The effect of a 1-year multiple micronutrient or n-3 fatty acid fortified food intervention on morbidity in Indian school children.
OBJECTIVE
Few studies have shown that supplementation with micronutrients (MNs) or n-3 fatty acids may have health benefits such as reduced morbidity in schoolchildren. The effect of a combination of these nutrients has never been investigated. This study aimed to determine the effect of a combination of two different doses of MN and n-3 fatty acids on morbidity in schoolchildren in Bangalore, India.


METHODS
In all 598 children (6-10 years) received foods fortified with either high (100% recommended dietary allowance) or low (15% recommended dietary allowance) MN, combined with either high (900 mg α-linolenic acid (ALA) plus 100 mg docosahexaenoic acid) or low (140 mg ALA) n-3 fatty acids for 1 year. Morbidity was measured by weekly self-reports using a structured questionnaire. Poisson regression analyses of episodes/child/year and duration/episode adjusted for age and sex were performed on clusters of symptoms, including upper and lower respiratory tract infections (URTI and LRTI), gastrointestinal complaints (GI) and general symptoms of illness to observe MN and n-3 fatty acid treatment effects.


RESULTS
Children consuming high n-3 fatty acids had significantly fewer episodes of URTI/child/year (relative risk (RR)=0.88, 95% confidence interval (CI): 0.79, 0.97) and significantly shorter duration/episode of URTI (RR=0.81, 95% CI: 0.78, 0.85), LRTI (RR=0.91, 95% CI: 0.85, 0.97), GI complaints (RR=0.79, 95% CI: 0.74, 0.85) and general symptoms (RR=0.90, 95% CI: 0.82, 0.98) compared with children who received low n-3 fatty acid intervention. The high MN intervention reduced the duration of general symptoms (RR=0.89, 95% CI: 0.82, 0.98).


CONCLUSIONS
Although n-3 fatty acids may be beneficial for reducing illness in Indian schoolchildren, more research is needed to confirm presence of combined effect with MN.
Epidemiology and Biostatistics Unit, St John's Research Institute, St John's National Academy of Health Sciences, Bangalore, India. tinku.sarah@sjri.res.in
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Thomas
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Eilander
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Muthayya
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McKay
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Thankachan
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Theis
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Gandhe
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Osendarp
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Kurpad
D002648:Child; D016000:Cluster Analysis; D019587:Dietary Supplements; D004281:Docosahexaenoic Acids / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D006801:Humans; D007194:India / Q000453:epidemiology; D018977:Micronutrients / Q000008:administration & dosage*; D018673:Nutrition Policy; D012044:Regression Analysis; D012141:Respiratory Tract Infections / Q000453:epidemiology; D011795:Surveys and Questionnaires; D044465:White People; D017962:alpha-Linolenic Acid / Q000008:administration & dosage
D015525:Fatty Acids, Omega-3; D018977:Micronutrients; D017962:alpha-Linolenic Acid; D004281:Docosahexaenoic Acids