Impact Of Micronutrient‐Fortified Milk Supplementation On Anthropometric Measures And Lipid Profile On School Children In Quito, Ecuador
Authors: Fornasini Marco , Guevara Daniela , Reyes Samira , López Mariuxi , Cocha Ignacio , Morales María , Flores Nancy , Aguirre Santiago , Baldeon Manuel E. 
Published: November 2023

Currently under and over‐nutrition are common public health problems among school children worldwide including Ecuador. Massive nutritional interventions to improve the indicated nutritional abnormalities should consider a common food that would provide a good source of macro‐ and micronutrients. However, universal measures of supplementation are challenging due to the diverse epidemiological composition of the school children population. The objective of the present study was to determine the changes in anthropometry and lipid profile of schoolchildren aged 6 to 10 supplemented with fortified (Zn, Vit A, and Fe) and unfortified cow's milk. Three hundred twenty eight children aged 6 – 10 were included in a double blind controlled study, 173 children received daily 480 mL of whole milk (300 Kcals; Zn = 1.96 mg, Fe = 0.14 mg, vit A = 136 ug; G1) and 155 children fortified milk (Zn = 7.16 mg, Fe = 4.56 mg, vit A = 360 ug; G2) for 23 weeks. All children received 2 glasses of milk, one in the morning and one in the afternoon. Children had a complete nutritional evaluation that included a clinical examination, anthropometry, and laboratory analysis before and after the intervention. The Institutional review board (IRB) of Universidad de Las Américas approved the study. Anthropometric and blood biochemistry data were analyzed as percentiles based on age and gender. At the beginning of the study, both groups were comparable for age, weight and height; in addition, a similar number of boys and girls were distributed in the 2 groups. Both fortified and non‐fortified milks were well accepted by children. Data indicated that both treatments resulted in significant height gain during the study, G1: 117.3 ± 9cm to 120.7 ± 9cm vs G2: 118.1 ± 8cm to 121.3 ± 7cm. Data also showed that after milk supplementation the percentage of children with BMI between 85th and 95th percentiles increased in both treatment groups, Table 1. There were not statistical differences in BMI between groups after the supplementation. Blood lipid profiles were normal before milk supplementation for the treatment groups. There were not differences in mean lipid serum concentration between groups after supplementation and the values were also within the normal range, Table 2. Data indicated that universal measures of nutritional supplementation in school children with cow's milk significantly improve children's height and BMI. Also, blood lipid profiles were not negatively affected with milk supplementation. Mass nutrition supplementation programs should take into account children's BMIs to decrease the risk to develop overweight or obesity in those children at the upper limit of normality.Support or Funding InformationUniversidad de las Américas; Nestlé ‐ Ecuador
Changes in BMI within treatment groups in school children supplemented with milk or fortified‐milk for 23 weeks.

Basal (G1) Milk
Final (G2) Fortified Milk

Age
<5th percentile
>5–85th percentile
>85th – 95th percentile
>95th percentile
<5th percentile
>5–85th percentile
>85th – 95th percentile
>95th percentile

6–8
2 (1,15%)
82 (47,3%)
25(13,29%)
4(2,31%)
0
74(43,52%)
33(19%)
4(2,31%)

9–11
0
52 (30%)
8 (4,62%)
0
0
44(25,43%)
15(8,67%)
0

Basal (G2) Milk
Final (G2) Fortified Milk

Age
<5th percentile
>5–85th percentile
>85th – 95th percentile
>95th percentile
<5th percentile
>5–85th percentile
>85th – 95th percentile
>95th percentile

6–8
6(3,87%)
79(50,96%)
22(14,19%)
4(2,58%)
5(3,31%)
70(46,35%)
27(17,88%)
5(3,31%)

9–11
1(0,64%)
31(20%)
8(5,16%)
4(2,58%)
0
30(19,86%)
9(5,96%)
5(3,31%)

Changes in blood lipid profile within treatment groups in school children supplemented with milk or fortified‐milk for 23 weeks.

Milk (G1)
Fortified Milk (G2)

Serum concentrations
Basal
Final
Δ(post‐basal)
P value
Basal
Final
Δ(post‐basal)
P value

Total cholesterol
151,82 (±22,33)
158,59 (±23,70)
6,77
0,000
151,29 (±29,79)
157,34 (±31,87)
6,05
0,002

LDL
86,0 (+26,0)
88,00 (±27)
2
0,060
82,00 (±31,0)
86,00 (+24)
4
0,011

HDL
51,50 (±11,04)
53,76 (±12,79)
2,26
0,004
50,77 (±12,75)
52,46 (±12,25)
1,69
0,040

Triglycerides
66,00 (±37,8)
68,00 (±40)
2
0,050
65,50 (±40,3)
60,00 (±43)
5,5
0,747