Multi-micronutrient Supplementation Research Articles

Randomized Trial to Improve Body Composition and Micronutrient Status Among South African Children

IntroductionPhysical activity (PA) promotion combined with multi-micronutrient supplementation (MMNS) among school-age children may reduce fat mass accrual and increase muscle mass through different mechanisms and so benefit child health. This study determined the efficacy of combined interventions on body composition among South African schoolchildren and determined if micronutrients mediate these effects. Study designLongitudinal cluster randomized controlled trial of children followed from 2019 to 2021. Statistical analyses carried form 2022-2023 Setting/participantsA total of 1304 children 6-12 years of age recruited from public schools in Gqeberha, South Africa. InterventionChildren were randomized by classes to either: (a) a physical activity group (PA); (b) a MMNS group; (c) a physical activity + multi-micronutrient supplementation group (PA + MMNS); and (d) a placebo control group. Main outcome measuresTrajectories of overall and truncal fat free mass (FFM) and fat mass (FM) estimates in modeled at 9 and 21 months using latent growth curve models (LGCM). Changes in micronutrient concentrations at 9 months from baseline. ResultsAn increased FFM trajectory was found among children in the MMNS arm at 9 months (Beta 0.16, 95% CI = 0.12, 0.31). The PA and MMNS arms both had positive indirect effects on this trajectory at 9 months (Beta 0.66, 95% CI = 0.44, 0.88 and Beta 0.32 95% CI = 0.1 0.5, respectively) and similarly at 21 months when mediated by zinc concentration changes. A reduced FM trajectory was found among children in the PA promotion arm at 9 months when using this collection point as the referent intercept. This arm was inversely associated with the FM trajectory at 9 months when mediated by zinc changes. ConclusionsPA and MMNS promotion in school-based interventions directly contributed to reductions in FM and increased FFM among South African children and indirectly through changes in micronutrient status.

Nutritional status of Vietnamese infants assessed by Fenton growth chart and related factors: A cross-sectional study.

Nutritional status of infants, measured by birth weight and length, is an essential factor in neonatal development. Malnutrition in newborns may lead to a higher risk of mortality, neurological and cognitive impairment, and poor language development. This study aims to assess the nutritional status of infants and related factors regarding maternal anthropometric characteristics and medical history. A cross-sectional study was conducted at the National Hospital of Obstetrics and Gynecology, Vietnam from May 2021 to May 2022 on 340 infants and mothers. Low birth weight was defined following the Intergrowth-21 standards. Stunting was evaluated using the Fenton growth chart when the length was below the 10% percentile line of the gestational week. Multivariate regression models were applied to identify factors associated with the nutritional status of infants. We found that 12.4% and 14.1% of infants in our study fell into stunted and underweight categories, respectively. Infants of mothers over 35 years old, having a height lower than 150 cm or experiencing anemia during pregnancy were more likely to be stunted or have low birth weight. Serum albumin deficiency during pregnancy was strongly associated with the infant being underweight (odds ratio [OR] = 2.8, 95% confidence interval [95%CI] 1.1-7.3). Newborns were more likely to be stunted if their mothers had a history of preterm birth (OR = 3.3, 95%CI 1.1-10.2). Maternal nutritional status is closely related to infant malnutrition, particularly in preterm infants. Improving the understanding of mothers regarding prenatal care, reproductive healthcare, adequate nutritional diet, and multi-micronutrient supplements during pregnancy is therefore important.

The Prevention of Anaemia among Pregnant Women: A Literature Review

Background: Anaemia is a serious problem and has a negative impact on pregnancy. WHO reported that 40% of pregnant women in the world are anaemic. This review aimed to identify evidence-based prevention of anaemia among pregnant women. Method: This is a literature review. Articles searching were conducted from a number of electronic databases including Science Direct, PubMed, Springer Link, Sage pub, and Google Scholar from 2016-February 2022. Researchers used the PRISMA method. Result: Ten studies were included in the final analysis (three cross-sectional, one RCT, six quasi-experiments). Two studies discussed the efficiency of supplements in expecting mothers, two studies discussed the effectiveness of Moringa leaves, and six studies discussed the effectiveness of health education on preventing anaemia in pregnancy. Conclusion: Iron supplementation, multi micronutrient supplementation, giving Moringa leaf biscuits along with iron supplementation, and providing health education are effective ways to prevent anaemia in pregnancy.

