The review finds that micronutrient powders containing vitamins and minerals – including iron, zinc and vitamin A – added to the semi-solid foods of infants and children between six months and two years of age can reduce their risk of anaemia and iron deficiency to the same extent as single iron supplements.
The review authors, led by Luz Maria De-Regil from the department of nutrition for health and development at the World Health Organization (WHO), reported that point of use (or home use) fortification with micronutrient powders “is an effective intervention to reduce anaemia and iron deficiency in infants and young children.”
The review noted that such an intervention “can be integrated into strategies to prevent anaemia and reduce the risk of iron deficiency in infants and children aged six to 23 months,” but noted that the benefit in reducing the risk of other vitamins and mineral deficiencies has not yet been demonstrated.
Commenting on the findings of the review, Françoise Chomé, director of World Initiative for Nutrition, a business unit of Fortitech, told NutraIngredients that the review was extremely timely, and will help policy makers to move towards solutions to end micronutrient malnutrition.
“With this review, policy makers, public health decision makers will have a tool to better assess the choice of intervention they want to see implemented to decrease iron deficiency,” said Chomé.
According to the WHO, vitamin and mineral deficiencies, particularly those of iron, vitamin A and zinc, affect more than two billion people worldwide.
Both the review authors and Chomé noted that after a six-month breast-feeding period, infants and young children become highly vulnerable to micronutrient deficiencies because their needs are very high, but the food they are given often do not contain adequate levels for rapid growth.
Micronutrient powders are single-dose packets containing multiple vitamins and minerals in powder form that can be sprinkled onto any semi-solid food immediately before eating at home or at any other place.
The review compared eight trials, which together involved 3748 children living in Asia, Africa and the Caribbean – where anaemia is a public health concern. Each study lasted between two and 12 months, and the powder formulations contained between five and 15 micronutrients.
They found that overall, home fortification with micronutrient powders reduced the risk of having anaemia by 31% and iron deficiency by 51% when compared with no intervention or placebo.
The researchers also found that the powders had a very similar effect to daily iron supplements, but noted that data needed to be treated with slight caution “because there was much less data for this comparison."
In addition, they noted that there was little or no evidence currently to suggest that micronutrient powders have wider effects on growth, survival or overall developmental outcomes.
Chomé argued that whilst the current review data could not show further long term benefits for other micronutrients, she believes further research would provide evidence to support such suggestions.
Chomé added that the results of the review should be welcomed by policy makers globally, as “those who are making the decisions will be better informed on the evidence.”
She said that in light of the findings, policy makers should begin to weigh up the costs and benefits of different solutions to nutritional deficiencies, noting that there are lots of possible solutions, one of which was micronutrient powders.
“Each group and region has specific needs … Many options are needed to try and solve the problem and micronutrient sachets are one option as part of that solution,” said Chomé.
“Of course, the review leaves many questions unanswered, but it is a good beginning,” she added.
Source: Cochrane Database of Systematic Reviews
Issue 9, Article number CD008959, doi: 10.1002/14651858.CD008959.pub2.
“Home fortification of foods with multiple micronutrient powders for health and nutrition in children under two years of age”
Authors: L.M. De-Regil, P.S. Suchdev, G.E. Vist, S. Walleser, J.P. Peña-Rosas