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      Impact of milk based micronutrient supplementation in school children in Quito-Ecuador Translated title: Impacto de la suplementación de micronutrientes con leche en niños escolares de Quito-Ecuador

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          Abstract

          Abstract Background: The most common micronutrient deficiencies in Ecuadorian schoolchildren are vitamin A (VA), zinc, and iron. The objective of the present study was to test the efficacy of cow's milk as a vehicle for VA, zinc, and iron supplementation. Methods: Three hundred twenty-eight children aged 6-10 years were included in a randomized, double blind controlled study; 173 children received 480 mL of whole milk (300 Kcals; G1) daily and 155 children received fortified milk (300 Kcals; G2) daily for 23 weeks. Participants had a nutritional evaluation before and after supplementation. Both treatment groups were comparable for gender, age, weight and height at the beginning of the study. Results: Both types of milk were well accepted by the participating children. Data showed that serum concentrations of VA, zinc, and iron significantly increased within both treatment groups. The increase in serum concentrations of the indicated micronutrients was significantly greater in children with deficiencies than in non-deficient ones. There were not significant differences in serum concentrations of VA, zinc, and iron between groups after supplementation. Data also showed that there was an increase in the percentage of children with normal BMI at the expense of a decrease of the percentage of children with excess weight at the end of the treatment period in G1 whereas in G2 it remained unchanged. Blood lipid profiles were normal before and after milk supplementation in both treatment groups. Conclusions: These data indicated that fortified and non-fortified milk are excellent options to increase serum VA, zinc, and iron concentration in schoolchildren.

          Translated abstract

          Resumen Introducción: las deficiencias de vitamina A (VA), zinc y hierro son las más comunes en escolares ecuatorianos. El objetivo del presente estudio fue estudiar la eficacia de la leche de vaca como vehículo para la suplementación de VA, zinc y hierro. Métodos: trescientos veintiocho niños en edades entre 6 y 10 años fueron incluidos en un estudio aleatorizado controlado, doble ciego durante 23 semanas; 173 niños recibieron diariamente 480 mL de leche entera (300 Kcals; G1) y 155 niños recibieron leche entera fortificada (300 Kcals, G2). Los niños tuvieron una evaluación nutricional antes y después de la suplementación. Al inicio del estudio, G1 y G2 fueron similares en género, edad, peso, y talla. Los dos tipos de leche fueron bien aceptados. Resultados: las concentraciones séricas de VA, zinc y hierro aumentaron significativamente en ambos grupos después del tratamiento. El aumento de estos micronutrientes fue significativamente mayor en los niños con deficiencias. No hubo diferencias significativas en las concentraciones de VA, zinc y hierro entre los grupos después de la suplementación. Además, hubo un incremento en el porcentaje de niños con IMC-normal dependiente de una disminución en el número de niños con exceso de peso al final del periodo de tratamiento en G1, mientras que en G2 no hubo cambios. Los perfiles lipídicos fueron normales antes y después de la suplementación con leche en los dos grupos. Conclusiones: en resumen, tanto la leche fortificada como la no fortificada son excelentes opciones para aumentar las concentraciones de VA, zinc y hierro en escolares.

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          Most cited references34

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          Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost?

          The Lancet, 382(9890), 452-477
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            Consumption of a healthy dietary pattern results in significant reductions in C-reactive protein levels in adults: a meta-analysis.

