title: Effect of micronutrient supplement on health and nutritional status of schoolchildren: bone health and body composition.
abstract: OBJECTIVE
  We investigated the effect of a micronutrient-enriched beverage on body composition, bone mineral content (BMC), bone area, and bone mineral density (BMD) at various sites in schoolchildren.
  
  
  METHODS
  A double-blind, placebo-controlled, matched-pair, cluster, randomization study was carried out in residential schoolchildren 6 to 16 y of age who lived near Hyderabad, India. Children (n = 268) were selected randomly from two classes of each grade (1 to 9) and were provided a micronutrient-enriched beverage (n = 146) or a placebo drink (n = 122). Bone parameters such as BMC, BMD, and bone area at various sites and the entire body were measured with dual-energy X-ray absorptiometry at the beginning and end of the study. Increments of outcome variables were subjected to paired t test with appropriate corrections to assess the effect of the supplement on bone health.
  
  
  RESULTS
  After 14 mo, increments for height, weight, fat-free mass, percentage of fat, whole-body BMC, whole-body bone area, and BMD at the neck of the femur were significantly greater (P < 0.05) in the supplemented group than in the placebo group.
  
  
  CONCLUSIONS
  The micronutrient-rich supplement increased tissue growth and skeletal shell in apparently normal children in the 14-mo period. It did not increase whole-body or site-specific BMD except at the neck of the femur. Amounts of calcium and other nutrients contained in the supplement were inadequate for tissue growth with density increases. This study raises important questions about the nutrient requirements of Indian children who consume a diet of cereals and pulses.
authors.affiliation: Division of Maternal and Child Health and Field Studies, National Institute of Nutrition (Indian Council of Medical Research), Hyderabad, India. veena52@yahoo.com
authors.forename: Veena
authors.initials: V
authors.lastname: Shatrugna
authors.forename: Nagalla
authors.initials: N
authors.lastname: Balakrishna
authors.forename: Kamala
authors.initials: K
authors.lastname: Krishnaswamy
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D001823:Body Composition / Q000187:drug effects*; D015519:Bone Density / Q000187:drug effects*; D001842:Bone and Bones / Q000378:metabolism; D002136:Calcium, Dietary / Q000008:administration & dosage*; D002648:Child; D016000:Cluster Analysis; D004311:Double-Blind Method; D005260:Female; D005527:Food, Fortified; D006304:Health Status; D006801:Humans; D007194:India; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage / Q000494:pharmacology*; D009751:Nutritional Requirements; D009752:Nutritional Status; D012574:Schools; D012885:Skinfold Thickness; D016896:Treatment Outcome
chemical_list: D002136:Calcium, Dietary; D018977:Micronutrients