Consumption Of Fortified Milk Research Articles

The Importance of Analyzing Child Development and Understanding of Milk-Based Fortified Foods for Primary Health Care Issue

Indonesia is already facing a high nutritional problem. Early detection of child wasting is the key to successful prevention and treatment. Increasing animal protein intake for children is one of the government's steps to address child malnutrition. Consumption of fortified milk as one of the animal proteins may support the growth and development of children. The general purpose of this community service is to increase the knowledge and the implementation of dairy products to improve child immunity and growth. This community service activity was carried out at the Sidodadi village hall, Central Bengkulu in 2021. Participants in the community service activity were maternal and child village health workers, plus representatives from the Puskesmas and village officials with a total of 32 participants. The methods used are socializing information, questions and answers with participants based on experience and field findings, providing materials related to sources of milk food ingredients and their fortification, carrying out copyright quizzes on milk-based healthy food recipes, and monitoring with evaluation. Evaluation sheets are used to assess participant satisfaction and record things that are still needed by cadres for further socialization activities. The performance test was carried out with a quiz on preparing healthy milk-based food recipes for children. Activity results are described with a satisfaction survey. Increasing education through health counseling greatly influences the knowledge of village health worker to be wise in providing education on fortified milk-based foods and providing examples of useful recipes for malnourished children.

Milk Fortification with Vitamin A & D: A Need of the Hour in India

Micronutrient deficiency is caused by a diet deficient in important vitamins and minerals, and it continues to be a serious public health issue for many low- and middle-income countries' populations. Vitamin A and D deficiency is extremely common in India, affecting both young children and adults. With 146.3 million tonnes of milk produced annually, India is the world's largest producer, yet only around 9% of the milk is fortified with vitamins and minerals.
 Milk fortification is one of the treatments for vitamin deficiency. Milk is one of the most nutrient-dense foods available. In India, it is a staple dish that is consumed by people of all age groups. Regular consumption of fortified milk led to an 18% reduction in diarrhoea, a 26% reduction in pneumonia, 7% fewer days with a high fever, and 15% fewer days sick with severe sickness. Out of 416 LLPD produced, about 198.4 LLPD gets fortified currently in India, reaching about 121 million people. There is still a significant gap between production and fortification. Governments must take appropriate steps to improve milk fortification and make India a healthy country.

135 VITAMIN D FORTIFIED MILK—EFFECT ON VITAMIN D STATUS IN OLDER ADULTS

Abstract Background Vitamin D fortified milk is used by some older adults to boost vitamin D status. Combined vitamin D/calcium supplements often cause gastrointestinal upset which reduces adherence. Consumption of fortified milk may be a more consistent and reliable way of increasing serum 25 hydroxyvitamin D [25(OH)D], though studies of it’s efficacy in older adults are limited. Methods We examined the vitamin D status of users of vitamin D fortified milk in participants of a longitudinal study of community dwelling Irish adults aged >60 yrs. Patients taking vitamin D supplements were excluded and independent effects were explored in multinomial regression models. Vitamin D deficiency was defined as a 25(OH)D level < 30 nmol/l. Results 2496 participants were identified: mean age was 70.5 ± 7.0 years (range 60–96 yrs) and 145 (5.8%) reported using vitamin D fortified milk. In those who consumed fortified milk, there was a lower prevalence of vitamin D deficiency (17.9 vs 34.5%, P < 0.001). Vitamin D fortified milk also predicted less deficiency after adjusting for age, gender, season, BMI and physical frailty (OR 0.30. CI 0.19–0.48, P < 0.001). Conclusion Vitamin D fortified milk was associated with a 70% reduction in the risk of vitamin D deficiency in older adults not taking vitamin D supplements. Findings support the use of vitamin D fortified milk as an effective means of improving vitamin D status. Fortified milk also contains additional calcium and so can be used to augment daily calcium intake.

Twelve-Week Daily Consumption of ad hoc Fortified Milk with ω-3, D, and Group B Vitamins Has a Positive Impact on Inflammaging Parameters: A Randomized Cross-Over Trial.

