Lucky iron fish are fish-shaped

cast iron Cast iron is a class of iron– carbon alloys with a carbon content more than 2%. Its usefulness derives from its relatively low melting temperature. The alloy constituents affect its color when fractured: white cast iron has carbide impur ...

ingots used to provide dietary supplementation of

iron Iron () is a chemical element with Symbol (chemistry), symbol Fe (from la, Wikt:ferrum, ferrum) and atomic number 26. It is a metal that belongs to the first transition series and group 8 element, group 8 of the periodic table. It is, Abundanc ...

to individuals affected by iron-deficiency anaemia. The ingots are placed in a pot of boiling water to leach elemental iron into the water and food. They were developed in 2008 by Canadian health workers in

Cambodia Cambodia (; also Kampuchea ; km, កម្ពុជា, UNGEGN: ), officially the Kingdom of Cambodia, is a country located in the southern portion of the Indochinese Peninsula in Southeast Asia, spanning an area of , bordered by Thailan ...

, and in 2012 a company, The Lucky Iron Fish Project, was formed to develop the iron fish on a larger scale, promote them among rural areas, and distribute them to

non-governmental organization A non-governmental organization (NGO) or non-governmental organisation (see American and British English spelling differences#-ise, -ize (-isation, -ization), spelling differences) is an organization that generally is formed independent from g ...

partners. Research published in 2017 found that the iron ingot had no effect on

Anemia Anemia or anaemia (British English) is a blood disorder in which the blood has a reduced ability to carry oxygen due to a lower than normal number of red blood cells, or a reduction in the amount of hemoglobin. When anemia comes on slowly, t ...

caused by factors other than iron deficiency. It was therefore not recommended for use in Cambodia and other countries where the majority of anaemia is not due to iron deficiency and the prevalence of genetic

hemoglobin Hemoglobin (haemoglobin BrE) (from the Greek word αἷμα, ''haîma'' 'blood' + Latin ''globus'' 'ball, sphere' + ''-in'') (), abbreviated Hb or Hgb, is the iron-containing oxygen-transport metalloprotein present in red blood cells (erythrocyt ...

disorders is high.

Motivation

About 60% of pregnant

Cambodian Cambodian usually refers to: * Something of, from, or related to the country of Cambodia ** Cambodian people (or Khmer people) ** Cambodian language (or Khmer language) ** For citizens and nationals of Cambodia, see Demographics of Cambodia ** Fo ...

women are (as of 2010)

anemic Anemia or anaemia (British English) is a blood disorder in which the blood has a reduced ability to carry oxygen due to a lower than normal number of red blood cells, or a reduction in the amount of hemoglobin. When anemia comes on slowly, th ...

as a result of dietary

iron deficiency Iron deficiency, or sideropenia, is the state in which a body lacks enough iron to supply its needs. Iron is present in all cells in the human body and has several vital functions, such as carrying oxygen to the tissues from the lungs as a key ...

, resulting in

premature labour Preterm birth, also known as premature birth, is the birth of a baby at fewer than 37 weeks gestational age, as opposed to full-term delivery at approximately 40 weeks. Extreme preterm is less than 28 weeks, very early preterm birth is between ...

and childbirth hemorrhaging. Babies have an increased incidence of brain development problems. Iron deficiency is the "most widespread nutritional disorder" in Cambodia, affecting 44% of the population and resulting in a GDP loss of about $70 billion annually.

Cast-iron cookware Heavy-duty cookware made of cast iron is valued for its heat retention, durability, ability to maintain high temperatures for longer time duration, and non-stick cooking when properly seasoned. Seasoning is also used to protect bare cast iron fr ...

is known to transmit iron to food through cooking, but the cost to obtain it is prohibitive for individuals living in poverty in rural Cambodia.

Development

University of Guelph , mottoeng = "to learn the reasons of realities" , established = May 8, 1964 ()As constituents: OAC: (1874) Macdonald Institute: (1903) OVC: (1922) , type = Public university , chancellor ...

student Christopher Charles received a grant to conduct epidemiological health research in

from the

Canadian International Development Agency The Canadian International Development Agency (CIDA) was a federal Canadian organization that administered foreign aid programs in developing countries. The agency was merged into the Department of Foreign Affairs in 2013 by the federal governmen ...

(CIDA) after completing an undergraduate degree in biomedical science. The research group distributed an iron disc to women in the village, asking them to place the disc in their pot while making soup or boiling water. The women were reluctant to use the chunk of iron while cooking, and "almost no one used it". Charles stated that it was a "challenge in social marketing". Several weeks before returning to Canada to start his Master's program, Charles called his

doctoral advisor A doctoral advisor (also dissertation director, dissertation advisor; or doctoral supervisor) is a member of a university faculty whose role is to guide graduate students who are candidates for a doctorate, helping them select coursework, as well ...

Alastair Summerlee Alastair J. S. Summerlee was the Interim President and Vice-Chancellor of Carleton University located in Ottawa, Ontario, Canada. He was previously the seventh president of the University of Guelph. President Summerlee, whose career as a schola ...

to postpone his hormone research project. Summerlee told him to focus his research on preventing iron deficiency anemia, which eventually "spiralled into a PhD project". Charles and others distributed iron ingots in the shape of a

lotus flower ''Nelumbo nucifera'', also known as sacred lotus, Laxmi lotus, Indian lotus, or simply lotus, is one of two extant species of aquatic plant in the family Nelumbonaceae. It is sometimes colloquially called a water lily, though this more often re ...

, but that was also rejected by the villagers. During discussions with village elders, Charles learned about a fish species deemed a symbol of good luck, health, and happiness in local folklore. The group created fish-shaped iron ingots, which were received more positively by the villagers and led to immediate increases in blood iron levels amongst the villagers. Charles would later state that "You can have the best treatment in the world, but if people won’t use it, it won't matter."