Efficacy of Macro and Micronutrient Interventions in Adolescent Nutritional Status: A Systematic Review

The authors conducted a systematic review of adolescents receiving a macronutrient (iron, zinc) intervention compared to a multi-micronutrient intervention to investigate their efficacy on nutritional status. Systematic searches were conducted in four database sources—Science Direct, ProQuest, EBSCO, and Google Scholar. A PICO worksheet was used to define keywords, including 1) Patient/Problem: Preconception for adolescent OR girl student, 2) Intervention: Iron and zinc OR Fe and Zn OR macronutrients, 3) Comparison: Multi-micronutrient, and 4) Outcome: Nutritional status. Inclusion criteria included female adolescents aged 9–24 years and English and Indonesian articles published from 2013 to 2020. The risk of bias was assessed by minimizing four potential sources of bias: sample selection, research design, control of confounding variables, and data collection techniques. Result: 10 relevant studies discussing iron, zinc, and multi-micronutrient supplements for adolescents were identified. Iron and zinc interventions are efficacious in preventing anemia, enhancing hemoglobin concentration, improving body mass index, and reducing the risk of low birth weight and preeclampsia for women in the preconception phase. The multi-micronutrient intervention has similar efficacy, but it can better affect the maternal immune response and the production of the human placental lactogen hormone, which ultimately increases placental weight and birth weight while lowering the risk of abortion and prematurity. Conclusion: Iron, zinc, and multi-micronutrient interventions play a pivotal role in improving the nutritional status of adolescents in preparing the preconception phase because they provide positive benefits and can prevent nutritional deficiencies before pregnancy, during pregnancy, and after delivery.

Development, Implementation, and Process Evaluation of Bukhali: An Intervention from Preconception to Early Childhood

The Healthy Life Trajectories Initiative, an international consortium developed in partnership with the World Health Organization, is addressing childhood obesity from a life-course perspective. It hypothesises that an integrated complex intervention from preconception, through pregnancy, infancy and early childhood, will reduce childhood adiposity and non-communicable disease risk, and improve child development. As part of the Healthy Life Trajectories Initiative in South Africa, the Bukhali randomised controlled trial is being conducted with 18–28-year-old women in Soweto, where young women face numerous challenges to their physical and mental health. The aims of this paper were to describe the intervention development process (including adaptations), intervention components, and process evaluation; and to highlight key lessons learned. Intervention materials have been developed according to the life-course stages: preconception (Bukhali), pregnancy (Bukhali Baby), infancy (Bukhali Nana; birth—2 years), and early childhood (Bukhali Mntwana, 2–5 years). The intervention is delivered by community health workers, and includes the provision of health literacy resources, multi-micronutrient supplementation, in-person health screening, services and referral, nutrition risk support, SMS-reminders and telephonic contacts to assist with behaviour change goals. A key adaption is the incorporation of principles of trauma-information care, given the mental health challenges faced by participants. The Bukhali process evaluation is focussing on context, implementation and mechanisms of impact, using a mixed methods approach. Although the completion of the trial is still a number of years away, the documentation of the intervention development process and process evaluation of the trial can provide lessons for the development, implementation, and evaluation of such complex life-course trials.

