Efficacy of iron supplementation on fatigue and physical capacity in non-anaemic iron-deficient adults: a systematic review of randomised controlled trials Daily and weekly iron supplementation and physical growth of school age Indonesian children. Iron fortified follow on formula from 9 to 18 months improves iron status but not development or growth: a randomised trial Iron supplementation and physical growth of rural Indonesian children. Iron and zinc supplementation improved iron and zinc status, but not physical growth, of apparently healthy, breast-fed infants in rural communities of northeast Thailand. Growth performance in anemia and following iron supplementation. High prevalence of obesity in low income and multiethnic schoolchildren: a diet and physical activity assessment. [Effect of daily or once weekly iron supplementation on growth and iron status of preschool children]. The effect of iron therapy on the growth of iron-replete and iron-deplete children. Improvements in growth following iron supplementation in young Kenyan school children. Effect of vitamin D supplementation on inflammation: protocol for a systematic review Long-term zinc and iron supplementation in children of short stature: effect of growth and on trace element content in tissues. The impact of weekly iron supplementation on the iron status and growth of adolescent girls in Tanzania. Effects of routine prophylactic supplementation with iron and folic acid on admission to hospital and mortality in preschool children in a high malaria transmission setting: community-based, randomised, placebo-controlled trial Combined zinc and iron compared with iron supplementation of diets of 6- to 12-year old village schoolchildren in southern Iran. Adverse effect of iron supplementation on weight gain of iron-replete young children Effectiveness of workplace interventions in rehabilitating musculoskeletal disorders and preventing its consequences among workers with physical and sedentary employment: systematic review protocol Long-term supplementation with iron does not enhance growth in malnourished Bangladeshi children. School-administered weekly iron supplementation – Effect on the growth and hemoglobin status of non-anemic Bolivian school-age children
A randomized placebo-controlled trial Iron supplementation, maternal packed cell volume, and fetal growth. No effect of maternal micronutrient supplementation on early childhood growth in rural western China: 30 month follow-up evaluation of a double blind, cluster randomized controlled trial Iron supplementation improves appetite and growth in anemic Kenyan primary school children. Effects of iron supplementation and anthelmintic treatment on motor and language development of preschool children in Zanzibar: double blind, placebo controlled study Zinc supplementation reduced morbidity, but neither zinc nor iron supplementation affected growth or body composition of Mexican preschoolers. Antenatal supplementation with folic acid + iron + zinc improves linear growth and reduces peripheral adiposity in school-age children in rural Nepal. The clinical effectiveness of different parenting programmes for children with conduct problems: a systematic review of randomised controlled trials Validation of the global resource of eczema trials (GREAT database) Weekly iron supplements given by teachers sustain the haemoglobin concentration of schoolchildren in the Philippines. Effect of antenatal multiple micronutrient supplementation on anthropometry and blood pressure in mid-childhood in Nepal: follow-up of a double-blind randomised controlled trial Multivitamin-multimineral and iron supplementation did not improve appetite of young stunted and anemic Beninese children. A cluster-randomized, controlled trial of nutritional supplementation and promotion of responsive parenting in Madagascar: the MAHAY study design and rationale Randomised comparison of the effects of Sprinkles and Foodlets with the currently recommended supplement (Drops) on micronutrient status and growth in Iranian children Rehabilitation for people with multiple sclerosis: an overview of Cochrane Reviews. Comparison of the effects of zinc delivered in a fortified food or a liquid supplement on the growth, morbidity, and plasma zinc concentrations of young Peruvian children. Impact of iron supplementation and deworming on growth performance in preschool Beninese children
