Effects of fortified milk on morbidity in young children in north India: community based, randomised, double masked placebo controlled trial (original) (raw)
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BMC Public Health, 2012
Background: Micronutrient deficiency is a common public health problem in developing countries, especially for infants and children in the first two years of life. As this is an important time window for child development, micronutrient fortified complementary feeding after 6 months of age, for example with milk or cereals products, in combination with continued breastfeeding, is recommended. The overall effect of this approach is unclear. Methods: We performed a Systematic Review and Meta-analysis to assess the impact of micronutrient fortified milk and cereal food on the health of infants and little children (aged 6 months to 5 years) compared to non-fortified food. We reviewed randomized controlled trials using electronic databases (MEDLINE and Cochrane library searches through FEB 2011), reference list screening and hand searches. Three reviewers assessed 1153 studies for eligibility and extracted data. One reviewer assessed risk of bias using predefined forms. Results: We included 18 trials in our analysis (n = 5'468 children; range of mean hemoglobin values: 9.0 to 12.6 g/ dl). Iron plus multi micronutrient fortification is more effective than single iron fortification for hematologic outcomes. Compared to non-fortified food, iron multi micronutrient fortification increases hemoglobin levels by 0.87 g/dl (95%-CI: 0.57 to 1.16; 8 studies) and reduces risk of anemia by 57% (relative risk 0.43; 95%-CI 0.26 to 0.71; absolute risk reduction 22%; number needed to treat 5 [95%-CI: 4 to 6]; 6 Studies). Compared to non-fortified food, fortification increases serum levels of vitamin A but not of zinc. Information about functional health outcomes (e.g. weight gain) and morbidity was scarce and evidence is inconclusive. Risk of bias is unclear due to underreporting, but high quality studies lead to similar results in a sensitivity analysis. Conclusions: Multi micronutrient fortified milk and cereal products can be an effective option to reduce anemia of children up to three years of age in developing countries. On the basis of our data the evidence for functional health outcomes is still inconclusive.
BackgroundNutritional deficiencies have many immediate and long-term effects on physical and cognitive development outcomes, with the children not achieving their full potential. A milk-based health drink fortified with micronutrients as a part of a daily balanced diet can promote physical and cognitive growth in children by increasing macronutrients and micronutrients availability in the body. The systematic analysis aims to quantify the effect of a formulated health drink on children’s physical, clinical, and cognitive development outcomes.MethodsThe dataset used in the analysis was obtained from literature and consisted of 900 children between 7 to 12 years of age. These children were distributed equally into the Control group (no micronutrient-fortified health drink is given), Group I (micronutrient-fortified health drink in water), and Group II (micronutrient-fortified health drink in the toned milk).ResultsThe analysis shows that micronutrient-fortified health drinks in water ...
PLoS ONE, 2010
Background: Multiple micronutrient deficiencies are highly prevalent among preschool children and often lead to anemia and growth faltering. Given the limited success of supplementation and health education programs, fortification of foods could be a viable and sustainable option. We report results from a community based double-masked, randomized trial among children 1-4 years evaluating the effects of micronutrients (especially of zinc and iron) delivered through fortified milk on growth, anemia and iron status markers as part of a four group study design, running two studies simultaneously.
Frontiers in Nutrition
Malnutrition results in a high prevalence of stunting, underweight, and micronutrient deficiencies. This study investigated the effect of a multi-nutrient fortified dairy-based drink on micronutrient status, growth, and cognitive development in malnourished [height-for-age z-score (HAZ) and/or weight-for-age z-score (WAZ) < -1 SD and >−3 SD] Nigerian toddlers (n = 184, 1–3 years). The product was provided in different daily amounts (200, 400, or 600 ml) for 6 months. At baseline and endline, venous blood and urine samples were collected to determine micronutrient status. Bodyweight, height, waist, and head circumference were measured, and corresponding Z-scores were calculated. The Bayley-III Screening Test was used to classify the cognitive development of the children. In a modified per-protocol (PP) population, the highest prevalence's of micronutrient deficiencies were found for vitamin A (35.5%) and selenium (17.9%). At endline, there were no significant improvements i...
