Synthesized evidence indicates that addition of multiple micronutrients to Fe supplementation may only marginally improve Hb response compared with Fe supplementation alone .
However , addition of ' other micronutrients ' may have a negative effect .
Routine addition of unselected multiple micronutrients to Fe therefore appears unjustified for nutritional anaemia control programmes
OBJECTIVES To study the effect of combining multiple ( two or more ) micronutrients with Fe supplementation on Hb response , when compared with placebo and with Fe supplementation , in children .
Biochemical indices and neuromuscular function tests in rural Gambian schoolchildren given a riboflavin, or multivitamin plus iron, supplement.
Ninety preselected children , aged between 8 and 14 years , living in two rural West African ( Gambian ) villages , were r and omly divided into three groups , matched for age and sex . One group received a placebo ( lactose ) tablet , one received riboflavin ( 5 mg ) on 5 d every week , which was sufficient to correct an endemic riboflavin deficiency , and one received a multivitamin supplement ( Protovit ; Hoffmann La Roche ) , on 5 d every week , together with FeSO4 ( 200 mg ) once weekly , and the supplements were given for 1 year . Neuromuscular tests , including arm tremor and manipulative skills , were performed on three occasions : once just before the introduction of the supplements ; again 6 weeks after commencing the supplements ; and again 1 year later . Venous blood sample s were collected at the same time as the first two sets of neuromuscular tests . These sample s were used for haematology and nutrient status indices : plasma ferritin , ascorbic acid , cyanocobalamin and pyridoxal phosphate , and erythrocyte tests for folate status , for riboflavin status ( erythrocyte glutathione reductase activation coefficient ) and thiamine status ( erythrocyte transketolase activation coefficient ) . The riboflavin in both supplements achieved a clear-cut response in biochemical status , which was dose-dependent . The pyridoxine , ascorbic acid and Fe components of the multivitamin also affected the associated biochemical indices . Although overall the arm tremor and related neuromuscular function tests did not respond significantly to the supplements , significant improvement was seen in the boys for the arm-tremor test in both the supplemented groups
Synthesized evidence indicates that addition of multiple micronutrients to Fe supplementation may only marginally improve Hb response compared with Fe supplementation alone .
However , addition of ' other micronutrients ' may have a negative effect .
Routine addition of unselected multiple micronutrients to Fe therefore appears unjustified for nutritional anaemia control programmes
OBJECTIVES To study the effect of combining multiple ( two or more ) micronutrients with Fe supplementation on Hb response , when compared with placebo and with Fe supplementation , in children .