Objective Iron supplementation in iron-deficiency anaemia is st and ard practice , but the benefits of iron supplementation in iron-deficient non-anaemic ( IDNA ) individuals remains controversial . Our objective is to identify the effects of iron therapy on fatigue and physical capacity in IDNA adults . Design Systematic review and meta- analysis of r and omised controlled trials ( RCTs ) . Setting Primary care . Participants Adults ( ≥18 years ) who were iron deficient but non-anaemic . Interventions Oral , intramuscular or intravenous iron supplementation ; all therapy doses , frequencies and duration s were included . Comparators Placebo or active therapy . Results We identified RCTs in Medline , Embase , Cochrane Central Register of Controlled Trials , Cumulative Index of Nursing and Allied Health , SportD iscus and CAB Abstract s from inception to 31 October 2016 . We search ed the WHO ’s International Clinical Trials Registry Platform for relevant ongoing trials and performed forward search es of included trials and relevant review s in Web of Science . We assessed internal validity of included trials using the Cochrane Risk of Bias tool and the external validity using the Grading of Recommendations Assessment , Development and Evaluation methodology . From 11 580 citations , we included 18 unique trials and 2 companion papers enrolling 1170 patients . Using a Mantel-Haenszel r and om-effects model , iron supplementation was associated with reduced self-reported fatigue ( st and ardised mean difference ( SMD ) −0.38 ; 95 % CI −0.52 to −0.23 ; I2 0 % ; 4 trials ; 714 participants ) but was not associated with differences in objective measures of physical capacity , including maximal oxygen consumption ( SMD 0.11 ; 95 % CI −0.15 to 0.37 ; I2 0 % ; 9 trials ; 235 participants ) and timed methods of exercise testing  . Iron supplementation significantly increased serum haemoglobin concentration ( MD 4.01 g/L ; 95 % CI 1.22 to 6.81 ; I2 48 % ; 12 trials ; 298 participants ) and serum ferritin ( MD 9.23 µmol/L ; 95 % CI 6.48 to 11.97 ; I2 58 % ; 14 trials ; 616 participants ) . Conclusion In IDNA adults , iron supplementation is associated with reduced subjective measures of fatigue but not with objective improvements in physical capacity . Given the global prevalence of both iron deficiency and fatigue , patients and practitioners could consider consumption of iron-rich foods or iron supplementation to improve symptoms of fatigue in the absence of documented anaemia . PROSPERO registration number CRD42014007085 OBJECTIVE To investigate the effect of 3 months iron supplementation on physical growth among anemic school children given daily and weekly and to know the response based on hemoglobin level . SUBJECT One hundred forty-four children were measured for height , weight and hemoglobin level . Ninety seven children were anemic ( 67.36 % ) with Hb level < 12 g/dl and forty seven children were non anemic . anemic children were divided into 2 subgroups and r and omly assigned to either daily and weekly Fe treatment for 12 weeks . The non anemic group were treated with weekly iron supplementation , which was accepted by the parents . OUTCOME MEASURES Children 's height , weight , and hemoglobin of T1 and T2 food recall method was used to know calorie , protein , vitamin C and iron intake in both daily and weekly subgroups . Three days food recall was performed in the second and third months by a nutritionist . RESULT After iron supplementation , the hemoglobin level in both group increased significantly . The average change of hemoglobin between the 2 groups gave no significant difference . W/A and H/A after iron supplementation showed significantly increased in both groups . The average change of W/A and H/A between the 2 groups gave no significant difference . CONCLUSION Daily and weekly iron supplementation showed no significant difference in increasing of hemoglobin level and physical growth . Further research must be done with appropriate sample size and well design AIMS Iron deficiency anaemia is associated , in observational studies , with developmental disadvantage . This study tested the hypothesis that feeding iron supplemented formula from 9 to 18 months of age would improve developmental performance . SUBJECTS AND METHODS 493 healthy children aged 9 months being fed pasteurised cows ’ milk were recruited from three UK centres . They were r and omised to : cows ’ milk as before , formula containing 0.9 mg/litre iron , or formula containing 1.2 mg/litre iron , until 18 months of age . Bayley mental and psychomotor developmental indices were measured at 18 months , as were growth and haematological indices . RESULTS Children fed iron fortified formula had higher plasma ferritin concentrations , but there were no significant intergroup differences in development or growth . CONCLUSIONS There are no developmental or growth advantages in children given iron supplemented formula , but a benefit for a minority who were anaemic , or the possibility that a benefit may emerge at a later age , can not be excluded The effect of oral iron supplementation on blood Fe levels and physical growth in 119 rural Indonesian school children was assessed in this double-blind study . The children were classified into anemic and normal groups according to their initial hemoglobin and transferrin saturation levels and were r and omly assigned to either Fe or placebo treatment for 12 wk . Hematological , anthropometric , and morbidity data were collected before and after the treatment period . Before treatment , anemic subjects were smaller and had higher morbidity than normal subjects . Treatment with 10 mg ferrous sulfate.kg-1.d-1 for 12 wk result ed in a significant improvement in anemic subjects ' hematological status , growth velocity , and level or morbidity Iron deficiency is prevalent in children and infants worldwide . Zinc deficiency may be prevalent , but data are lacking . Both iron and zinc deficiency negatively affect growth and psychomotor development . Combined iron and zinc supplementation might be beneficial , but the potential interactions need to be verified . In a r and omized , placebo-controlled trial using 2 x 2 factorial design , 609 Thai infants aged 4 - 6 mo were supplemented daily with 10 mg of iron and /or 10 mg of zinc for 6 mo to investigate effects and interactions on micronutrient status and growth . Iron supplementation alone increased hemoglobin and ferritin concentrations more than iron and zinc combined . Anemia prevalence was significantly lower in infants receiving only iron than in infants receiving iron and zinc combined .  Baseline iron deficiency was very low , and iron deficiency anemia was almost nil . After supplementation , prevalence of iron deficiency and iron deficiency anemia were significantly higher in infants receiving placebo and zinc than in those receiving iron or iron and zinc .  Serum zinc was higher in infants receiving zinc ( 16.7 + /- 5.2 micromol/L ) , iron and zinc ( 12.1 + /- 3.8 micromol/L ) or iron alone ( 11.5 + /- 2.5 micromol/L ) than in the placebo group ( 9.8 + /- 1.9 micromol/L ) . Iron and zinc interacted to affect iron and zinc status , but not hemoglobin . Iron supplementation had a small but significant effect on ponderal growth , whereas zinc supplementation did not . To conclude , in Thai infants , iron supplementation improved hemoglobin , iron status , and ponderal growth , whereas zinc supplementation improved zinc status . Overall , for infants , combined iron and zinc supplementation is preferable to iron or zinc supplementation alone The growth status of anemic ( n = 117 , Hb 7 - 10 g/dl ) and normal ( n = 53 , H > or = 11 g/dl ) children 3 - 5 years of age living under similar environmental and socio-economic conditions was evaluated . The dietary intake was assessed on a r and om sub sample of the anemic and normal children . The anemic children had a poorer growth status than normal children as indicated by their significantly ( p < 0.001 ) lower body weight , height and weight for age and significantly ( p < 0.001 ) larger number in Grade s II and III malnutrition . Iron supplementation ( 40 mg elemental iron/day ) for six months produced a significant ( p < 0.001 ) increase in Hb levels of both groups ( 1.6 g/dl in the anemic and 0.8 g/dl in the non-anemic ) compared to their respective controls who received sugar placebos . The growth performance of the anemic children supplemented with iron was superior to that of anemic placebo treated children as indicated by a better weight gain and a significantly higher weight for height ( p < 0.05 ) . Weight for age was a good differentiator of the anemic from normal while weight for height was a good indicator of the impact of iron  supplements on growth The objective of the study was to assess the prevalence of obesity and /or undernutrition and evaluate diet and activity patterns among schoolchildren from an ethnically diverse low income urban population . A cross-sectional survey of 498 children aged 9 - 12 y from 24 schools in low income multiethnic neighborhoods in Montreal , Canada was undertaken . Height , weight , dietary intake , physical activity record , and lifestyle and demographic characteristics were measured . There was no evidence of undernutrition because linear growth was appropriate for age , but 39.4 % of children were overweight ( > 85th percentile NHANES II ) .  Dietary fat intake  was higher in children from single-parent families ( P < 0.001 ) and those with mothers born in Canada .  Intake of vitamins A , C , iron and folate was directly related to income sufficiency . Children who did more physical activity had significantly higher intakes of energy , calcium , iron , zinc and fiber but were not heavier . Dietary intake  was systematic ally underreported among overweight children , i.e. , their reported intakes did not meet calculated energy needs . This underreporting makes it difficult to attribute the accumulated energy imbalance to either energy intake or expenditure OBJECTIVE The effect of daily and once weekly iron supplementation on hemoglobin(Hb ) , serum ferritin ( SF ) , erythrocyte protoporphyrin ( EFP ) in whole blood , prevalence of iron deficiency , body weight and height of preschool children was compared in this study . METHODS Preschool children ( n = 353 ) from one kindergarten in Baotou City , was recruited . All children were divided into three groups by class , and received either daily or once weekly iron supplementation , or a placebo ( control ) for 14 weeks . RESULTS The prevalence of iron deficiency was reduced in both intervention groups , and the rate in the group supplemented with iron once weekly was significantly lower than that of the control group(P < 0.05 ) . The levels of Hb , SF , increased after once weekly and daily iron supplementation . Weight gain and WAZ were greater in children who received daily supplement than in those who received placebo .  