            Consumption of healthy dietary patterns has been associated with reduced risk of cardiovascular disease and metabolic syndrome. Dietary intervention targets disease prevention, so studies increasingly use biomarkers of underlying inflammation and metabolic syndrome progression to examine the diet-health relationship. The extent to which these biomarkers contribute to the body of evidence on healthy dietary patterns is unknown. The aim of this meta-analysis was to determine the effect of healthy dietary patterns on biomarkers associated with adiposity, insulin resistance, and inflammation in adults. A systematic search of Scopus, PubMed, Web of Science, and Cochrane Central Register of Controlled Trials (all years to April 2015) was conducted. Inclusion criteria were randomized controlled trials; effects of dietary patterns assessed on C-reactive protein (CRP), total adiponectin, high-molecular-weight adiponectin, tumor necrosis factor-α, adiponectin:leptin, resistin, or retinol binding protein 4. Random effects meta-analyses were conducted to assess the weighted mean differences in change or final mean values for each outcome. Seventeen studies were included in the review. These reflected research on dietary patterns associated with the Mediterranean diet, Nordic diet, Tibetan diet, and the Dietary Approaches to Stop Hypertension diet. Consumption of a healthy dietary pattern was associated with significant reductions in CRP (weighted mean difference, -0.75 [-1.16, -0.35]; P = .0003). Non-significant changes were found for all other biomarkers. This analysis found evidence for favorable effects of healthy dietary patterns on CRP, with limited evidence for other biomarkers. Future research should include additional randomized controlled trials incorporating a greater range of dietary patterns and biomarkers.
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              A community-based randomized controlled trial of iron and zinc supplementation in Indonesian infants: effects on growth and development.

              Deficiencies of iron and zinc are associated with delayed development, growth faltering, and increased infectious-disease morbidity during infancy and childhood. Combined iron and zinc supplementation may therefore be a logical preventive strategy. The objective of the study was to compare the effects of combined iron and zinc supplementation in infancy with the effects of iron and zinc as single micronutrients on growth, psychomotor development, and incidence of infectious disease. Indonesian infants (n = 680) were randomly assigned to daily supplementation with 10 mg Fe (Fe group), 10 mg Zn (Zn group), 10 mg Fe and 10 mg Zn (Fe+Zn group), or placebo from 6 to 12 mo of age. Anthropometric indexes, developmental indexes (Bayley Scales of Infant Development; BSID), and morbidity were recorded. At 12 mo, two-factor analysis of variance showed a significant interaction between iron and zinc for weight-for-age z score, knee-heel length, and BSID psychomotor development. Weight-for-age z score was higher in the Zn group than in the placebo and Fe+Zn groups, knee-heel length was higher in the Zn and Fe groups than in the placebo group, and the BSID psychomotor development index was higher in the Fe group than in the placebo group. No significant effect on morbidity was found. Single supplementation with zinc significantly improved growth, and single supplementation with iron significantly improved growth and psychomotor development, but combined supplementation with iron and zinc had no significant effect on growth or development. Combined, simultaneous supplementation with iron and zinc to infants cannot be routinely recommended at the iron-to-zinc ratio used in this study.
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                Author and article information

                Journal
                nh
                Nutrición Hospitalaria
                Nutr. Hosp.
                Grupo Arán (Madrid, Madrid, Spain )
                0212-1611
                1699-5198
                February 2018
                : 35
                : 1
                : 50-58
                Affiliations
                [4] Quito orgnameNetLab Laboratorios especializados Ecuador
                [3] Quito Quito orgnameUniversidad Tecnológica Equinoccial orgdiv1Facultad de Ciencias de la Salud Eugenio Espejo orgdiv2Centro de Investigación Biomédica Ecuador
                [2] Salem orgnameNorth Shore Medical Center USA
                [1] Quito Quito orgnameUniversidad de las Américas orgdiv1Facultad de Ciencias de la Salud orgdiv2Centro de Investigación Traslacional Ecuador
                Article
                S0212-16112018000100050 S0212-1611(18)03500100050
                10.20960/nh.1353
                d820a56c-3d31-48b6-9b07-6c6c95ae8cb8

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 30 July 2017
                : 13 June 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 34, Pages: 9
                Product

                SciELO Spain

                Categories
                Original Papers

                Diet,Vitamina A,Leche,Hierro,food,Vitamin A,Zinc,and nutrition,Iron,Micronutrient,Nutrición,alimentación y dieta,Micronutriente,Milk

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