Micronutrient Fortification at Child-Care Centers Reduces Anemia in Young Children

Arcanjo, Francisco Plácido Nogueira; Rocha, Thaís Cristina da Costa; Arcanjo, Caio Plácido Costa; Santos, Paulo Roberto

doi:10.1080/19390211.2018.1474987

Cited by 5 publications

(3 citation statements)

References 15 publications

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“…It consists of the direct addition of powdered nutrients to foods of children aged <6 years, aiming to prevent vitamin and mineral deficiencies. In a cluster-randomised clinical trial with infants aged 12-36 months, after 12 weeks of intervention, NutriSUS micronutrient fortification provided a beneficial effect on Hb values, reducing the prevalence of anaemia (55) . Similar results were obtained through a multicentre pragmatic controlled trial carried out in primary health centres (56) .…”

Section: Discussionmentioning

confidence: 99%

Prevalence of anaemia in Brazilian children in different epidemiological scenarios: an updated meta-analysis

Ferreira

Vieira

Livramento

et al. 2020

Public Health Nutr.

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Objective: To update the estimation of the prevalence of anaemia in Brazilian children according to four different epidemiological scenarios. Design: A new systematic review was conducted with a meta-analysis of the results published between 2007 and May 2019. Literature search was carried out in the PubMed and LILACS databases using keywords anaemia, child and Brazil. A total of thirty-seven articles (17 741 children) were selected and categorised according to the origin of their respective samples: childcare centres (Childcare; n 13 studies/2697 individuals), health services (Services; n 4/755), populations with social inequities (Inequities, n 7/6798) and population-based studies (Populations; n 13/7491). Assuming a prevalence of 20·9 % as reference (Health National Survey; n 3455), the combined prevalence ratios (PR) were calculated. A random-effects model was used. Participants: Brazilian children 6–60 months of age. Results: The prevalence of anaemia, by scenario, was: Childcare 24·8 % (PR 1·06; 95 % CI 0·81, 1·40); Services 39·9 % (PR 1·76, 95 % CI 1·33, 2·35); Inequities 51·6 % (PR 2·02, 95 % CI 1·87, 2·18); and Populations 35·8 % (PR 1·42, 95 % CI 1·23, 1·64). Therefore, the values were all higher than the national prevalence; the Inequities had the highest prevalence, and only Childcare did not reach statistical significance. Concerning the previous meta-analysis, there was a reduction in anaemia prevalence in all scenarios: –52·3, –33·7, –22·4 and –10·7 %, respectively. Conclusions: Compared to the situation revealed in the previous meta-analysis, anaemia, although observed to a lesser extent, remains an important public health problem in the different scenarios analysed, especially for children living in Inequities. Access to Childcare mitigates the risk for this condition.

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Section: Discussionmentioning

confidence: 99%

Prevalence of anaemia in Brazilian children in different epidemiological scenarios: an updated meta-analysis

Ferreira

Vieira

Livramento

et al. 2020

Public Health Nutr.

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“…The efficacy of oral iron replacement is limited by low gastrointestinal absorption [46], alongside side effects such as abdominal pain, nausea, and constipation that affect around a third of patients and reduce compliance [46,47]. At a population level, fortification of foods with iron-containing micronutrient powders has been efficacious for treating iron deficiency anemia [48, 49]. Anemia refractory to oral supplementation or severe anemia may be managed with intravenous iron infusion [46].…”

Section: Discussionmentioning

confidence: 99%

Associations of genetically determined iron status across the phenome: A mendelian randomization study