Background and Aim: A state of chronic, subclinical inflammation known as inflammaging is present in elderly people and represents a risk factor for all age-related diseases. Dietary supplementation with ad hoc fortified foods seems an appealing strategy to counteract inflammaging. The purpose of this study was to test the efficacy of elderly-tailored fortified milk on inflammaging and different health parameters. Methods: A double-blind randomized cross-over study was performed on forty-eight volunteers aged 63–80 years. The fortified milk was enriched with ω-3 polyunsaturated fatty acids (eicosapentaenoic acid, EPA; docosahexaenoic acid, DHA), vitamins (25-hydroxyvitamin D, E, C, B6, B9, B12), and trace elements (zinc, selenium). The two intervention periods lasted for 12 weeks, with a 16-week washout intermission. Results: Compared to placebo, the consumption of fortified milk increased the circulating levels of different micronutrients, including vitamins and the ω-3 index of erythrocyte membranes. Conversely, it reduced the amount of arachidonic acid, homocysteine, and ω-6/ω-3 ratio. Conclusion: Twelve-week daily consumption of ad hoc fortified milk has an overall positive impact on different health parameters related to inflammaging in the elderly.

Content of vitamins and mineral substancеs in enriched milk

The enrichment of food products of industrial production in order to replenish vitamin and mineral deficiency is an actual trend in optimizing the diet of adults and children. Enriched milk as a healthy food is in constant demand. In this regard, monitoring the content of nutrients declared by the manufacturer in fortified milk and identification of its assortment is an important task. The aim of the research was assessment of the content of vitamins and mineral substances as micronutrients that form a balanced diet, in enriched milk marketed in Kemerovo. Material and methods. The content of micronutrients declared by the manufacturer in the information on the individual product label has been determined: vitamins C and B1; mineral substances (calcium, iron, iodine, zinc) in 10 samples of fortified drinking milk with a fat content of 2.5% from different manufacturers. Iron was determined by colorimetric method based on measuring the color intensity of red solution of a complex compound of divalent iron with ortho-phenanthroline. The content of zinc and iodine was determined by inversion voltammetry, the content of calcium and ascorbic acid by titrimetric method, the content of thiamine by the voltammetric method. Results and discussion. The actual content of ascorbic acid in fortified milk was in the range from 6 to 12 mg/100 g, thiamine - from 0.10 to 0.20 mg/100 g, which corresponded to their declared amount. The content of calcium varied from 99 to 155 mg per 100 g, iron - from 1.4 to 1.7 mg per 100 g, zinc - from 0.7 to 1.5 mg per 100 g, iodine - from 94.0 up to 151.0 mcg/kg. The compliance of the declared mineral substances in fortified milk has been confirmed. It has been shown that due to the consumption of 200 ml of product, the daily physiological requirement for the analyzed vitamins and minerals for adults will be: for vitamins C and B1 on average 13-26%; calcium - 18-31%; iron - from 14-18% for women to 28-34% for men; zinc - 12-25%; iodine - 12-20%. Conclusion. It was found that all samples of fortified milk corresponded to the declared characteristics for the content of vitamins and mineral substances. Regular consumption of fortified milk will improve the supply with essential micronutrients in the residents of the Kuzbass region.

Anemia as public health problem among child under five years age

Anemia has a serious consequences effects on child growth, development, and survival. Analytical, cross-sectional, non-probability co nvenient study done with sampling of 240 children aged less than five years (6-60 months) which was conducted in five primary health care centers in Al-Resafa sector and two pediatric hospitals in Baghdad city (Central child hospital and Ibn Al-Baldi hospital). The study started from 1st March till 31 of August 2017. The data was collected by direct interview with parent using special questionnaire to obtain information. The results of the study revealed that the age of child is known to be a important and a significant factor associated with anemia 38.3% of the anemic child were at 13-24 months age, 56.3% were male, 60.9% mother age were ≥ 20, 35.8% of mother had primary degree of education, 77.5% of them were unemployed, 68.7% had anemia during pregnancy, 45.8% of family income of anemic child were intermediate, 64.2% of family drinking untreated water, 59.6% had pad sewage system, 73.7% of them sometime eating meat and egg. The study showed no significant differences between anemia in children and anthropometric measures. Other results showed that 69.5% of child had continuous breast feeding, 81.7% had no history of cow milk consumption, 40.8% given complementary feeding at age of > 4 months, 74.2% had no history of consumption of fortified milk. Regarding causes of anemia iron deficiency was the major causes in 67.9% of child under five years age