ANALYSIS OF MICRO NUTRITIONAL CONSUMPTION AND FERRITIN LEVELS OF ADOLESCENT WOMEN IN GIANYAR REGENCY, BALI PROVINCE

Background: Based on Riskesdas, 2018 shows that the prevalence of anemia in women of childbearing age (WUS) in Indonesia is 23.7% with anemia sufferers aged 5-14 years at 26.8%, anemia sufferers aged 15-24 years at 32.0%, anemia aged 25-34 years by 15.1% and anemia patients aged 35-44 years by 16.7%. In Bali, research on the prevalence of anemia in adolescents as far as the author's knowledge is still very minimal.
 
 Objective: The purpose of this research in the first year is to determine the relationship between consumption of micronutrients and ferritin levels in adolescent girls in Gianyar Regency, Bali Province. The aim in the second year was to determine the effectiveness of iron folate and Multi Micronutrient Supplements (MMS) in adolescent girls whose hemoglobin or ferritin levels were below normal. This research is an epidemiological study of community nutrition that will be carried out in Gianyar Regency, Bali Province, the first year from March to October 2021 and the second year from March to October 2022.
 
 Methods: The first year research method used a community trial with a Cross Sectional design with a sample size of 168 samples. The second year with a different subject design with a sample size of 86 samples consisting of 43 control groups and 43 treatment groups.
 
 Results: The results of the study in year 1 (2021) showed that the Ferritin levels of adolescent girls in Gianyar Regency, Bali Province showed 29.2% in the low category (<30 g/l) and 4.8% in the high category (>160 g/l), The average consumption of micronutrients for adolescent girls in Gianyar Regency, Bali Province, namely iron (55%), zinc (74.25%), folic acid (31.7%) and vitamin C (39.2%), there is a relationship Consumption of Micronutrients, namely Folic Acid and Zinc with ferritin levels, while there is no relationship between consumption of iron and Vitamin C with ferritin levels in adolescent girls in Gianyar Regency, Bali Province
 
 Conslusion: There is a relationship between consumption of micronutrients, namely Folic Acid and Zinc with ferritin levels, while there is no relationship between consumption of iron and Vitamin C with ferritin levels in young women in Gianyar Regency, Bali Province

Selenium Status and Supplementation Effects in Pregnancy-A Study on Mother-Child Pairs from a Single-Center Cohort.

The demand for selenium (Se) increases during pregnancy since this element supports child growth, proper neuronal development and maternal thyroid function. The issue is particularly relevant for populations living in areas with a limited selenium supply, where many pregnant women opt for Se supplementation. The efficiency of this measure is unknown, although it seems vital in the prevention of severe Se deficiency. In order to evaluate this hypothesis, an observational study was conducted in Poland, where Se deficiency is prevalent. Pregnant women were invited to participate in the study and provided serum samples at the end of pregnancy (n = 115). Information on the supplemental intake of micronutrients was recorded in a face-to-face interview. In addition, serum samples were isolated from the cord blood of newborns at delivery (n = 112) and included in the analyses. Thyroid hormone status was evaluated by routine laboratory tests, and Se status was determined by total Se and selenoprotein P (SELENOP) concentrations and extracellular glutathione peroxidase (GPX3) activity. The three parameters of Se status correlated strongly within the group of mothers and within the group of newborns, with an additional significant correlation found among mother–child pairs. One-third of mothers reported additional Se intake, mainly as a component of multi-micronutrient supplements, at a mean (±SD) dosage of 42 ± 14 µg Se/day. Despite this regime, most of the women presented an insufficient Se status, with 79% of mothers displaying serum Se concentrations below 70 µg/L (indicating Se deficiency) and 22% showing levels below 45.9 µg/L (severe Se deficiency). The inadequate Se supply was also reflected in relatively low SELENOP concentrations and GPX3 activity. Neither total Se nor SELENOP or GPX3 levels were significantly higher in the group of mothers reporting the intake of supplements than in the non-supplementing group. Nevertheless, elevated SELENOP concentrations were observed in the subgroup receiving supplements with more than 55 µg/day. We conclude that the self-administered supplementation of small Se dosages was not sufficient to achieve replete Se status in the micronutrient scant area. However, the maternal Se deficit measured by either Se, SELENOP or GPX3 was transferred from mothers to the newborns, as the parameters correlated strongly in the mother–newborn pairs of samples. It is vital to re-evaluate the guidelines concerning pregnancy care and monitoring of micronutrient status during pregnancy, in particular in areas where deficiencies are present.

