Effects of iron supplementation twice a week on attention score and haematologic measures in female high school students. Dance and reducing television viewing to prevent weight gain in African-American girls: the Stanford GEMS pilot study. Improving dietary intake to prevent anemia in adolescent girls through community kitchens in a periurban population of Lima, Peru. Leaf concentrate as an alternative to iron and folic acid supplements for anaemic adolescent girls: a randomised controlled trial in India. Evaluation of a multiple ecological level child obesity prevention program: Switch® what you Do, View, and Chew Zinc supplementation during pregnancy in low-income teenagers of Mexican descent: effects on selected blood constituents and on progress and outcome of pregnancy. Concomitant supplemental vitamin A enhances the response to weekly supplemental iron and folic acid in anemic teenagers in urban Bangladesh. Weekly micronutrient supplementation to build iron stores in female Indonesian adolescents. Regular consumption of NaFeEDTA-fortified fish sauce improves iron status and reduces the prevalence of anemia in anemic Vietnamese women. School-administered weekly iron-folate supplements improve hemoglobin and ferritin concentrations in Malaysian adolescent girls. The use of NaFeEDTA-fortified fish sauce is an effective tool for controlling iron deficiency in women of childbearing age in rural Vietnam. Iron status, menarche, and calcium supplementation in adolescent girls. Dutch obesity intervention in teenagers: effectiveness of a school-based program on body composition and behavior. Promoting physical activity in middle school girls: Trial of Activity for Adolescent Girls. Randomized control trial to improve adiposity and insulin resistance in overweight Latino adolescents. Once Weekly Low-dose Iron Supplementation Effectively Improved Iron Status in Adolescent Girls Physiological and behavioural outcomes of a randomised controlled trial of a cognitive behavioural lifestyle intervention for overweight and obese adolescents. Biofortified yellow cassava and vitamin A status of Kenyan children: a randomized controlled trial. School randomised trial on prevention of excessive weight gain by discouraging students from drinking sodas. A Policy-Based School Intervention to Prevent Overweight and Obesity Calcium Supplementation and the Risk of Preeclampsia in Ecuadorian Pregnant Teenagers The influence of a behavior modification interventional program on body mass index in obese adolescents. The effect of weekly iron and vitamin A supplementation on hemoglobin levels and iron status in adolescent schoolgirls in western Kenya Kalèdo, a new educational board-game, gives nutritional rudiments and encourages healthy eating in children: a pilot cluster randomized trial The effect of weekly iron supplementation on anaemia and on iron deficiency among female tea pluckers in Bangladesh. Effects of Dietary Calcium Intervention on Adolescent Mothers and Newborns: A Randomized Controlled Trial Evaluation of a nutrition intervention in adolescents of an urban area in Greece: short- and long-term effects of the VYRONAS study. Anemia prophylaxis in adolescent school girls by weekly or daily iron-folate supplementation. [Changes in plasma zinc and folic acid concentrations in pregnant adolescents submitted to different supplementation regimens]. The efficacy of micronutrient supplementation in reducing the prevalence of anaemia and deficiencies of zinc and iron among adolescents in Sri Lanka Effectiveness of weekly vitamin A (10 000 IU) and iron (60 mg) supplementation for adolescent boys and girls through schools in rural and urban East Java, Indonesia Preventing Obesity Among Adolescent Girls: One-Year Outcomes of the Nutrition and Enjoyable Activity for Teen Girls (NEAT Girls) Cluster Randomized Controlled Trial. Community-Led Initiative for Control of Anemia among Children 6 to 35 Months of Age and Unmarried Adolescent Girls in Rural Wardha, India Will iron supplementation given during menstruation improve iron status better than weekly supplementation? Weekly vs daily iron and folic acid supplementation in adolescent Nepalese girls. A positive dose-response effect of vitamin D supplementation on site-specific bone mineral augmentation in adolescent girls: a double-blinded randomized placebo-controlled 1-year intervention. Effect of long-term intermittent supplementation with multiple micronutrients compared with iron-and-folic acid supplementation on Hb and micronutrient status of non-anaemic adolescent schoolgirls in rural Bangladesh. Effects of administration of iron, iodine and simultaneous iron-plus-iodine on the thyroid hormone profile in iron-deficient adolescent Iranian girls The use of technology for delivering a weight loss program for adolescents with intellectual and developmental disabilities. The impact of weekly iron supplementation on the iron status and growth of adolescent girls in Tanzania. Energy and Protein Supplementation Does Not Affect Protein and Amino Acid Kinetics or Pregnancy Outcomes in Underweight Indian Women. Iron and Energy Supplementation Improves the Physical Work Capacity of Female College Students Long-term intermittent multiple micronutrient supplementation enhances hemoglobin and micronutrient status more than iron + folic acid supplementation in Bangladeshi rural adolescent girls with nutritional anemia. A randomised trial in Mali of the effectiveness of weekly iron supplements given by teachers on the haemoglobin concentrations of schoolchildren. New Moves: a school-based obesity prevention program for adolescent girls. The great beginnings program: impact of a nutrition curriculum on nutrition knowledge, diet quality, and birth outcomes in pregnant and parenting teens. Effect of daily and intermittent iron supplementation on iron status of high school girls. Randomised study of cognitive effects of iron supplementation in non-anaemic iron-deficient adolescent girls Adolescent pregnancy: associations among body weight, zinc nutriture, and pregnancy outcome. Supplementation with iron and folic acid enhances growth in adolescent Indian girls. The COPE Healthy Lifestyles TEEN program: feasibility, preliminary efficacy, & lessons learned from an after school group intervention with overweight adolescents. Evaluation of a 2-year physical activity and healthy eating intervention in middle school children. Two-year outcomes of an adjunctive telephone coaching and electronic contact intervention for adolescent weight-loss maintenance: the Loozit randomized controlled trial Overweight and obesity prevention for adolescents: a cluster randomized controlled trial in a school setting. Action Schools! BC: a school-based physical activity intervention designed to decrease cardiovascular disease risk factors in children. Effect of zinc- and micronutrient-rich food supplements on zinc and vitamin A status of adolescent girls.
INTRODUCTION Iron deficiency , associated with a decline in cognitive function , is the most common nutritional deficiency globally . The present study aim ed to identify the impact of weekly iron supplements on the attention function of female students from a high school in North Khorasan Province , Iran . METHODS This was a blind , controlled , clinical trial study , involving 200 female students who were chosen using the stratified r and omised sampling method . First , laboratory studies were performed to detect iron consumption limitations . Next , the 200 students were divided r and omly and equally into case and control groups . The case group was treated with 50 mg of ferrous sulfate twice a week for 16 weeks . We compared both groups ' data on attention , iron status and erythrocyte indices . Question naires were used to collect demographic data , while clinical data was collected using complete blood count and Toulouse-Piéron tests . Data was analysed using descriptive statistics , as well as paired and independent t-tests . RESULTS The mean attention scores of the case and control groups were 104.8 ± 7.0 and 52.7 ± 9.6 , respectively ( p < 0.001 ) . The mean haemoglobin levels of the two groups were 12.5 ± 0.9 and 11.2 ± 1.0 , respectively ( p < 0.001 ) . Compared to the control group , the attention scores and haemoglobin concentrations of the case group were found to be improved by approximately 90 % and 10 % , respectively . CONCLUSION Oral iron supplements ( 50 mg twice a week for 16 weeks ) were able to improve the attention span and haematologic indices of female high school students OBJECTIVE To test the feasibility , acceptability , and potential efficacy of after-school dance classes and a family-based intervention to reduce television viewing , thereby reducing weight gain , among African-American girls . DESIGN Twelve-week , 2-arm parallel group , r and omized controlled trial . SETTING Low-income neighborhoods . PARTICIPANTS Sixty-one 8 - 10-year-old African-American girls and their parents/guardians . INTERVENTIONS The treatment intervention consisted of after-school dance classes at 3 community centers , and a 5-lesson intervention , delivered in participants ' homes , and design ed to reduce television , videotape , and video game use . The active control intervention consisted of disseminating newsletters and delivering health education lectures . MAIN OUTCOME MEASURES Implementation and process measures , body mass index , waist circumference , physical activity measured by accelerometry , self-reported media use , and meals eaten with TV . RESULTS Recruitment and retention goals were exceeded . High rates of participation were achieved for assessment s and intervention activities , except where transportation was lacking . All interventions received high satisfaction ratings . At follow up , girls in the treatment group , as compared to the control group , exhibited trends toward lower body mass index ( adjusted difference = -.32 kg/m2 , 95 % confidence interval [ CI ] -.77 , .12 ; Cohen 's d = .38 st and ard deviation units ) and waist circumference ( adjusted difference = -.63 cm , 95 % CI -1.92 , .67 ; d = .25 ) ; increased after-school physical activity ( adjusted difference = 55.1 counts/minute , 95 % CI -115.6 , 225.8 ; d = .21 ) ; and reduced television , videotape , and video game use ( adjusted difference = -4.96 hours/week , 95 % CI -11.41 , 1.49 ; d = .40 ) . The treatment group reported significantly reduced household television viewing ( d = .73 , P = .007 ) and fewer dinners eaten while watching TV ( adjusted difference = -1.60 meals/week , 95 % CI -2.99 , -.21 ; d = .59 ; P = .03 ) . Treatment group girls also reported less concern about weight ( d = .60 ; P = .03 ) , and a trend toward improved school grade s ( d = .51 ; P = .07 ) . CONCLUSIONS This study confirmed the feasibility , acceptability , and potential efficacy of using dance classes and a family-based intervention to reduce television viewing , thereby reducing weight gain , in African-American girls Peru has high rates of iron deficiency anemia . The prevalence is 35 % in nonpregnant women of fertile age and 24.7 % in adolescent girls in slums of periurban Lima . The major cause of anemia is low intake of dietary iron . A community-based , r and omized behavioral and dietary intervention trial was conducted to improve dietary iron intake and iron bioavailability of adolescent girls living in periurban areas of Lima , Peru . Results show that there was a change in knowledge about anemia and improved dietary iron intake in the 71 girls who completed the study compared with the 66 girls in the control group . Although the 9-mo . intervention was not sufficient to improve hemoglobin levels significantly , there appeared to be a protective effect in maintaining the iron status of girls in comparison with the control group OBJECTIVE Despite public health campaigns based on Fe and folic acid supplements , Fe-deficiency anaemia remains highly prevalent among women in India . We investigated leaf concentrate as an alternative to Fe and folic acid supplements for treating  anaemia in adolescent girls . DESIGN R and omised controlled two-arm trial over 3 months : one group received daily Fe and folic acid ( IFA ; 60 mg Fe , 500 microg folic acid ) ; the other daily leaf concentrate ( LC ; 5 mg Fe , 13 microg folic acid ) . Hb concentration , mean cell volume , serum Fe , serum ferritin and total Fe-binding capacity were measured pre- and post-intervention . SETTING Jaipur , India . SUBJECTS One hundred and two adolescent girls aged 14 - 18 years . RESULTS Of the 102 girls r and omized to the two arms of the trial , four ( 3.9 % ) were severely anaemic  ( Hb < 7 g/dl ) , twenty-eight ( 27.5 % ) were moderately anaemic ( Hb > or = 7 g/dl , < 