Consumption of Micronutrient Powder, Syrup or Fortified Food Significantly Improves Zinc and Iron Status in Young Mexican Children: A Cluster Randomized Trial
Abstract
:1. Introduction
2. Materials and Methods
2.1. Setting and Design
2.2. Data Collection and Descriptions
2.3. Data Management, Statistical Analysis, and Power
2.3.1. Data Management
2.3.2. Statistical Analysis
2.3.3. Statistical Power
2.4. Ethical Considerations
3. Results
Differential Effects of Supplementation
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Nutrisano (Fortified Food) | Micronutrient Powder | Syrup | |
---|---|---|---|
Quantity to be consumed | (44 g) | (1.0 g) | (5 mL) |
Energy, kcal | 194 | - | - |
Protein, g | 5.8 | - | - |
Carbohydrates, g | 27.9 | - | - |
Lipid, g | 6.6 | - | - |
Sodium, mg | 24.5 | - | - |
Iron, mg 2 | 10.0 | 10.0 | 10.0 |
Zinc, mg 3 | 10.0 | 10.0 | 10.0 |
Vitamin A, µg ER | 400.0 | 400.0 | 400.0 |
Vitamin E, µg ET | 6.0 | 6.0 | 6.0 |
Vitamin C, mg | 50.0 | 50.0 | 50.0 |
Vitamin B2, mg | 0.8 | 0.8 | 0.8 |
Vitamin B12, µg | 0.7 | 0.7 | 0.7 |
Folic acid, µg | 50.0 | 50.0 | 50.0 |
Fortified Food | Syrup | MNP 1 | Total | |
---|---|---|---|---|
n = 73 | n = 105 | n = 105 | n = 283 | |
General characteristics | ||||
Age, months | 8.2 ± 2.5 | 8.5 ± 2.6 | 8.4 ± 2.4 | 8.4 ± 2.5 |
Sex, % males | 47.9 | 47.1 | 55.2 | 50.2 |
Socioeconomic Index # | 0.2 ± 1.0 | −0.2 ± 1.0 | 0.1 ± 1.0 | 0.0 ± 1.0 |
Anthropometric measurements | ||||
Length, cm | 67.3 ± 4.3 | 67.5 ± 4.5 | 67.8 ± 4.2 | 67.6 ± 4.3 |
Weight, kg | 7.9 ± 1.2 | 7.8 ± 1.3 | 8.1 ± 1.2 | 7.9 ± 1.2 |
Nutritional Status | ||||
Length for age, Z | −1.0 ± 1.0 | −1.1 ± 1.0 | −1.0 ± 1.0 | −1.0 ± 1.0 |
Stunting 2, % | 17.8 | 14.4 | 20.0 | 17.3 |
Weight for age, Z | −0.4 ± 1.0 | −0.6 ± 1.0 | −0.4 ± 1.0 | −0.5 ± 1.0 |
Weight for length, Z | 0.3 ± 0.9 | 0.1 ± 1.0 | 0.3 ± 0.9 | 0.3 ± 0.9 |
BMI for age, Z | 0.3 ± 0.9 | 0.1 ± 1.0 | 0.3 ± 0.9 | 0.2 ± 0.9 |
Overweight or obesity 3, % | 2.7 | 1.0 | 1.9 | |
CRP, mg/L | ||||
Median | 1.7 | 1.1 | 0.8 | 1.0 |
[p25, p75] | [0.4, 8] | [0.3, 4.2] | [0.2, 3.4] | [0.3, 4.2] |
FF | Syrup | MNP 1 | Syrup vs. FF | MNP vs. FF | MNP vs. Syrup | |
---|---|---|---|---|---|---|
Zinc, µmol/L | ||||||
n = 73 | n = 99 | n = 104 | ||||
Baseline | 11.3 (10.9, 11.8) | 10.8 (10.5, 11.2) | 10.9 (10.4, 11.3) | −0.5 (−1.1, 0.1) | −0.5 (−1.1, 0.2) | 0.0 (−0.6, 0.6) |
