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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)

by Grant J. Aaron 1,*,†, Daphna K. Dror 2,† and Zhenyu Yang 3,†
1
Global Alliance for Improved Nutrition (GAIN), Rue de Vermont 37-39, Geneva CH-1202, Switzerland
2
United States Department of Agriculture (USDA), Western Human Nutrition Research Center (WHNRC), 430 W. Health Sciences Dr., Davis, CA 95616, USA
3
Key Laboratory of Trace Element Nutrition, Ministry of Health of China, National Institute for Nutrition and Health, Chinese Center for Disease Control (CCDC), No. 29 Nanwei Road, Xicheng District, Beijing 100050, China
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Nutrients 2015, 7(5), 3847-3868; https://doi.org/10.3390/nu7053847
Received: 26 February 2015 / Revised: 24 April 2015 / Accepted: 5 May 2015 / Published: 21 May 2015
(This article belongs to the Special Issue Beverage Consumption and Human Health)
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. View Full-Text
Keywords: fortification; multiple-micronutrients; beverages; children; low-income fortification; multiple-micronutrients; beverages; children; low-income
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Aaron, G.J.; Dror, D.K.; Yang, Z. 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, 7, 3847-3868.

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