10 g/dl ) and seventy ( 68.6 % ) were mildly anaemic ( Hb > or = 10 g/dl , < 12 g/dl ) . In the IFA group , eleven girls ( 20.4 % ) withdrew due to side-effects , compared with one girl ( 2.1 % ) in the LC group ( P = 0.005 ) . Total losses to follow-up were 14/54 in the IFA group and 2/48 in the LC group . At the end of the trial , none of the eighty-six remaining girls were severely anaemic , nine ( 10.5 % ) were moderately anaemic and twenty-six ( 30.2 % ) were mildly anaemic ; fifty-one ( 59.3 % ) had normal Hb levels ( > or = 12 g/dl ) . After adjustment for baseline values , LC was as effective as IFA in improving serum Fe parameters and treating anaemia . CONCLUSIONS Leaf concentrate is an effective , and more palatable , alternative to Fe and folic acid supplements for treating anaemia in adolescent girls Background Schools are the most frequent target for intervention programs aim ed at preventing child obesity ; however , the overall effectiveness of these programs has been limited . It has therefore been recommended that interventions target multiple ecological levels ( community , family , school and individual ) to have greater success in changing risk behaviors for obesity . This study examined the immediate and short-term , sustained effects of the Switch program , which targeted three behaviors ( decreasing children 's screen time , increasing fruit and vegetable consumption , and increasing physical activity ) at three ecological levels ( the family , school , and community ) . Methods Participants were 1,323 children and their parents from 10 schools in two states . Schools were matched and r and omly assigned to treatment and control . Measures of the key behaviors and body mass index were collected at baseline , immediately post-intervention , and 6 months post-intervention . Results The effect sizes of the differences between treatment and control groups ranged between small ( Cohen 's d = 0.15 for body mass index at 6 months post-intervention ) to large ( 1.38 ; parent report of screen time at 6 months post-intervention ) , controlling for baseline levels . There was a significant difference in parent-reported screen time at post-intervention in the experimental group , and this effect was maintained at 6 months post-intervention ( a difference of about 2 hours/week ) . The experimental group also showed a significant increase in parent-reported fruit and vegetable consumption while child-reported fruit and vegetable consumption was marginally significant . At the 6-month follow-up , parent-reported screen time was significantly lower , and parent and child-reported fruit and vegetable consumption was significantly increased . There were no significant effects on pedometer measures of physical activity or body mass index in the experimental group . The intervention effects were moderated by child sex ( for fruit and vegetable consumption , physical activity , and weight status ) , family involvement ( for fruit and vegetable consumption ) , and child body mass index ( for screen time ) . The perception of change among the experimental group was generally positive with 23 % to 62 % indicating positive changes in behaviors . Conclusion The results indicate that the Switch program yielded small-to-modest treatment effects for promoting children 's fruit and vegetable consumption and minimizing screen time . The Switch program offers promise for use in youth obesity prevention As a follow-up of our study of pregnant women , we report effects of zinc supplementation during pregnancy in another population of 138 Hispanic teenagers in Los Angeles . Teenagers were r and omized ( double-blind ) to a control or zinc-supplemented group and received similar daily vitamin and mineral supplements except for 20 mg zinc added to the zinc-supplemented group 's capsules . Initially , mean dietary zinc intakes of both groups were about 50 % of the Recommended Dietary Allowance and their mean serum zinc levels did not differ significantly ( 69.8 + /- 11.2 micrograms/dl in control and 69.0 + /- 11.4 micrograms/dl in zinc-supplemented group ) . Zinc supplementation did not maintain mean serum zinc levels during pregnancy but , as in our earlier study , it reduced ( p = 0.018 ) the number of low serum zinc values ( less than or equal to 53 micrograms/dl ) in late pregnancy . Zinc supplementation did not affect outcome of pregnancy but serum zinc levels were lower ( p = 0.038 ) in teenagers with pregnancy-induced hypertension than in normotensives BACKGROUND Iron deficiency is the most common micronutrient deficiency and affects > 2 billion persons worldwide , leading to anemia in > 40 % of women of reproductive age in the developing world . OBJECTIVE The objective was to determine whether weekly supplementation with iron and folate would reduce the frequency of anemia in teenage women in urban Bangladesh before they became pregnant . DESIGN Participants with a hemoglobin concentration of 80 - 120 g/L were entered into a r and omized , double-blind , placebo-controlled trial and received supplements of placebo , vitamin A , iron + folic acid , or iron + folic acid + vitamin A weekly for 12 wk . The supplements contained 2.42 mg vitamin A ( retinol ) as retinyl palmitate , 120 mg elemental Fe as ferrous sulfate , and 3.5 mg folic acid . RESULTS Hemoglobin concentrations increased significantly more after supplementation with iron + folic acid or iron + folic acid + vitamin A than after either the placebo or vitamin A alone . There was a significantly greater increase in hemoglobin after iron + folic acid + vitamin A than after iron + folic acid , but the additional effect disappeared after adjustment for baseline hemoglobin , serum vitamin A , and ferritin and the number of supplements taken . Those with the lowest baseline hemoglobin had the greatest increase in hemoglobin . Compared with the placebo , iron + folic acid + vitamin A reduced anemia by 92 % , iron deficiency by 90 % , and vitamin A deficiency by 76 % . CONCLUSION There may be significant health benefits from a program that enhances the nutritional status of iron , folate , and vitamin A in poor urban young women before they become pregnant Different supplementation schemes to build iron stores in female Indonesian adolescents were investigated . Subjects were 273 high-school girls allocated r and omly to four treatment groups . During a 3-mo period one group received 60 mg Fe , 750 micrograms retinol , 250 micrograms folic acid , and 60 mg vitamin C per day ; a second group received 60 mg Fe , 6000 micrograms retinol , 500 mg folic acid , and 60 mg vitamin C once a week ; a third group received 120 mg Fe and the same amount of the other three micronutrients as the second group once a week ; and a fourth group received only placebos . All subjects were dewormed and supplement allocation was double blind . Blood sample s were collected at baseline , after 2 and 3 mo of supplementation , and 6 mo after the last supplement . After 2 mo of supplementation , groups supplemented weekly and daily showed similar significant improvements ( P < 0.001 ) in hemoglobin and retinol concentrations , and supplementation for 3 instead of 2 mo did not significantly increase these two indicators . After 3 mo , the increase in ferritin was approximately equal to 27 micrograms/L in the daily and 14 - 15 micrograms/L in the weekly groups ( P < 0.001 ) , the latter having a final concentration of 42 - 45 micrograms/L. At 6 mo postsupplementation there were no significant differences among daily and weekly groups , but the ferritin concentration was still approximately equal to 10 - 12-micrograms/L higher ( P < 0.001 ) than in the placebo group . The group supplemented weekly with 60 mg Fe complained less about side effects than the other supplemented groups ( P < 0.05 ) . Weekly supplementation with 60 mg Fe and 6000 micrograms retinol for 3 mo was optimal for improving the iron status of the adolescents for approximately equal to 9 mo BACKGROUND Fish sauce is consumed daily by a large proportion of the Vietnamese population and could therefore be a potentially useful food vehicle for iron-fortification programs . OBJECTIVE We evaluated the efficacy of iron-fortified fish sauce in improving the iron status of anemic women . DESIGN In a r and omized , double-masked study of 152 anemic ( hemoglobin concentration of 81 - 119 g/L ) women , a meal based on noodles or rice was served 6 d/wk with 10 mL fish sauce containing either 10 mg Fe as NaFeEDTA ( iron-fortified group ) or no added iron ( control group ) . Concentrations of hemoglobin , serum ferritin ( SF ) , and serum transferrin receptor ( TfR ) were measured at baseline and after 3 and 6 mo . RESULTS After 6 mo , hemoglobin and SF concentrations were higher and TfR concentrations were lower in the iron-fortified group than in the control group [ hemoglobin : 116.3 + /- 8.7 ( + /- SD ) compared with 107.6 + /- 11.0 g/L ( P < 0.0001 ) ; SF : 30.9 ( 95 % CI : 23.4 , 40.6 ) compared with 14.6 ( 11.3 , 19.0 ) micro g/L ( P = 0.0002 ) ; TfR : 7.2 ( 6.4 , 7.9 ) compared with 9.0 ( 8.1 , 9.9 ) mg/L ( P = 0.002 ) ] . The prevalence of iron deficiency ( SF < 12 micro g/L or TfR > 8.5 mg/L ) and iron deficiency anemia ( iron deficiency with hemoglobin < 120 g/L ) was lower in the iron-fortified group than in the control group [ 32.8 % compared with 62.5 % ( P = 0.0005 ) and 20.3 % compared with 58.3 % ( P < 0.0001 ) , respectively ] . CONCLUSIONS Regular consumption of iron-fortified fish sauce significantly reduced the prevalence of iron  deficiency anemia in Vietnamese women during the 6-mo intervention . Fortifying fish sauce with iron by using a water-soluble , highly bioavailable compound ( NaFeEDTA ) is a promising strategy for combating iron deficiency anemia in Vietnam BACKGROUND Iron deficiency and its consequent anemia constitute the commonest micronutrient deficiency in the world . OBJECTIVE We investigated whether long-term , weekly iron-folate supplements administered at school would improve hemoglobin and ferritin concentrations in adolescent girls , including those with mild-to-moderate anemia and hemoglobin concentrations indicating borderline anemia . DESIGN Subjects were 266 girls with hemoglobin concentrations of 80 - 119.9 g/L ( group A ) and 358 girls with hemoglobin concentrations of 120 - 130 g/L ( group B ) who were otherwise healthy . Two hundred sixty-six girls in group A and 268 girls in group B were r and omly assigned to receive either 60 or 120 mg Fe plus 3.5 mg folic acid weekly for 22 wk . Ninety of the girls in group B were r and omly assigned to receive only 5 mg folic acid weekly . Capillary hemoglobin and plasma ferritin were measured at baseline and after 12 and 22 wk of supplementation . RESULTS By the end of the study , 2 % of the girls had dropped out and > 96 % had taken > or = 20 of the 22 tablets ; side effects were minimal . Mean plasma ferritin increased significantly in all iron-supplemented groups , independently of initial hemoglobin values and iron doses . Ferritin concentrations decreased in the girls supplemented with folic acid only . As expected , hemoglobin responses to iron were higher in group A than in group B and increases were positively correlated with initial plasma ferritin . Hemoglobin failed to respond to folate supplementation if initial plasma ferritin concentrations were low . Mean hemoglobin increased significantly and consistently in relation to the length of treatment . CONCLUSION Long-term , weekly iron-folate supplementation was found to be a practical , safe , effective , and inexpensive method for improving iron nutrition in adolescent schoolgirls One cost-effective strategy for controlling iron deficiency is the fortification of staple foods or condiments with iron . We evaluated the effectiveness of fortifying fish sauce with NaFeEDTA for improving iron status in women of childbearing age in Vietnam in a double-blind intervention with r and omization by village . All families in the selected villages were supplied with fish sauce that was either unfortified ( Group C , 10 villages ) or fortified with NaFeEDTA [ 9 mmol ( 500 mg ) Fe/L , Group F , 11 villages ] for 18 mo . The effect of fortification was assessed in the 576 women ( n = 288/group ) by measuring hemoglobin and serum ferritin ( SF ) at 6 , 12 , and 18 mo . Analysis of the group x time interaction using a repeated- measures test for each response demonstrated a significant effect of fortification on hemoglobin ( P = 0.039 ) and log SF ( P < 0.0001 ) in Group F with no significant changes in Group C. The prevalence of iron deficiency ( SF < 12 microg/L ) decreased from 22.3 to 4.0 % and the prevalence of anemia ( hemoglobin < 120 g/L ) from 24.7 to 8.5 % in Group F with no significant changes in Group C. NaFeEDTA fortification of fish sauce is an effective method for reducing the prevalence of iron deficiency in women in Vietnam The effects of growth , menstrual status , and calcium supplementation on iron status were studied over 4 y in 354 girls in pubertal stage 2 who were premenarcheal at baseline ( x+/-SD age : 10.8+/-0.8 y ) . Girls were r and omly assigned to placebo or treatment with 1000 mg Ca/d as calcium citrate malate .  