Can multi-micronutrient food fortification improve the micronutrient status, growth, health, and cognition of schoolchildren? A systematic review

Abstract

Micronutrient deficiencies compromise the health and development of many school-age children worldwide. Previous research suggests that micronutrient interventions might benefit the health and development of school-age children and that multiple micronutrients might be more effective than single micronutrients. Fortification of food is a practical way to provide extra micronutrients to children. Earlier reviews of (multiple) micronutrient interventions in school-age children did not distinguish between supplementation or fortification studies. The present review includes studies that tested the impact of multiple micronutrients provided via fortification on the micronutrient status, growth, health, and cognitive development of schoolchildren. Twelve eligible studies were identified. Eleven of them tested the effects of multiple micronutrients provided via fortified food compared to unfortified food. One study compared fortification with multiple micronutrients to fortification with iodine alone. Multi-micronutrient food fortification consistently improved micronutrient status and reduced anemia prevalence. Some studies reported positive effects on morbidity, growth, and cognitive outcomes, but the overall effects on these outcomes were equivocal.

Diet, Nutritional Status and School Performance of Schoolchildren in the District of Abidjan: Case of Yopougon and Bingerville

“…These data are consistent with, which is a significant relationship between nutritional status and academic achievement [9,13]. On the other hand, the nutritional status measured by the importance of the micronutrients indicated a strong association on the cognitive capacity of the students or better academic performance [18]. This may justify the relationship between academic performance and nutritional status in this study because schoolchildren would always be present at school and assumed to be in good health.…”

Improving Learning in Primary Schools of Developing Countries

“…The treatments included deworming medications (Dickson, Awasthi, Williamson, Demellweek, & Garner, 2000;Taylor-Robinson, Maayan, Soares-Weiser, Donegan, & Garner, 2012), iron supplementation (Falkingham et al, 2011;Grantham-McGregor & Ani, 2001;Hermoso et al, 2011), multiple micronutrient supplementation (Best et al, 2011;Eilander et al, 2010), malaria medications (S. D. Fernando, Rodrigo, & Rajapakse, 2010), and school feeding programs (Jomaa, McDonnell, & Probart, 2010;Kristjansson et al, 2006). Finally, I consulted World Bank reports on learning in developing countries (Bruns, Filmer, & Patrinos, 2011;Vegas & Petrow, 2008 …”

Multi-micronutrient Fortified Beverage Delivered through the School-Based System Improved Iron Status and Test Scores of Children

“…In the same manner, studies on multiple micronutrient-fortified beverages [18][19][20], iron-fortified candies [21], biscuits [22] and drinking water [23] showed positive response to intervention by increased hemoglobin levels, serum ferritin or decreased prevalence of anemia among subjects after the intervention period. The multiple micronutrient intervention was effective in reducing the prevalence of anemia in children [24][25][26][27][28][29].…”