QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: 139/5/1013    most recent jn.108.099754v1 Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Nga, T. T. Articles by Wieringa, F. T. Search for Related Content PubMed PubMed Citation Articles by Nga, T. T. Articles by Wieringa, F. T.

---

Community and International Nutrition

Multi-Micronutrient–Fortified Biscuits Decreased Prevalence of Anemia and Improved Micronutrient Status and Effectiveness of Deworming in Rural Vietnamese School Children^1,2

³ National Institute of Nutrition, Hanoi, Vietnam; ⁴ Institute of Nutrition, Mahidol University, Nakhon Pathom 73170, Thailand; ⁵ Department Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; ⁶ Department of Nutritional Sciences, University of Wisconsin, Madison, WI 53706; and ⁷ Institut de Recherche pour le Développement UR-106, Montpellier BP 64501, 34394 CEDEX 5, France

Concurrent micronutrient deficiencies are prevalent among Vietnamese school children. A school-based program providing food fortified with multiple micronutrients could be a cost-effective and sustainable strategy to improve health and cognitive function of school children. However, the efficacy of such an intervention may be compromised by the high prevalence of parasitic infestation. To evaluate the efficacy of school-based intervention using multi-micronutrient–fortified biscuits with or without deworming on anemia and micronutrient status in Vietnamese schoolchildren, a randomized, double-blind, placebo-controlled trial was conducted among 510 primary schoolchildren, aged 6–8 y, in rural Vietnam. Albendazole (Alb) (400 mg) or placebo was given at baseline. Nonfortified or multi-micronutrient–fortified biscuits including iron (6 mg), zinc (5.6 mg), iodine (35 µg), and vitamin A (300 µg retinol equivalents) were given 5 d/wk for 4 mo. Multi-micronutrient fortification significantly improved the concentrations of hemoglobin (+1.87 g/L; 95% CI: 0.78, 2.96), plasma ferritin (+7.5 µg/L; 95% CI: 2.8, 12.6), body iron (+0.56 mg/kg body weight; 95% CI: 0.29, 0.84), plasma zinc (+0.61 µmol/L; 95% CI: 0.26, 0.95), plasma retinol (+0.041 µmol/L; 95% CI: 0.001, 0.08), and urinary iodine (+22.49 µmol/L; 95% CI: 7.68, 37.31). Fortification reduced the risk of anemia and deficiencies of zinc and iodine by >40%. Parasitic infestation did not affect fortification efficacy, whereas fortification significantly enhanced deworming efficacy, with the lowest reinfection rates in children receiving both micronutrients and Alb. Multi-micronutrient fortification of biscuits is an effective strategy to improve the micronutrient status of Vietnamese schoolchildren and enhances effectiveness of deworming.

^* To whom correspondence should be addressed. E-mail: nupwn{at}mahidol.ac.th.

Manuscript received 17 September 2008. Initial review completed 9 November 2008. Revision accepted 11 February 2009.

Published online 25 March 2009.