Anthropometric characteristics , bone mass , and nutritional status were measured biannually ; ferritin was measured annually ; and red blood cell indexes were determined at 4 y. The simultaneous effects of iron intake and menstrual status on serum ferritin , after change in lean body mass ( LBM ) was controlled for , were evaluated in subjects in the upper and lower quartiles of cumulative iron intake . The average maximal accumulation of LBM ( 386 g/mo ; 95 % CI : 372 , 399 ) occurred 0.5 y before the onset of menarche . Change in LBM was a significant predictor of serum ferritin ( P < 0.0001 ) , with a negative influence on iron status ( t ratio=-4.12 ) . The 2 fitted mathematical models representing ferritin concentrations of subjects in the upper and lower quartiles of cumulative iron intake were significantly different ( P < 0.018 ) . The regression line of the ferritin concentration in menstruating girls with high iron intakes had a less negative slope than the line fit to serum ferritin concentrations in girls with low iron intakes ( NS ) . Serum ferritin concentrations at 0 , 1 , 2 , 3 , and 4 y were not significantly different between groups . In addition , there was no significant difference between groups in any of the red blood cell indexes . In summary , growth spurt and menstrual status had adverse effects on iron stores in adolescent girls with low iron intakes ( < 9 mg/d ) , whereas long-term supplementation with calcium ( total intake : approximately 1500 mg/d ) did not affect iron status OBJECTIVE To determine whether a multicomponent health promotion intervention for Dutch adolescents ( defined as persons between 12 and 14 years of age ) would be successful in influencing body composition and dietary and physical activity behavior in both the short and long terms . DESIGN R and omized controlled trial . SETTING Ten intervention and 8 control prevocational secondary schools . PARTICIPANTS A total of 1108 adolescents ( mean age , 12.7 years ) . Intervention An interdisciplinary program with an adapted curriculum for 11 lessons in biology and physical education and environmental change options . MAIN OUTCOME MEASURES Body height and weight , waist circumference , 4 skinfold thickness measurements , and dietary and physical activity behavior data . RESULTS Multilevel analyses showed that the intervention remained effective in preventing unfavorable increases in important measures of body composition after 20-month follow-up in girls ( biceps skinfold and sum of 4 skinfolds ) and boys ( triceps , biceps , and subscapular skinfolds ) . Consumption of sugar-containing beverages was significantly lower in intervention schools both after intervention ( boys : -287 mL/d ; 95 % confidence interval [ CI ] , -527 to -47 ; girls : -249 ; -400 to -98 ) and at 12-month follow-up ( boys : -233 ; -371 to -95 ; girls : -271 ; -390 to -153 ) . For boys , screen-viewing behavior was significantly lower in the intervention group after 20 months ( -25 min/d ; 95 % CI , -50 to -0.3 ) . No significant intervention effects on consumption of snacks or active commuting to school were found . CONCLUSION The Dutch Obesity Intervention in Teenagers program result ed in beneficial effects on the sum of skinfold thickness measurements in girls and consumption of sugar-containing beverages in both boys and girls in both the short and long terms BACKGROUND Physical activity is important for weight control and good health ; however , activity levels decline in the adolescent years , particularly in girls . DESIGN Group r and omized controlled trial . SETTING / PARTICIPANTS Middle school girls with English-speaking skills and no conditions to prevent participation in physical activity in 36 schools in six geographically diverse areas of the United States . R and om , cross-sectional sample s were drawn within schools : 6th grade rs in 2003 ( n=1721 ) and 8th grade rs in 2005 ( n=3504 ) and 2006 ( n=3502 ) . INTERVENTION A 2-year study -directed intervention ( fall 2003 to spring 2005 ) targeted schools , community agencies , and girls  to increase opportunities , support , and incentives for increased physical activity . Components included programs linking schools and community agencies , physical education , health education , and social marketing . A third-year intervention used school and community personnel to direct intervention activities . MAIN OUTCOME MEASURES The primary outcome , daily MET-weighted minutes of moderate-to-vigorous physical activity ( MET-weighted MVPA ) , was assessed using accelerometry . Percent body fat was assessed using anthropometry . RESULTS After the staff-directed intervention ( pre-stated primary outcome ) , there were no differences ( mean= -0.4 , 95 % CI= -8.2 to 7.4 ) in adjusted MET-weighted MVPA between 8th- grade girls in schools assigned to intervention or control . Following the Program Champion-directed intervention , girls in intervention schools were more physically active than girls in control schools ( mean difference 10.9 MET-weighted minutes of MVPA , 95 % CI=0.52 - 21.2 ) . This difference is about 1.6 minutes of daily MVPA or 80 kcal per week . There were no differences in fitness or percent body fat at either 8th- grade timepoint . CONCLUSION A school-based , community-linked intervention modestly improved physical activity in girls Few r and omized trials attempt to improve insulin sensitivity and associated metabolic risks in overweight Latino youth . The purpose of this study is to examine the effects of a modified carbohydrate nutrition program combined with strength training on insulin sensitivity , adiposity , and other type 2 diabetes risk factors in overweight Latino adolescents . In a 16-week r and omized trial , 54 overweight Latino adolescents ( 15.5 + /- 1.0 years ) were r and omly assigned to : ( i ) Control ( C ; n = 16 ) , ( ii ) Nutrition ( N ; n = 21 ) , or ( iii ) Nutrition + Strength training ( N+ST ; n = 17 ) . The N group received modified carbohydrate nutrition classes ( once per week ) , while the N+ST received the same nutrition classes plus strength training ( twice per week ) . The following were measured at pre- and postintervention : strength by 1-repetition maximum , dietary intake by 3-day records , body composition by dual-energy X-ray absorptiometry , glucose/insulin indices by oral glucose tolerance test ( OGTT ) and intravenous glucose tolerance test with minimal modeling . Across intervention group effects were tested using analysis of covariance with post hoc pairwise comparisons . A significant overall intervention effect was found for improvement in bench press ( P < 0.001 ) and reductions in energy ( P = 0.05 ) , carbohydrate ( P = 0.04 ) and fat intake ( P = 0.03 ) . There were no significant intervention effects on insulin sensitivity , body composition , or most glucose/insulin indices with the exception of glucose incremental area under the curve ( IAUC ) ( P = 0.05 ) , which decreased in the N and N+ST group by 18 and 6.3 % compared to a 32 % increase in the C group . In conclusion , this intense , culturally tailored intervention result ed in no significant intervention effects on measured risk factors with the exception of a beneficial effect on glycemic response to oral glucose Iron supplementation has been suggested as a strategy for prevention and treatment of iron deficiency ( ID ) and iron deficiency anemia ( IDA ) in many countries , but non-compliance of daily regimens and common dosage remain as major challenges . The aim of this study was to investigate the effects of low dose once weekly iron supplementation in adolescent girls . The study was design ed as a community-based , r and omized , supplementation trial . The initial sample consisted of 200 female high school students , aged 14–16 years old , of whom 193 students concluded the study . They were r and omly selected and assigned into either iron-supplemented group ( ISG ) or iron-unsupplemented group ( IUG ) . The ISG received 150 mg ferrous sulfate once weekly for 16 weeks , whereas the IUG received nothing .  Weight , height , and hematological parameters were measured and compared between the two groups before and after the intervention . There was no significant difference between the initial measures of the two groups before the intervention . After 16 weeks of intervention , mean of hemoglobin and serum ferritin improved significantly in ISG compared to IUG . At the beginning of the study , percent of anemia , IDA , and ID in ISG were 12.5 % , 8.3 % , and 30.2 % , whereas these figures for IUG in this period of study were 14.4 , 10.3 , and 38.2 , respectively , which were not significantly different between the two groups . However , percentages of the above items at the end of study in ISG were 2.1 % , 0 % , and 21.9 % , respectively . In contrast to IUG , all cases of IDA were abolished in the ISG . Our study showed that once weekly supplementation of 150 mg ferrous sulfate for 16 weeks significantly improved iron status in female adolescents and effectively treated IDA . There is no need for higher dosage of iron for supplementation that may cause adverse effects and bear higher costs AIM This study evaluates the efficacy of the Choose Health program , a family-based cognitive behavioural lifestyle program targeting improved eating and activity habits , in improving body composition , cardiovascular fitness , eating and activity behaviours in overweight and obese adolescents . METHOD The sample comprised 29 male and 34 female overweight ( n = 15 ) or obese ( n = 48 ) adolescents aged 11.5 - 18.9 years ( M = 14.3 , SD = 1.9 ) . Participants were r and omly allocated to treatment or waitlist control conditions ; waitlist condition participants were offered treatment after 6 months .  DEXA-derived and anthropometric measures of body composition ; laboratory-based cycle ergometer and field-assessed cardiovascular fitness data ; objective and self-report physical activity measures ; and self-report measures of eating habits and 7-day weighed food diaries  were used to assess treatment outcome . Adherence to treatment protocol s was high . RESULTS Treatment result ed in significant ( p < .05 ) and sustained improvements in a range of body composition ( body fat , percent body fat , lean mass ) and anthropometric measures ( weight , BMI , BMI -for-age z-score and percentiles ) . Minimal improvements were seen in cardiovascular fitness . Similar results were obtained in completer and intention-to-treat analysis . Poor adherence to assessment protocol s limits conclusions that can be drawn from physical activity and dietary data . CONCLUSIONS Participation in the Choose Health program result ed in significant improvement in body composition . Longer-term follow up is required to determine the durability of intervention effects . Alternative approaches to the measurement of diet and physical activity may be required for adolescents BACKGROUND Whereas conventional white cassava roots are devoid of provitamin A , biofortified yellow varieties are naturally rich in β-carotene , the primary provitamin A carotenoid . OBJECTIVE We assessed the effect of consuming yellow cassava on serum retinol concentration in Kenyan schoolchildren with marginal vitamin A status . DESIGN We r and omly allocated 342 children aged 5 - 13 y to receive daily , 6 d/wk , for 18.5 wk 1 ) white cassava and placebo supplement ( control group ) , 2 ) provitamin A-rich cassava ( mean content : 1460 μg β-carotene/d ) and placebo supplement ( yellow cassava group ) , and 3 ) white cassava and β-carotene supplement ( 1053 μg/d ; β-carotene supplement group ) . The primary outcome was serum retinol concentration ; prespecified secondary outcomes were hemoglobin concentration and serum concentrations of β-carotene , retinol-binding protein , and prealbumin . Groups were compared by using ANCOVA , adjusting for inflammation , baseline serum concentrations of retinol and β-carotene , and stratified design . RESULTS The baseline prevalence of serum retinol concentration < 0.7 μmol/L and inflammation was 27 % and 24 % , respectively . For children in the control , yellow cassava , and β-carotene supplement groups , the mean daily intake of cassava was 378 , 371 , and 378 g , respectively , and the total daily supply of provitamin A and vitamin A from diet and supplements was equivalent to 22 , 220 , and 175 μg retinol , respectively . Both yellow cassava and β-carotene supplementation increased serum retinol concentration by 0.04 μmol/L ( 95 % CI : 0.00 , 0.07 μmol/L ) ; correspondingly , serum β-carotene concentration increased by 524 % ( 448 % , 608 % ) and 166 % ( 134 % , 202 % ) . We found no effect on hemoglobin concentration or serum concentrations of retinol-binding protein and prealbumin . CONCLUSIONS In our study population , consumption of yellow cassava led to modest gains in serum retinol concentration and a large increase in β-carotene concentration . It can be an efficacious , new approach to improve vitamin A status . This study was registered with clinical trials.gov as NCT01614483 OBJECTIVE To determine whether an educational programme aim ed at discouraging students from drinking sugar-sweetened beverages could prevent excessive weight gain . DESIGN Forty-seven classes in twenty-two schools were r and omised as intervention or control . SUBJECTS Participants were 1140 , 9 - 12-year-old fourth grade rs ( 435 in the intervention group and 608 in the control group ) .  