Evaluation of a Physical Activity and Multi-Micronutrient Intervention on Cognitive and Academic Performance in South African Primary Schoolchildren.

Executive functions (EFs) are essential for optimal academic development. Appropriate nutrition and physical activity (PA) have been shown to facilitate optimal cognitive development. Therefore, this study examined whether a 12-week school-based PA and multi-micronutrient supplementation (MMNS) intervention would improve cognitive and academic performance. A cluster-randomized controlled trial (RCT) was conducted. Children from four schools located in a peri-urban area of South Africa were randomly assigned to (i) PA + MMNS, (ii) PA + placebo, (iii) MMNS or (iv) placebo. Information processing and inhibitory control were measured with a computerized Flanker task. End-of-year results provided insight into academic achievement. Anthropometric measures were used to determine nutritional status. Data were analyzed with linear mixed-models, adjusting for baseline scores, school classes and age; 932 children (458 girls (49.1%), Mage (mean age) = 8.42 ± 1.94 years) completed baseline and post-intervention assessments. Cognitive performance improved among all four groups, with no significant group × time effects. For academic achievement, there was no significant interaction effect between the combined intervention group and placebo. We encourage future studies in this neglected area in order to determine the most optimal design of school-based nutrition and PA programs to enhance overall cognitive performance.

Impact of a school-based health intervention program on body composition among South African primary schoolchildren: results from the KaziAfya cluster-randomized controlled trial

BackgroundThe prevalence of overweight and obesity is increasing among African children potentially predisposing them to greater obesity and non-communicable diseases (NCDs) in adulthood. This risk may be higher among growth-impaired children who may have greater fat mass. Therefore, we examined the effects of school-based physical activity (PA) promotion and multi-micronutrient supplementation (MMNS) on body composition among South African children enrolled in a longitudinal school-based randomized controlled trial.MethodsChildren were cluster-randomized by class to one of four groups: (a) a physical activity group (PA), (b) a multi-micronutrient supplementation group (MMNS), (c) a physical activity + multi-micronutrient supplementation group (PA + MMNS), and (d) control group, and were being followed for 3 years. Linear random effects regression models with random intercepts for school classes tested the associations of each intervention arm with overall fat mass (FM), fat-free mass (FFM), truncal fat mass (TrFM), and truncal fat-free mass (TrFFM) at 9 months (T2) for boys and girls. These differences were then explored among children who differed in height velocity (HV).ResultsA total of 1304 children (614 girls, 667 boys) in twelve clusters were assessed at baseline and after 9 months follow-up (T2). At baseline, approximately 15% of children were classified as overweight or obese while approximately 38% of children were classified as mildly stunted or moderately/severely stunted. Among girls, promotion of PA was associated with reduced FM and TrFM at T2 while MMNS was associated with increased FFM. Children with reduced HV in the PA arm had reduced FM while children in the MMNS arm with lower HV had increased FFM compared to children in the control arm. Similarly, children with lower HV in the MM and PA groups had reduced TrFM compared to children in the control arm.ConclusionsOur study suggests that the promotion of school-based physical activity programs and micronutrient supplementation can reduce childhood adiposity and so reduce the risk of obesity and chronic diseases later in adulthood.Trial registrationISRCTN, ISRCTN29534081. Registered on August 9, 2018. The trial was designed, analyzed, and interpreted based on the CONSORT protocol (Additional file 1: CONSORT checklist for randomized trial)

Differences in Hemoglobin Levels in Pregnant Women through Multi-Micronutrient Supplements and Iron Tablets

