title: Impact of multiple micronutrient supplementation ("sprinkles") on iron deficiency anemia in Bedouin Arab and Jewish infants.
abstract: BACKGROUND
  A high prevalence of iron deficiency anemia persists in Bedouin Arab and Jewish pediatric populations in southern Israel.
  
  
  OBJECTIVE
  To compare the effect of daily use of the micronutrient supplementation (MMS), "Sprinkles," a powdered formulation of iron, vitamins A and C, folic acid and zinc, with liquid iron and vitamins A and D on iron deficiency at 12 months of age.
  
  
  METHODS
  The 621 eligible Bedouin and Jewish infants in the study were assigned to the MMS and control arms and received supplementations from age 6 to 12 months. We examined the change in hemoglobin, hematocrit, mean cell volume, red blood cell distribution, serum ferritin and transferrin saturation. In addition, we used the high Iron Deficiency Index (IDI) if two or more of the above six parameters showed abnormal levels.
  
  
  RESULTS
  Rates of anemia decreased significantly over the 6 month period, from 58.8% to 40.6% among Bedouin infants (P = 0.037) and from 40.6 to 15.8% among Jewish infants (P = 0.017). In Bedouin infants the prevalence of high IDI decreased significantly from 79.2% to 67.4% (P = 0.010) in the MMS group, but there was no change in the controls. Among Jewish infants, the high IDI prevalence decreased from 67% to 55.6% with no statistically significant difference in the two study arms. In the multivariate analysis in Bedouin infants MMS use was associated with a reduced risk of 67% in high IDI at age 12 months as compared to controls (P = 0.001). Fewer side effects in the intervention groups in both ethnic populations were reported.
  
  
  CONCLUSIONS
  MMS fortification of home food can be recommended as an effective and safe method for preventing iron deficiency anemia at 12 months of age.
authors.forename: Natalya
authors.initials: N
authors.lastname: Bilenko
authors.forename: Drora
authors.initials: D
authors.lastname: Fraser
authors.forename: Hillel
authors.initials: H
authors.lastname: Vardy
authors.forename: Ilana
authors.initials: I
authors.lastname: Belmaker
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000453:epidemiology / Q000208:ethnology* / Q000517:prevention & control*; D018912:Arabs / Q000706:statistics & numerical data*; D019587:Dietary Supplements; D005260:Female; D006400:Hematocrit; D006801:Humans; D007223:Infant; D007225:Infant Food; D007557:Israel / Q000453:epidemiology; D007585:Jews / Q000706:statistics & numerical data*; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage*; D009752:Nutritional Status / Q000208:ethnology; D012959:Socioeconomic Factors
chemical_list: D018977:Micronutrients