Sugar-sweetened beverages and juice intake were measured through one 24 h recall at baseline and another at the end of the trial . The main outcome was the change in BMI ( BMI = weight (kg)/height ( m2 ) ) , measured at the beginning and at the end of the school year . Intention-to-treat analysis was performed taking into account the cluster ( classes ) effect . RESULTS A statistically significant decrease in the daily consumption of carbonated drinks in the intervention compared to control ( mean difference = -56 ml ; 95 % CI -119 , -7 ml ) was followed by a non-significant overall reduction in BMI , P = 0.33 . However , among those students overweight at baseline , the intervention group showed greater BMI reduction ( -0.4 kg/m2 compared with -0.2 kg/m2 in the control group ( P = 0.11 ) ) , and this difference was statistically significant among girls ( P = 0.009 ) . Fruit juice consumption was slightly increased in the intervention group ( P = 0.08 ) , but not among girls . CONCLUSION Decreasing sugar-sweetened beverages intake significantly reduced BMI  among overweight children , and mainly among girls . Efforts to reduce energy intake through liquids need to emphasise overall sweetened beverages and addition of sugar on juices BACKGROUND . The prevalence and seriousness of childhood obesity has prompted calls for broad public health solutions that reach beyond clinic setting s. Schools are ideal setting s for population -based interventions to address obesity . OBJECTIVE . The purpose of this work was to examine the effects of a multicomponent , School Nutrition Policy Initiative on the prevention of overweight ( 85.0th to 94.9th percentile ) and obesity ( > 95.0th percentile ) among children in grade s 4 through 6 over a 2-year period . METHODS . Participants were 1349 students in grade s 4 through 6 from 10 schools in a US city in the Mid-Atlantic region with ≥50 % of students eligible for free or reduced-price meals .  Schools were matched on school size and type of food service and r and omly assigned to intervention or control . Students were assessed at baseline and again after 2 years . The School Nutrition Policy Initiative included the following components : school self- assessment , nutrition education , nutrition policy , social marketing , and parent outreach . RESULTS . The incidences of overweight and obesity after 2 years were primary outcomes . The prevalence and remission of overweight and obesity , BMI z score , total energy and fat intake , fruit and vegetable consumption , body dissatisfaction , and hours of activity and inactivity were secondary outcomes . The intervention result ed in a 50 % reduction in the incidence of overweight . Significantly fewer children in the intervention schools ( 7.5 % ) than in the control schools ( 14.9 % ) became overweight after 2 years . The prevalence of overweight was lower in the intervention schools . No differences were observed in the incidence or prevalence of obesity or in the remission of overweight or obesity at 2 years . CONCLUSION . A multicomponent school-based intervention can be effective in preventing the development of overweight among children in grade s 4 through 6 in urban public schools with a high proportion of children eligible for free and reduced-priced school meals Objective To determine whether increased calcium intake ( 2 g/day ) in pregnancy is effective in reducing the risk of preeclampsia in pregnant teenagers . Methods The present study was a prospect i ve , r and omized , double-blind , controlled clinical trial . Two hundred sixty teenaged pregnant girls attending the Hospital Gíneco-Obstétrico Isidro Ayora in Quito , Ecuador , were included . Selection criteria were age less than 17.5 years , nulliparity , first prenatal visit before 20 weeks ' gestation , and residency in Quito ( 2800-m altitude ) . We used a table of r and om numbers to assign 125 girls to receive 2000 mg of elemental calcium daily , beginning at 20 weeks of gestation and continuing until delivery ; 135 women in the control group received a placebo .  Blood pressure ( BP ) was measured twice every 4 weeks until delivery and at 48 hours after delivery . The diagnosis of preeclampsia was defined as BP greater than 140/90 mmHg on at least two occasions more than 6 hours apart and proteinuria greater than 30 mg/dL ( over one cross by dipstick on two occasions 4 - 24 hours apart ) . Results The average daily calcium intake in this population was approximately 51 % of the Recommended Dietary Allowance . Calcium supplementation was associated with a significantly decreased risk of preeclampsia ( risk reduction 12.35 % ; P < .001 ) , with 3.2 % ( n = 4 ) developing preeclampsia in the treatment group versus 15.5 % ( n = 21 ) in the placebo group . Moreover , calcium supplementation led to a reduction in systolic BP of 9.1 mmHg and in diastolic BP of 6.0 mmHg . Conclusion These results suggest that calcium supplementation during pregnancy in population s with low calcium intake is a safe , effective , and inexpensive preventive measure that significantly reduces the risk of preeclampsia BACKGROUND / PURPOSE The prevalence of obesity and overweight among children and adolescents is increasing rapidly . The present research was performed to determine the influence of a ' ' behavior modification ' ' program on body mass index ( BMI ) in obese public high school students in Iran . METHODS In this study , 152 adolescence and their parents were selected from 12 high schools of Khorram Abad from 2004 to 2006 , and they were r and omly assigned to either the intervention or the control groups . The " behavior modification " interventional program consisted of nutritional education , modifying dietary habits , teaching exercise programs , teaching nutritional facts to the parents , and performing exercises 3 days a week . The height and weight as well as waist , hip , and wrist circumferences of the participants were measured before and after implementing the interventional program .  BMI and waist to hip ratio ( WHR ) were calculated . The adolescents and parents completed a nutrition knowledge question naire . Adolescents also completed the Beck 's Depression Question naire . RESULTS Adolescent 's mean weight , BMI , and waist and hip circumferences decreased significantly after implementing the interventional program , in the intervention group ( p≤0.001 ) . In addition , the students ' and parents ' nutrition knowledge increased in the intervention group after implementing the interventional program ( p<0.046 ) . The symptoms of depression decreased and the frequency of students without symptoms of depression increased in the case group , but it did not reveal a statistically significant difference between case and control groups . CONCLUSION The ' ' behavior modification ' ' interventional program is effective in reducing BMI in obese students , and therefore , school principals and planners can play an important role in controlling obesity by implementing this program via the students , their parents , and the school staff Background / Objectives : Iron deficiency anemia is a major public health problem in developing countries and may affect school performance and physical work capacity in nonpregnant adolescents , and may increase the risk of anemia during subsequent teenage pregnancies . We assessed the effect of weekly iron ( 120 mg elemental iron ) and vitamin A ( 25 000 IU ) supplementation on hemoglobin , iron status and malaria and nonmalaria morbidity in adolescent schoolgirls . Subjects/ Methods : A total of 279 schoolgirls aged 12–18 years from public primary schools in Kisumu , western Kenya . Double-blind r and omized placebo-controlled trial using a factorial design . Results : Five months of iron supplementation was associated with a 0.52 g dl−1 ( 0.21 , 0.82 ) greater increase in hemoglobin relative to iron placebo . The effect was only observed in girls with iron deficiency on enrollment ( 1.34 g dl−1 ( 0.79 , 1.88 ) ) , but not in iron-replete girls ( −0.20 g dl−1 ( −0.59 , 0.18 ) ) . Similar differences in treatment effect were seen between menstruating and nonmenstruating girls . The effect of iron was independent of vitamin A. The baseline prevalence of vitamin A deficiency was low ( 6.7 % ) and no sustained increase in hemoglobin was seen with weekly vitamin A ( −0.07 g dl−1 ( −0.38 , 0.25 ) ) . Incidence of malaria parasitemia was higher in the iron than iron-placebo groups ( Rate ratio 1.33 ( 0.94 , 1.88 ) ) . Conclusions : Weekly iron supplementation results in substantial increases in hemoglobin concentration in adolescent schoolgirls in western Kenya , which may outweigh possible risks caused by malaria , but only in iron-deficient or menstruating girls and not in iron-replete and nonmenstruating girls Introduction Prevention of obesity and overweight is an important target for health promotion . Early prevention requires an intervention during childhood and adolescence . At these stages , the game could be an appropriate means to teach nutrition knowledge and to influence dietary behaviour . To this end , the authors developed Kalèdo , a new board-game . Objective The aim of the present study was to test the efficacy of Kalèdo on changes in nutrition knowledge and dietary behaviour in a pilot study conducted in three middle schools in Naples , Italy . Material s and Methods A simple two-group design ( treatment and control ) with pre- and post- assessment was employed . The classroom was the unit of recruitment and r and om assignment to groups . All students ( 307 ) in the participating schools were invited to participate . Data analysis was performed on 241 subjects . During 24 weeks , a group of 153 children from 8 classrooms ( 11–14 year old Caucasian subjects ; 78 male , 75 female ) was involved in 15–30 minute-long play sessions once a week . A question naire was given to the participants at the beginning and at the end of the study to evaluate nutrition knowledge ( 31 questions ) , physical activity ( 8 questions ) and food intake ( 34 questions ) . Anthropometric measurements were also carried out . A second group of 88 children from 5 classrooms ( same age and ethnicity ; 55 male , 33 female ) was investigated at the same times with the same question naire and anthropometric measures but they did not receive any play sessions with Kalèdo . ObservationChildren playing Kalèdo showed a significant increase in nutrition knowledge ( p<0.05 ) and in weekly vegetable intake ( p<0.01 ) with respect to the control . Conclusion The results suggest that Kalèdo could be an effective instrument to teach children about healthy diet . More research is needed to study the long term effect of this intervention AIM To investigate the effect of weekly iron supplementation on anaemia and iron deficiency among adult , female tea pluckers . METHOD A r and omized double-blind intervention trial was conducted in a tea estate in Bangladesh where a total of 280 women received either weekly iron supplementation ( 200 mg ferrous fumarate and 200 mg folic acid )  for 24 weeks or a  matching placebo . Capillary blood sample s were drawn at baseline and post-trial to determine haemoglobin , haematocrit and ferritin concentration . Mean corpuscular haemoglobin concentration ( MCHC ) was calculated using the haemoglobin and haematocrit values . RESULTS The mean haemoglobin concentration in the supplemented group increased by 5.52 g L-1 over the study period , on average , while ferritin values decreased