Poster Topical Area: Global Nutrition
Location: Hall D
Poster Board Number: 570
Objectives: To investigate if genetic hemoglobin disorders (GHbD) and iron status modify the impact of micronutrient powders (MNP) on growth and morbidity among young Lao children.
Methods: In a double-blind controlled trial, 1704 children ages 6-23 mo were randomized to one of two groups: daily MNP (with 6 mg iron and 14 other micronutrients) or placebo for 36 wks. Baseline and final hemoglobin (Hb), iron status, length and weight were assessed. GHbD were detected by Hb electrophoresis and polymerase chain reaction. Morbidity was assessed weekly. Treatment effect and effect modification were assessed by generalized linear models and interaction models.
Results: Mean age was 14.2±5.0 mo at enrollment and 55.6% were anemic. 39.3% had no sign of GHbD, 1.8% had thalassemia disease, 2.8% had α-thalassemia trait, 13.4% had β-thalassemia or were homozygous Hb E, 42.7% were heterozygous Hb E. At endline, stunting prevalence did not differ significantly between the MNP (48.0%) and the placebo group (42.8%). Baseline Hb modified the effect of MNP on LAZ and MUAC (P for interaction=0.082 and 0.038). Among non-anemic children, final mean LAZ in the MNP group was slightly lower (-1.93±0.02) vs placebo (-1.88±0.02); similarly final mean MUAC was slightly smaller in the MNP group (14.01±0.03 cm) vs placebo (14.05±0.03 cm). Among initially anemic children, final mean LAZ (-1.90±0.02 vs -1.92±0.02) and final mean MUAC were similar in the two groups (13.98±0.03cm vs 13.96± 0.03cm). There was no overall difference in longitudinal diarrhea prevalence between groups (1.23 vs 1.24 per 100d observed). GHbD modified the intervention effect on diarrhea prevalence marginally (P=0.095). Among children with GHbD, the MNP group had higher diarrhea prevalence (1.37±0.08 vs. 1.21±0.08), while it was lower among children without GHbD (1.15±0.10 vs. 1.37±0.10) compared to placebo.
Conclusions: MNP had no overall impact on growth and longitudinal diarrhea prevalence. However, there was a trend towards a small adverse effect on growth among non-anemic children. Similarly, the intervention had a small beneficial impact on diarrhea prevalence among children without GHbD and a small adverse effect among children with GHbD.
Funding: By the Mathile Institute for the Advancement of Human Nutrition, Nutrition International and the Bill & Melinda Gates Foundation.
Associate Research Nutritionist
University of California Davis