Dietary intake influences gut microbiota development of healthy Australian children from the age of one to two years

Early life nutrition is a vital determinant of an individual’s life-long health and also directly influences the ecological and functional development of the gut microbiota. However, there are limited longitudinal studies examining the effect of diet on the gut microbiota development in early childhood. Here, up to seven stool samples were collected from each of 48 healthy children during their second year of life, and microbiota dynamics were assessed using 16S rRNA gene amplicon sequencing. Children’s dietary information was also collected during the same period using a validated food frequency questionnaire designed for this age group, over five time points. We observed significant changes in gut microbiota community, concordant with changes in the children’s dietary pattern over the 12-month period. In particular, we found differential effects on specific Firmicutes-affiliated lineages in response to frequent intake of either processed or unprocessed foods. Additionally, the consumption of fortified milk supplemented with a Bifidobacterium probiotic and prebiotics (synbiotics) further increased the presence of Bifidobacterium spp., highlighting the potential use of synbiotics to prolong and sustain changes in these lineages and shaping the gut microbiota community in young children.

Effects of different vitamin D supplementation strategies in reversing metabolic syndrome and its component risk factors in adolescents

There is little evidence on the efficacy of various vitamin D supplementation strategies in reversing metabolic syndrome (MetS) in adolescents. The present study aims to fill this gap. A total of 535 (243/292) out of 650 apparently healthy Saudi adolescents were randomly selected from the Vitamin D School Project database which has baseline and post-intervention information of more than 1000 Saudi adolescents 12–18 years old attending 34 schools in Riyadh, Saudi Arabia from Nov 2014-May 2015. Allocation of intervention was done in 3 groups using cluster randomization: vitamin D tablet, 1000IU/day (N = 180; 69 boys, 111 girls); vitamin D fortified milk consumption, 200 ml/day, 40IU/100 ml (N = 189; 93 boys, 96 girls) and control (educational awareness) (N = 166; 81 boys, 85 girls). All groups were given educational awareness on how to increase vitamin D levels. All groups were matched for BMI and analysis adjusted for age. Post-intervention and using intent-to-treat approach, within-group analysis revealed a statistically significant increase in 25(OH)D levels in all groups, and a clinically significant increase in favor of the tablet group (between-group) [10.7 nmol/l (34.7%) versus 6.3 nmol/l (19.8%) in milk and 2.1 nmol/l (7.0%) in control; p < 0.001], adjusted for age and BMI-matched. Between group analysis also revealed a clinically significant decrease in triglycerides (p = 0.05), glucose (p < 0.001) and systolic blood pressure (p = 0.005) as well as a clinically significant increase in HDL-cholesterol (p = 0.004) over time, all in favor of the tablet group. Within-group comparison showed a significant decrease in the incidence of MetS in the tablet group (9.4% versus 4.4%; p < 0.05) only. In conclusion, oral vitamin D supplementation is superior to vitamin D fortified milk in improving vitamin D status. Reduction in the incidence of MetS in the Arab adolescent population secondary to vitamin D correction may be dose-dependent.

An exploratory analysis of associations of diet, sun exposure, and body composition with 25OHD at five years of age: Findings from the ROLO Kids Study

Serum 25-hydroxyvitamin D (25OHD) is the main circulating form of vitamin D in the blood. Vitamin D status in adults is determined by numerous factors such as oral intake, skin generation, and body composition. However, there is limited understanding regarding determinants of 25OHD in young children. The aim of this study was to identify modifiable factors that may act as determinants of 25OHD at five years of age. Analysis conducted on 79 children from the ROLO Kids study. Dietary intakes and dietary habits were measured using a food frequency questionnaire and levels of sun exposure were assessed using a lifestyle questionnaire, both completed by the mother. Child weight, height, and skinfolds were measured. Vitamin D status was sufficient (25OHD > 50 nmol/L) in 61% of the participants. Neither reported dietary vitamin D nor calcium intake was significantly associated with 25OHD. Intakes of standard milk, eggs, and oily fish were not associated with 25OHD. However, reported consumption of fortified milk, and more than 7 bowls of cereal a week were independently associated with higher 25OHD (p < 0.001 and p = 0.049, respectively). Sun exposure (measured as obtaining at least half an hour of sun per day) was not significantly associated with 25OHD, but reported use of sunscreen was associated with higher 25OHD (p = 0.016). There was no association of body composition with 25OHD. These findings suggest the primacy of dietary and lifestyle habits as indicators of 25OHD in early childhood. This may have utility in identifying at-risk individuals for public health campaigns about education surrounding dietary habits, which may be useful to ensure sufficient vitamin D status within this age group.

