title: Efficacy of twice-weekly multiple micronutrient supplementation for improving the hemoglobin and micronutrient status of anemic adolescent schoolgirls in Bangladesh.
abstract: BACKGROUND
  Although iron deficiency is a major cause of anemia, other micronutrient deficiencies may also play a role.
  
  
  OBJECTIVE
  We examined whether multiple micronutrient supplementation is more efficacious than is supplementation with iron and folic acid alone for improving the hemoglobin and iron status of anemic adolescent girls in Bangladesh.
  
  
  METHODS
  Anemic (hemoglobin < 12.0 g/dL) girls (n = 197) aged 14-18 y from rural schools in Dhaka District were entered into a randomized double-blind trial and received twice-weekly supplements of iron and folic acid (IFA group) or multiple micronutrients (15 micronutrients, including iron and folic acid; MMN group) for 12 wk.
  
  
  RESULTS
  At recruitment, the characteristics of the girls in the 2 groups were not significantly different, except for family size and body mass index. At the end of the study, although both groups benefited significantly from supplementation, mean changes in hemoglobin and serum ferritin concentrations were not significantly different between groups. Compared with the IFA group, girls in the MMN group had significantly greater increases in mean serum vitamin A, plasma vitamin C, red blood cell folic acid, and riboflavin concentrations (assessed as erythrocyte glutathione reductase activation coefficient). After 12 wk of supplementation, only the prevalence of vitamins A and C and riboflavin deficiencies decreased more significantly in the MMN group than in the IFA group.
  
  
  CONCLUSIONS
  Twice-weekly MMN supplementation for 12 wk significantly improved the status of the micronutrients assessed but was not more efficacious than was supplementation with iron and folic acid alone in improving the hematologic status of anemic adolescent girls. More frequent doses may be needed to achieve full benefit.
authors.affiliation: Nutrition Program, School of Population Health, The University of Queensland, Queensland, Australia. f.ahmed@sph.uq.edu.au
authors.forename: Faruk
authors.initials: F
authors.lastname: Ahmed
authors.forename: Moududur Rahman
authors.initials: MR
authors.lastname: Khan
authors.forename: Mohammad
authors.initials: M
authors.lastname: Akhtaruzzaman
authors.forename: Rezaul
authors.initials: R
authors.lastname: Karim
authors.forename: Geoffrey Christopher
authors.initials: GC
authors.lastname: Marks
authors.forename: Cadi Parvin
authors.initials: CP
authors.lastname: Banu
authors.forename: Badrun
authors.initials: B
authors.lastname: Nahar
authors.forename: Gail
authors.initials: G
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D017195:Adolescent Nutritional Physiological Phenomena; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D001459:Bangladesh / Q000453:epidemiology; D019587:Dietary Supplements; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage / Q000627:therapeutic use; D006397:Hematinics / Q000008:administration & dosage / Q000627:therapeutic use; D006454:Hemoglobins / Q000187:drug effects* / Q000378:metabolism; D006801:Humans; D019266:Iron, Dietary / Q000008:administration & dosage / Q000627:therapeutic use*; D018977:Micronutrients / Q000008:administration & dosage / Q000627:therapeutic use*; D009752:Nutritional Status; D010349:Patient Compliance; D012423:Rural Health; D016896:Treatment Outcome
chemical_list: D004338:Drug Combinations; D006397:Hematinics; D006454:Hemoglobins; D019266:Iron, Dietary; D018977:Micronutrients; D005492:Folic Acid