title: Multivitamin-mineral supplementation is not as efficacious as is iron supplementation in improving hemoglobin concentrations in nonpregnant anemic women living in Mexico.
abstract: BACKGROUND
  Iron supplements improve hemoglobin status and reduce anemia due to iron deficiency. It is not known whether multiple micronutrient (MM) supplements are as efficacious as are iron supplements alone in improving hemoglobin concentrations.
  
  
  OBJECTIVE
  We conducted a randomized, double-blind community trial in Mexico to compare the efficacy of MM supplements containing iron with that of iron alone in improving hemoglobin concentrations in nonpregnant women.
  
  
  METHODS
  Nonpregnant women (n = 158) were recruited from a semirural community in Mexico and were randomly assigned to receive iron alone (60 mg; Fe group) or MM supplements (vitamins A, B complex, C, D, E, and K and iron, zinc, and magnesium; MM group) 6 d/wk in their home for 12 wk. Hemoglobin concentrations were measured in capillary blood samples at baseline and follow-up.
  
  
  RESULTS
  The treatment groups (MM: n = 75; Fe: n = 77) did not differ significantly at recruitment in age, schooling, literacy, or socioeconomic status. There were no significant differences between groups in compliance (median: 97.5%), baseline hemoglobin concentrations, or prevalence of anemia (20%). Losses to follow-up (4%) and mean (+/-SD) changes in hemoglobin (MM group: 6.7 +/- 10.6 g/L; Fe group: 7.1 +/- 13.6 g/L) were not significantly different between groups. However, the change in hemoglobin in anemic subjects was greater in the Fe group than in the MM group (P < 0.05 for interaction), and there was no significant difference in nonanemic subjects.
  
  
  CONCLUSIONS
  MM supplements may not be as efficacious as is iron alone in improving the hemoglobin status of anemic women.
authors.affiliation: Program in Nutrition and Health Sciences, Graduate Division of Biological and Biomedical Sciences and the Department of International Health, Rollins School of Public Health, Emory University, Atlanta, USA.
authors.forename: Siobhan E
authors.initials: SE
authors.lastname: Moriarty-Craige
authors.forename: Usha
authors.initials: U
authors.lastname: Ramakrishnan
authors.forename: Lynnette
authors.initials: L
authors.lastname: Neufeld
authors.forename: Juan
authors.initials: J
authors.lastname: Rivera
authors.forename: Reynaldo
authors.initials: R
authors.lastname: Martorell
mesh_terms: D000328:Adult; D000740:Anemia / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006454:Hemoglobins / Q000187:drug effects*; D006801:Humans; D007501:Iron / Q000627:therapeutic use*; D008800:Mexico; D012923:Social Class; D014815:Vitamins / Q000627:therapeutic use*
chemical_list: D006454:Hemoglobins; D014815:Vitamins; D007501:Iron