by 0.33 microgram L-1 . The control group showed a decrease in both mean haemoglobin ( -0.24 g L-1 ) and ferritin ( -5.32 micrograms L-1 ) . Those individuals in the supplemented group with the lowest pretrial haemoglobin and ferritin values experienced the greatest improvements post-trial , whereas nonanaemic individuals showed a decrease in both haemoglobin and ferritin concentrations . A total of 62.2 % of women in the supplemented group reported feeling better and more energetic compared to 51.1 % in the placebo group ; 14.4 % of the supplemented group and 22.7 % of the control group complained about side-effects . CONCLUSION Weekly iron supplementation was logistically simpler and cheaper than daily supplementation but would have to be continued on a longer term basis in order to combat both anaemia and iron deficiency OBJECTIVE : To evaluate the effects of dietary calcium ( Ca ) intervention on adolescent pregnant mothers and their newborns . METHODS : Seventy-two pregnant adolescent mothers were r and omized into one of 3 groups : control , orange juice fortified with calcium , and dairy . The orange juice and dairy groups were required to take more than 1,200 mg Ca . Calcium tablets were added for those not able to meet required Ca . Maternal and infant weight , length , and blood pressure ( BP ) were recorded . Maternal dietary records were evaluated . Mother ’s blood was drawn for serum Ca , phosphate ( P ) , magnesium ( Mg ) , and vitamin 25-hydroxyvitamin D ( D ) . Cord blood was collected for serum Ca and D. Newborn total body Ca was determined . RESULTS : All mothers were similar in weight , height , and BP . Mothers in the orange juice plus calcium and dairy groups had higher intakes of Ca ( 1,472 mg and 1,771 mg ) than controls ( 862 mg ) . One half of the mothers in the orange juice plus calcium group required Ca tablets . Mothers in the dairy group had higher intakes of P , D , and Mg , higher serum folate and D , and higher cord D levels . Mothers in the orange juice plus calcium group had higher serum P but lower serum folate and D. Infants ( 3,517±273 g ) in the dairy group were heavier than infants in the control ( 3,277±177 g ) and orange juice plus calcium ( 3,292±165 g ) groups . Infants in the dairy group had higher total body calcium than control infants . CONCLUSION : Calcium diet supplemented with dairy products during adolescent pregnancy result ed in higher maternal vitamin D and folate serum levels and higher newborn weight and bone mineralization compared with controls . CLINICAL TRIAL REGISTRATION : Clinical Trials.gov , www . clinical trials.gov , NCT00320125 LEVEL OF EVIDENCE : OBJECTIVE To assess the short-term ( 15-d ) and long-term ( 12-month ) effects of a school-based health and nutrition education intervention on diet , nutrition intake and BMI . DESIGN The 12-week teacher-implemented intervention in combination with seminars organized for parents was aim ed at improving children 's diet and nutrition knowledge . The intervention took place between September 2007 and January 2008 . The participants were r and omized to two study groups , the intervention group ( IG ) and control group ( CG ) , and were examined prior to the intervention on a variety of health knowledge , dietary , behavioural and anthropometric indices . The same measurements were collected 15 d and 1 year after the intervention . SETTING All high schools in Vyronas , a densely populated district of Athens , Greece . SUBJECTS The sample consisted of 191 students aged 12 - 13 years . RESULTS Twelve months after the intervention , the programme was effective in reducing various indices in the IG compared with baseline findings ( BMI : 23.3 ( sd 2.8 ) v. 24.0 ( sd 3.1 ) kg/m2 , P < 0.001 ; daily energy intake : 8112.4 ( sd 1412.4 ) v. 8503.3 ( sd 1419.3 ) kJ/d , P < 0.001 ; total fat intake : 31.3 ( sd 4.4 ) v. 35.4 ( sd 4.7 ) % of daily energy , P < 0.001 ) . Except for BMI , decreases in the aforementioned indices were also observed 15 d after the intervention . In addition , students of the IG reduced their weekly consumption of red meat and non-home-made meals and increased their frequency of fruit and breakfast cereal consumption . CONCLUSIONS The beneficial effects of this nutrition education intervention among adolescents may highlight the potential of such programmes in the prevention of obesity OBJECTIVE To examine the benefits of anemia prophylaxis in adolescent school.girls by weekly or daily iron-folate supplementation . DESIGN Prospect i ve study . SETTING Government girl schools of northeast Delhi . SUBJECTS 2088 subjects ( with hemoglobin greater than 7.9 g/dL ) , including 702 on daily and 695 on weekly iron-folate administration ; 691 girls served as controls .  RESULTS About 85 % girls were iron deficient out of which 49.3 % were anemic . Weekly administration took longer time to raise hemoglobin but was effective as well as practical . Plasma ferritin estimation in girls showed rise in level in both the treated groups . CONCLUSION Weekly administration of iron-folate was a practical and effective strategy for anemia prophylaxis in adolescent school girls Zinc and folic acid nutritional status was evaluated in 74 low-income pregnant adolescents ranging from 13 to 18 years of age who received prenatal care at the Evangelina Rosa Maternity Hospital in Teresina , Piau State , Brazil . In order to evaluate the effects of different supplementation regimens on nutritional status , the adolescents were distributed into five groups . Groups I and II received equal amounts of folic acid ( 250 micro;g ) and different doses of iron ( ferrous sulfate ) , 120 and 80 mg , respectively . Groups III and IV received equal amounts of folic acid ( 250 micro;g ) associated with zinc sulfate and iron at doses of 120 and 80 mg , respectively , while group V received only 120 mg of iron ( routine dosage ) . There was a reduction in the zinc plasma concentration , and this decline was significant only in those groups which did not receive zinc supplementation . In relation to combination iron/folic acid and iron/folic acid/zinc  , an excellent response was observed for folic acid , and this effect was larger in the groups that received folic acid combined with zinc , suggesting a possible role for zinc in folic acid metabolism Objective : To determine the effectiveness of combined iron and zinc over the iron or zinc-only supplementation in correcting deficiency and possible interactive effects in a group of adolescent school children . Subjects and methods : Schoolchildren ( n=821 ) of 12–16 years of age were r and omized into four groups and supplemented with iron ( 50 mg/day ) , zinc ( 14 mg/day ) , iron+zinc or placebo capsules 5 days per week for 24 weeks . Anthropometry , and haemoglobin ( Hb ) , serum zinc ( SZn ) and serum ferritin ( SF ) concentrations were determined before and after the intervention . Results : There were no significant effects between-groups in their weight , height and Hb concentrations with the intervention when compared with the placebo group . Iron-only and combination-supplemented groups had reached mean SF concentrations of 55.1 μg/l with no difference between them ( P=0.99 ) . The zinc-only group had a mean change of 4.3 μmol//l whereas the combine-supplemented group had a mean change of 4.0 μmol/l ( P=0.82 ) . The prevalence of anaemia was found to be 70.3 % in the iron group at baseline ; this was reduced to 14.5 % after the supplementation . In the combine-supplemented group anaemia , prevalence was reduced from 64.8 to 19.3 % . Conclusions : Zinc alone or in combination with iron has not shown a significant improvement in growth in adolescence . Severe and moderate forms of anaemia were successfully treated in children who received iron supplementation . Initial high prevalence of low SZn and iron stores was significantly improved with micronutrient supplementation Objective : High prevalences of vitamin A deficiency and anaemia among adolescents warrant interventions . This study evaluated the effectiveness of school-based supplementation to reduce anaemia and improve vitamin A status . Design : School-based , grade -r and omized , intervention . Subjects and setting : In all , 1757 girls and 1859 boys , aged 12–15 y , in 24 Junior High Schools . Interventions : Weekly supplementation for 14 weeks with 60 mg iron and 250 μg folate ( Fe group ; n=978 ) , 10 000 IU vitamin A ( VA group ; n=970 ) or both ( VAFe group ; n=1042 ) to subjects in 15 schools , compared to subjects in nine other schools not receiving supplements  ( control ; n=626 ) . Results : The baseline anaemia prevalence ( Hb < 120 g/l ) in girls was 20 % ( prepubertal ) and 26 % ( pubertal ) , and in boys 24 % ( pre-pubertal ) and 11 % ( pubertal ) . Serum retinol concentrations were low ( < 1.05 μmol/l ) in 41 % of boys and 45 % of girls . The interventions did not increase haemoglobin concentrations . Serum retinol concentration of boys , but not girls , in the VA group increased ( 0.33 vs 0.07 μmol/l in controls ; P<0.01 ) . The risk factors for low serum retinol concentration were lower baseline serum retinol concentration ( OR 0.02–0.03 ) with , for girls , nightblindness at baseline ( OR 5.88 ) , and for boys , not receiving vitamin A ( OR control : 1.00 ; VA : 0.37 ; Fe : 0.77 ; VAFe : 0.34 ) and maternal illiteracy ( OR mother never attended school 1.00 , mother received any formal education 0.17–0.33 ) . Conclusions : Supplementation with vitamin A increased serum retinol concentration of boys . Iron supplementation did not change Hb . This appeared to be due to poor compliance , and partly related to side effects . Sponsorship : This study was funded by USAID through the OMNI Project OBJECTIVE To evaluate the impact of a 12-month multicomponent school-based obesity prevention program , Nutrition and Enjoyable Activity for Teen Girls among adolescent girls . DESIGN Group r and omized controlled trial with 12-month follow-up . SETTING Twelve secondary schools in low-income communities in the Hunter and Central Coast regions of New South Wales , Australia . PARTICIPANTS Three hundred fifty-seven adolescent girls aged 12 to 14 years . INTERVENTION A multicomponent school-based intervention program tailored for adolescent girls .  The intervention was based on social cognitive theory and included teacher professional development , enhanced school sport sessions , interactive seminars , nutrition workshops , lunch-time physical activity sessions , h and books and pedometers for self-monitoring , parent newsletters , and text messaging for social support . MAIN OUTCOME MEASURES Body mass index ( BMI , calculated as weight in kilograms divided by height in meters squared ) , BMI z score , body fat percentage , physical activity , screen time , dietary intake , and self-esteem . RESULTS After 12 months , changes in BMI ( adjusted mean difference , -0.19 ; 95 % CI , -0.70 to 0.33 ) , BMI z score ( mean , -0.08 ; 95 % CI , -0.20 to 0.04 ) , and body fat percentage ( mean , -1.09 ; 95 % CI , -2.88 to 0.70 ) were in favor of the intervention , but they were not statistically different from those in the control group . Changes in screen time were statistically significant ( mean , -30.67 min/d ; 95 % CI , -62.43 to -1.06 ) , but there were no group by time effects for physical activity , dietary behavior , or self-esteem . CONCLUSIONS A school-based intervention tailored for adolescent girls from schools located in low-income communities did not significantly reduce BMI gain . However , changes in body composition were of a magnitude similar to previous studies and may be associated with clinical ly important health outcomes . TRIAL REGISTRATION anzctr.org.au Identifier : 12610000330044 Background Studies in India have reported a high prevalence of nutritional anemia among children and adolescent girls . Nutritional anemia is associated with impaired mental , physical , and cognitive performance in children and is a significant risk factor for maternal mortality . Objective To evaluate the effect of a community-led initiative for control of nutritional anemia among children 6 to 35 months of age and unmarried rural adolescent girls 12 to 19 years of age . Methods This Participatory Action Research was done in 23 villages of the Primary Health Centre , Anji , in Wardha District of Maharashtra . In February and March 2008 , needs assessment was undertaken by interviewing the mothers of 261 children and 260 adolescent girls . Hemoglobin levels of adolescent girls and children were measured with the use of the hemoglobin color scale . The girls were given weekly iron — folic acid tablets , and the children were given daily liquid iron prophylaxis for 100 days in a year through