Efficacy Trials of a Micronutrient Dietary Supplement in Schoolchildren and Pregnant Women in Tanzania

Abstract

Traditionally, the main strategies used to control micronutrient deficiencies have been food diversification, consumption of medicinal supplements, and food fortification. In Tanzania, we conducted efficacy trials using a dietary supplement as a fourth approach. These were randomized, double-blind, placebo-controlled efficacy trials conducted separately first in children and later in pregnant women. The dietary supplement was a powder used to prepare an orange-flavored beverage. In the school trial, children consumed 25 g per school day attended. In the pregnancy trial, women consumed the contents of two 25-g sachets per day with meals. This dietary supplement, unlike most medicinal supplements, provided 11 micronutrients, including iron and vitamin A, in physiologic amounts. In both trials we compared changes in subjects consuming either the fortified or the nonfortified supplement. Measures of iron and vitamin A status were similar in the groups at the baseline examination, but significantly different at follow-up, always in favor of the fortified groups. Children receiving the fortified supplement had significantly improved anthropometric measures when compared with controls. At four weeks postpartum, the breast milk of a supplemented group of women had significantly higher mean retinol content than did the milk of mothers consuming the nonfortified supplement. The advantages of using a fortified dietary supplement, compared with other approaches, include its ability to control several micronutrient deficiencies simultaneously; the use of physiologic amounts of nutrients, rather than megadoses that require medical supervision; and the likelihood of better compliance than with the use of pills because subjects liked the beverage used in these trials.

Assessment of nutrient and water intake among adolescents from sports federations in the Federal District, Brazil

“…This was not the case in the present study, where the consumption of vegetables was low and monotonous, helping to explain the low micronutrient and fibre intakes found among the adolescents. Given the low intake of certain nutrients, there has been a suggestion that the use of dietary supplements should be widely encouraged among children and adolescents ( 30 , 31 ) . Other strategies have been developed to provide adequate nutrient intakes.…”

Efficacy Trials of a Micronutrient Dietary Supplement in Schoolchildren and Pregnant Women in Tanzania

“…In terms of anthropometry, there were no significant differences in mean weight, height, and BMI between groups at the baseline examination [7]. However, at follow-up, incremental changes in weight (1.79 versus 1.24 kg, a difference of 0.55 kg); in height (3.2 cm versus 2.6 cm, a difference of 0.6 cm); and in BMI units (0.88 versus 0.53, a difference of 0.35) were significantly higher in the fortified compared with the nonfortified group (results not shown).…”

“…In the Dodoma Region of Tanzania, two separate double-blind, placebo-controlled field efficacy trials have been completed using a multiple-micronutrientfortified dietary supplement. The first trial [6,7] was conducted with young primary schoolchildren and the second with pregnant women, some of whom were followed postpartum during 4 weeks of lactation [8].…”

How effective are food for education programs?: A critical assessment of the evidence from developing countries

“…In older children, there is also evidence of improved outcomes related to supplementation. A supplementation study in Tanzania showed anthropometric improvements and improvements in iron and vitamin A status among primary-school children consuming fortified beverages (Ash et al 2003;Latham et al 2003). And in Cambodia, iron and folic acid supplementation was shown to decrease the prevalence of anemia among 5-to 11-year-olds, but was less effective among 12-to 15-year-olds (Longfils et al 2005).…”

“…Several other studies also evaluate the effectiveness of supplements on micronutrient status among school-aged children. See, for exampleLatham et al (2003) andSolon et al (2003).…”