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Multi-micronutrient-fortified biscuits decreased the prevalence of anaemia and improved iron status, whereas weekly iron supplementation only improved iron status in Vietnamese school children.
Br J Nutr. 2012 Oct 28; 108(8):1419-27.BJ

Abstract

In Vietnam, nutrition interventions do not target school children despite a high prevalence of micronutrient deficiencies. The present randomised, placebo-controlled study evaluated the impact of providing school children (n 403) with daily multiple micronutrient-fortified biscuits (FB) or a weekly Fe supplement (SUP) on anaemia and Fe deficiency. Micronutrient status was assessed by concentrations of Hb, and plasma ferritin (PF), transferrin receptor (TfR), Zn and retinol. After 6 months of intervention, children receiving FB or SUP had a significantly better Fe status when compared with the control children (C), indicated by higher PF (FB: geometric mean 36·9 (95% CI 28·0, 55·4) μg/l; SUP: geometric mean 46·0 (95% CI 33·0, 71·7) μg/l; C: geometric mean 34·4 (95% CI 15·2, 51·2) μg/l; P < 0·001) and lower TfR concentrations (FB: geometric mean 5·7 (95% CI 4·8, 6·52) mg/l; SUP: geometric mean 5·5 (95% CI 4·9, 6·2) mg/l; C: geometric mean 5·9 (95% CI 5·1, 7·1) mg/l; P = 0·007). Consequently, body Fe was higher in children receiving FB (mean 5·6 (sd 2·2) mg/kg body weight) and SUP (mean 6·1 (sd 2·5) mg/kg body weight) compared with the C group (mean 4·2 (sd 3·3) mg/kg body weight, P < 0·001). However, anaemia prevalence was significantly lower only in the FB group (1·0%) compared with the C group (10·4%, P = 0·006), with the SUP group being intermediate (7·4%). Children receiving FB had better weight-for-height Z-scores after the intervention than children receiving the SUP (P = 0·009). Vitamin A deficiency at baseline modified the intervention effect, with higher Hb concentrations in vitamin A-deficient children receiving FB but not in those receiving the SUP. This indicates that vitamin A deficiency is implicated in the high prevalence of anaemia in Vietnamese school children, and that interventions should take other deficiencies besides Fe into account to improve Hb concentrations. Provision of biscuits fortified with multiple micronutrients is effective in reducing anaemia prevalence in school children.

Authors+Show Affiliations

Groupe de Recherche et d'Echanges Technologiques, 45 bis avenue de la Belle Gabrielle, 94736 Nogent-sur-Marne, France.No 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

22244363

Citation

Hieu, Nguyen Trung, et al. "Multi-micronutrient-fortified Biscuits Decreased the Prevalence of Anaemia and Improved Iron Status, Whereas Weekly Iron Supplementation Only Improved Iron Status in Vietnamese School Children." The British Journal of Nutrition, vol. 108, no. 8, 2012, pp. 1419-27.
Hieu NT, Sandalinas F, de Sesmaisons A, et al. Multi-micronutrient-fortified biscuits decreased the prevalence of anaemia and improved iron status, whereas weekly iron supplementation only improved iron status in Vietnamese school children. Br J Nutr. 2012;108(8):1419-27.
Hieu, N. T., Sandalinas, F., de Sesmaisons, A., Laillou, A., Tam, N. P., Khan, N. C., Bruyeron, O., Wieringa, F. T., & Berger, J. (2012). Multi-micronutrient-fortified biscuits decreased the prevalence of anaemia and improved iron status, whereas weekly iron supplementation only improved iron status in Vietnamese school children. The British Journal of Nutrition, 108(8), 1419-27. https://doi.org/10.1017/S0007114511006945
Hieu NT, et al. Multi-micronutrient-fortified Biscuits Decreased the Prevalence of Anaemia and Improved Iron Status, Whereas Weekly Iron Supplementation Only Improved Iron Status in Vietnamese School Children. Br J Nutr. 2012 Oct 28;108(8):1419-27. PubMed PMID: 22244363.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Multi-micronutrient-fortified biscuits decreased the prevalence of anaemia and improved iron status, whereas weekly iron supplementation only improved iron status in Vietnamese school children. AU - Hieu,Nguyen Trung, AU - Sandalinas,Fanny, AU - de Sesmaisons,Agnès, AU - Laillou,Arnaud, AU - Tam,Nguyen Phuong, AU - Khan,Nguyen Cong, AU - Bruyeron,Olivier, AU - Wieringa,Frank Tammo, AU - Berger,Jacques, Y1 - 2012/01/16/ PY - 2012/1/17/entrez PY - 2012/1/17/pubmed PY - 2012/12/27/medline SP - 1419 EP - 27 JF - The British journal of nutrition JO - Br J Nutr VL - 108 IS - 8 N2 - In Vietnam, nutrition interventions do not target school children despite a high prevalence of micronutrient deficiencies. The present randomised, placebo-controlled study evaluated the impact of providing school children (n 403) with daily multiple micronutrient-fortified biscuits (FB) or a weekly Fe supplement (SUP) on anaemia and Fe deficiency. Micronutrient status was assessed by concentrations of Hb, and plasma ferritin (PF), transferrin receptor (TfR), Zn and retinol. After 6 months of intervention, children receiving FB or SUP had a significantly better Fe status when compared with the control children (C), indicated by higher PF (FB: geometric mean 36·9 (95% CI 28·0, 55·4) μg/l; SUP: geometric mean 46·0 (95% CI 33·0, 71·7) μg/l; C: geometric mean 34·4 (95% CI 15·2, 51·2) μg/l; P < 0·001) and lower TfR concentrations (FB: geometric mean 5·7 (95% CI 4·8, 6·52) mg/l; SUP: geometric mean 5·5 (95% CI 4·9, 6·2) mg/l; C: geometric mean 5·9 (95% CI 5·1, 7·1) mg/l; P = 0·007). Consequently, body Fe was higher in children receiving FB (mean 5·6 (sd 2·2) mg/kg body weight) and SUP (mean 6·1 (sd 2·5) mg/kg body weight) compared with the C group (mean 4·2 (sd 3·3) mg/kg body weight, P < 0·001). However, anaemia prevalence was significantly lower only in the FB group (1·0%) compared with the C group (10·4%, P = 0·006), with the SUP group being intermediate (7·4%). Children receiving FB had better weight-for-height Z-scores after the intervention than children receiving the SUP (P = 0·009). Vitamin A deficiency at baseline modified the intervention effect, with higher Hb concentrations in vitamin A-deficient children receiving FB but not in those receiving the SUP. This indicates that vitamin A deficiency is implicated in the high prevalence of anaemia in Vietnamese school children, and that interventions should take other deficiencies besides Fe into account to improve Hb concentrations. Provision of biscuits fortified with multiple micronutrients is effective in reducing anaemia prevalence in school children. SN - 1475-2662 UR - https://www.unboundmedicine.com/medline/citation/22244363/Multi_micronutrient_fortified_biscuits_decreased_the_prevalence_of_anaemia_and_improved_iron_status_whereas_weekly_iron_supplementation_only_improved_iron_status_in_Vietnamese_school_children_ L2 - https://www.cambridge.org/core/product/identifier/S0007114511006945/type/journal_article DB - PRIME DP - Unbound Medicine ER -