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Long-term intermittent multiple micronutrient supplementation enhances hemoglobin and micronutrient status more than iron + folic acid supplementation in Bangladeshi rural adolescent girls with nutritional anemia.
J Nutr. 2010 Oct; 140(10):1879-86.JN

Abstract

Previous short-term supplementation studies showed no additional hematologic benefit of multiple micronutrients (MMN) compared with iron + folic acid (IFA) in adolescent girls. This study examines whether long-term once- or twice-weekly supplementation of MMN can improve hemoglobin (Hb) and micronutrient status more than twice-weekly IFA supplementation in anemic adolescent girls in Bangladesh. Anemic girls (n = 324) aged 11-17 y attending rural schools were given once- or twice-weekly MMN or twice-weekly IFA, containing 60 mg iron/dose in both supplements, for 52 wk in a randomized double-blind trial. Blood samples were collected at baseline and 26 and 52 wk. Intent to treat analysis showed no significant difference in the Hb concentration between treatments at either 26 or 52 wk. However, after excluding girls with hemoglobinopathy and adjustment for baseline Hb, a greater increase in Hb was observed with twice-weekly MMN at 26 wk (P = 0.045). Although all 3 treatments effectively reduced iron deficiency, once-weekly MMN produced significantly lower serum ferritin concentrations than the other treatments at both 26 and 52 wk. Both once- and twice-weekly MMN significantly improved riboflavin, vitamin A, and vitamin C status compared with IFA. Overall, once-weekly MMN was less efficacious than twice-weekly MMN in improving iron, riboflavin, RBC folic acid, and vitamin A levels. Micronutrient supplementation beyond 26 wk was likely important in sustaining improved micronutrient status. These findings highlight the potential usefulness of MMN intervention in this population and have implications for programming.

Authors+Show Affiliations

Department of Family Sciences, College for Women, Kuwait University, Safat 13060, Kuwait. fahmed_001@yahoo.com.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20702745

Citation

Ahmed, Faruk, et al. "Long-term Intermittent Multiple Micronutrient Supplementation Enhances Hemoglobin and Micronutrient Status More Than Iron + Folic Acid Supplementation in Bangladeshi Rural Adolescent Girls With Nutritional Anemia." The Journal of Nutrition, vol. 140, no. 10, 2010, pp. 1879-86.
Ahmed F, Khan MR, Akhtaruzzaman M, et al. Long-term intermittent multiple micronutrient supplementation enhances hemoglobin and micronutrient status more than iron + folic acid supplementation in Bangladeshi rural adolescent girls with nutritional anemia. J Nutr. 2010;140(10):1879-86.
Ahmed, F., Khan, M. R., Akhtaruzzaman, M., Karim, R., Williams, G., Torlesse, H., Darnton-Hill, I., Dalmiya, N., Banu, C. P., & Nahar, B. (2010). Long-term intermittent multiple micronutrient supplementation enhances hemoglobin and micronutrient status more than iron + folic acid supplementation in Bangladeshi rural adolescent girls with nutritional anemia. The Journal of Nutrition, 140(10), 1879-86. https://doi.org/10.3945/jn.109.119123
Ahmed F, et al. Long-term Intermittent Multiple Micronutrient Supplementation Enhances Hemoglobin and Micronutrient Status More Than Iron + Folic Acid Supplementation in Bangladeshi Rural Adolescent Girls With Nutritional Anemia. J Nutr. 2010;140(10):1879-86. PubMed PMID: 20702745.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term intermittent multiple micronutrient supplementation enhances hemoglobin and micronutrient status more than iron + folic acid supplementation in Bangladeshi rural adolescent girls with nutritional anemia. AU - Ahmed,Faruk, AU - Khan,Moududur R, AU - Akhtaruzzaman,Mohammad, AU - Karim,Rezaul, AU - Williams,Gail, AU - Torlesse,Harriet, AU - Darnton-Hill,Ian, AU - Dalmiya,Nita, AU - Banu,Cadi P, AU - Nahar,Badrun, Y1 - 2010/08/11/ PY - 2010/8/13/entrez PY - 2010/8/13/pubmed PY - 2010/10/20/medline SP - 1879 EP - 86 JF - The Journal of nutrition JO - J. Nutr. VL - 140 IS - 10 N2 - Previous short-term supplementation studies showed no additional hematologic benefit of multiple micronutrients (MMN) compared with iron + folic acid (IFA) in adolescent girls. This study examines whether long-term once- or twice-weekly supplementation of MMN can improve hemoglobin (Hb) and micronutrient status more than twice-weekly IFA supplementation in anemic adolescent girls in Bangladesh. Anemic girls (n = 324) aged 11-17 y attending rural schools were given once- or twice-weekly MMN or twice-weekly IFA, containing 60 mg iron/dose in both supplements, for 52 wk in a randomized double-blind trial. Blood samples were collected at baseline and 26 and 52 wk. Intent to treat analysis showed no significant difference in the Hb concentration between treatments at either 26 or 52 wk. However, after excluding girls with hemoglobinopathy and adjustment for baseline Hb, a greater increase in Hb was observed with twice-weekly MMN at 26 wk (P = 0.045). Although all 3 treatments effectively reduced iron deficiency, once-weekly MMN produced significantly lower serum ferritin concentrations than the other treatments at both 26 and 52 wk. Both once- and twice-weekly MMN significantly improved riboflavin, vitamin A, and vitamin C status compared with IFA. Overall, once-weekly MMN was less efficacious than twice-weekly MMN in improving iron, riboflavin, RBC folic acid, and vitamin A levels. Micronutrient supplementation beyond 26 wk was likely important in sustaining improved micronutrient status. These findings highlight the potential usefulness of MMN intervention in this population and have implications for programming. SN - 1541-6100 UR - https://www.unboundmedicine.com/medline/citation/20702745/Long_term_intermittent_multiple_micronutrient_supplementation_enhances_hemoglobin_and_micronutrient_status_more_than_iron_+_folic_acid_supplementation_in_Bangladeshi_rural_adolescent_girls_with_nutritional_anemia_ L2 - https://academic.oup.com/jn/article-lookup/doi/10.3945/jn.109.119123 DB - PRIME DP - Unbound Medicine ER -