4 months | 12.3 (11.9, 12.7) | 15.2 (14.3, 16.2) | 13.7 (13.2, 14.2) | 2.9 (1.9, 4.0) | 1.5 (0.8, 2.1) | −1.5 (−2.6, −0.4) |
Change | 0.9 (0.3, 1.6) | 4.4 (3.2, 5.5) | 2.9 (2.1, 3.6) | 3.4 (2.1, 4.7) | 1.9 (0.9, 2.9) | −1.5 (−2.9, −0.1) |
Ferritin, µg/L | ||||||
n = 70 | n = 98 | n = 99 | ||||
Baseline | 18.7 (12.7, 24.7) | 26.5 (20.0, 32.9) | 22.3 (16.7, 27.8) | 7.8 (−1.4, 16.9) | 3.6 (−4.7, 11.8) | −4.2 (−12.9, 4.4) |
4 months | 14.5 (10.5, 18.6) | 24.7 (19.8, 29.6) | 25.7 (20.2, 31.2) | 10.2 (3.5, 16.8) | 11.2 (4.3, 18.1) | 1.0 (−6.5, 8.6) |
Change | −4.2 (−11.6, 3.3) | −1.8 (−7.6, 4.0) | 3.5 (−5.6, 12.6) | 2.4 (−7.1, 11.8) | 7.6 (−4.1, 19.4) | 5.3 (−5.5, 16.0) |
sTfR, mg/L | ||||||
n = 70 | n = 99 | n = 99 | ||||
Baseline | 4.14 (3.44, 4.83) | 4.73 (4.27, 5.20) | 4.52 (4.17, 4.86) | 0.60 (−0.25, 1.45) | 0.38 (−0.42, 1.19) | −0.22 (−0.82, 0.39) |
4 months | 4.87 (4.35, 5.40) | 4.36 (4.15, 4.57) | 4.49 (4.20, 4.77) | −0.51 (−1.09, 0.06) | −0.39 (−0.99, 0.21) | 0.13 (−0.23, 0.49) |
Change | 0.74 (−0.23, 1.71) | −0.38 (−0.88, 0.12) | −0.03 (−0.53, 0.47) | −1.11 (−2.21, −0.02) | −0.77 (−1.86, 0.32) | 0.34 (−0.36, 1.05) |
Hemoglobin, g/L | ||||||
n = 73 | n = 100 | n = 103 | ||||
Baseline | 110.6 (108.0, 113.2) | 109.2 (105.6, 112.7) | 110.2 (107.7, 112.6) | −1.4 (−5.9, 3.0) | −0.4 (−4.0, 3.2) | 1.0 (−3.3, 5.4) |
4 months | 109.3 (107.4, 111.3) | 113.6 (110.6, 116.6) | 115.6 (114.0, 117.3) | 4.3 (0.7, 7.8) | 6.3 (3.5, 9.1) | 2.1 (−1.5, 5.6) |
Change | −1.3 (−4.1, 1.6) | 4.4 (−1.4, 10.3) | 5.5 (2.5, 8.4) | 5.7 (−0.8, 12.2) | 6.7 (2.7, 10.8) | 1.0 (−5.5, 7.6) |
FF | Syrup | MNP 1 | Syrup vs. FF | MNP vs. FF | MNP vs. Syrup | |
---|---|---|---|---|---|---|
Zinc deficiency (Zn < 9.9 µmol/L), % | ||||||
n = 73 | n = 99 | n = 104 | ||||
Baseline | 22.9 (14.2, 31.6) | 39.2 (31.0, 47.5) | 32.1 (24.0, 40.3) | 16.4 (3.9, 28.9) | 9.3 (−3.0, 21.5) | −7.1 (−19.4, 5.2) |
4 months | 10.8 (4.0, 17.5) | 3.0 (0.1, 5.9) | 8.6 (4.7, 12.5) | −7.8 (−15.1, −0.4) | −2.2 (−10.2, 5.9) | 5.6 (0.8, 10.4) |
Change | −12.1 (−22.6, −1.6) | −36.2 (−45.8, −26.6) | −23.5 (−34.3, −12.8) | −24.1 (−38.8, −9.4) | −11.4 (−26.4, 3.5) | 12.7 (−2.2, 27.6) |
Low iron stores (ferritin < 12 µg/L), % | ||||||
n = 70 | n = 98 | n = 99 | ||||
Baseline | 33.8 (21.2, 46.3) | 27.9 (17.4, 38.4) | 25.7 (18.3, 33.1) | −5.9 (−22.6, 10.8) | −8.1 (−22.9, 6.7) | −2.2 (−15.2, 10.8) |
