No abstract

No abstract

Objective To measure the effects of iron supplementation and anthelmintic treatment on iron status, anaemia, growth, morbidity, and development of children aged 6-59 months. Design Double blind, placebo controlled randomised factorial trial of iron supplementation and anthelmintic treatment. Setting Community in Pemba Island, Zanzibar. Participants 614 preschool children aged 6-59 months. Main outcome measures Development of language and motor skills assessed by parental interview before and after treatment in age appropriate subgroups. Results Before intervention, anaemia was prevalent and severe, and geohelminth infections were prevalent and light-Plasmodium falciparum infection was nearly universal. Iron supplementation significantly improved iron status, but not haemoglobin status. Iron supplementation improved language development by 0.8 (95% confidence interval 0.2 to 1.4) points on the 20 point scale. Iron supplementation also improved motor development, but this effect was modified by baseline haemoglobin concentrations (P = 0.015 for interaction term) and was apparent only in children with baseline haemoglobin concentrations < 90 g/l. In children with a baseline haemoglobin concentration of 68 g/l (one standard deviation below the mean value), iron treatment increased scores by 1.1 (0.1 to 2.1) points on the 18 point motor scale. Mebendazole significantly reduced the number and severity of infections caused by Ascaris lumbricoides and Trichuris trichiura, but not by hookworms. Mebendazole increased development scores by 0.4 ( − 0.3 to 1.1) points on the motor scale and 0.3 ( − 0.3 to 0.9) points on the language scale. Conclusions Iron supplementation improved motor and language development of preschool children in rural Africa. The effects of iron on motor development were limited to children with more severe anaemia (baseline haemoglobin concentration < 90 g/l). Mebendazole had a positive effect on motor and language development, but this was not statistically significant.

This Monograph reports results from a study of the effects of supplementary feeding of newborn to 7-year-old children on their subsequent performance as adolescents and young adults (11-24 years) on a battery of psychoeducational and information-processing tests. The study, which began in 1969, was conducted in a nutritionally at-risk population in the Department of El Progreso, Eastern Guatemala. The intent was to test the hypothesis that protein deficiency in infants and children delays mental development.We report the effects of the nutritional intervention on cognition during infancy, the preschool period, and, more extensively, adolescence and early adulthood. Issues of differential effects from pre-versus postnatal supplement are excluded; similarly, the current analyses do not attend to the possible differential effect of specific nutrients. BACKGROUNDThis section describes the key theoretical and research issues in international nutrition and in developmental biology and psychology that were dominant at the time the study was launched (1969). The discussion aims to justify the study design that was chosen and the research questions of concern here. International Nutrition and the Protein GapCicely Williams's (1933) description of kwashiorkor and her suggestion that its etiology could be found in a deficiency of "amino acids or protein" became a landmark; thereafter, protein deficiency became the object of I. INTRODUCTIONThis Monograph reports results from a study of the effects of supplementary feeding of newborn to 7-year-old children on their subsequent performance as adolescents and young adults (11-24 years) on a battery of psychoeducational and information-processing tests. The study, which began in 1969, was conducted in a nutritionally at-risk population in the Department of El Progreso, Eastern Guatemala. The intent was to test the hypothesis that protein deficiency in infants and children delays mental development.We report the effects of the nutritional intervention on cognition during infancy, the preschool period, and, more extensively, adolescence and early adulthood. Issues of differential effects from pre-versus postnatal supplement are excluded; similarly, the current analyses do not attend to the possible differential effect of specific nutrients. BACKGROUNDThis section describes the key theoretical and research issues in international nutrition and in developmental biology and psychology that were dominant at the time the study was launched (1969). The discussion aims to justify the study design that was chosen and the research questions of concern here. International Nutrition and the Protein GapCicely Williams's (1933) description of kwashiorkor and her suggestion that its etiology could be found in a deficiency of "amino acids or protein" became a landmark; thereafter, protein deficiency became the object of intensive study and international concern.1 For at least the following four decades, protein was considered to be the major limiting factor in the diets of most undernourished ch...

No abstract

The present study investigates the effect of iron supplementation on measures of school performance among 78 iron-deficient anemic and 41 nonanemic children in an economically deprived rural area in Central Java, Indonesia. All the subjects were treated for ancylostomiasis before iron supplementation. They were randomly assigned to either an iron or placebo group. Hematological and behavioral measurements were obtained immediately before (T1) and after (T2) the iron and placebo treatments. Iron treatment for a 3-mo period resulted in substantive increases in mean Hgb, Hct, and transferrin saturation among the iron-deficient anemic children. Furthermore, changes in the iron status of iron-deficient anemic children were associated with significant changes in the school achievement test scores of iron-deficient anemic children. T2 evaluation of achievement test scores indicated that the difference between iron-treated anemic and nonanemic children was still statistically significant. However, when T1 scores were entered as a covariate, iron-deficient anemic subjects treated with iron obtained significantly higher delta achievement scores. Findings from the present study indicate that iron supplementation among iron-deficient anemic children benefits learning processes as measured by the school achievement test scores.

This double-blind clinical trial was conducted in Thailand to assess the impact of iron treatment on the IQ and educational attainment of 1358 9-11-y-old children. The children were classified into one of three groups: iron replete, iron depleted, and iron-deficient anemic. The Raven Progressive Matrices was used to measure IQ. A Thai language and a math test were administered to assess school attainment. A 50-mg/d tablet of ferrous sulphate was given for 2 wk and a 100 mg/d tablet, for 14 wk. An anthelminthic drug was given on the day of the blood test before treatment and 3 mo after the intervention started. There is evidence of a positive association between iron status and IQ and a language school achievement test but there is no support for the internal validity of the hypothesis that this association is causal.

In this supplement, the papers presented at the International Symposium on Breakfast and Performance in Napa, CA in 1995 are summarized and integrated with data published since that time. In particular, the focus is on issues of research design, measurements, mechanisms, potential effect modifiers (eg, age), and relevance for public policy. No definitive conclusions can be drawn from the existing data on either the long- and short-term benefits of breakfast on cognition and school learning or the mechanisms that mediate this relation. The pooled data suggest that omitting breakfast interferes with cognition and learning, an effect that is more pronounced in nutritionally at-risk children than in well-nourished children. At the very least, breakfast consumption improves school attendance and enhances the quality of the students' diets.