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Community and International Nutrition

A Multiple-Micronutrient-Fortified Beverage Affects Hemoglobin, Iron, and Vitamin A Status and Growth in Adolescent Girls in Rural Bangladesh^1,2

³ Department of Public Health Sciences, University of Toronto and Research Institute, the Hospital for Sick Children, Toronto, Canada M5G 1X8; ⁴ Research and Evaluation Division, Bangladesh Rural Advancement Committee, Dhaka, Bangladesh 1212; ⁵ The Manoff Group, Inc., Washington, DC, 20008; ⁶ Division of Clinical Nutrition, University of California, Davis, CA 95616; ⁷ Micronutrient Initiative, Ottawa, ON, Canada K2P 2K3; and ⁸ Snacks and Beverages Technology Division, Procter & Gamble Company, Cincinnati, OH, 45253

^* To whom correspondence should be addressed. E-mail: ziauddin.hyder{at}sickkids.ca.

Adolescent girls have high nutrient needs and are susceptible to micronutrient deficiencies. The objective of this study was to test the effect of a multiple-micronutrient-fortified beverage on hemoglobin (Hb) concentrations, micronutrient status, and growth among adolescent girls in rural Bangladesh. A total of 1125 girls (Hb 70 g/L) enrolled in a randomized, double-blind, placebo-controlled trial and were allocated to either a fortified or nonfortified beverage of similar taste and appearance. The beverage was provided at schools 6 d/wk for 12 mo. Concentrations of Hb and serum ferritin (sFt), retinol, zinc, and C-reactive protein were measured in venous blood samples at baseline, 6 mo, and 12 mo. In addition, weight, height, and mid-upper arm circumference (MUAC) measurements were taken. The fortified beverage increased the Hb and sFt and retinol concentrations at 6 mo (P < 0.01). Adolescent girls in the nonfortified beverage group were more likely to suffer from anemia (Hb <120 g/L), iron deficiency (sFt <12 µg/L), and low serum retinol concentrations (serum retinol <0.70 µmol/L) (OR = 2.04, 5.38, and 5.47, respectively; P < 0.01). The fortified beverage group had greater increases in weight, MUAC, and BMI over 6 mo (P < 0.01). Consuming the beverage for an additional 6 mo did not further improve the Hb concentration, but the sFt level continued to increase (P = 0.01). The use of multiple-micronutrient-fortified beverage can contribute to the reduction of anemia and improvement of micronutrient status and growth in adolescent girls in rural Bangladesh.

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