4 months | 39.8 (26.5, 53.0) | 15.2 (9.2, 21.2) | 14.8 (7.1, 22.4) | −24.6 (−39.7, −9.5) | −25.0 (−40.2, −9.8) | −0.4 (−10.5, 9.7) |
Change | 6.0 (−11.4, 23.3) | −12.7 (−22.2, −3.2) | −10.9 (−24.1, 2.3) | −18.7 (−38.5, 1.1) | −16.9 (−38.6, 4.8) | 1.8 (−14.4, 18.0) |
Tissue iron deficiency (sTfR > 6 mg/L), % | ||||||
n = 70 | n = 99 | n = 99 | ||||
Baseline | 16.3 (3.3, 29.2) | 19.6 (9.4, 29.8) | 18.1 (9.2, 27.1) | 3.3 (−13.6, 20.3) | 1.9 (−14.9, 18.6) | −1.5 (−15.0, 12.1) |
4 months | 16.3 (7.4, 25.1) | 7.8 (2.5, 13.1) | 6.5 (0.9, 12.1) | −8.5 (−18.7, 1.8) | −9.8 (−20.5, 1.0) | −1.3 (−9.2, 6.6) |
Change | 0.0 (−10.8, 10.8) | −11.8 (−24.4, 0.9) | −11.6 (−23.1, −0.2) | −11.8 (−28.5, 4.9) | −11.6 (−27.4, 4.1) | 0.2 (−16.8, 17.1) |
Anemia (Hb < 110 g/L), % | ||||||
n = 73 | n = 100 | n = 103 | ||||
Baseline | 49.3 (42.9, 55.7) | 48.4 (37.5, 59.4) | 44.2 (33.2, 55.2) | −0.9 (−13.9, 12.2) | −5.1 (−18.5, 8.3) | −4.2 (−20.0, 11.5) |
4 months | 53.4 (46.7, 60.1) | 35.5 (24.5, 46.5) | 26.8 (21.6, 32.0) | −17.9 (−31.1, −4.7) | −26.6 (−35.4, −17.8) | −8.7 (−21.3, 3.9) |
Change | 4.1 (−4.1, 12.2) | −12.9 (−31.8, 5.9) | −17.4 (−29.6, −5.2) | −17.0 (−37.5, 3.5) | −21.5 (−36.2, −6.8) | −4.5 (−26.9, 17.9) |
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García-Guerra, A.; Rivera, J.A.; Neufeld, L.M.; Quezada-Sánchez, A.D.; Dominguez Islas, C.; Fernández-Gaxiola, A.C.; Bonvecchio Arenas, A. Consumption of Micronutrient Powder, Syrup or Fortified Food Significantly Improves Zinc and Iron Status in Young Mexican Children: A Cluster Randomized Trial. Nutrients 2022, 14, 2231. https://doi.org/10.3390/nu14112231
García-Guerra A, Rivera JA, Neufeld LM, Quezada-Sánchez AD, Dominguez Islas C, Fernández-Gaxiola AC, Bonvecchio Arenas A. Consumption of Micronutrient Powder, Syrup or Fortified Food Significantly Improves Zinc and Iron Status in Young Mexican Children: A Cluster Randomized Trial. Nutrients. 2022; 14(11):2231. https://doi.org/10.3390/nu14112231
Chicago/Turabian StyleGarcía-Guerra, Armando, Juan A. Rivera, Lynnette M. Neufeld, Amado D. Quezada-Sánchez, Clara Dominguez Islas, Ana Cecilia Fernández-Gaxiola, and Anabelle Bonvecchio Arenas. 2022. "Consumption of Micronutrient Powder, Syrup or Fortified Food Significantly Improves Zinc and Iron Status in Young Mexican Children: A Cluster Randomized Trial" Nutrients 14, no. 11: 2231. https://doi.org/10.3390/nu14112231