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Interventions and public health nutrition

Efficacy of a multi micronutrient-fortified drink in improving iron and micronutrient status among schoolchildren with low iron stores in India: a randomised, double-masked placebo-controlled trial

European Journal of Clinical Nutrition volume 67, pages 36–41 (2013)Cite this article

Subjects

Abstract

Background/Objectives:

A multiple micronutrient-fortified drink could be an effective strategy to combating micronutrient deficiencies in school going children. To assess the efficacy of a multiple micronutrient-fortified drink in reducing iron deficiency (ID), ID anemia (IDA), anemia and improving micronutrient status among schoolchildren with low iron stores. The study employed a school-based, randomized, double-blind, placebo-controlled design.

Subjects/Methods:

Schoolchildren with low serum ferritin (SF <20 μg/l) (n=246), aged 6–12 years were randomly assigned to receive either a multi-micronutrient fortified or an unfortified identical control drink. The drinks were provided 6 days/week for 8 weeks. Anthropometric and biochemical assessments were taken at baseline and endline.

Results:

Study groups at baseline were comparable, and compliance to the intervention was similar. The overall prevalence of ID, IDA and anemia was 64%, 19% and 24%, respectively. The prevalence of ID, IDA, vitamin C and vitamin B12 deficiencies significantly reduced by 42%, 18%, 21% and 5%, respectively, in the intervention arm (P<0.01) as compared with the control arm at the end of the study. Similarly, the concentration of hemoglobin, SF, vitamin A, vitamin B12, vitamin C and body iron stores were significantly higher in the intervention arm in comparison to the control arm (P<0.001). Red cell folate levels also improved significantly in the intervention arm (P=0.04), however, serum zinc status did not change in either of the study arms. Children who had received the fortified drink had significantly lower odds of being ID (0.15; 95% confidence interval (CI): 0.09–0.27), IDA (0.14; 95% CI: 0.04–0.52), vitamin B12 deficient (0.36; 95% CI: 0.18–0.73) and vitamin C deficient (0.24; 95% CI: 0.13–0.46), after adjusting for baseline age, gender and weight.

Conclusions:

The multi micronutrient-fortified drink was efficacious in reducing the prevalence of ID, IDA, vitamin C and vitamin B12 deficiency and improved micronutrient status in schoolchildren.

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Acknowledgements

We are most grateful to the principals and teachers of the schools, the children and their parents for their participation in the study. We want to express our thanks to all our colleagues who were involved in data collection, biochemical analyses and the preparation and distribution of drinks: Stella Mary, Beena Bose, Kiran and all the study staff from St John’s Medical College and Research Institute, Bangalore. This study was supported by Coca-Cola, India.

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Authors and Affiliations

  1. Division of Nutrition, St John’s Research Institute, St John’s National Academy of Health Sciences, Bangalore, India

    P Thankachan, S Selvam, D Surendran, S Chellan, M Pauline & A V Kurpad

  2. USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA

    S A Abrams

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  1. P Thankachan
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  2. S Selvam
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  3. D Surendran
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  7. A V Kurpad
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Corresponding author

Correspondence to P Thankachan.

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Competing interests

AVK is a member of the Kraft Health and Wellness Advisory Board. The remaining authors declare no conflict of interest.

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Thankachan, P., Selvam, S., Surendran, D. et al. Efficacy of a multi micronutrient-fortified drink in improving iron and micronutrient status among schoolchildren with low iron stores in India: a randomised, double-masked placebo-controlled trial. Eur J Clin Nutr 67, 36–41 (2013). https://doi.org/10.1038/ejcn.2012.188

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