Effect of multiple micronutrient fortified milk consumption on vitamin D status among school-aged children in rural region of Morocco

Vitamin D deficiency is a health problem in both developed and developing countries. The aim of this study was to determine the effect of multi-vitamin fortified milk consumption on vitamin D status among children living in the mountainous region of Morocco. Children aged 7 to 9 years (n = 239; 49% of girls vs 51% of boys) participated in a double-blind longitudinal study, where they were divided in 2 groups: a fortified group that received daily 200 mL of fortified ultra-high-temperature (UHT) milk enriched with 3 μg of vitamin D3 and a nonfortified group that received 200 mL of nonfortified UHT milk with a natural abundance of vitamin D3 (about 1.5 μg). Blood samples were collected 3 times (at baseline, then at the fourth and ninth months). The average weight, height, and z score of body mass index for age of participants were 22.8 ± 2.6 kg, 121.5 ± 5.2 cm, and -0.2 ± 0.6 kg/m2, respectively. At baseline, 47.5% of children had a concentration of 25-hydroxyvitamin D below 50 nmol/L. At the end of the study the prevalence of vitamin D <50 nmol/L decreased significantly by 37.6% in the fortified group. These results reveal prevalent vitamin D insufficiency (<50 nmol/L) during winter among rural Moroccan school-aged children, which seems to be better improved by consuming the fortified milk instead of the nonfortified one.

Effects of Aerobic and Resistance Training Combined with Fortified Milk on Muscle Mass, Muscle Strength, and Physical Performance in Older Adults: A Randomized Controlled Trial.

Fortified milk and resistance training (RT) increase muscle mass, muscle strength, and physical performance in older adults, but it remains unclear whether RT combined with aerobic training (AT) would have stronger effects on these outcomes. The purpose of this study was to examine the effects of aerobic and resistance training (ART) combined with fortified milk consumption on muscle mass, muscle strength, and physical performance in older adults. Open-labeled randomized controlled trial. University of Tsukuba. Fifty-six older adults aged 65-79. Participants were randomly allocated into resistance training (RT + fortified milk, n = 28) and aerobic and resistance training (ART + fortified milk, n = 28) groups. All participants attended supervised exercise programs twice a week at University of Tsukuba and ingested fortified milk every day for 12 weeks. Skeletal muscle index ([SMI]: appendicular lean mass/height2) was assessed using dual-energy X-ray absorptiometry as a muscle mass measure. One-repetition maximum strength was measured using four kinds of resistance training machines (chest press, leg extension, leg curl, and leg press) as muscle strength measures. Sit-to-stand and arm curl tests were also assessed as physical performance measures. The primary measurements were muscle mass and strength. The secondary outcomes were physical performance, blood samples, habitual diet, habitual physical activity, and medication use. Although the muscle strength and physical performance measures significantly improved in both groups, SMI significantly improved in only the RT group. There was no significant difference in the change in SMI and muscle strength measures between the two groups. However, the change in sit-to-stand and arm curl measures in the ART group were significantly higher than those in the RT group. These results suggest that AT before RT combined with fortified milk consumption has similar effects on skeletal muscle mass and strength compared with RT alone, but it may be a more useful strategy to improve physical performance in older adults. Although the mechanism of our intervention is uncertain, our program would be an effective prevention for sarcopenia in older adults.

Fortified Iodine Milk Improves Iodine Status and Cognitive Abilities in Schoolchildren Aged 7-9 Years Living in a Rural Mountainous Area of Morocco.

