Next Article in Journal
Long-Term Blackcurrant Supplementation Modified Gut Microbiome Profiles in Mice in an Age-Dependent Manner: An Exploratory Study
Next Article in Special Issue
The Effects of Community Home Visit and Peer Group Nutrition Intervention Delivery Platforms on Nutrition Outcomes in Low and Middle-Income Countries: A Systematic Review and Meta-Analysis
Previous Article in Journal
Fat and Fat-Free Mass of Preterm and Term Infants from Birth to Six Months: A Review of Current Evidence
Previous Article in Special Issue
Effectiveness of Interventions for Managing Acute Malnutrition in Children under Five Years of Age in Low-Income and Middle-Income Countries: A Systematic Review and Meta-Analysis
Review

Micronutrient Supplementation and Fortification Interventions on Health and Development Outcomes among Children Under-Five in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

1
Centre for Global Child Health, Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
2
Centre of Excellence in Women and Child’s Health, Aga Khan University, Karachi 74800, Pakistan
3
Division of Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
*
Author to whom correspondence should be addressed.
Nutrients 2020, 12(2), 289; https://doi.org/10.3390/nu12020289
Received: 23 December 2019 / Revised: 10 January 2020 / Accepted: 19 January 2020 / Published: 21 January 2020
Micronutrient deficiencies continue to be widespread among children under-five in low- and middle-income countries (LMICs), despite the fact that several effective strategies now exist to prevent them. This kind of malnutrition can have several immediate and long-term consequences, including stunted growth, a higher risk of acquiring infections, and poor development outcomes, all of which may lead to a child not achieving his or her full potential. This review systematically synthesizes the available evidence on the strategies used to prevent micronutrient malnutrition among children under-five in LMICs, including single and multiple micronutrient (MMN) supplementation, lipid-based nutrient supplementation (LNS), targeted and large-scale fortification, and point-of-use-fortification with micronutrient powders (MNPs). We searched relevant databases and grey literature, retrieving 35,924 papers. After application of eligibility criteria, we included 197 unique studies. Of note, we examined the efficacy and effectiveness of interventions. We found that certain outcomes, such as anemia, responded to several intervention types. The risk of anemia was reduced with iron alone, iron-folic acid, MMN supplementation, MNPs, targeted fortification, and large-scale fortification. Stunting and underweight, however, were improved only among children who were provided with LNS, though MMN supplementation also slightly increased length-for-age z-scores. Vitamin A supplementation likely reduced all-cause mortality, while zinc supplementation decreased the incidence of diarrhea. Importantly, many effects of LNS and MNPs held when pooling data from effectiveness studies. Taken together, this evidence further supports the importance of these strategies for reducing the burden of micronutrient malnutrition in children. Population and context should be considered when selecting one or more appropriate interventions for programming. View Full-Text
Keywords: micronutrient; iron; vitamin A; zinc; lipid-based nutrient supplement; fortification; under-five; efficacy; effectiveness micronutrient; iron; vitamin A; zinc; lipid-based nutrient supplement; fortification; under-five; efficacy; effectiveness
Show Figures

Figure 1

MDPI and ACS Style

Tam, E.; Keats, E.C.; Rind, F.; Das, J.K.; Bhutta, Z.A. Micronutrient Supplementation and Fortification Interventions on Health and Development Outcomes among Children Under-Five in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis. Nutrients 2020, 12, 289. https://doi.org/10.3390/nu12020289

AMA Style

Tam E, Keats EC, Rind F, Das JK, Bhutta ZA. Micronutrient Supplementation and Fortification Interventions on Health and Development Outcomes among Children Under-Five in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis. Nutrients. 2020; 12(2):289. https://doi.org/10.3390/nu12020289

Chicago/Turabian Style

Tam, Emily, Emily C. Keats, Fahad Rind, Jai K. Das, and Zulfiqar A. Bhutta 2020. "Micronutrient Supplementation and Fortification Interventions on Health and Development Outcomes among Children Under-Five in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis" Nutrients 12, no. 2: 289. https://doi.org/10.3390/nu12020289

Find Other Styles
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop