A Micronutrient Fortified Beverage Given at Different Dosing Frequencies Had Limited Impact on Anemia and Micronutrient Status in Filipino Schoolchildren.

This study evaluated the effects of a multi-micronutrient fortified juice drink given in different frequencies of consumption on hemoglobin (Hb) concentration of schoolchildren. Hb was measured in 2423 schoolchildren aged 6- to 9-years-old at baseline. All anemic children (n = 246) were randomly allocated into groups: Daily dose (HD: high dose), 5X/week (MD: Moderate Dose), 3X/week (LD: Low Dose) and unfortified (Control). Pre- and post-study measurements of micronutrients were collected from 228 children. At the endpoint, significant Hb increases were observed in all groups, but there was no significant difference between groups. There was a significant reduction in anemia prevalence in all groups from 100% to 36% (Control), 30% (LD), 23% (MD) and 26% (HD). No dose-response effect was observed in Hb in this population. Most likely, this resulted from better than expected micronutrient status and lower than expected severity of anemia and micronutrient deficiencies in this cohort. It is unlikely that the addition of a fortified beverage to school feeding programs in this population would have a positive impact. Whether such an intervention would be cost-effective as a preventative approach needs to be assessed. This study demonstrates the importance of targeting such interventions to appropriate populations.

Fortified juice drink improved iron and zinc status of schoolchildren.

Energy and micronutrient deficiency remain prevalent among Filipino children. Juice drinks are commonly consumed and could be a viable vehicle for fortification to supplement the nutrient gap. This study determined the effects of a newly developed non-carbonated fortified juice drink on the iron, zinc and nutritional status of schoolchildren. One hundred randomly selected anemic children were randomly allocated into two groups in a doubly-masked placebo controlled manner: Group 1 received the fortified juice, Group 2 received the non-fortified juice for 100 days, five days a week under strict supervision. The juice drink was fortified with vitamin A, zinc, iron, vitamin C and lysine. The non-fortified juice was fortified only with vitamin C. All children were dewormed prior to the intervention. Hemoglobin, plasma ferritin and plasma zinc, weight and height were assessed using standard methods before and after intervention. A two-day 24-hour food recall was also collected. The basal prevalence of anemia was significantly reduced in both the fortified group (100% to 13%) and the non-fortified group (100% to 40%) at endline. The mean plasma ferritin levels were similar in both groups at baseline and endline. At endline, mean plasma zinc in the fortified group has significantly increased by 20 µg/dL from a baseline value of 83.9 µg/dL to 103.9 µg/dL, while the non-fortified group remained at similar levels with baseline. Basal weight and height significantly increased among all children at endline. The fortified juice drink was effective in reducing the prevalence of anemia and improved the zinc status of children.

The effect of vitamin A-fortified coconut cooking oil on the serum retinol concentration of Filipino children 4-7 years old.

A 6-month intervention trial was conducted among 542 Filipino children aged 4 to 7 years to determine the effect of vitamin A-fortified coconut cooking oil intake on their vitamin A status and to identify factors that influence this. Children were randomly assigned to the Experimental group, with vitamin A-fortified cooking oil ration; to Control-1 group with unfortified cooking oil ration; and to Control-2 group without cooking oil ration. In all groups, children's serum retinol concentration improved. Relative change in serum retinol concentration was significantly higher among the Experimental group, with one-third of total vitamin A intake coming from vitamin A-fortified cooking oil intake, than in the Control groups, with more than half of intake from other vitamin A-rich foods. Determinants of post-intervention serum retinol concentration included baseline serum retinol concentration, caregiver's education, receipt of high-dose vitamin A capsule, interaction between consumption of vitamin A-fortified cooking oil and of other vitamin A-rich foods, and between households purchasing cooking oil and food expenditure. Intake of vitamin A-fortified cooking oil combined with vitamin A-rich foods was necessary to increase serum retinol concentration. It is recommended to vigorously promote the consumption of vitamin A-fortified cooking oil together with other vitamin A-rich sources to sustain the prevention and control of vitamin A deficiency.