Effect of combining multiple micronutrients with iron
supplementation on Hb response in children: systematic
review of randomized controlled trials
Effect of combining multiple micronutrients with iron
supplementation on Hb response in children: systematic
review of randomized controlled trials
Objectives
To study the effect of combining multiple (two or more) micronutrients with Fe supplementation on Hb response, when compared with placebo and with Fe supplementation, in children.
Data sources Electronic databases, personal files, hand search of reviews, bibliographies of books, and abstracts and proceedings of international conferences.
Review methods
Randomized controlled trials evaluating change in Hb levels with interventions that included Fe and multiple-micronutrient supplementation in comparison to placebo alone or Fe alone were analysed in two systematic reviews.
Results
Twenty-five trials were included in the review comparing Fe and micronutrient supplementation with placebo. The pooled estimate (random effects model) for change in Hb with Fe and micronutrient supplementation (weighted mean difference) was 0·65 g/dl (95 % CI 0·50, 0·80, P < 0·001). Lower baseline Hb, lower height-for-age Z score, non-intake of ‘other micronutrients’ and malarial non-hyperendemic region were significant predictors of greater Hb response and heterogeneity.
Thirteen trials were included in the review comparing Fe and micronutrient supplementation with Fe alone. The pooled estimate for change in Hb with Fe and micronutrient supplementation (weighted mean difference) was 0·14 g/dl (95 % CI 0·00, 0·28, P = 0·04). None of the variables were found to be significant predictors of Hb response.
Conclusions
Synthesized evidence indicates that addition of multiple micronutrients to Fe supplementation may only marginally improve Hb response compared with Fe supplementation alone. However, addition of ‘other micronutrients’ may have a negative effect. Routine addition of unselected multiple micronutrients to Fe therefore appears unjustified for nutritional anaemia control programmes.
anaemia, haemoglobin, iron supplementation, multiple-micronutrient supplementation, meta-analysis
783-799
Gera, Tarun
15530368-f679-4c76-a7b6-365c48339f2b
Sachdev, Harsh Pal Singh
1d67551b-ebfd-4dc4-89b0-0a8d1184cca6
Nestel, Penelope
64dfcf3f-2e0f-4653-9fdf-1a48f1c99a1e
June 2009
Gera, Tarun
15530368-f679-4c76-a7b6-365c48339f2b
Sachdev, Harsh Pal Singh
1d67551b-ebfd-4dc4-89b0-0a8d1184cca6
Nestel, Penelope
64dfcf3f-2e0f-4653-9fdf-1a48f1c99a1e
Gera, Tarun, Sachdev, Harsh Pal Singh and Nestel, Penelope
(2009)
Effect of combining multiple micronutrients with iron
supplementation on Hb response in children: systematic
review of randomized controlled trials.
Journal of Public Health Nutrition, 12 (6), .
(doi:10.1017/S136898000800267X).
Abstract
Objectives
To study the effect of combining multiple (two or more) micronutrients with Fe supplementation on Hb response, when compared with placebo and with Fe supplementation, in children.
Data sources Electronic databases, personal files, hand search of reviews, bibliographies of books, and abstracts and proceedings of international conferences.
Review methods
Randomized controlled trials evaluating change in Hb levels with interventions that included Fe and multiple-micronutrient supplementation in comparison to placebo alone or Fe alone were analysed in two systematic reviews.
Results
Twenty-five trials were included in the review comparing Fe and micronutrient supplementation with placebo. The pooled estimate (random effects model) for change in Hb with Fe and micronutrient supplementation (weighted mean difference) was 0·65 g/dl (95 % CI 0·50, 0·80, P < 0·001). Lower baseline Hb, lower height-for-age Z score, non-intake of ‘other micronutrients’ and malarial non-hyperendemic region were significant predictors of greater Hb response and heterogeneity.
Thirteen trials were included in the review comparing Fe and micronutrient supplementation with Fe alone. The pooled estimate for change in Hb with Fe and micronutrient supplementation (weighted mean difference) was 0·14 g/dl (95 % CI 0·00, 0·28, P = 0·04). None of the variables were found to be significant predictors of Hb response.
Conclusions
Synthesized evidence indicates that addition of multiple micronutrients to Fe supplementation may only marginally improve Hb response compared with Fe supplementation alone. However, addition of ‘other micronutrients’ may have a negative effect. Routine addition of unselected multiple micronutrients to Fe therefore appears unjustified for nutritional anaemia control programmes.
Text
gera.pdf
- Version of Record
More information
Published date: June 2009
Additional Information:
doi:10.1017/S1368980008003145
Keywords:
anaemia, haemoglobin, iron supplementation, multiple-micronutrient supplementation, meta-analysis
Identifiers
Local EPrints ID: 143253
URI: http://eprints.soton.ac.uk/id/eprint/143253
PURE UUID: d804c881-da9c-4e03-9d98-aeab5d2d683e
Catalogue record
Date deposited: 08 Apr 2010 08:35
Last modified: 14 Mar 2024 00:42
Export record
Altmetrics
Contributors
Author:
Tarun Gera
Author:
Harsh Pal Singh Sachdev
Download statistics
Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.
View more statistics