Winichagoon Pattanee, McKenzie Joanne E, Chavasit Visith, Pongcharoen Tippawan, Gowachirapant Sueppong, Boonpraderm Atitada, Manger Mari S, Bailey Karl B, Wasantwisut Emorn, Gibson Rosalind S
Institute of Nutrition, Mahidol University, Salaya, Thailand.
J Nutr. 2006 Jun;136(6):1617-23. doi: 10.1093/jn/136.6.1617.
Anemia and co-existing deficiencies of zinc, iron, iodine, and vitamin A occur among children in many developing countries including NE Thailand, probably contributing to impairments in growth, immune competence, and cognition. Sustainable strategies are urgently required to combat these deficiencies. We assessed the efficacy of a micronutrient-fortified seasoning powder served with a school lunch on reducing anemia and improving the micronutrient status of rural NE Thai children. Children (n = 569) aged 5.5-13.4y from 10 schools were randomly assigned to receive a seasoning powder either unfortified or fortified with zinc (5 mg), iron (5 mg), vitamin A (270 microg), and iodine (50 microg) (per serving) and incorporated into a school lunch prepared centrally and delivered 5 d/wk for 31 wk. Teachers monitored school lunch consumption. Baseline and final micronutrient status, hemoglobinopathies, and infection or inflammation were assessed from blood and urine samples. For the primary outcome, anemia (based on hemoglobin), no intervention effect was apparent (odds ratio: 1.02 95% CI: 0.69, 1.51) after adjustment for design strata. The odds of zinc (based on serum zinc) and urinary iodine deficiency in the fortified group were 0.63 (0.42, 0.94) and 0.52 (0.38, 0.71) times those in the unfortified group, respectively. Fortification had no effect on serum retinol (0.61: 0.25,1.51), ferritin (1.12: 0.43, 2.96), or mean red cell volume (1.16: 0.82, 1.64). Therefore, a micronutrient-fortified seasoning powder is a promising vehicle for improving zinc, iodine, and hemoglobin status, and its potential for incorporation into lunch programs in day care centers and schools in NE Thailand warrants investigation.
在包括泰国东北部在内的许多发展中国家,儿童中存在贫血以及锌、铁、碘和维生素A同时缺乏的情况,这可能会导致生长、免疫能力和认知能力受损。迫切需要可持续的策略来应对这些营养缺乏问题。我们评估了一种在学校午餐中提供的微量营养素强化调味粉对减少泰国东北部农村儿童贫血和改善其微量营养素状况的效果。来自10所学校的569名5.5至13.4岁儿童被随机分配,分别接受未强化或强化了锌(5毫克)、铁(5毫克)、维生素A(270微克)和碘(50微克)(每份含量)的调味粉,并将其添加到集中制作并每周五天配送、持续31周的学校午餐中。教师监督学校午餐的食用情况。通过血液和尿液样本评估基线和最终的微量营养素状况、血红蛋白病以及感染或炎症情况。对于主要结局指标贫血(基于血红蛋白),在对设计分层进行调整后,未观察到干预效果(优势比:1.02,95%置信区间:0.69,1.51)。强化组锌缺乏(基于血清锌)和尿碘缺乏的优势分别是未强化组的0.63倍(0.42,0.94)和0.52倍(0.38,0.71)。强化对血清视黄醇(0.61:0.25,1.51)、铁蛋白(1.12:0.43,2.96)或平均红细胞体积(1.16:0.82,1.64)没有影响。因此,微量营养素强化调味粉是改善锌、碘和血红蛋白状况的一种有前景的载体,其纳入泰国东北部日托中心和学校午餐计划的潜力值得研究。