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Open AccessArticle

Multi-Micronutrient Fortified Rice Improved Serum Zinc and Folate Concentrations of Cambodian School Children. A Double-Blinded Cluster-Randomized Controlled Trial

1
Department of Fisheries Post-Harvest Technologies and Quality control (DFPTQ), Fisheries Administration, Ministry of Agriculture, Forestry and Fisheries, Phnom Penh, Cambodia
2
Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg, Denmark
3
Institut Pasteur du Cambodge, Phnom Penh, Cambodia
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UMR-204 Nutripass, Institut de Recherche pour le Développement (IRD), IRD/Université de Montpellier/SupAgro, 34394 Montpellier, France
5
World Food Programme (WFP), Phnom Penh, Cambodia
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PATH (Program for Appropriate Technology in Health), 2201 Westlake Avenue, Suite 200, Seattle, WA 98121, USA
*
Authors to whom correspondence should be addressed.
Nutrients 2019, 11(12), 2843; https://doi.org/10.3390/nu11122843
Received: 27 September 2019 / Revised: 13 November 2019 / Accepted: 15 November 2019 / Published: 20 November 2019
Background: Within Cambodia, micronutrient deficiencies continue to be prevalent in vulnerable groups, such as women and children. Fortification of staple foods such as rice could be a promising strategy for Cambodia to improve micronutrient status. Objective: Our objective was to investigate the impact of multiple-micronutrient fortified rice (MMFR), distributed through a World Food Program school-meals program (WFP-SMP) on serum zinc concentrations and folate status in a double-blind, cluster-randomized, placebo-controlled trial. Methods: Sixteen schools were randomly assigned to receive one of three different types of extruded-fortified rice (UltraRice Original (URO), UltraRice New (URN), or NutriRice) or unfortified rice (placebo) six days a week for six months. A total of 1950 schoolchildren (6–16 years old) participated in the study. Serum zinc (all groups) and folate (only in NutriRice and placebo group) concentrations were assessed from morning non-fasting antecubital blood samples and were measured at three time points (baseline and after three and six months). Results: After six months of intervention, serum zinc concentrations were significantly increased in all fortified rice group compared to placebo and baseline (0.98, 0.85 and 1.40 µmol/L for URO, URN and NutriRice, respectively) (interaction effect: p < 0.001 for all). Children in the intervention groups had a risk of zinc deficiencies of around one third (0.35, 039, and 0.28 for URO, URN, and NutriRice, respectively) compared to the placebo (p < 0.001 for all). The children receiving NutriRice had higher serum folate concentrations at endline compared to children receiving normal rice (+2.25 ng/mL, p = 0.007). Conclusions: This study showed that the high prevalence of zinc and folate deficiency in Cambodia can be improved through the provision of MMFR. As rice is the staple diet for Cambodia, MMFR should be considered to be included in the school meal program and possibilities should be explored to introduce MMFR to the general population. View Full-Text
Keywords: fortified rice; micronutrient; deficiency; zinc; school children; Cambodia fortified rice; micronutrient; deficiency; zinc; school children; Cambodia
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MDPI and ACS Style

Kuong, K.; Tor, P.; Perignon, M.; Fiorentino, M.; Chamnan, C.; Berger, J.; Burja, K.; Dijkhuizen, M.A.; Parker, M.; Roos, N.; Wieringa, F.T. Multi-Micronutrient Fortified Rice Improved Serum Zinc and Folate Concentrations of Cambodian School Children. A Double-Blinded Cluster-Randomized Controlled Trial. Nutrients 2019, 11, 2843. https://doi.org/10.3390/nu11122843

AMA Style

Kuong K, Tor P, Perignon M, Fiorentino M, Chamnan C, Berger J, Burja K, Dijkhuizen MA, Parker M, Roos N, Wieringa FT. Multi-Micronutrient Fortified Rice Improved Serum Zinc and Folate Concentrations of Cambodian School Children. A Double-Blinded Cluster-Randomized Controlled Trial. Nutrients. 2019; 11(12):2843. https://doi.org/10.3390/nu11122843

Chicago/Turabian Style

Kuong, Khov; Tor, Pety; Perignon, Marlene; Fiorentino, Marion; Chamnan, Chhoun; Berger, Jacques; Burja, Kurt; Dijkhuizen, Marjoleine A.; Parker, Megan; Roos, Nanna; Wieringa, Frank T. 2019. "Multi-Micronutrient Fortified Rice Improved Serum Zinc and Folate Concentrations of Cambodian School Children. A Double-Blinded Cluster-Randomized Controlled Trial" Nutrients 11, no. 12: 2843. https://doi.org/10.3390/nu11122843

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