community participation . The adolescent girls and the mothers of the children and adolescent girls were also given nutritional education on the benefits and side effects of iron supplementation . In June and July 2008 , follow-up assessment was performed by survey and force field analysis . Results There was a significant reduction in the prevalence of nutritional anemia from 73.8 % to 54.6 % among the adolescent girls and from 78.2 % to 64.2 % among the children . There was improvement in awareness of iron-rich food items among the adolescent girls and the mothers of the children . The benefits to girls , such as increase in appetite and reduction in scanty menses , tiredness , and weakness , acted as positive factors leading to better compliance with weekly iron supplementation . The benefits to children perceived by the mothers , such as increase in appetite , weight gain , reduction in irritability , and reduction in mud-eating behavior , acted as a dominant positive force and generated dem and for iron syrup . Conclusions The community-led initiative for once-weekly iron supplementation for adolescent girls and iron prophylaxis for children , in addition to nutritional education , improved the hemoglobin status of children 6 to 35 months of age and unmarried rural adolescent girls 12 to 19 years of age To investigate the efficacy of two different iron supplements administered either on a weekly basis or during menstruation , a 16-week community experimental study was carried out among postmenarcheal female adolescent students in Kupang , East Nusa Tenggara , Indonesia . Forty eight students received a placebo tablet  weekly , 48 other students got an iron tablet weekly and 41 students took an iron tablet for four consecutive days during their menstruation cycle . All subjects were given deworming tablets before supplementation . Haemoglobin , serum ferritin , height , weight , mid-upper arm circumference and dietary intake were assessed before and after intervention . The supplementation contributed to a significant improvement in the iron status of the intervention groups compared to the placebo group ( P < 0.05 ) . In the menstruation group , the haemoglobin concentrations of the anaemic subjects improved significantly ( P < 0.05 ) while for the non-anaemic subjects , serum ferritin concentrations also increased significantly ( P < 0.05 ) . In the weekly group for anaemic and nonanaemic subjects , there was a significant increase in both haemoglobin and serum ferritin concentrations ( P < 0.05 ) . This study revealed that weekly supplementation of iron tablets continued for 16 weeks contributed a higher improvement to haemoglobin concentration , compared with supplementing iron tablets for four consecutive days during menstruation for four menstrual cycles . This suggests that weekly iron supplementation is preferable OBJECTIVE To compare the effectiveness of weekly vs daily iron and folic acid supplementation for control of anemia in adolescent Nepalese girls . DESIGN R and omized controlled trial . SETTING A Government Girl School in Dharan , Nepal , an urban foothill town that is 305 m above sea level . SUBJECTS Consecutive healthy adolescent girls ( n = 209 , median age 15 years ) r and omized to 3 groups matched for age , anthropometry , and personal and sociodemographic characteristics . Of 209 subjects , 181 completed the trial . Two girls had adverse reactions to treatment and were excluded . INTERVENTION Group A ( n = 70 ) received a 350-mg ferrous sulfate and 1.5-mg folic acid combination once daily for 90 to 100 days . Group B ( n = 67 ) received the tablet under supervision once a week for 14 weeks . Group C ( n = 72 ) did not receive any drugs . OUTCOME VARIABLE Presupplementation and postsupplementation differences in prevalence of anemia and change in hematocrit . RESULTS Prevalence of anemia ( defined as hematocrit < 36 % ) declined from 68.6 % and 70.1 % in groups A and B to 20 % and 13.4 % , respectively , postsupplementation ( P<.001 ) , whereas the prevalence in group C changed little ( 68.1 % to 65.3 % , P = .81 ) . There was a significant rise in the mean hematocrit of both supplemented groups ( group A , 32.9 % + /- 3.5 % to 41.0 % + /- 5.6 % , P<.001 ; group B , 33.2 % + /- 3.6 % to 40.4 % + /- 4.9 % , P<.001 ) but no appreciable change in controls ( 34.2 % + /- 2.9 % to 34.1 % + /- 3.3 % , P = .91 ) . Net change in mean hematocrit in both the supplementation groups was comparable ( P = .57 ) . CONCLUSIONS The prevalence of anemia in adolescent Nepalese girls is high . Supervised iron and folic acid therapy once a week is an effective alternative to daily administration and helps lower the prevalence of anemia in adolescent girls UNLABELLED The effect of vitamin D supplementation on bone mineral augmentation in 212 adolescent girls with adequate calcium intake was studied in a r and omized placebo-controlled setting . Bone mineral augmentation determined by DXA increased with supplementation both in the femur and the lumbar vertebrae in a dose-responsive manner . Supplementation decreased the urinary excretion of resorption markers , but had no impact on formation markers . INTRODUCTION Adequate vitamin D intake protects the elderly against osteoporosis , but there exists no indisputable evidence that vitamin D supplementation would benefit bone mineral augmentation . The aim of this 1-year study was to determine in a r and omized double-blinded trial the effect of 5 and 10 microg vitamin D3 supplementation on bone mineral augmentation in adolescent girls with adequate dietary calcium intake . MATERIAL S AND METHODS Altogether , 228 girls ( mean age , 11.4 + /- 0.4 years ) participated . Their BMC was measured by DXA from the femur and lumbar spine . Serum 25-hydroxyvitamin D [ S-25(OH)D ] , intact PTH ( S-iPTH ) , osteocalcin ( S-OC ) , and urinary pyridinoline ( U-Pyr ) and deoxypyridinoline ( U-Dpyr ) were measured . Statistical analysis was performed both with the intention-to-treat ( IT ) and compliance-based ( CB ) method . RESULTS In the CB analysis , vitamin D supplementation increased femoral BMC augmentation by 14.3 % with 5 microg and by 17.2 % with 10 microg compared with the placebo group ( ANCOVA , p = 0.012 ) . A dose-response effect was observed in the vertebrae ( ANCOVA , p = 0.039 ) , although only with the highest dose . The mean concentration of S-25(OH)D increased ( p < 0.001 ) in the 5-microg group by 5.7 + /- 15.7 nM and in the 10-microg group by 12.4 + /- 13.7 nM , whereas it decreased by 6.7 + /- 11.3 nM in the placebo group . Supplementation had no effect on S-iPTH or S-OC , but it decreased U-DPyr ( p = 0.042 ) . CONCLUSIONS Bone mineral augmentation in the femur was 14.3 % and 17.2 % higher in the groups receiving 5 and 10 microg of vitamin D , respectively , compared with the placebo group , but only 10 mug increased lumbar spine BMC augmentation significantly . Vitamin D supplementation decreased the concentration of bone resorption markers , but had no impact on bone formation markers , thus explaining increased bone mineral augmentation . However , the positive effects were noted with the CB method but not with IT The present study examined whether long-term supplementation with once- and twice-weekly multiple micronutrients ( MMN-1 and MMN-2 ) can improve Hb and micronutrient status more than twice-weekly Fe-folic acid ( IFA-2 ) supplementation in non-anaemic adolescent girls in Bangladesh . An equal number of 324 rural schoolgirls aged 11 - 17 years were given MMN-1 or MMN-2 or IFA-2 supplements for 52 weeks in a r and omised , double-blind trial . Blood sample s were collected at baseline , and at 26 and 52 weeks of supplementation . The girls receiving IFA-2 supplements were more likely to be anaemic than the girls receiving MMN-2 supplements for 26 weeks ( OR 5·1 , 95 % CI 1·3 , 19·5 ; P = 0·018 ) . All three supplements reduced Fe deficiency effectively . Both the MMN-1 and MMN-2 groups showed significantly greater improvements in vitamins A , B(2 ) and C status than the girls in the IFA-2 group , as might be expected . Receiving a MMN-1 supplement was found to be less effective than MMN-2 supplement in improving Fe , vitamins A , B(2 ) and folic acid status . Receiving micronutrient supplements beyond 26 weeks showed little additional benefit in improving micronutrient status . In conclusion , given twice-weekly for 26 weeks , MMN supplements can improve micronutrient status effectively with no significant increase in Hb concentration compared with IFA supplements in non-anaemic Bangladeshi adolescent girls . However , it significantly reduces the risk of anaemia . Before any recommendations can be made , further research , including into cost-effectiveness , is needed to see whether MMN supplementation has any additional longer-term health benefits over that of IFA supplementation in this population Objective : To investigate whether iron supplementation can improve thyroid hormone function in iron-deficient adolescent girls . Design : A double-blind r and omized intervention study . Setting : The study was performed from 2002 through 2003 in the Islamic Republic of Iran . Subjects:103 iron-deficient non-anaemic girls who fulfilled all inclusion criteria were included , and 94 subjects successfully completed the study . Interventions : Patients were r and omly assigned to one of four groups and treated with a single oral dose of 190 mg iodine plus 300 mg ferrous sulphate 5 times/week ( n=24 ) , 300 mg ferrous sulphate 5 times/week ( n=23 ) , a single oral dose of 190 mg iodine ( n=25 ) , or a placebo ( n=22 ) for 12 weeks . Results : All groups were comparable at baseline . After the intervention , there was a significant increase in ferritin and transferrin saturation in the iron+iodine group ( 17.6 vs 8.7 μg/dl , and 18.8 vs 7.2 % , respectively , P<0.001 for both ) and in the iron group ( P<0.001 for both ) . Urinary iodine doubled in the iron+iodine group and in the iodine group ( P<0.001 for both ) . Thyroid indices tT4 , tT3 and T3RU increased and reverse RT3 decreased in the iron+iodine group ( 10 vs 8.9 μg/dl , P < 0.001 ; 143 vs 138 μg/dl , P<0.05 ; 32.3 vs 28.4 % , P<0.001 and 24.8 vs 44.2 ng/dl , P<0.001 , respectively ) and in the iron group . These two groups did not differ for any of the four indices , but both differed significantly from the iodine and placebo groups . Conclusions : Our results indicate that improvement of iron status was accompanied by an improvement in some indices of thyroid hormones . Sponsorship : This study was supported by the Dean of Research Affairs of the Tehran University of Medical Sciences Adolescents with intellectual and developmental disabilities ( IDD ) are at an increased risk of obesity , with up to 55 % considered overweight and 31 % obese . However , there has been minimal research on weight management strategies for adolescents with IDD . The purpose of this study was to compare the effectiveness of two weight loss diets , an enhanced Stop Light Diet ( eSLD ) and a conventional diet ( CD ) , and to determine the feasibility of using tablet computers as a weight loss tool in overweight and obese adolescents with IDD . A 2-month pilot intervention was conducted . All participants were r and omized to the eSLD or CD  and were given a tablet computer that they used to track daily dietary intake and physical activity . Participants and parents met weekly with a registered dietitian nutritionist via video chat on the tablet computer to receive diet and physical activity feedback and education . Twenty participants ( 45 % female , aged 14.9±2.2 years ) were r and omized and completed the intervention . Participants in both diets were able to lose weight , and there were no significant differences between the eSLD and CD ( -3.89±2.66 kg vs -2.22±1.37 kg ) . Participants were able to use the tablet computer to track their dietary intake 83.4%±21.3 % of possible days and to attend 80.0 % of the video chat meetings . Both dietary interventions appear to promote weight loss in adolescents with IDD , and the use of tablet computers appears to be a feasible tool to deliver a weight loss intervention in adolescents with IDD We evaluated the effect of weekly doses of 400 mg of ferrous sulphate for 4 months on the iron status of adolescent girls in a controlled trial in Tanga , Tanzania . Supplementation led to a significantly greater increase in serum ferritin compared with the control group ( + 15.6 microg/l vs. 8.6 microg/l ) ( P = 0.002 ) but there was no significant difference in change in haemoglobin . Children given iron showed a significantly greater weight gain than controls ( + 2.4 kg vs. + 1.4 kg ) ( P = 0.03 ) . Weekly iron supplementation may