Evaluation

A trial conducted from September 2008 to February 2009 increased blood iron levels in individuals for at least three months, but continued use was found to have negligible long-term effects on blood iron levels. The research spanned the late

monsoon A monsoon () is traditionally a seasonal reversing wind accompanied by corresponding changes in precipitation but is now used to describe seasonal changes in atmospheric circulation and precipitation associated with annual latitudinal osci ...

season and a dry season that began in December. The villagers relied on harvested monsoon water during the former period, and

tube well A tube well is a type of water well in which a long, -wide, stainless steel tube or pipe is bored underground. The lower end is fitted with a strainer, and a pump lifts water for irrigation. The required depth of the well depends on the dep ...

water during the latter. In the study area, tube well water has high concentrations of

arsenic Arsenic is a chemical element with the symbol As and atomic number 33. Arsenic occurs in many minerals, usually in combination with sulfur and metals, but also as a pure elemental crystal. Arsenic is a metalloid. It has various allotropes, ...

and

manganese Manganese is a chemical element with the symbol Mn and atomic number 25. It is a hard, brittle, silvery metal, often found in minerals in combination with iron. Manganese is a transition metal with a multifaceted array of industrial alloy use ...

ions, which act as complexing agents in the presence of iron. This may have resulted in the sequestration of the iron released by the ingot as well as that normally available from the food. The researchers interpreted the difference in

water quality Water quality refers to the chemical, physical, and biological characteristics of water based on the standards of its usage. It is most frequently used by reference to a set of standards against which compliance, generally achieved through tr ...

as a confounding variable, and conducted a second study to control for it. Research on iron-arsenic chemistry in the local aquifer sands shows that

ferric In chemistry, iron(III) refers to the element iron in its +3 oxidation state. In ionic compounds (salts), such an atom may occur as a separate cation (positive ion) denoted by Fe3+. The adjective ferric or the prefix ferri- is often used to sp ...

oxides are associated with low-arsenic groundwater, whereas

ferrous In chemistry, the adjective Ferrous indicates a compound that contains iron(II), meaning iron in its +2 oxidation state, possibly as the divalent cation Fe2+. It is opposed to " ferric" or iron(III), meaning iron in its +3 oxidation state, suc ...

oxides indicate higher arsenic concentrations. For a description of arsenic distributions and processes, see: . The subsequent trial found that, compared to the base blood iron rate at the beginning of the trial, individuals using the iron fish had increased levels of blood iron after 12 months, and the rate of anemia decreased by 43%. A randomized control trial in 2017 found that the iron fish did not increase hemoglobin concentrations in a sample group of 340 Cambodian women. These women did have anemia, but it was not attributed to low levels of iron. The conclusion of the study stated "We do not recommend the use of the fish-shaped iron ingot in Cambodia or in countries where the prevalence of iron deficiency is low and genetic hemoglobin disorders are high".

Production

In December 2012, University of Guelph biomedical science doctoral student Gavin Armstrong established ''The Lucky Iron Fish Project'', a company founded to commercialize the concept. The company employs "hard-to-employ Cambodians" to manufacture the fish-shaped iron ingots using recycled scrap iron from a nearby factory. The company began promoting the product in a few rural villages in October 2013, and began a full marketing campaign in Kandal Province in January 2014. In May 2014, the company announced that it had obtained in financing, including from

Grand Challenges Canada Grand Challenges Canada (GCC) is a Canadian nonprofit organization that uses a Grand Challenges model to fund solutions to critical health and development challenges in the developing world. The organization has supported over 1,000 projects in ...

, for scale production of 60,000 iron fish at a cost of about per fish. It also received $1.1 million from private investors. The company had delivered about 11,000 units to

partners in the first five months of 2014. It sells the units when possible, as it is more likely that individuals will use it if it is purchased, but will also distribute if for free where needed. It also planned to sell units in Canada for $25, each purchase accompanied by the donation of three units in Cambodia. As of November 2015, the company donates one unit for each unit purchased. On 28 April 2014, the company announced in a press release that it had obtained the

B Corporation In the United States, a benefit corporation (or in several jurisdictions including Delaware, a public-benefit corporation or PBC) is a type of for-profit corporate entity, authorized by 35 U.S. states and the District of Columbia, that include ...

certification issued by the nonprofit organisation

B Lab B, or b, is the second letter of the Latin-script alphabet, used in the modern English alphabet, the alphabets of other western European languages and others worldwide. Its name in English is ''bee'' (pronounced ), plural ''bees''. It rep ...

Use

The smiling iron fish is long and weighs about . It is placed in a cooking vessel with 1 or 2 drops of

lemon juice The lemon (''Citrus limon'') is a species of small evergreen trees in the flowering plant family Rutaceae, native to Asia, primarily Northeast India (Assam), Northern Myanmar or China. The tree's ellipsoidal yellow fruit is used for culina ...

for 10 minutes in 1 litre of boiling water. The lemon juice improves intestinal iron absorption. The iron fish is also used while cooking rice or stews. Approximately 92% of villagers who have an iron fish use it regularly, and many of them recommend it to friends and family as a symbol of luck. The flattened ingot was designed to maximize the exposed surface area during cooking, thus maximizing the amount of iron leached from the ingot to the food or water in the pot. Its use results in the average villager obtaining about 75% of the daily recommended dietary iron. Armstrong states that the iron does not change the taste of the water or food into which it is leached. The project targets youth in Cambodia to promote the project because of the high level of adult illiteracy in its rural areas.

Notes

References

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External links

The Lucky Iron Fish ProjectAbout Lucky Iron Fish
at

Cast iron Iron metabolism Iron objects