Micronutrient powders to combat anaemia in young children: Do they work?

Hans Verhoef*, Emily Teshome, Andrew M. Prentice

*Corresponding author for this work

Research output: Contribution to journalComment/Letter to the editorAcademic

4 Citations (Scopus)

Abstract

In 2016, the World Health Organization (WHO) recommended point-of-use fortification of complementary foods with iron-containing micronutrient powders to improve iron status and reduce anaemia in children at risk of anaemia. This recommendation continues to be debated. In a recent trial among Kenyan children aged 12-36 months, we found no evidence that daily point-of-use fortification was efficacious in improving haemoglobin concentration or plasma iron markers. An updated meta-analysis indicated that, on average, in an arbitrarily selected setting and with adherence as obtained under trial conditions, one may expect a small increase in haemoglobin concentration in preschool children, with the upper limit of the 95% CI virtually excluding an effect beyond 5.5 g/L. In the present paper, we elaborate on the interpretation of these findings and the meta-analyses that formed the basis for the WHO guidelines. In particular, we draw attention to the phenomenon that small group differences in the distribution of continuous outcomes (haemoglobin concentration, ferritin concentrations) can give a false impression of relatively large effects on the prevalence of the dichotomised outcomes (anaemia, iron deficiency). Please see related articles: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0839-z , https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0867-8
Original languageEnglish
Article number7
JournalBMC Medicine
Volume16
Issue number1
DOIs
Publication statusPublished - 22 Jan 2018

Keywords

  • Anaemia
  • Child
  • Fe(III)-EDTA
  • Food
  • Fortified
  • Iron
  • Iron deficiency
  • Meta-analysis
  • Preschool

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  • Research Output

    • 4 Citations
    • 1 Article

    Daily home fortification with iron as ferrous fumarate versus NaFeEDTA: A randomised, placebo-controlled, non-inferiority trial in Kenyan children

    Teshome, E. M., Andang'o, P. E. A., Osoti, V., Terwel, S. R., Otieno, W., Demir, A. Y., Prentice, A. M. & Verhoef, H., 2017, In : BMC Medicine. 15, 16 p., 89.

    Research output: Contribution to journalArticleAcademicpeer-review

    Open Access
  • 13 Citations (Scopus)

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