BACKGROUND: A high incidence of anemia, particularly severe anemia, among pregnant women has been a major cause of maternal mortality worldwide. Multi-micronutrient supplement (MMS) has been beneficial for health outcomes. AIM: The study was aimed to examine the effect of MMS compared to iron-folic acid supplement (IFA) on hemoglobin (Hb) levels among pregnant women. METHODS: The study was a quasi-experiment with a three-group pre-post-test design, namely, IFA group, MMS group, and MMS + IFA group. A total of 120 participants enrolled were divided equally in each group. The statistical analysis performed was paired t-test and one-way ANOVA using SPSS. RESULTS: The study result shows that there was a significant difference in the Hb levels of pregnant women after the intervention in all groups (p < 0.001). The highest increase in Hb levels was in the IFA + MMS combining group by 1.1 g/dL of Hb followed by MMS and IFA (0.8 ± 0.37 and 0.4 ± 0.31, respectively). CONCLUSION: The combination of Fe and MMS groups could increase Hb levels compared to IFA. Thus, replacing IFA with MMS is reasonably in preventing anemia among pregnant women.

Pre-conceptional Maternal Vitamin B12 Supplementation Improves Offspring Neurodevelopment at 2 Years of Age: PRIYA Trial.

Background: The first thousand days window does not include the pre-conceptional period. Maternal pre-conceptional health has a profound influence on early embryonic development (implantation, gastrulation, placentation etc). Nutrition provided by B-complex vitamins is important for fetal growth, especially neural development. We report effects of a maternal pre-conceptional vitamin B12 and multi micronutrient (MMN) supplementation on offspring neurodevelopmental performance.Methods: In the Pune Rural Intervention in Young Adolescents trial (PRIYA), adolescents (N = 557, 266 females) were provided with vitamin B12 (2 μg/day) with or without multiple micronutrients, or a placebo, from preconception until delivery. All groups received mandatory iron and folic acid. We used the Bayley's Scale of Infant Development (BSID-III) at 24–42 months of age to investigate effects on offspring neurodevelopment.Results: Participants had similar baseline B12 levels. The levels improved in the B12 supplemented groups during pre-conception and pregnancy (28 weeks gestation), and were reflected in higher cord blood holotranscobalamin (holo-TC) levels compared to the placebo group. Neurodevelopmental outcomes in the B12 alone group (n = 21) were better than the placebo (n = 27) in cognition (p = 0.044) and language (p = 0.020) domains (adjusted for maternal baseline B12 levels). There was no difference in neurodevelopmental outcomes between the B12 + MMN (n = 26) and placebo group. Cord blood Brain Derived Neurotrophic Factor (BDNF) levels were highest in the B12 alone group, though not significant.Conclusion: Pre-conceptional vitamin B12 supplementation improved maternal B12 status and offspring neurodevelopment at 2 years of age. The usefulness of cord BDNF as a marker of brain development needs further investigation. Our results highlight the importance of intervening during pre-conception.

THE EFFECTIVENESS OF MICRONUTRIENT SUPPLEMENTATION ON ZINC DEFICIENCY, VITAMIN A DEFICIENCY AMONG ADOLESCENT GIRLS IN MOUNTAINOUS HIGH SCHOOL IN THANH HOA PROVINCE IN 2019 - 2020

A community intervention study with a placebo group, double-blind, evaluating the effect of using multi-micronutrient tablets on zinc deficiency, vitamin A deficiency among adolescent girls in mountainous high school in Thanh Hoa province in 2019 - 2020, using WHO and IZiNCG classifications. A double-blind randomized controlled trial was conducted among 322 school girls randomly divided into 2 groups. The multi-micronutrient supplements consist of 23 vitamins and minerals, including zinc (10.8 mg), vitamin A (550mcg), while the placebo group took a placebo tablet, once a week for 9 months. All of the children were dewormed by Albendazole 400 mg at baseline. Results showed that after 9 months of intervention, the mean serum zinc concentration of the intervention group (11.35 ± 2.88 µmol/l) was significantly improved and significantly higher than that of the Control group (10.51 ± 2.08 µmol/l) with p<0.05. The retinol concentration did not show significant difference between the two groups, but there was a significant improvement compared to the baseline time the intervention group with an increase level of 0.07 ± 0.30 mol. /l. After the intervention, the rate of zinc deficiency, sub-clinical vitamin A deficiency was not statistically significant between the two groups.

