dietary iron education programme (DIEP) on children’s iron status and intelligence quotient (IQ) score. Methods: This pre-test post-test quasi-experimental study with followup utilised the Health Belief Model (HBM). Participants were children who had iron deficiency (ID) (serum ferritin <30 µg/L), with anaemia (haemoglobin 80.0 – 114.0 g/L) or without, and their caregivers. The DIEP incorporated group talks, presentations, game-based learning, and cooking. Knowledge of ID and dietary iron, caregivers’ perceptions of preventing anaemia and ID in their children, and children’s dietary intake, iron status, and IQ score (based on 60-question items adjusted for age) were determined. Statistical tests (one-way MANOVA, Friedman’s two-way ANOVA by ranks, Wilcoxon signed-rank test, Monte Carlo exact test) determined differences between pre-test, post-test, and follow-up. Results: A total of 32 child-caregiver dyads completed the study; 6.3% (n=2) of children met the Thai dietary reference intake for iron at pre-test versus 28.1% (n=9) at post-test (p=0.039) and 31.3% (n=10) at follow-up (p=0.021). Almost half of the children (n=15) who had ID at pre-test were iron replete at post-test and half (n=16) were iron replete at follow-up (p<0.001). Median IQ scores improved from pre-test to posttest (109.0 vs. 116.0; p=0.010) and were similar at post-test and follow-up (116.0 vs. 117.0; p=0.952). Conclusion: Iron status and IQ score improved following the implementation of DIEP. We recommend that this programme serves as a model for similar interventions in other schools.