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Iron Status and Inherited Hemoglobin Disorders Modify the Effects of Micronutrient Powders on Linear Growth and Morbidity among Young Lao Children in a Double-Blind Randomized Trial

  • Sonja Y. Hess (a1), K. Ryan Wessells (a1), Guy-Marino Hinnouho (a1), Maxwell A. Barffour (a1) (a2), Kanokwan Sanchaisuriya (a3), Charles D. Arnold (a1), Kenneth H. Brown (a1), Charles P. Larson (a4), Supan Fucharoen (a3) and Sengchanh Kounnavong (a5)...

Abstract

Some studies found that providing micronutrient powder (MNP) causes adverse health outcomes; modifying factors are unknown. We aimed to investigate if iron status and inherited hemoglobin disorders (IHbD) modify the impact of MNP on growth and diarrhea among young Lao children. In a double-blind controlled trial, 1704 children ages 6-23mo were randomized to: daily MNP (with 6mg iron plus 14 micronutrients) or placebo for ~36wks. IHbD, and baseline and final hemoglobin (Hb), iron status, and anthropometrics were assessed. Caregivers provided weekly morbidity reports. At enrollment 55.6% were anemic; only 39.3% had no sign of clinically significant IHbD. MNP had no overall impact on growth and longitudinal diarrhea prevalence. Baseline Hb modified the effect of MNP on LAZ (P for interaction=0.082). Among children who were initially non-anemic, final mean LAZ in the MNP group was slightly lower (−1.93 (95%CI: −1.88, −1.97)) vs. placebo (−1.88 (95%CI: −1.83, −1.92)), and the opposite occurred among initially anemic children (final mean LAZ −1.90 (95% CI: −1.86, −1.94) in MNP vs. −1.92 (95% CI: −1.88, −1.96) in placebo). IHbD modified the effect on diarrhea prevalence (P=0.095). Among children with IHbD, the MNP group had higher diarrhea prevalence (1.37 (95%CI: 1.17, 1.59) vs. 1.21 (95%CI: 1.04, 1.41)), while it was lower among children without IHbD who received MNP (1.15 (95%CI: 0.95, 1.39) vs. 1.37 (95%CI: 1.13, 1.64)). In conclusion, there was a small adverse effect of MNP on growth among non-anemic children and on diarrhea prevalence among children with IHbD.

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      Iron Status and Inherited Hemoglobin Disorders Modify the Effects of Micronutrient Powders on Linear Growth and Morbidity among Young Lao Children in a Double-Blind Randomized Trial
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      Iron Status and Inherited Hemoglobin Disorders Modify the Effects of Micronutrient Powders on Linear Growth and Morbidity among Young Lao Children in a Double-Blind Randomized Trial
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Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

Corresponding author: Sonja Y. Hess, Program in International and Community Nutrition, Department of Nutrition, University of California, One Shields Avenue, Davis, CA 95616, USA Email: syhess@ucdavis.edu, Phone: 530-752-1992, Fax: 530-752-3406

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