be an effective means of increasing iron stores and growth in children vulnerable to iron deficiency BACKGROUND In India , the prevalence of low birth weight is high in women with a low body mass index ( BMI ) , suggesting that underweight women are not capable of providing adequate energy and protein for fetal growth . Furthermore , as pregnancy progresses , there is increased need to provide methyl groups for methylation reactions associated with the synthesis of new proteins and , unlike normal- BMI American women , low- BMI Indian women are unable to increase methionine transmethylation and remethylation rates as pregnancy progresses from trimester 1 to 3 . This also negatively influences birth weight . OBJECTIVE The aim was to determine the effect of dietary supplementation with energy and protein from 12 ± 1 wk of gestation to time of delivery compared with no supplement on pregnancy outcomes , protein kinetics , and the fluxes of the methyl group donors serine and glycine . METHODS Protein kinetics and serine and glycine fluxes were measured by using st and ard stable isotope tracer methods in the fasting and postpr and ial states in 24 pregnant women aged 22.9 ± 0.7 y with low BMI s [ BMI ( in kg/m(2 ) ) ≤18.5 ] at 12 ± 1 wk ( trimester 1 ) and 30 ± 1 wk ( trimester 3 ) of gestation . After the first measurement , subjects were r and omly assigned to either receive the supplement ( 300 kcal/d , 15 g protein/d ) or no supplement . RESULTS Supplementation had no significant effect on any variable of pregnancy outcome , and except for fasting state decreases in leucine flux ( 125 ± 7.14 compared with 113 ± 5.06 μmol ⋅ kg(-1 ) ⋅ h(-1 ) ; P = 0.04 ) and nonoxidative disposal ( 110 ± 6.97 compared with 101 ± 3.69 μmol ⋅ kg(-1 ) ⋅ h(-1 ) ; P = 0.02 ) from trimesters 1 to 3 , it had no effect on any other leucine kinetic variable or urea , glycine , and serine fluxes . CONCLUSION We conclude that in Indian women with a low BMI  , supplementation with energy and protein from week 12 of pregnancy to time of delivery does not improve pregnancy outcome , whole-body protein kinetics , or serine and glycine fluxes A nutritionally controlled study was conducted on two groups of 15 female college students aged 16 to 20 years , selected from Punjab Agricultural University , Ludhiana , Punjab , India . the girls were either anemic ( hemoglobin 7.7 g/dl ) but energy adequate ( AEA ) , or anemic ( hemoglobin 7.4 g/dl ) and energy deficient ( AED ) . the AEA group was given iron supplementation ( 60 mg iron/day ) for 6 to 9 months along with 100 mg of ascorbic acid , and the AED group was given iron as well as energy supplementation for 3 months . There was a significant ( p < .01 ) increase in weight , body mass index , mid-upper-arm circumference , and body fat in the AED group after iron – energy supplementation . Hemoglobin , serum iron , transferrin saturation , total iron-binding capacity , and unsaturated iron-binding capacity were below normal in both groups ; however , after iron and iron – energy supplementation , there was a significant ( p < .01 ) increase , and these indices were in the normal range . There was a significant ( p < .01 ) increase in exercise time and maximum work load tolerance after iron and iron – energy supplementation . Combined energy and iron deficiency had a greater adverse effect on physical work capacity than energy or iron deficiency alone Previous short-term supplementation studies showed no additional hematologic benefit of multiple micronutrients ( MMN ) compared with iron + folic acid ( IFA ) in adolescent girls . This study examines whether long-term once- or twice-weekly supplementation of MMN can improve hemoglobin ( Hb ) and micronutrient status more than twice-weekly IFA supplementation in anemic adolescent girls in Bangladesh . Anemic girls ( n = 324 ) aged 11 - 17 y attending rural schools were given once- or twice-weekly MMN or twice-weekly IFA , containing 60 mg iron/dose in both supplements , for 52 wk in a r and omized double-blind trial . Blood sample s were collected at baseline and 26 and 52 wk . Intent to treat analysis showed no significant difference in the Hb concentration between treatments at either 26 or 52 wk . However , after excluding girls with hemoglobinopathy and adjustment for baseline Hb , a greater increase in Hb was observed with twice-weekly MMN at 26 wk ( P = 0.045 ) . Although all 3 treatments effectively reduced iron deficiency , once-weekly MMN produced significantly lower serum ferritin concentrations than the other treatments at both 26 and 52 wk . Both once- and twice-weekly MMN  significantly improved riboflavin , vitamin A , and vitamin C status compared with IFA . Overall , once-weekly MMN was less efficacious than twice-weekly MMN in improving iron , riboflavin , RBC folic acid , and vitamin A levels .  Micronutrient supplementation beyond 26 wk was likely important in sustaining improved micronutrient status . These findings highlight the potential usefulness of MMN intervention in this population and have implication s for programming OBJECTIVE To assess the effect on the haemoglobin concentrations of schoolchildren of weekly iron tablets administered by teachers . DESIGN Sixty schools were r and omly assigned to two groups : in 30 schools children were given weekly for 10 weeks a tablet providing 65 mg of iron and 0.25 mg of folic acid ; in the other 30 schools  no iron tablets were given . All children were dewormed and given vitamin A before the study began . The haemoglobin concentration of up to 20 r and omly selected children in each school was estimated before and 2 weeks after the end of treatment . SETTING Rural community schools in Kolondieba district of Mali . SUBJECTS Some 1113 schoolchildren aged 6 - 19 years with a mean of 11.4 years . RESULTS The haemoglobin concentration of treated children rose on average by 1.8 g l(-1 ) and the prevalence of anaemia fell by 8.2 % ; in untreated children the haemoglobin concentration fell by an average of -2.7 g l(-1 ) and the prevalence of anaemia rose by 9.4 % . The fall in haemoglobin concentration among untreated girls of -4.0 g l(-1 ) was greater than in untreated boys ( -0.3 g l(-1 ) ) . CONCLUSIONS Weekly iron tablets given by teachers prevented a general fall in the haemoglobin concentrations of untreated children , and led to a small but statistically significant rise among treated children . Young children benefited more than children aged > or=12 years , and girls benefited more than boys BACKGROUND This study tests the feasibility of an innovative school-based program for  obesity prevention  among adolescent girls . New Moves was implemented as a multicomponent , girls-only , high-school physical education class . METHODS Six schools were equally r and omized into intervention and control conditions . Data were collected at baseline , postintervention , and 8-month follow-up to assess program impact on physical activity , eating patterns , self-perceptions , and body mass index ( BMI ) among 89 girls in the intervention and 112 girls in the control conditions . Program evaluation also included interviews with school staff , parent surveys , and participant interviews and process evaluation surveys . RESULTS The feasibility of implementing New Moves was high , as indicated by strong satisfaction among participants , parents , and school staff , and by program sustainability . Participants perceived a positive program impact on their physical activity , eating patterns , and self-image . Girls in the intervention significantly progressed in their stage of behavioral change for physical activity from baseline to follow-up . However , for the majority of outcome variables , differences between intervention and control schools at postintervention and follow-up were not statistically significant . CONCLUSIONS New Moves was well received and fills a needed niche within school physical education programs . An exp and ed intervention and evaluation is needed to enhance and assess long-term program effectiveness The Great Beginnings curriculum result ed in participants achieving outcome objectives for healthy teenage childbearing .  The experimental group demonstrated significantly better outcomes in nutrition knowledge maintenance of diet quality adequate for pregnancy mean maternal weight gain and mean infant birth weight . When compared with the C-l group the experimental group demonstrated a significantly better outcome in low-birth-weight incidence nutrition knowledge and maintenance of diet quality adequate for pregnancy . Based on the results of this study pregnant adolescents receiving the Great Beginnings curriculum  achieved healthier birth outcomes than those not receiving the curriculum . Participation in Great Beginnings does make a substantial difference in the health status of the adolescents for whom it was intended . ( excerpt This experimental study was design ed to investigate the effects of daily versus intermittent iron supplementation on iron status of high school girls in Zahedan and Rasht cities in 1996 - 1997 . The subjects were selected r and omly from among students of grade s 1 - 3 of four high schools in each city .  Anemia was determined by measuring hematological indices . 260 anemic and a similar number of non-anemic subjects of 4 high schools were selected and allocated r and omly to 4 treatment groups . During a 3-month period , the test groups were given 150 mg ferrous sulfate tablets ( 50 mg Fe ) . Subjects in group 1 received a daily dose , groups 2 & 3 received twice or once weekly doses respectively . The control group received no iron supplement . For these subjects , in addition to hematological indices biochemical iron indices were measured in the beginning and at the end of the study . The increases in hemoglobin concentration in anemic subjects were not significantly different among supplemented groups but were different from the control group ( p < 0.00001 ) . Among anemic subjects , changes in serum ferritin levels in 3 supplemented groups were significantly different from the control group . Serum ferritin in Group 1 was also increased to a greater extent than groups 2 and 3 ( P < 0.00001 ) . It is concluded that over the study period a weekly iron dose was as effective as a daily dose in treating anemia but the daily dose was more effective in improving iron stores than a weekly dose in the short run BACKGROUND Up to 25 % of adolescent girls in the USA are iron deficient . This double-blind , placebo-controlled clinical trial assessed the effects of iron supplementation on cognitive function in adolescent girls with non-anaemic iron deficiency . METHODS 716 girls who enrolled at four Baltimore high schools were screened for non-anaemic iron deficiency ( serum ferritin < or = 12 micrograms/L with normal haemoglobin ) . 98 ( 13.7 % ) girls had non-anaemic iron deficiency of whom 81 were enrolled in the trial . Participants were r and omly assigned oral ferrous sulphate ( 650 mg twice daily ) or placebo for 8 weeks . The effect of iron treatment was assessed by question naires and haematological and cognitive tests , which were done before treatment started and repeated after the intervention . We used four tests of attention and memory to measure cognitive functioning . Intention-to-treat and per- protocol analyses were done . FINDINGS Of the 81 enrolled girls with non-anaemic iron deficiency , 78 ( 96 % ) completed the study ( 39 in each group ) . Five girls ( three control , two treatment ) developed anaemia during the intervention and were excluded from the analyses . Thus , 73 girls were included in the per- protocol analysis . Ethnic distribution , mean age , serum ferritin concentrations , haemoglobin concentrations , and cognitive test scores of the groups did not differ significantly at baseline . Postintervention haematological measures of iron status were significantly improved in the treatment group ( serum ferritin 27.3 vs 12.1 micrograms/L , p < 0.001 ) . Regression analysis showed that girls who received iron performed better on a test of verbal learning and memory than girls in the control group ( p < 0.02 ) . INTERPRETATION In this urban population of non-anaemic iron-deficient adolescent girls , iron supplementation improved verbal learning and memory In a double-blind zinc trial in low-income , pregnant adolescents thought to be at risk for poor zinc nutriture , subjects were r and omly assigned to receive 30 mg zinc ( gluconate ) or placebo . Response to zinc was related to maternal weight . Infants of normal-weight mothers given zinc had reduced rates of prematurity ( p = 0.05 ) and assisted respiration ( p = 0.006 ) . Underweight multiparas given zinc had longer gestational lengths ( p = 0.008 ) than did subjects given the placebo . Multiple stepwise regression analysis , used to identify predictors of infant size , revealed that 14 - 26 % more variance was accounted for in the zinc than in the placebo group . Except for gestational age , the predictors selected were entirely different in the two groups . The zinc group had a positive toxemia screen more often , which did not appear to affect outcome . Zinc supplementation improved pregnancy outcome in normal-weight women and in underweight multiparas . The nonresponse in underweight primiparas was perhaps due to multiple limiting factors The prevalence of anemia is high in adolescent girls in India , with over 70 % anemic .  