Iodine is required for the production of the thyroid hormones essential for the growth and development of the brain. All forms of iodine deficiency (ID) affect the mental development of the child. Our study aims to assess the impact of ID on the intellectual development of Moroccan schoolchildren and to evaluate the effect of consumption of fortified milk on reducing ID. In a double-blind controlled trial conducted on schoolchildren, children were divided into two groups to receive fortified milk (30% of cover of RDI iodine) or nonfortified milk for 9 months. Urinary iodine was analyzed using the Sandell-Kolthoff reaction, a dynamic cognitive test using Raven's Standard Progressive Matrices to assess learning potential was performed at baseline and end line, and anthropometric assessment was done only at baseline. The study included schoolchildren who were severely iodine deficient. The prevalence of malnutrition was high in both groups; in this study, we found improvements in iodine status and in cognitive abilities among Moroccan schoolchildren. Our study showed that the consumption of fortified milk led to a clear improvement in iodine status and also appeared to have a favorable effect on the cognitive ability of Moroccan schoolchildren in a rural mountainous region.

Fortified milk consumption among 6-year old children: changes in biochemical markers of trace minerals and vitamins

Fortified milk consumption among 6-year old children: changes in biochemical markers of trace minerals and vitamins

Efficacy of Multiple Micronutrients Fortified Milk Consumption on Iron Nutritional Status in Moroccan Schoolchildren.

Iron deficiency constitutes a major public health problem in Morocco, mainly among women and children. The aim of our paper is to assess the efficacy of consumption of multiple micronutrients (MMN) fortified milk on iron status of Moroccan schoolchildren living in rural region. Children (N = 195), aged 7 to 9 y, were recruited from schools and divided into two groups: the nonfortified group (NFG) received daily a nonfortified Ultra-High-Temperature (UHT) milk and the fortified group received (FG) daily UHT milk fortified with multiple micronutrients including iron sulfate. Blood samples were collected at baseline (T0) and after 9 months (T9). Hemoglobin (Hb) was measured in situ by Hemocue device; ferritin and C Reactive Protein were assessed in serum using ELISA and nephelometry techniques, respectively. Results were considered significant when the p value was <0.05. At T9 FG showed a reduction of iron deficiency from 50.9% to 37.2% (p = 0.037). Despite the low prevalence of iron deficiency anemia (1.9%); more than 50% of children in our sample suffered from iron deficiency at baseline. The consumption of fortified milk reduced the prevalence of iron deficiency by 27% in schoolchildren living in high altitude rural region of Morocco. Clinical Trial Registration. Our study is registered in the Pan African Clinical Trial Registry with the identification number PACTR201410000896410.

Impact of fortified milk on the iron and zinc levels in Mexican preschool children

The aim of this study was to assess the efficacy of a national program of consumption of fortified milk "Liconsa" on the nutritional status of iron and zinc in pre-school children (3-5 y). The study was conducted in 77 healthy children of both genders. 54 of them consumed Liconsa fortified milk (GCLFL) and 23 consumed no fortified milk (GR). Iron status was determined by measuring hemoglobin and ferritin and zinc status by serum zinc. The consumption of milk was on free demand and it was estimated at baseline and 6 mo after. Through 24-h recall of measured consumption of iron and zinc in the total diet. Descriptive statistics, Student's t test for independent samples and chi-square test for differences in proportions. Children who consumed fortified milk showed an increase of hemoglobin and ferritin levels [1.13 g/dL (p < 0.05) and 5.83 μg/L (p < 0.05) respectively]. Additionally, a decrease was found of the prevalence of low iron stores from 20.4 to 4.1% (p < 0.05). The serum zinc level showed an increase of 45.2 μg/dL (p < 0.05). At the end of the study no child showed a micronutrient deficiency. Children who did not consume fortified milk Liconsa showed no significant change in their serum iron and zinc values. The average consumption of milk powder Liconsa was 22.7 ± 14.5 g, providing 2.5 mg of daily iron and zinc. Supplied diet 9.2 ± 3.4 mg of iron and 6.9 ± 3 mg of zinc. The consumption of fortified milk had a beneficial effect on the serum levels of iron and zinc in children's social welfare program Liconsa.

