Effect of a multiple micronutrient enriched maize-based liquid meal supplement on iron status of grade 3 and 4 learners attending Sunnyside primary school, Pretoria

Abstract

Background: About one half of school-age children in developing countries are estimated to be affected by iron deficiency. Failure to treat micronutrient deficiencies can negatively affect health and economic development. Objective: To determine the effect of multiple micronutrient maize-based liquid meal supplement on the iron status and the nutritional status of primary school children. Design: A randomized double-blind placebo controlled trial was conducted. Setting and subjects: The study took place at Sunnyside Primary School in Sunnyside, Pretoria, in the urban area of Tshwane (Gauteng Province, South Africa). Grades 3 and 4 male and female learners aged 8-12 years, enrolled in the 2010 academic year were recruited for the study. Methods: Participants were dewormed, to eliminate parasitic infestaion at the beginning of the study. The experimental product was a maize-based liquid meal supplement enriched with macronutrients and micronutrients including chelated ferrous bisglycinate, while the control had the same macronutrient profile but no added micronutrients. The learners took the meal supplement every morning on school days for 14 weeks. Iron status was measured by Haemoglobin (Hb) levels and the nutritional status was measured by anthropometric measures at baseline and end. Groups were compared with respect to change in Hb and change in anthropometry using an analysis of covariance (ANCOVA) with baseline Hb values as covariate. Testing was done at the 0.05 level of significance. Results: There was no significant difference in the Hb levels at baseline (12.6 ± 1.1 g/dL and 12.8 ± 1.1 g/dL) (P = 0.250) between the experimental and control groups respectively. The prevalence of mild anemia (Hb< 11g/dL) was low in both the experimental and control groups. Over the 14 weeks study period, consumption of experimental products was similar and there was no significant effect on Hb levels of the participants observed (P = 0.806) in the experimental and control groups. There was also no significant change observed in the anthropometry of the participants. Conclusion: The maize-based liquid meal supplement enriched with multiple micronutrients did not have a significant effect on the iron status of the participants in this study, possibly owing to low prevalence of anemia, a low rate of consumption and therefore iron absorption.