Department of Family and Consumer Sciences, Faculty of Agriculture, Food and Consumer Sciences, University for Development Studies, Tamale, 1882, Ghana.
Institute for Global Nutrition, University of California, Davis, USA.
Br J Nutr. 2024 Feb 28;131(4):707-719. doi: 10.1017/S0007114523002234. Epub 2023 Oct 5.
Adolescent girls are an important target group for micronutrient interventions particularly in Sub-Saharan Africa where adolescent pregnancy and micronutrient deficiencies are common. When consumed in sufficient amounts and at levels appropriate for the population, fortified foods may be a useful strategy for this group, but little is known about their effectiveness and timing (regarding menarche), particularly in resource-poor environments. We evaluated the effect of consuming multiple micronutrient-fortified biscuits (MMB), sold in the Ghanaian market, 5 d/week for 26 weeks compared with unfortified biscuits (UB) on the micronutrient status of female adolescents. We also explored to what extent the intervention effect varied before or after menarche. Ten2Twenty-Ghana was a 26-week double-blind, randomised controlled trial among adolescent girls aged 10-17 years ( 621) in the Mion District, Ghana. Biomarkers of micronutrient status included concentrations of Hb, plasma ferritin (PF), soluble transferrin receptor (TfR) and retinol-binding protein (RBP), including body-iron stores. Intention-to-treat analysis was supplemented by protocol-specific analysis. We found no effect of the intervention on PF, TfR and RBP. MMB consumption did not affect anaemia and micronutrient deficiencies at the population level. MMB consumption increased the prevalence of vitamin A deficiency by 6·2 % (95 % CI (0·7, 11·6)) among pre-menarche girls when adjusted for baseline micronutrient status, age and height-for-age -score, but it decreased the prevalence of deficient/low vitamin A status by -9·6 % (95 % CI (-18·9, -0·3)) among post-menarche girls. Consuming MMB available in the market did not increase iron status in our study, but reduced the prevalence of deficient/low vitamin A status in post-menarcheal girls.
青春期女孩是微量营养素干预的一个重要目标群体,尤其是在撒哈拉以南非洲地区,那里青春期怀孕和微量营养素缺乏很常见。在足够数量和适合人群水平摄入强化食品可能是该群体的一个有用策略,但对于其效果和时机(关于初潮)知之甚少,特别是在资源匮乏的环境中。我们评估了每周 5 天、连续 26 周食用在加纳市场上销售的多种微量营养素强化饼干(MMB)与食用未强化饼干(UB)对青春期少女微量营养素状况的影响。我们还探讨了干预效果在初潮前后有多大程度的差异。Ten2Twenty-加纳是一项为期 26 周的双盲、随机对照试验,在加纳 Mion 区 10-17 岁的青春期女孩(621 人)中进行。微量营养素状况的生物标志物包括血红蛋白(Hb)、血浆铁蛋白(PF)、可溶性转铁蛋白受体(TfR)和视黄醇结合蛋白(RBP)的浓度,包括体内铁储存。意向治疗分析由特定方案的分析补充。我们没有发现干预对 PF、TfR 和 RBP 有影响。MMB 的消费并没有在人群水平上影响贫血和微量营养素缺乏。MMB 的消费增加了维生素 A 缺乏的流行率 6.2%(95%CI(0.7,11.6))在调整了基线微量营养素状况、年龄和身高年龄评分的初潮前女孩中,但在初潮后女孩中,它使缺乏/低维生素 A 状态的流行率降低了 9.6%(95%CI(-18.9,-0.3))。在我们的研究中,食用市场上可获得的 MMB 并没有增加铁的状况,但降低了初潮后女孩缺乏/低维生素 A 状态的流行率。