Multiple-Micronutrient Fortified Non-Dairy Beverage Interventions Reduce the Risk of Anemia and Iron Deficiency in School-Aged Children in Low-Middle Income Countries: A Systematic Review and Meta-Analysis (i-iv)

Nutrients. 2015 May 21;7(5):3847-68. doi: 10.3390/nu7053847.

Abstract

Multiple-micronutrient (MMN) fortification of beverages may be an effective option to deliver micronutrients to vulnerable populations. The aim of the present systematic review and meta-analysis is to evaluate the nutritional impacts of MMN fortified beverages in the context of low-middle income countries. A systematic search of published literature yielded 1022 citations, of which 10 randomized controlled trials (nine in school-aged children and one in pregnant women) met inclusion criteria. Results of school-aged children were included in the meta-analysis. Compared to iso-caloric controls, children who received MMN fortified beverages for 8 weeks to 6 months showed significant improvements in hemoglobin (+2.76 g/L, 95% CI [1.19, 4.33], p = 0.004; 8 studies) and serum ferritin (+15.42 pmol/L, [5.73, 25.12], p = 0.007; 8 studies); and reduced risk of anemia (RR 0.58 [0.29, 0.88], p = 0.005; 6 studies), iron deficiency (RR 0.34 [0.21, 0.55], p = 0.002; 7 studies), and iron deficiency anemia (RR 0.17 [0.06, 0.53], p = 0.02; 3 studies). MMN fortified beverage interventions could have major programmatic implications for reducing the burden of anemia and iron deficiency in school-aged children in low-middle income countries. Additional research is needed to investigate effects on other biochemical outcomes and population subgroups.

Keywords: beverages; children; fortification; low-income; multiple-micronutrients.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Anemia / etiology
  • Anemia / metabolism
  • Anemia / prevention & control*
  • Anemia, Iron-Deficiency / etiology
  • Anemia, Iron-Deficiency / metabolism
  • Anemia, Iron-Deficiency / prevention & control*
  • Beverages*
  • Child
  • Developing Countries*
  • Food, Fortified*
  • Hemoglobins / metabolism
  • Humans
  • Income
  • Iron / therapeutic use
  • Iron Deficiencies*
  • Micronutrients / deficiency
  • Micronutrients / therapeutic use*
  • Poverty

Substances

  • Hemoglobins
  • Micronutrients
  • Iron