Abstract

Maternal and child under-nutrition is highly prevalent in the developing world with serious consequences for human health and socio-economic development. The World Heal Organization estimates that nearly 2 billion people are anemic, with the largest burden of disease in women, children and infants. Current prevention and control practices rely on either supplementation with iron pills or large-scale food fortification. The former is an unsustainable means of introducing iron into the diet, and the latter has not yet shown success in many low- and middle-income countries. The Lucky Iron Fish™ is a novel iron supplementation technique: a culturally acceptable, inexpensive and lightweight iron ingot that is produced in the shape of a species of fish, which is considered lucky in Cambodian culture. Laboratory studies demonstrate that theoretically more than 75% of daily iron requirements can be met by consuming just one litre of boiled drinking water when prepared with the iron ingot. Randomized controlled trials demonstrate a nearly two-fold reduction in the prevalence of anemia after 12 consecutive months of use, with near 90% compliance to the treatment regime. This research highlights both the acceptability and effectiveness of a fish-shaped iron ingot as a means of improving dietary iron content. The Lucky Iron Fish™ represents a promising solution to the problem of iron deficiency anemia in resource-poor settings, which has significant, beneficial impacts on the lives of women and their families. Given the serious and irreversible functional consequences of anemia and iron deficiency, it is imperative that the public health nutrition community adopts simple, cost-effective and evidence-based solutions that are accessible to rural and urban populations alike.