Trial of a micronutrient dietary supplement to control vitamin A, iron and iodine deficiencies in Tanzania
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Date
1998
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Publisher
Faseb Journal
Abstract
The three main strategies used to control micronutrient deficiencies are food diversification, fortification, and consumption of medicinal supplements through the health care system. In Tanzania, a fourth strategy is currently being evaluated. A micronutrient fortified beverage supplement that provides nutrients in physiological doses, not megadoses, has been developed to control several deficiencies at the same time. The efficacy of the supplement was evaluated in a randomized, double-blind, placebo-controlled trial among 830 primary schoolchildren in Mpwapwa District, Dodoma Region. The supplement was packaged in individual serving sachets containing 25 gm net of a powder that when added to 200 ml of water produces a very palatable, orange-flavored drink. The serving provides between 30 and 120% of the RDA for vitamin A, iron, iodine, zinc, vitamin E, ascorbic acid, and several B vitamins. The children drank one serving every attended school day for a 6 month intervention period. At baseline, 44% of the children were anemic (Hb<12.0 g/dL) and 4 children with Bitot's spots were excluded from the study and treated. Participation in the study was excellent with a 91% retention rate. The mean incremental change in Hb, for those with an initial Hb <11.0g/dL, was 1.3g/dL and 0.14g/dL in the fortified and non-fortified group, respectively. At baseline, 21.4% of the fortified group and 20.6% of the non-fortified group had serum retinol levels <20 mg/dL. After 6 month intervention, serum retinol levels <20 mg/dL were nearly twice as prevalent in the non-fortified group as the fortified group (19.7% vs. 11.3%, respectively, p<.000). The supplement was highly acceptable and compliance was high. In this population where iron and vitamin A deficiency are prevalent, the beverage supplement was effective in improving nutritional status. Children who had lower hemoglobin and vitamin A status benefited more from the micronutrient fortified beverage.
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Keywords
Micronutrient dietary supplement, Tanzania, Vitamin A
Citation
Ash, D.M., Tatal, S.R., Frongillo, E.A., Ndossi, G.D., Mehansho, H. and Latham, M.C., 1998, March. Trial of a micronutrient dietary supplement to control vitamin A, iron and iodine deficiencies in Tanzania. In FASEB JOURNAL (Vol. 12, No. 5, pp. A648-A648). 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA: FEDERATION AMER SOC EXP BIOL.