et al. 2019

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Background Iron is integral to many physiological processes, and variations in its levels, even within the normal range, can have implications for health. The objective of this study was to explore the broad clinical effects of varying iron status. Methods and findings Genome-wide association study (GWAS) summary data obtained from 48,972 European individuals (55% female) across 19 cohorts in the Genetics of Iron Status Consortium were used to identify 3 genetic variants (rs1800562 and rs1799945 in the hemochromatosis gene [ HFE ] and rs855791 in the transmembrane protease serine 6 gene [ TMPRSS6 ]) that associate with increased serum iron, ferritin, and transferrin saturation and decreased transferrin levels, thus serving as instruments for systemic iron status. Phenome-wide association study (PheWAS) of these instruments was performed on 424,439 European individuals (54% female) in the UK Biobank who were aged 40–69 years when recruited from 2006 to 2010, with their genetic data linked to Hospital Episode Statistics (HES) from April, 1995 to March, 2016. Two-sample summary data mendelian randomization (MR) analysis was performed to investigate the effect of varying iron status on outcomes across the human phenome. MR–PheWAS analysis for the 3 iron status genetic instruments was performed separately and then pooled by meta-analysis. Correction was made for testing of multiple correlated phenotypes using a 5% false discovery rate (FDR) threshold. Heterogeneity between MR estimates for different instruments was used to indicate possible bias due to effects of the genetic variants through pathways unrelated to iron status. There were 904 distinct phenotypes included in the MR–PheWAS analyses. After correcting for multiple testing, the 3 genetic instruments for systemic iron status demonstrated consistent evidence of a causal effect of higher iron status on decreasing risk of traits related to anemia (iron deficiency anemia: odds ratio [OR] scaled to a standard deviation [SD] increase in genetically determined serum iron levels 0.72, 95% confidence interval [CI] 0.64–0.81, P = 4 × 10 −8 ) and hypercholesterolemia (hypercholesterolemia: OR 0.88, 95% CI 0.83–0.93, P = 2 × 10 −5 ) and increasing risk of traits related to infection of the skin and related structures (cellulitis and abscess of the leg: OR 1.25, 95% CI 1.10–1.42, P = 6 × 10 −4 ). The main limitations of this study relate to possible bias from pleiotropic effects of the considered genetic variants and misclassification of diagnoses in the HES data. Furthermore, this work only investigated participants with European ancestry, and the findings may not be applicable to other ethnic groups. Conclusions Our findings offer novel, to our knowledge, insight into previously unr...

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“…In this context, several studies have been conducted to verify the effectiveness of different fortification and supplementation programs. Arcanjo et al (2019) evaluated the impact of NutriSUS micronutrient fortification for the prophylaxis and treatment of IDA. This cluster-randomized clinical trial was conducted with 130 infants aged 12-36 months during a period of 12 weeks.…”

Section: Discussionmentioning

confidence: 99%

The Effectiveness of a School-Based Intervention for the Treatment of Iron Deficiency Anemia

Vellozo

Arcanjo

Vitalle

et al. 2021

Int. J. Res. Granthaalayah

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Background: In Brazil, iron deficiency anemia is considered a public health problem, which has a direct impact on the process of child growth and development. To assess the impact of a powdered supplement added to food preparations, on hemoglobin (Hb) levels and other hematimetric parameters in children. Method: This study is a double-blind, community-controlled clinical trial conducted in education centers in the northeast of Brazil. In this trial, food preparations were offered with a powdered supplement, enriched with iron (intervention) and control (no supplementation), Monday through Friday, for 60 days. Two biochemical evaluations were performed to determine Hb, hematocrit (Ht), mean corpuscular volume and ferritin levels before and after the intervention. Results: For participants in the 6- to 59-month age range, we identified an increase in mean Hb concentrations and other hematimetric parameters. In the 5- to 11-year age group, there was a significant increase in both groups for Hb and Ht values, and mean Hb concentration was significantly greater in the intervention group (12.25±0.76 vs. 11.93±0.94, p<.0035). In the 12- to 14-year-olds, all variables analyzed presented an increase. Conclusions: This school-based intervention effectively increased Hb concentrations other hematimetric parameters and reduced the prevalence of anemia in children and adolescents.

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Micronutrient Fortification at Child-Care Centers Reduces Anemia in Young Children

Cited by 5 publications

References 15 publications

Prevalence of anaemia in Brazilian children in different epidemiological scenarios: an updated meta-analysis

Prevalence of anaemia in Brazilian children in different epidemiological scenarios: an updated meta-analysis

Associations of genetically determined iron status across the phenome: A mendelian randomization study

The Effectiveness of a School-Based Intervention for the Treatment of Iron Deficiency Anemia

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