title: Retinol and riboflavin supplementation decreases the prevalence of anemia in Chinese pregnant women taking iron and folic Acid supplements.
abstract: In rural China, many pregnant women in their third trimester suffer from anemia (48%) and iron deficiency (ID; 42%), often with coexisting deficiencies of retinol and riboflavin. We investigated the effect of retinol and riboflavin supplementation in addition to iron plus folic acid on anemia and subjective well-being in pregnant women. The study was a 2-mo, double-blind, randomized trial. Subjects (n = 366) with anemia [hemoglobin (Hb) </= 105 g/L] were randomly assigned to 4 groups, all receiving 60 mg/d iron and 400 mug/d folic acid. The iron+folic acid (IF) group (n = 93) served as reference, the iron+folic acid+retinol group (IFA) (n = 91) was treated with 2000 mug retinol, the iron+folic acid+riboflavin group (IFB) (n = 91) with 1.0 mg riboflavin, and the iron+folic acid+retinol+riboflavin group (IFAB) (n = 91) with retinol and riboflavin. After the 2-mo intervention, the Hb concentration increased in all 4 groups (P < 0.001). The increase in the IFAB group was 5.4 +/- 1.1 g/L greater than in the IF group (P < 0.001). The reduced prevalence of anemia (Hb < 110g/L) and ID anemia were significantly greater in the groups supplemented with retinol and /or riboflavin than in the IF group. Moreover, gastrointestinal symptoms were less prevalent in the IFA group than in the IF group (P < 0.05) and improved well-being was more prevalent in the groups receiving additional retinol and/or riboflavin than in the IF group (P < 0.05). Thus, a combination of iron, folic acid, retinol, and riboflavin was more effective than iron plus folic acid alone. Multimicronutrient supplementation may be worthwhile for pregnant women in rural China.
authors.affiliation: Institute of Human Nutrition, Medical College of Qingdao University, 266021 Qingdao, China. aiguom502@hotmail.com
authors.forename: Ai G
authors.initials: AG
authors.lastname: Ma
authors.forename: Evert G
authors.initials: EG
authors.lastname: Schouten
authors.forename: Feng Z
authors.initials: FZ
authors.lastname: Zhang
authors.forename: Frans J
authors.initials: FJ
authors.lastname: Kok
authors.forename: Fang
authors.initials: F
authors.lastname: Yang
authors.forename: Dian C
authors.initials: DC
authors.lastname: Jiang
authors.forename: Yong Y
authors.initials: YY
authors.lastname: Sun
authors.forename: Xiu X
authors.initials: XX
authors.lastname: Han
mesh_terms: D000328:Adult; D000740:Anemia / Q000453:epidemiology / Q000517:prevention & control*; D002681:China / Q000453:epidemiology; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D005865:Gestational Age; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007501:Iron / Q000008:administration & dosage / Q000627:therapeutic use*; D018579:Patient Selection; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood* / Q000517:prevention & control; D015995:Prevalence; D012256:Riboflavin / Q000008:administration & dosage / Q000627:therapeutic use*; D014801:Vitamin A / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D006454:Hemoglobins; D014801:Vitamin A; D005492:Folic Acid; D007501:Iron; D012256:Riboflavin