title: Multiple micronutrient-fortified rice affects physical performance and plasma vitamin B-12 and homocysteine concentrations of Indian school children.
abstract: Fortifying rice with multiple micronutrients could be a promising strategy for combat micronutrient deficiencies in developing countries. We determined the efficacy of extruded rice grains fortified with multiple micronutrients on the prevalence of anemia, micronutrient status, and physical and cognitive performance in 6- to 12-y-old, low-income school children in Bangalore, India. In a randomized, double-blind, controlled trial, 258 children were assigned to 1 of 3 intervention groups to receive rice-based lunch meals fortified with multiple micronutrients with either low-iron (6.25 mg) or high-iron (12.5 mg) concentrations or identical meals with unfortified rice. The meals were provided 6 d/wk for 6 mo. Anthropometric, biochemical, physical performance, and cognitive assessments were taken at baseline and endpoint. At baseline, study groups were comparable, with 61% of the children being anemic. However, only <10% were deficient in iron, vitamin A, and zinc. After 6 mo, plasma vitamin B-12 and homocysteine concentrations (both P < 0.001) as well as physical performance (P < 0.05) significantly improved in the intervention arms. No between-group differences were observed in hemoglobin concentration, anemia, and deficiencies of other micronutrients or cognitive function after 6 mo, but paired analyses revealed a small reduction in anemia prevalence in children in the low-iron group. The fortified rice was efficacious in improving vitamin B-12 status and physical performance in Indian school children.
authors.affiliation: Division of Nutrition, St John's Research Institute, St John's National Academy of Health Sciences, Bangalore, India.
authors.forename: Prashanth
authors.initials: P
authors.lastname: Thankachan
authors.forename: Jee Hyun
authors.initials: JH
authors.lastname: Rah
authors.forename: Tinku
authors.initials: T
authors.lastname: Thomas
authors.forename: Sumithra
authors.initials: S
authors.lastname: Selvam
authors.forename: Vani
authors.initials: V
authors.lastname: Amalrajan
authors.forename: Krishnamachari
authors.initials: K
authors.lastname: Srinivasan
authors.forename: Georg
authors.initials: G
authors.lastname: Steiger
authors.forename: Anura V
authors.initials: AV
authors.lastname: Kurpad
mesh_terms: D000740:Anemia / Q000453:epidemiology / Q000517:prevention & control*; D002648:Child; D015362:Child Nutrition Disorders / Q000453:epidemiology / Q000517:prevention & control*; D003071:Cognition; D004522:Educational Status; D005260:Female; D005522:Food Services; D005527:Food, Fortified; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D007194:India / Q000453:epidemiology; D007501:Iron / Q000008:administration & dosage; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage*; D009017:Morbidity; D009043:Motor Activity; D012275:Oryza; D015995:Prevalence; D012574:Schools; D014805:Vitamin B 12 / Q000097:blood*
chemical_list: D018977:Micronutrients; D006710:Homocysteine; D007501:Iron; D014805:Vitamin B 12