Multimicronutrient supplements in nutrition of pregnant women: critical analysis of research results

The purpose of the review is to analyze the results of the use of vitamin-mineral supplements (MMS) during pregnancy using the databases of the RSCI, CyberLeninka, pubMed. The detection of micronutrient deficiency in a significant part of pregnant women requires its unconditional correction by taking vitamin-mineral supplements. In recent years, the emphasis has shifted to studying the effect of MMS intake on the course and outcomes of pregnancy. The effects described in the literature should be treated critically. Most of the studies are based only on a retrospective survey of pregnant women (according to the ‘yes' or ‘no' principle), their supply of micronutrients is not monitored; no causal relationship is established. There is no objective monitoring of the MMS intake. Uncertainties include the composition and doses of micronutrients in the MMS used, the lack of data on drug intake, the assumption that all MMS are equivalent in composition and micronutrient content, and the grouping of women taking MMS with different composition into one group. In addition, the use of incorrect indicators in assessing the physical growth of children occurs. The positive effect of additional intake of MMS is manifested only if initially there was a deficiency of micronutrients.Conclusions. The intake of MMS during pregnancy improves the supply of vitamins for those women in whose diet there is a lack of them. This prophylaxis reduces the risk of adverse pregnancy outcomes due to vitamin deficiencies.

Dietary intake, intestinal infection, and safe drinking water among children with anemia in Peru: a cross-sectional analysis

BackgroundAnemia is a major public health concern that is present in 41.7% of children under 5 worldwide. The prevalence of anemia in Peru was 43.6% in 2017, a decrease by only 6.8% in 8 years. Despite great efforts made by the government to reduce anemia by distributing free multi-micronutrient supplements and promote the consumption of iron rich foods, progress has been slow. The current study sought to better understand why the prevalence remains high by analyzing the dietary intake, incidence of intestinal infectious disease, and access to safe drinking water by children with anemia in Peru.MethodsA cross-sectional analysis was conducted using data from two national surveys that were combined by child ID. Descriptive statistics was analyzed to understand the experience of children with anemia in comparison to child without anemia. Logistic multivariate regression analyses were conducted to test the associations between anemia and dietary intake, intestinal infection, and access to safe drinking water.ResultsThe sample included 586 children between 6 and 35 months. The prevalence of anemia in this population was 53%. The portion of children that consumed sufficient iron to meet the recommendation for their age was 62%. Of the children with anemia, 52% consumed sufficient iron to meet their recommendation, vs. 72% of children without anemia (p < 0.001). The children with anemia were more likely to have an intestinal infection during the previous year (35% vs. 26%, p = 0.057) and less likely to have access to safe drinking water (77% vs. 86%, p = 0.002) than those without anemia. The logistic analysis revealed that having an intestinal infection increased the odds of having anemia (OR = 1.64, CI 95% [1.041–2.584]), and having access to safe drinking waters decreased the odds of having anemia (OR = 0.578, [0.334–0.998]).ConclusionsMore than half of the children with anemia in Peru already consume sufficient iron to meet their daily requirement. However, they continue to have anemia, likely due to intestinal infection, such as diarrhea and parasites, from a lack of access to safe drinking water and hygienic practices.