Height gain and HAZ were not significantly different among three groups . CONCLUSION Daily micronutrient supplement can improve growth of preschool children . Once weekly iron supplement is effective same as daily supplement in improving iron status and reducing the prevalence of iron deficiency in the preschool children This prospect i ve , double-blind , placebo-controlled trial was design ed to study the effect of iron therapy on the growth of iron-replete and iron-deficient children , and to study the change in iron status in iron-deficient children with iron therapy . One hundred and fifty children ( aged 6 - 24 months ) were included in the study . After an informed written consent , 100 healthy children , who were iron replete ( group I ) according to preset criteria , were r and omly allocated to receive iron supplements 2 ng/kg/day ( group IA ) or placebo ( group IB ) . Fifty iron-deficient children ( group II ) were administered iron syrup 6 mg/kg/day . Growth parameters ( weight , length and head-circumference ) and hematological parameters were studied for 4 months . Iron therapy , as compared with placebo , produced a significant improvement of mean monthly weight gain ( p < 0.001 ) and linear growth ( p < 0.001 ) in the iron-deficient children . However , it significantly decreased the weight gain ( p < 0.001 ) and linear growth ( p < 0.001 ) of iron-replete children . Caution should therefore be exercised while supplementing iron to children with apparently normal growth and when the iron status of the child is not known The study was conducted to determine whether provision of oral supplementary iron to primary school children in Kenya would improve their growth .  Children in the two lowest grade s who satisfied study criteria were allocated to either an  iron-supplementation group ( n = 29 ) or a placebo group ( n = 26 ) . At the baseline before intervention the groups did not differ significantly in age , sex ratio , prevalence and intensity of intestinal helminthic infections , most anthropometric measurements or hemoglobin levels . Although the study lasted for 32 weeks , children only took iron or placebos on school days thus omitting weekends and school holidays . Examination at the end of the study showed that the iron-supplemented children had grown significantly more in terms of weight , weight for height , arm circumference and skinfold thickness compared with the placebo group . Hemoglobin levels had also improved significantly . We conclude that where iron deficiency anemia and undernutrition are prevalent in children , iron supplementation will improve growth and hemoglobin levels Introduction The extraskeletal role of vitamin D is being increasingly recognised . This has important clinical implication s , as vitamin D deficiency has reached epidemic proportions worldwide . Vitamin D has proposed anti-inflammatory properties , yet the role of vitamin D supplementation in reducing inflammation remains largely unknown . The purpose of this review is to investigate the impact of vitamin D supplementation on inflammation , and to identify relevant knowledge gaps in the field . Methods and analysis Medline , CINAHL , EMBASE and All EBM will be systematic ally search ed for r and omised controlled trials ( RCTs ) and systematic review s of RCTs , comparing vitamin D supplementation with placebo , usual care or other pharmacological or non-pharmacological interventions . One review er will assess articles for eligibility according to prespecified selection criteria , after which 2 independent review ers will perform data extraction and quality appraisal . Meta-analyses will be conducted where appropriate . Ethics and dissemination Formal ethical approval is not required as no primary data is collected . This systematic review will identify potential clinical implication s of vitamin D deficiency and supplementation , and will be disseminated through a peer- review ed publication and at conference meetings , to inform future research on the efficacy of vitamin D supplementation for inflammation and inflammatory diseases . PROSPERO registration number CRD42016037104 We evaluated the effect of one year of supplementation with iron plus zinc ( 12 mg/day of Fe+++ and 12.5 mg/day of Zn++ ) , zinc alone ( 12.5 mg/day of Zn++ ) and placebo on growth and on the iron , zinc , copper and selenium tissue contents in 30 well-selected children of short stature ( 16 M and 14 F ; 4 - 11 years old ) . Before and after supplementation , we measured the concentrations