Iron Status Biomarkers and C-Reactive Protein in Children Aged 19 to 72 Months in Chile

The Chilean Ministry of Health has combated iron deficiency through the delivery of fortified milk by the National Complementary Feeding Program (NCFP). To assess iron status and associations between biomarkers of iron status and serum C-reactive protein (CRP) in 218 beneficiaries of the NCFP aged 19 to 72 months in Santiago and Valparaiso, Chile. Blood was collected from a cross-sectional representative sample. Iron status (measured by hemoglobin, zinc protoporphyrin, and serum ferritin levels) and inflammation (according to CRP level) were determined. Serum CRP level was positively associated with serum ferritin and zinc protoporphyrin levels (r = 0.16 and r = 0.15; p = .0168 and p = .0290, respectively). Serum ferritin was higher among children with high CRP (> 10 mg/dL) than among those with low CRP (< or = 10 mg/dL) (p = .003). After adjustment for 10, 6, and 5 mg/L CRP, the prevalence of low serum ferritin changed from 56.4% without adjustment to 60.6%, 61.5%, and 42.7%, respectively, and the prevalence of high zinc protoporphyrin changed from 22.9% to 21.6%, 17.4%, and 17.9%, respectively. There were no differences between regions in biomarkers of iron status. There was no association between consumption of fortified milk and the prevalence of abnormal serum ferritin (< 15 microg/L) after adjustment for sex, age, and breastfeeding (OR, 1.00; 95% CI, 0.99 to 1.01; p = .288). After adjustment for 10 mg/L CRP, 5.5% were classified as having iron-deficiency anemia, 42.7% as having iron-deficiency erythropoiesis, 17.9% as having depleted iron stores, and 35.8% as having normal iron status. CONCLUSIONS. CRP level was positively associated with: serum ferritin and zinc protoporphyrin levels. Chilean children aged 19 to 72 months from Santiago and Valparaiso who were beneficiaries of the NCFP had a low prevalence of iron-deficiency anemia, a high prevalence of iron-deficiency erythropoiesis, and a moderate prevalence of depleted iron stores.

Additional benefit in CVD risk indices derived from the consumption of fortified milk when combined with a lifestyle intervention.

The current study aimed to evaluate the effect of fortified milk combined with a lifestyle and counselling programme on several CVD risk factors after a 3-month dietary intervention. Hypercholesterolaemic adults were randomized to a group supplemented with low-fat milk that was enriched with phytosterols, α-linolenic and linoleic fatty acids, vitamins and antioxidants (enriched milk group, EMG: n 40), a placebo milk group (PMG: n 36) or a control group (CG: n 25). The EMG and PMG consumed respectively 500 ml of enriched milk or placebo milk daily and attended biweekly counselling sessions over a 3-month period. Harokopio University, Athens, Greece. A sample of 101 hypercholesterolemic adults aged 40-60 years. Regarding lifestyle changes, total and saturated fat intakes decreased significantly in both intervention groups compared with the CG (P < 0·005). Furthermore, total steps were increased (P = 0·029) and BMI was decreased (P = 0·017) significantly in both intervention groups compared with the CG. Regarding biochemical indices, EPA content in erythrocyte membranes increased (P < 0·001) while serum C-reactive protein decreased (P = 0·003) significantly in both intervention groups compared with the CG. Finally, significant increases in plasma folic acid and vitamin B12 levels and a significant decrease in homocysteine levels were observed in the EMG compared with the PMG and CG (all P < 0·001). A favourable change in LDL cholesterol:HDL cholesterol was also observed in the EMG and tended to be significant compared with the PMG and CG (P = 0·066). The present study showed that consumption of fortified milk accompanied with lifestyle counselling induces extra benefits in terms of LDL cholesterol:HDL cholesterol and serum homocysteine levels.