BMJ Nutrition, Prevention & Health, 2021
BackgroundIn the tribal state of Jharkhand, there have been very few studies on micronutrient deficiency and how it is addressed among school children. This study was conceived and undertaken to assess the effect of milk supplementation on the micronutrient status of school children.DesignA comparative observational study was conducted among school children of a tribal district in India during 2017–2018. Two groups of schools/clusters were randomly selected, one with milk supplementation and the other without supplementation. A total of 318 children from the two groups of schools were recruited for biochemical analysis of certain micronutrients, such as calcium, vitamin D, vitamin B12 and iron (haemoglobin level), using cluster random sampling. Data were analysed using SPSS V.20.0 software, and multiple logistic regression analysis was done to determine the predictors of serum calcium and vitamin B12 level among school children.ResultsAlmost all children from both groups had vitamin...
Trace Elements and Electrolytes, 2015
Micronutrient fortification of commonly consumed foods remains to be both a practical and a sustainable option to fight malnutrition. This paper determined the changes in biochemical markers of vitamins and minerals after fortified milk consumption among 6-year-old school children. A total of 141 school children were grouped based on their fluid consumption: one group consumed water; the other consumed 1-glass of milk; and the last group consumed 2-glasses of milk. Blood and urine samples were analyzed for hemoglobin, serum ferritin, serum zinc, serum vitamins A, C, and D. The hemoglobin concentration of study participants was borderline anemic (11.5 -11.6 mg/dL) at baseline and significantly increased at midline for the 2-glassess group (p < 0.05). Serum ferritin and vitamin A were within the normal values at baseline and endline. A significant increase was observed for serum zinc in children fed with 1-glass and 2-glasses (p < 0.05). All children were vitamin C deficient at baseline (0.2 -0.3 mg/dL), and attained normalcy at endline. No vitamin D deficiency was observed among study participants at baseline but a significant increase was observed at endline within acceptable levels. Fortified milk supplementation among 6-year-old school children is effective for significant changes in hemoglobin and serum zinc and is more pronounced at 2-glasses/day.
The Journal of nutrition, 2018
Iron deficiency (ID) and vitamin D deficiency (VDD) are significant pediatric health issues in New Zealand and Australia and remain prevalent micronutrient deficiencies in young children globally. We aimed to investigate the effect of a micronutrient-fortified, reduced-energy growing-up milk (GUMLi) compared with cow milk (CM) consumed for 1 y on dietary iron and vitamin D intakes and the status of New Zealand and Australian children at 2 y of age. The GUMLi Trial was a multicenter, double-blind, randomized controlled trial in 160 healthy 1-y-old New Zealand and Australian children conducted in 2015-2017. Participants were randomly assigned 1:1 to receive GUMLi (1.7 mg Fe/100 mL; 1.3 µg cholecalciferol/100 mL) or CM (0.02 mg Fe/100 mL; 0.06 µg cholecalciferol/100 mL) for 12 mo. Secondary outcomes, reported here, included change in dietary iron and vitamin D intakes, iron status, and 25-hydroxyvitamin D [25(OH)D] concentrations from blood samples at age 2 y. All regression models wer...
International Journal of Current Science (IJCSPUB), 2023
Micronutrient deficiency is a common public health problem in India. India's history of fortification began in 1533, and in 1998, iodized salt became mandatory. According to the WHO, more than 2 billion people are deficient in vitamins and minerals, with common micronutrient deficiencies including iron, iodine, vitamin A, and vitamin D. Children, particularly those from low and middle-income families, are among the most vulnerable to these deficiencies. Fortification of food is used in many countries to improve nutrition, and this study aims to identify and analyse food fortification studies and their effectiveness in improving nutritional deficiencies in children. We searched databases such as Google Scholar and PubMed, and reviewed 10 research papers. The studies show that fortified food can play an important role in improving nutrition-related deficiencies in children. The food vehicles used for fortification are cereals, oils and salts, and other options such as school meals. Multi-micronutrient foods fortified with iron, iodine, vitamin A, and vitamin D are strongly associated with health benefits. The studies show that iron increases haemoglobin levels, thereby decreasing the prevalence of anaemia, while iodine supplementation improves cognition and zinc has a positive effect on anthropometry and common morbidity symptoms. Existing government nutrition programs, especially those targeting children, are a good approach for implementing food fortification.