Poor diets lacking in iron limit brain development and learning capacity, hampering the potential of individuals and societies, generation after generation. Countries like India are at the heart of this challenge, as nearly half of all Indian women and children under five are anemic. Iron deficiency is a major—and preventable—cause. A study recently published in the Journal of Nutrition provides evidence biofortified high-iron pearl millet can stem the deleterious ripple effect of iron deficiency by significantly improving nutrition and cognitive performance.

When Indian adolescents consumed biofortified pearl millet twice daily as bhakri (a local flatbread) or shev (a savory snack) for six months, researchers found the students had significantly improved learning and mental abilities related to perception, attention, and memory.

This is the second landmark study to demonstrate that iron biofortification results in functional cognitive improvements that could profoundly impact women and teen’s daily lives, including their ability to succeed at school and work.

“If we can improve adolescents’ performance in school by improving their iron status we may also have longer term impacts in terms of their ability to secure a good job, or be admitted to a college program,” says Dr. Samuel Scott, Associate Research Fellow at the International Food Policy Research Institute, lead author of the publication.

The randomized, controlled efficacy study in Maharashtra, India, among 140 economically-disadvantaged 12-16 year olds, compared the effects of eating biofortified iron pearl millet to conventional pearl millet. Computer-based tasks were administered before and after six months of consuming the pearl millet to measure cognitive skills.

Adolescents are particularly vulnerable to iron deficiency because of periods of rapid growth, the onset of menstruation, and poor dietary habits. Addressing adolescent iron deficiency is crucial to ending the intergenerational cycle of malnutrition. More than half of females in India marry by 18 years old, and soon bear children. Their infants depend on iron stores at birth, and iron status in these young women may also be related to how well they interact with their children.

“Teenage girls are soon entering child bearing years and we know iron status carries over from one generation to the next. Therefore, if we can improve a girl’s iron status in adolescence, it can allow her to enter pregnancy with better iron stores, and that benefit will be conferred in a positive way to the next generation,” says Dr. Laura E. Murray-Kolb, Associate Professor at The Pennsylvania State University and co-author.

For resource-poor families or rural communities who rely on staple crops such as pearl millet for much of their diet, nutrient-enriched versions of these crops present a cost-effective, sustainable strategy to improve nutrition by eating the foods they readily have available and are accustomed to. Biofortification, which uses conventional crop breeding to increase micronutrient levels, helps address preventable deficiencies of key vitamins and minerals like iron, vitamin A and zinc. This hidden hunger often results from diets lacking in diversity or essential nutrients.

“Biofortification holds immense promise in helping people and economies reach their full potential,” says Dr. Erick Boy, head of nutrition at HarvestPlus. “This study reinforces that functional impacts are achievable with a food-based, low-dose intervention like biofortification, which does not require changes to eating behavior or access to dietary supplements or commercially fortified foods.”

A previous paper from the study showed that eating the biofortified pearl millet for six months resolved iron deficiency, faster than the conventional pearl millet. A systematic review in 2017 showed biofortification’s efficacy to improve iron status in diverse settings including the Philippines, India and Rwanda, and at-risk populations such as women of reproductive age and school-age adolescent children. Most encouragingly, the effects were highest among those with the greatest potential to benefit from the intervention: individuals who were iron deficient at baseline and among participants who consumed the greatest amount of the crop.