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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

Hieu, Nguyen Trung ; Sandalinas, Fanny ; de Sesmaisons, Agnès ; Laillou, Arnaud ; Tam, Nguyen Phuong ; Khan, Nguyen Cong ; Bruyeron, Olivier ; Wieringa, Frank Tammo ; Berger, Jacques

In: British Journal of Nutrition, 2012, vol. 108, no. 8, p. 1419-1427

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    Titel
    • 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
    Autor
    • Hieu, Nguyen Trung. Groupe de Recherche et d'Echanges Technologiques (GRET), 45 bis avenue de la Belle Gabrielle, 94736 Nogent-sur-Marne, France
    • Sandalinas, Fanny. Institute of Research for Development (IRD), UMR 204 NutriPass, IRD/Montpellier 1/Montpellier 2/SupAgro, BP 64501, 34394 Montpellier, Cedex 5, France
    • de Sesmaisons, Agnès. Groupe de Recherche et d'Echanges Technologiques (GRET), 45 bis avenue de la Belle Gabrielle, 94736 Nogent-sur-Marne, France
    • Laillou, Arnaud. GAIN - Global Alliance for Improved Nutrition, PO Box 55, 1211, Geneva 20, Switzerland
    • Tam, Nguyen Phuong. Groupe de Recherche et d'Echanges Technologiques (GRET), 45 bis avenue de la Belle Gabrielle, 94736 Nogent-sur-Marne, France
    • Khan, Nguyen Cong. Vietnam Food Administration, 138A, Giang Vo, Ba Dinh, Vietnam
    • Bruyeron, Olivier. Groupe de Recherche et d'Echanges Technologiques (GRET), 45 bis avenue de la Belle Gabrielle, 94736 Nogent-sur-Marne, France
    • Wieringa, Frank Tammo. Institute of Research for Development (IRD), UMR 204 NutriPass, IRD/Montpellier 1/Montpellier 2/SupAgro, BP 64501, 34394 Montpellier, Cedex 5, France
    • Berger, Jacques. Institute of Research for Development (IRD), UMR 204 NutriPass, IRD/Montpellier 1/Montpellier 2/SupAgro, BP 64501, 34394 Montpellier, Cedex 5, France
    Dokumententyp
    • Postprint
    Sprache
    • Englisch
    Veröffentlicht in
    • British Journal of Nutrition, 2012, vol. 108, no. 8, p. 1419-1427. Cambridge University Press
    Andere elektronische Ausgabe
    OAI-PMH-ID
    • oai:doc.rero.ch:298682
    Summary
    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