Interpreting_a_reseach_article_biscuits - Effect of iron...

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ABSTRACT Background: Deficiencies of iron, iodine, and vitamin A are prevalent worldwide and can affect the mental development and learning ability of schoolchildren. Objective: The aim of this study was to determine the effect of micronutrient-fortified biscuits on the micronutrient status of primary school children. Design: Micronutrient status was assessed in 115 children aged 6–11 y before and after consumption of biscuits (fortified with iron, iodine, and b -carotene) for 43 wk over a 12-mo period and was compared with that in a control group ( n = 113) who con- sumed nonfortified biscuits. Cognitive function, growth, and morbidity were assessed as secondary outcomes. Results: There was a significant between-group treatment effect on serum retinol, serum ferritin, serum iron, transferrin satura- tion, and urinary iodine ( P <0.0001) and in hemoglobin and hematocrit ( P <0.05). The prevalence of low serum retinol con- centrations (<0.70 m mol/L) decreased from 39.1% to 12.2%, of low serum ferritin concentrations (<20 m g/L) from 27.8% to 13.9%, of anemia (hemoglobin <120 g/L) from 29.6% to 15.6%, and of low urinary iodine concentrations (<100 m g/L) from 97.5% to 5.4%. There was a significant between-group treatment effect ( P <0.05) in cognitive function with the digit span forward task (short-term memory). Fewer school days were missed in the intervention than in the control group because of respiratory- ( P = 0.097) and diarrhea-related ( P = 0.013) illnesses. The inter- vention had no effect on morbidity and cognitive function. Conclusions: Fortified biscuits resulted in a significant improve- ment in the micronutrient status of primary school children from a poor rural community and also appeared to have a favorable effect on anthropometric status. Am J Clin Nutr 1999;69:497–503. KEY WORDS Vitamin A, b -carotene, iron, iodine, fortification, school feeding program, micronutrient deficiencies, intervention, cognitive function, morbidity, primary school children INTRODUCTION Deficiencies of iron, iodine, and vitamin A are considered to be a public health problem worldwide (1). According to a national survey in South Africa (2), 33% of children aged <6 y suffer from subclinical vitamin A deficiency (serum retinol <0.70 m mol/L) and 21% from anemia (hemoglobin <110 g/L). Although less is known about the prevalence of iodine deficiency, its occurrence has been reported in certain geographic areas (3, 4) as well as in countries bordering South Africa (5). Goals set for the year 2000 at the World Summit for Children in 1990 include the virtual elimination of vitamin A and iodine deficiencies and the reduc- tion of iron deficiency in women by one-third (1). Deficiencies of both iron and iodine can affect the mental devel- opment and learning ability of schoolchildren. Supplementing anemic children (6, 7) and even nonanemic, iron-deficient children (8) with iron has been shown to have a positive effect on cognitive performance. Iron deficiency can also increase susceptibility to infections (9), which can affect school attendance and achieve- ment. Iodine deficiency can lead to a spectrum of disorders rang-
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This note was uploaded on 09/08/2010 for the course NUFS 139 at San Jose State.

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Interpreting_a_reseach_article_biscuits - Effect of iron...

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