ASSOCIATION BETWEEN EXCLUSIVE BREASTFEEDING PRACTICE, TABURIA SUPPLEMENTATION, AND STUNTING PREVALENCE AMONG CHILDREN AGED 24–60 MONTHS IN SIDOTOPO WETAN, SURABAYA

Stunting is a condition in which a child’s height is shorter than other children of the same age. Exclusive breastfeeding is a factor that can aff ect the stunting prevalence in Indonesia. In addition, specifi c nutritional intervention through multi-micronutrient supplementation called Taburia is given to prevent stunting. This study was aimed to determine the relationship between exclusive breastfeeding practice and taburia supplementation in children aged 24-60 months in the working area of Sidotopo Wetan Health Center, Surabaya City. This study used secondary data obtained from a child monitoring survey database from the Surabaya City Health Offi ce in the working area of Sidotopo Wetan Health Center. The samples size was 141 children aged 24–60 month, and the statistical analysis employed was the chi-square test. The results showed that the stunting proportion was 54.60%. There was a relationship between exclusive breastfeeding practice and the stunting incidence (p = 0.047). Children who did not provide exclusive breastfeeding had a higher risk 1.97 times of stunting. Taburia supplementation also had a signifi cant relationship with stunting incidence (p = 0.016). Children with non taburia had a higher risk 2.35 times of stunting. Based on these results, it can be concluded that the prevention of stunting can be overcome by maximizing exclusive breastfeeding practice and complementary foods, also the allocation of taburia

The Effect Of Multi-Micronutrient Supplementation Since Preconception On Levels Of Malondialdehyde (Mda) For Pregnant Women

The nutritional status of a mother before and during pregnancy is important for a healthy pregnancy outcome. The preconception period is a critical time for improving the nutritional status of pregnant women and preventing pregnancy complications. (MMN) compared to iron folate (IFA). Methodology: A double-blind randomized cohort study was carried out in three districts of Luwuk, South Luwuk, and North Luwuk, Banggai Regency with a total sample of 19 pregnant women given MMN supplementation and IFA supplementation. See the effect of multi-micronutrient supplementation during pregnancy on MDA levels measured several times (preconception, trimester 1, trimester 2, trimester 3). Results: MMN supplementation group MDA levels from preconception (144.43) decreased in trimester 1 (127.60) to trimester 2 (130.94) again until trimester 3 (96.03), while the average IFA supplementation group MDA from preconception (110.54), increased in trimester 1 (153.87) increased again in trimester 2 (172.50) then decreased in trimester 3 (81.75), a decrease in MDA levels was better in the MMN supplementation group.

Multi-Micronutrient Supplementation and Immunoglobulin Response in Well-Fed Firefighters.

Intensive physical training programs can affect the immune system. This study aims to verify the multi-micronutrient supplementation effects on serum immunoglobulins levels prior to and after a five-week physical training program. Twenty-four male recruit firefighters were randomly allocated into supplemented (with Prisfar Ever-Fit Plus over 35 consecutive days) and placebo groups (n=12 each). Serum immunoglobulins G, A, and M were assessed. Supplementation effect was detected for immunoglobulin G (eta-squared, η 2 : 0.09; p =0.035; power: 0.56), A (η 2 : 0.24; p =0.001; power: 0.95), and M (η 2 : 0.09; p =0.036; power: 0.56). Although immunoglobulin A was different between groups at baseline (mean difference: 42.58; 95%CI: 7.00 to 78.16 mg/dL; p =0.021; d =2.48), within-group (before vs . after five weeks) showed no differences for both supplemented and control groups. In addition, even if immunoglobulin G and M were similar at baseline, immunoglobulin G decreased (mean diff.: 46.4; 95%CI: 6.7 to 86.1 mg/dL; p =0.03; d =0.74) and immunoglobulin M increased (mean diff.: −10.7; 95%CI: −15.8 to −5.5 mg/dL; p =0.001; d =−1.33) in the control group. Although mean values remained within the reference values, changes observed for immunoglobulin G and M may reflect some immune protection for firefighters engaged in recruit training.

Multiple Micronutrients, Lutein, and Docosahexaenoic Acid Supplementation during Lactation: A Randomized Controlled Trial.

