Smuts Cornelius M, Dhansay Muhammad A, Faber Mieke, van Stuijvenberg Martha E, Swanevelder Sonja, Gross Rainer, Benadé A J Spinnler
Nutritional Intervention Research Unit, MRC, Parow, South Africa.
J Nutr. 2005 Mar;135(3):653S-659S. doi: 10.1093/jn/135.3.653S.
Growth faltering, anemia, and multiple micronutrient deficiency are common during infancy in developing countries. This South African trial was part of a multicenter study aimed at testing the efficacy of multiple micronutrient supplementation on growth, anemia, micronutrient status, and morbidity during infancy across 4 countries. A total of 265 infants aged 6-12 mo were individually randomized to 1 of 4 intervention groups: a daily multiple micronutrient supplement (DMM), a daily placebo supplement (P); a multiple micronutrient supplement 1 d of the week and placebo supplement on the other days of the week (WMM), and a daily iron supplement (DI). For 6 mo, the blinded supplements were provided to mothers at monthly health clinic sessions, and consumption was verified during weekly household visits by community health workers, when morbidity was also checked. Weight and height of the infants were measured monthly, and blood samples were taken at the beginning and at the end for assessing the infants micronutrient status. There were no significant differences in nutritional status of the groups at baseline with 40% of infants with anemia (hemoglobin < 110 g/L), 16% vitamin A deficiency (plasma retinol < 0.7 micromol/L), 47% zinc deficiency (plasma zinc < 10.7 micromol/L), 2% underweight, and 11% stunting. There was no difference in growth or morbidity between the micronutrient supplemented groups and the P group during the 6-mo study. The DMM was the most effective intervention tested, not only for improving anemia but also for improving iron, zinc, riboflavin, and tocopherol status.
在发展中国家，生长发育迟缓、贫血和多种微量营养素缺乏在婴儿期很常见。这项南非试验是一项多中心研究的一部分，该研究旨在测试多种微量营养素补充剂对4个国家婴儿期生长、贫血、微量营养素状况和发病率的疗效。共有265名6至12个月大的婴儿被随机分为4个干预组中的1组：每日多种微量营养素补充剂（DMM）、每日安慰剂补充剂（P）；一周中的1天服用多种微量营养素补充剂，其余几天服用安慰剂补充剂（WMM），以及每日铁补充剂（DI）。在6个月的时间里，在每月的健康诊所就诊时，将盲法补充剂提供给母亲，并由社区卫生工作者在每周的家访中核实服用情况，同时检查发病率。每月测量婴儿的体重和身高，并在开始和结束时采集血样，以评估婴儿的微量营养素状况。各组在基线时的营养状况无显著差异，40%的婴儿贫血（血红蛋白<110 g/L），16%维生素A缺乏（血浆视黄醇<0.7 μmol/L），47%锌缺乏（血浆锌<10.7 μmol/L），2%体重不足，11%发育迟缓。在6个月的研究中，微量营养素补充组和P组在生长或发病率方面没有差异。DMM是测试的最有效的干预措施，不仅能改善贫血，还能改善铁、锌、核黄素和生育酚状况。
