title: Micronutrient fortified milk improves iron status, anemia and growth among children 1-4 years: a double masked, randomized, controlled trial.
abstract: BACKGROUND
  Multiple micronutrient deficiencies are highly prevalent among preschool children and often lead to anemia and growth faltering. Given the limited success of supplementation and health education programs, fortification of foods could be a viable and sustainable option. We report results from a community based double-masked, randomized trial among children 1-4 years evaluating the effects of micronutrients (especially of zinc and iron) delivered through fortified milk on growth, anemia and iron status markers as part of a four group study design, running two studies simultaneously.
  
  
  RESULTS
  Enrolled children (n = 633) were randomly allocated to receive either micronutrients fortified milk (MN = 316) or control milk (Co = 317). Intervention of MN milk provided additional 7.8 mg zinc, 9.6 mg iron, 4.2 microg selenium, 0.27 mg copper, 156 microg vitamin A, 40.2 mg vitamin C, and 7.5 mg vitamin E per day (three serves) for one year. Anthropometry was recorded at baseline, mid- and end-study. Hematological parameters were estimated at baseline and end-study. Both groups were comparable at baseline. Compliance was over 85% and did not vary between groups. Compared to children consuming Co milk, children consuming MN milk showed significant improvement in weight gain (difference of mean: 0.21 kg/year; 95% confidence interval [CI] 0.12 to 0.31, p<0.001) and height gain (difference of mean: 0.51 cm/year; 95% CI 0.27 to 0.75, p<0.001). Mean hemoglobin (Hb) (difference of 13.6 g/L; 95% CI 11.1 to 16.0, p<0.001) and serum ferritin levels (difference of 7.9 microg/L; 95% CI 5.4 to 10.5, p<0.001) also improved. Children in MN group had 88% (odds ratio = 0.12, 95% CI 0.08 to 0.20, p<0.001) lower risk of iron deficiency anemia.
  
  
  CONCLUSIONS
  Milk provides an acceptable and effective vehicle for delivery of specific micronutrients, especially zinc and iron. Micronutrient bundle improved growth and iron status and reduced anemia in children 1-4 years old.
authors: Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
authors: Sunil
authors: S
authors: Sazawal
authors: Usha
authors: U
authors: Dhingra
authors: Pratibha
authors: P
authors: Dhingra
authors: Girish
authors: G
authors: Hiremath
authors: Archana
authors: A
authors: Sarkar
authors: Arup
authors: A
authors: Dutta
authors: Venugopal P
authors: VP
authors: Menon
authors: Robert E
authors: RE
authors: Black
mesh_terms: D000740:Anemia / Q000178:diet therapy*; D000818:Animals; D002675:Child, Preschool; D004311:Double-Blind Method; D005527:Food, Fortified; D048788:Growth and Development / Q000187:drug effects*; D015438:Health Behavior; D006801:Humans; D007223:Infant; D007501:Iron / Q000378:metabolism*; D018977:Micronutrients; D008892:Milk; D013997:Time Factors
chemical_list: D018977:Micronutrients; D007501:Iron