Iron-folic acid ( IFA ) supplements have been shown to enhance adolescent growth elsewhere in the world . To confirm these results in India , a study was conducted in urban areas of Vadodora , India to investigate the effect of IFA supplements on hemoglobin , hunger and growth in adolescent girls 10 - 18 y of age . Results show that there was a high dem and for IFA supplements and > 90 % of the girls consumed 85 out of 90 tablets provided . There was an increment of 17.3 g/L hemoglobin in the group of girls receiving IFA supplements , whereas hemoglobin decreased slightly in girls in the control group . Girls and parents reported that girls increased their food intake . A significant weight gain of 0.83 kg was seen in the intervention group , whereas girls in the control group showed little weight gain . The growth increment was greater in the 10- to 14-y-old age group than in the 15- to 18-y-old group , as expected , due to rapid growth during the adolescent spurt . IFA supplementation is recommended for growth promotion among adolescents who are underweight INTRODUCTION There has been a paucity of theory-based interventions to improve health outcomes in overweight adolescents . Therefore , two intervention studies were conducted to : ( a ) determine the feasibility of implementing the Creating Opportunities for Personal Empowerment ( COPE ) Healthy Lifestyles Thinking , Emotions , Exercise , and Nutrition ( TEEN ) program with overweight adolescents ; ( b ) obtain feedback that could be used to refine the program ; and ( c ) examine the preliminary efficacy of the COPE program on the adolescents ' weight and body mass index ( BMI ) . METHOD Phase I and Phase II clinical trials were conducted with 23 overweight teens . The Phase 1 trial used a pre-experimental design with one group of 11 urban adolescents . The Phase 2 trial was conducted with 12 suburban teens using a r and omized controlled pilot study . COPE teens received a 15-session cognitive-behavioral skills building program that included physical activity , while the control group received an attention control program .  Weight change and BMI were the key outcomes . RESULTS COPE teens experienced a significantly greater reduction in weight and BMI than did teens in the control group , who gained weight over time . Although the COPE program was well received by all of the teens , retention of subjects across time and parent involvement in the program were challenges in the urban high school . DISCUSSION These studies provide preliminary data to indicate that the implementation of COPE is feasible and may lead to a reduction in weight and BMI in overweight teens . Implementing COPE within the context of the school day may be more successful in sustaining adolescent involvement in the program versus using an after-school format The aim of the present study was to evaluate the effects of a  middle school physical activity and healthy eating intervention , including an environmental and computer-tailored component , and to investigate the effects of parental involvement . A r and om sample of 15 schools with seventh and eight grade rs was r and omly assigned to one of three conditions : ( i ) intervention with parental involvement , ( ii ) intervention alone and ( iii ) control group . In 10 schools , an intervention , combining environmental changes with computer-tailored feedback , was implemented over 2 school years . In five intervention schools , increased parental support was added . Physical activity was measured with question naires in the total sample and with accelerometers in a sub- sample of children . Fat intake , fruit , water and soft drink consumption were measured using food-frequency question naires . Results showed significant positive intervention effects on physical activity in both genders and on fat intake in girls . Parental involvement did not increase intervention effects . It can be concluded that physical activity and eating behaviours of middle school children can be improved by school-based strategies combining environmental and personal interventions . The use of personalized computer-tailored interventions seems to be a promising tool for targeting adolescents but needs to be further explored This paper reports the final 24-month outcomes of a r and omized controlled trial evaluating the effect of additional therapeutic contact ( ATC ) as an adjunct to a community-based weight-management program for overweight and obese 13–16-year-olds .  ATC involved telephone coaching or short-message-service and /or email communication once per fortnight . Adolescents were r and omized to receive the Loozit group program —  a  two-phase behavioral lifestyle intervention with ( n=73 ) , or without ( n=78 ) , ATC in Phase 2 . Adolescents/parents separately attended seven weekly group sessions ( Phase 1 ) , followed by quarterly adolescent sessions ( Phase 2 ) . Assessor-blinded , 24-month changes in anthropometry and metabolic health included primary outcomes body mass index ( BMI ) z-score and waist : height ratio ( WHtR ) . Secondary outcomes were self-reported psychosocial and lifestyle changes . By 24 months , 17 adolescents had formally withdrawn . Relative to the Loozit program alone , ATC largely had no impact on outcomes . Secondary pre-post assessment of the Loozit group program showed mean ( 95 % CI ) reductions in BMI z-score ( −0.13 ( −0.20 , −0.06 ) ) and WHtR ( −0.02 ( −0.03 , −0.01 ) ) in both arms , with several metabolic and psychosocial improvements . Adjunctive ATC did not provide further benefits to the Loozit group program . We recommend that further work is needed to optimize technological support for adolescents in weight-loss maintenance . Australian New Zeal and Clinical Trials Registry Number ACTRNO12606000175572 BACKGROUND Given the increasing prevalence of obesity among youth over the past decade , prevention has become an international public health priority . PURPOSE To evaluate the 2-year effectiveness of three strategies aim ed at preventing overweight and obesity among adolescents in a high school setting . DESIGN PRomotion de l'ALIMentation et de l'Activité Physique ( PRALIMAP ) is a school-based RCT . Each study high school was assigned to receive or not , over a 2-year period ( Grade s 10 and 11 ) , each of three prevention strategies according to a 2 × 2 × 2 factorial school r and omization . Data were collected in 2006 - 2009 and analyzed in 2009 - 2011 . SETTING / PARTICIPANTS A total of 3538 adolescents ( aged 15.6±0.7 years at baseline ) in 24 public high schools in Lorraine ( northeastern France ) completed the PRALIMAP trial . INTERVENTIONS The prevention strategies were education ( development of nutritional knowledge and skills ) ; environment ( creation of a favorable environment by improving availability of " healthy " dietary items and physical activity ) ; and screening and care ( detection of overweight/obesity and , if necessary , adapted care management ) . MAIN OUTCOMES MEASURES The main outcome of interest was BMI ; BMI z-score and prevalence of overweight/obesity were considered as secondary outcomes . RESULTS Adolescents who completed the PRALIMAP trial were younger , less often suspected of having eating  disorders and depression , and came from a higher socioeconomic class than those who did not . The 2-year change of outcomes was more favorable in the 12 screening and care high schools compared to the no-screening ones : a 0.11 lower increase in BMI ( p=0.0303 ) ; a 0.04 greater decrease in BMI z-score ( p=0.0173 ) ; and a 1.71 % greater decrease in overweight/obesity prevalence ( p=0.0386 ) . Education and environment strategies were not more effective than no strategy intervention . CONCLUSIONS Although the screening and care strategy is an effective way to prevent , at 2 years , overweight and obesity among adolescents in a high school setting , its effects over and above no strategy intervention were small . TRIAL REGISTRATION This study is registered at www . clinical trials.govNCT00814554 OBJECTIVE Our primary objective was to determine whether a novel ' active school ' model -- Action Schools ! BC -- improved the cardiovascular disease ( CVD ) risk profile in elementary-school children . Our secondary objective was to determine the percentage of children with elevated CVD risk factors . METHODS We undertook a cluster-r and omized controlled school-based trial with 8 elementary schools across 1 school year , in British Columbia , Canada , beginning in 2003 . Boys and girls ( n=268 , age 9 - 11 years ) were r and omly assigned ( by school ) to usual practice ( UP , 2 schools ) or intervention ( INT , 6 schools ) groups . We assessed change between groups in cardiovascular fitness ( 20-m Shuttle Run ) , blood pressure ( BP ) , and body mass index ( BMI , wt/ht(2 ) ) . We evaluated total cholesterol ( TC ) , total : high-density cholesterol ( TC : HDL-C ) , low-density lipoprotein , apolipoprotein B , C-reactive protein and fibrinogen on a subset of volunteers ( n=77 ) . RESULTS INT children had a 20 % greater increase in fitness and a 5.7 % smaller increase in BP compared with children attending UP schools ( P<0.05 ) . Forty five percent of children had at least one elevated risk factor ( fitness , BP or BMI ) at baseline . There were no significant differences between groups for change in BMI or in any of the blood variables . CONCLUSION Action Schools ! BC was an effective school-based physical activity model for improving the CVD risk profile of elementary-school children . Our multi-component intervention exposed children to fitness enhancing physical activity . It may be important for education stakeholders to adequately re source the delivery of the active school models if cardiovascular health benefits are to be achieved on a population basis OBJECTIVES The present study was aim ed at assessing the effect of zinc- and micronutrient-rich food supplementation compared with ayurvedic zinc tablets on the blood levels of zinc and vitamin A in adolescent girls . METHODS One hundred eighty apparently healthy schoolgirls ( 12.5 ± 0.85 y old ) were recruited for a 10-wk intervention trial . They were r and omized to three groups : one group received a food supplement that was prepared using zinc- and micronutrient-rich foods and by adopting food-processing methods that increase zinc bioavailability ; the second group received ayurvedic zinc ( Jasad ) tablets as a natural elemental zinc supplement ; and the third group served as the control without any supplementation . Diet was assessed by 24-h recall on 3 non-consecutive days . Fasting blood sample s were analyzed for plasma levels of zinc , β-carotene , retinol , vitamin C , and hemoglobin at baseline and the end of the study period . RESULTS Food supplementation showed a significant increase in plasma levels of zinc ( 9.9 % ) , β-carotene ( 56.2 % ) , and vitamin C ( 28.0 % , P < 0.05 ) and a non-significant increase in hemoglobin ( 1.7 % ) , although small , non-significant changes in blood micronutrient levels were observed in the control group ( P > 0.1 ) . Food supplementation decreased the prevalence of zinc deficiency ( 73 % to 53.1 % ) , β-carotene deficiency ( 31.1 % to 17.4 % ) , and mild anemia ( 32.2 % to 23.7 % ) . Ayurvedic zinc supplementation significantly improved plasma zinc ( 61.3 % ) and plasma retinol ( 38.2 % ) and decreased the prevalence of zinc deficiency ( 73.7 % to 36.2 % ) and vitamin A deficiency ( 65.4 % to 20.4 % , P < 0.05 ) . CONCLUSION Zinc- and micronutrient-rich food supplementation was effective in improving the zinc and vitamin A status of adolescent girls
Adolescence is a critical stage in the life cycle , and adequate nutrition is necessary for the proper growth and development of individuals and their offspring .
Here , we comprehensively review all published systematic review s ( through October 2016 ) on adolescents ( 10 - 19 years ) and women of reproductive age , including pregnant women , which targeted interventions related to nutrition .