Breastfed infants require an adequate supply of critical nutrients for growth, tissue functions, and health. Recommended intakes for several nutrients are considerably higher in lactating than non-lactating women but are not always met with habitual diets. We report a randomized, double-blind clinical trial in 70 healthy lactating women in Germany evaluating the effects of supplementation with multiple micronutrients, lutein, and docosahexaenoic acid (DHA) compared to placebo on maternal nutrient status and milk composition. The primary endpoint was the effect on the change of human milk DHA content (as a proportion of total milk fatty acids) during 12 weeks of supplementation. Maternal blood and milk biomarkers were measured as secondary endpoints. Supplementation increased maternal milk DHA by 30% compared to a decline in the placebo group. Supplementation also increased maternal blood DHA (17%), eicosapentaenoic acid (4%), 25-OH-vitamin D (24%), vitamin B12 (12%), lutein (4%), and beta carotene (49%), while homocysteine decreased. No significant difference in the number of adverse events was observed between supplementation and placebo groups. In conclusion, multi-micronutrient supplementation was safe and increased maternal blood and milk concentrations of selected nutrients in healthy women.

High Prevalence of Supplement Intake with a Concomitant Low Information Quality among Swiss Fitness Center Users.

Background: The aim of this study was to screen the prevalence of supplement use in Swiss fitness center users and what information sources they consulted. Methods: Customers of 10 fitness centers were screened with a quantitative questionnaire. Results: Eighty two percent of the 417 fitness center users consumed at least one supplement per week. Supplement intake correlated with training frequency (rs = 0.253, p < 0.001). The most prevalent products were protein supplements (used by 49% of the study population), magnesium (34%), and multi-micronutrient supplements (31%). The average number of supplement servings per week among consumers was 17.1 (SD: 16.1, median: 11.0) and the average number of different products used was 6.9 (SD: 4.4, median: 6.0). The most frequently used information sources were the coach/trainer (28%), the website of the supplement seller (26%), and training peers (24%). Thirty seven percent were informed or informed themselves about potential risks associated with the supplement used. The leading reasons for selecting the information source were the desire for scientific-based information followed by the education level of the informing person. Conclusions: A high prevalence of supplement intake among Swiss fitness center users was associated with a low level of information quality and a low prevalence of risk information. A discrepancy between a desire for high quality evidence-based information and a contrasting behavior was detected.

The Role of Multimicronutrient Supplementation in Pediatric HIV Management in Nigeria: A Randomized Controlled Study.

We aimed to compare the immunologic and hematologic effects of 3 multimicronutrient supplements in human immunodeficiency virus-positive children in Lagos, Nigeria. This double-blind, randomized controlled study included 190 children, aged 5-12 years, in Lagos, Nigeria. Sixty-four, 63, and 63 participants were assigned to multimicronutrient group A, B, or C, respectively, for 6 months. Supplements A, B, and C contained 7 micronutrients at the recommended daily allowance (RDA) (comparable to standard-of-care multivitamin), 22 micronutrients at the RDA, and 22 micronutrients at 3 times the recommended daily allowance (3RDA), respectively. Using paired sample t tests and factorial repeat-measures analysis of variance (ANOVA), within- and between-group changes in CD4 count and hemoglobin levels were evaluated after 6 months. After 6 months of supplementation, paired-sample t test showed that CD4 cell count did not significantly differ from baseline for all 3 groups. Between-subject effect also did not significantly differ in the 3 groups after 6 months (factorial repeat-measures ANOVA (F [degrees of freedom {df} = 2, 187] = 0.846; P = .436; partial η 2 = 0.009). Hemoglobin levels were significantly increased after supplementation in all 3 supplement groups. Increases were not significantly different between groups (factorial repeat-measures ANOVA (F [df = 2, 187] = 0.549; P = .591; partial η 2 = 0.006). Equivalent effects were observed. After 6 months of supplementation, mean CD4 count was not significantly different between groups. Hemoglobin concentration was significantly increased in all 3 groups, but increase did not differ between groups. NCT02552602.