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 .
Spread fortified with vitamins and minerals induces catch-up growth and eradicates severe anemia in stunted refugee children aged 3-6 y.
BACKGROUND Multiple micronutrient deficiencies are often the basic causative factor in stunting and anemia , 2 conditions that affect entire generations of children in deprived population s. No generally accepted recommendations for micronutrient intakes for recovery from stunting are available . OBJECTIVE The objective was to assess the effect of a highly nutrient-dense spread fortified with vitamins and minerals , with or without antiparasitic metronidazole treatment , in correcting retarded linear growth and reducing anemia in stunted children . DESIGN Saharawi refugee children ( n = 374 ) aged 3 - 6 y with initial height-for-age z scores < -2 were assigned to 1 of 5 groups : fortified spread ( FS ) , fortified spread plus metronidazole ( FS+M ) , unfortified spread ( US ) , unfortified spread plus metronidazole ( US+M ) , or control . Supervised supplementation was given daily for 6 mo . Weight , height , knee-heel length , hematologic indexes , parasitic infections , and morbidity were assessed at 0 , 3 , and 6 mo . RESULTS Linear growth of children fed FS was 30 % faster at 3 mo than in US and control groups , after which height-for-age z scores increased only slightly in the FS group and remained unchanged in the other groups . No additional benefits from metronidazole were observed . Increase in hemoglobin concentrations in the FS group at 6 mo was twofold that in the US and control groups ( 37 + /- 40 , 19 + /- 15 , and 16 + /- 17 g/L , respectively ; P < 0.0001 ) , and anemia was reduced by nearly 90 % . CONCLUSIONS FS , and not US , induces catch-up growth in stunted children whose diets are poor in micronutrients . Our trial provides support for delivering multiple micronutrients to reverse stunting and reduce anemia in children up to age 6
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 .