Low Prevalence of Anemia in Children Aged 19 to 72 Months in Chile

In 1974/75, the prevalence of anemia in Chilean preschoolers was 18.8%. Since 2000, the Chilean Ministry of Health has combated anemia through the delivery of iron-fortified milk by the National Complementary Feeding Program (NCFP). To determine the prevalence of anemia in children aged 19 to 72 months who are beneficiaries of the NCFP. A cross-sectional representative sample of 224 beneficiaries of the NCFP aged 19 to 72 months from the Santiago and Valparaiso regions was recruited. The mean (+/- SD) hemoglobin concentration was 12.3 +/- 1.0 g/dL. Four percent of all children studied were anemic. In simple linear regression analysis, it was observed that hemoglobin concentration was positively correlated with age (r = 0.23, p = .001). There was no association between hemoglobin concentration and duration of breastfeeding (r = -0.12, p = .175). The prevalence of anemia among the 69% of children consuming iron-fortified milk delivered by NCFP was 2.6%, as compared with 7.1% among children not consuming iron-fortified milk (p = 0.227). Consumption of iron-fortified milk did not show a positive significant relationship with hemoglobin concentration (r = 0.063, p = .529). Similarly, multiple logistic regression did not show an association between consumption of fortified milk and anemia, after adjusting for sex, age, and breastfeeding (p = .150; OR = 0.98; 95% CI, 0.95 to 0.10). In 2009 anemia was not a public health problem in Chilean children aged 19 to 72 months from Santiago and Valparaiso.

Relationship of Maternal Knowledge of Anemia with Maternal and Child Anemia and Health-Related Behaviors Targeted at Anemia Among Families in Indonesia

Our specific aim was to characterize maternal knowledge of anemia and its relationship to maternal and child anemia and to behaviors related to anemia reduction. We examined the relationship between maternal knowledge of anemia and anemia in the mother and the youngest child, aged 6-59 months, in 7,913 families from urban slums and 37,874 families from rural areas of Indonesia. Knowledge of anemia was defined based upon the mother's ability to correctly name at least one symptom of anemia and at least one treatment or strategy for reducing anemia. Hemoglobin was measured in both the mother and the child. In urban and rural areas, respectively, 35.8 and 36.9% of mothers had knowledge of anemia, 28.7 and 25.1% of mothers were anemic (hemoglobin <12 g/dL), and 62.3 and 54.0% of children were anemic (hemoglobin <11 g/dL). Maternal knowledge of anemia was associated with child anemia in urban and rural areas, respectively (odds ratio [OR] 0.90, 95% confidence interval [CI] 0.79, 1.02, P = 0.10; OR 0.93, 95% CI 0.87, 0.98, P = 0.01) in multivariate logistic regression models adjusting for potential confounders. There was no significant association between maternal knowledge of anemia and maternal anemia. Maternal knowledge of anemia was significantly associated with iron supplementation during pregnancy and child consumption of fortified milk. There was no association of maternal knowledge of anemia with child deworming. Maternal knowledge of anemia is associated with lower odds of anemia in children and with some health behaviors related to reducing anemia.

Consumption of Micronutrient-Fortified Milk and Noodles is Associated with Lower Risk of Stunting in Preschool-Aged Children in Indonesia

Stunting is highly prevalent in developing countries and is associated with greater morbidity and mortality. Micronutrient deficiencies contribute to stunting, and micronutrient-fortified foods are a potential strategy to reduce child stunting. To examine the relationship between the use of fortified powdered milk and noodles and child stunting in a large, population-based sample of Indonesian children. Consumption of fortified milk and fortified noodles was assessed in children 6 to 59 months of age from 222,250 families living in rural areas and 79,940 families living in urban slum areas in Indonesia. The proportions of children who consumed fortified milk and fortified noodles were 34.0% and 22.0%, respectively, in rural families, and 42.4% and 48.5%, respectively, in urban families. The prevalence of stunting among children from rural and urban families was 51.8% and 48.8%, respectively. Children from rural and urban families were less likely to be stunted if they consumed fortified milk (in rural areas, OR = 0.87; 95% CI, 0.85 to 0.90; p < .0001; in urban areas, OR = 0.80; 95% CI, 0.76 to 0.85; p < .0001) or fortified noodles (in rural areas, OR = 0.95; 95% CI, 0.91 to 0.99;p = .02; in urban areas, OR = 0.95; 95% CI, 0.91 to 1.01; p = .08) in multiple logistic regression models adjusted for potential confounders. In both rural and urban families, the odds of stunting were lower when a child who consumed fortified milk also consumed fortified noodles, or when a child who consumed fortified noodles also consumed fortified milk. The consumption of fortified milk and noodles is associated with decreased odds of stunting among Indonesian children. These findings add to a growing body of evidence regarding the potential benefits of multiple micronutrient fortification on child growth.