title: Effect of micronutrient supplement on health and nutritional status of schoolchildren: biochemical status.
abstract: OBJECTIVE
  We assessed the effect of a daily intake of a micronutrient-fortified beverage for 14 mo on indicators of biochemical status of important micronutrients in schoolchildren.
  
  
  METHODS
  A double-blind, placebo-controlled, matched-pair, cluster, randomization study design was used. Biochemical indicators of micronutrient status were evaluated at baseline and at the end of 14 mo on a subsample in nine matched pairs. Prevalence (percentage) of subclinical deficiency, mean, and mean increments of each indicator were compared between supplemented and placebo groups.
  
  
  RESULTS
  Extent of inadequacy at baseline was more or less 100% for folic acid, 65% for vitamins B2 and B6, and 55% for vitamins C and A. Prevalence of anemia among subjects was 55%, with inadequacy of vitamin B12 being 40% and that of vitamin D being 30%. No subject had inadequacy of iodine based on urinary iodine. Supplementation of a micronutrient-enriched beverage for 14 mo significantly improved the status of many of the nutrients. The effect was significant with respect to vitamins A, B2, and B12, folic acid, vitamin D, parathyroid hormone, and thyroid-stimulating hormone in children who received the supplement compared with those who received only placebo. Hemoglobin status improved only in children who had anemia in the supplemented group.
  
  
  CONCLUSIONS
  Prevalence of multiple subclinical micronutrient deficiencies are high in middle-income Indian school children. Daily consumption of a micronutrient-enriched beverage had positive effects that were confined to those nutrients that were inadequate at baseline.
authors.affiliation: Division of Biophysics, National Institute of Nutrition (Indian Council of Medical Research), Hyderabad, India. dirnin_hyd@yahoo.co.in
authors.forename: Battiprolu
authors.initials: B
authors.lastname: Sivakumar
authors.forename: Krishnapillai Madhavan
authors.initials: KM
authors.lastname: Nair
authors.forename: Dande
authors.initials: D
authors.lastname: Sreeramulu
authors.forename: Palla
authors.initials: P
authors.lastname: Suryanarayana
authors.forename: Punjal
authors.initials: P
authors.lastname: Ravinder
authors.forename: Veena
authors.initials: V
authors.lastname: Shatrugna
authors.forename: Prattipati Ajey
authors.initials: PA
authors.lastname: Kumar
authors.forename: Manchala
authors.initials: M
authors.lastname: Raghunath
authors.forename: Varaganti Vikas
authors.initials: VV
authors.lastname: Rao
authors.forename: Nagalla
authors.initials: N
authors.lastname: Balakrishna
authors.forename: Putcha Uday
authors.initials: PU
authors.lastname: Kumar
authors.forename: Namala
authors.initials: N
authors.lastname: Raghuramulu
mesh_terms: D000293:Adolescent; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000453:epidemiology / Q000628:therapy; D001774:Blood Chemical Analysis; D002648:Child; D016000:Cluster Analysis; D004311:Double-Blind Method; D005260:Female; D005527:Food, Fortified; D006304:Health Status; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D018977:Micronutrients / Q000097:blood / Q000172:deficiency / Q000494:pharmacology; D008903:Minerals / Q000008:administration & dosage / Q000097:blood; D009748:Nutrition Disorders / Q000097:blood* / Q000453:epidemiology / Q000628:therapy*; D009752:Nutritional Status; D012574:Schools; D013963:Thyroid Hormones / Q000097:blood; D016896:Treatment Outcome; D014815:Vitamins / Q000008:administration & dosage / Q000097:blood
chemical_list: D018977:Micronutrients; D008903:Minerals; D013963:Thyroid Hormones; D014815:Vitamins