of iron , transferrin , ferritin , zinc and copper in serum , of zinc in erythrocytes and leukocytes , and of zinc , copper and selenium in hair , as well as glutathione peroxidase activity in erythrocytes . Before supplementation , ferritin and serum , erythrocyte and hair zinc contents were significantly lower than in age-matched controls , while the other measured indices were in the normal range . Iron plus zinc supplementation caused an improvement in growth rate in all subjects , i.e. , the median Z-score increased from -2.22 + /- 0.45 to -0.64 + /- 0.55 ; ( p < 0.01 ) . In the zinc-supplemented group , only the subjects whose ferritin levels were higher than 20 ng/L before supplementation showed a similar improvement of growth rate .  Iron plus zinc supplementation could be a reasonable treatment in short , prepubertal children affected by marginal zinc and iron deficiency 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 Anaemia caused by iron deficiency is common in children younger than age 5 years in eastern Africa . However , there is concern that universal supplementation of children with iron and folic acid in areas of high malaria transmission might be harmful . METHODS We did a r and omised , placebo-controlled trial , of children aged 1 - 35 months and living in Pemba , Zanzibar . We assigned children to daily oral supplementation with : iron ( 12.5 mg ) and folic acid ( 50 mug ; n=7950 ) , iron , folic acid , and zinc ( n=8120 ) , or placebo ( n=8006 ) ; children aged 1 - 11 months received half the dose . Our primary endpoints were all-cause mortality and admission to hospital . Analyses were by intention to treat . This study is registered as an International St and ard R and omised Controlled Trial , number IS RCT N59549825 . FINDINGS The iron and folic acid-containing groups of the trial were stopped early on Aug 19 , 2003 , on the recommendation of the data and safety monitoring board . To this date , 24 076 children contributed a follow-up of 25,524 child-years . Those who received iron and folic acid with or without zinc were 12 % ( 95 % CI 2 - 23 , p=0.02 ) more likely to die or need treatment in hospital for an adverse event and 11 % ( 1 - 23 % , p=0.03 ) more likely to be admitted to hospital ; there were also 15 % ( -7 to 41 , p=0.19 ) more deaths in these groups . INTERPRETATION Routine supplementation with iron and folic acid in preschool children in a population with high rates of malaria can result in an increased risk of severe illness and death . In the presence of an active programme to detect and treat malaria and other infections , iron-deficient and anaemic children can benefit from supplementation . However , supplementation of those who are not iron deficient might be harmful . As such , current guidelines for universal supplementation with iron and folic acid should be revised The effects of supplementation of the diets of 6- to 12-year-old children in a village near Shiraz in Iran with  zinc plus iron or iron alone , together with the indispensable amino acids in the form of egg white protein , vitamins , minerals , and corn oil have been evaluated . Initially 48 of 59 children had zinc concentrations  below the minimum found in well-nourished persons . Eight months of supplementation with zinc plus iron ( 20 mg daily of elemental zinc as carbonate and 20 mg ferrous iron as fumarate ) failed to stimulate growth or bone development or to bring about an increase in plasma zinc concentrations . However , supplementation with iron in the above amount was associated with an acceleration of growth in height and weight . The persistence of low concentrations of zinc in plasma and the failure of supplemental zinc to stimulate growth are attributed to the poor availability of both dietary and supplemental zinc result ing from sequestering action of fiber and phytate present in large amounts in the unleavened whole meal bread consumed by villagers . In addition , the results suggest that simultaneous administration of iron and zinc supplements may impair utilization of the metals The efficacy of iron supplementation for iron-deficient subjects is in no doubt . However , the assumption that iron supplementation of iron-replete subjects is harmless may not be valid . We have studied the effect of iron supplementation on growth rate in 47 iron-sufficient young children ( 12 - 18 months ) in Indonesia . The children were r and omly assigned either ferrous sulphate ( 3 mg/kg daily ) or placebo every day for 4 months . Before treatment the length , weight , and arm circumference of the two groups were similar . During the 4 months of supplementation the rate of weight gain was significantly greater in the placebo group than in the iron-supplemented group ( 0.106 [ SE 0.010 ] vs 0.070 [ 0.011 ] kg every 2 weeks , p = 0.02 ) . The rates of gain in length and arm circumference did not differ significantly by treatment . There were no differences between the groups in rates of respiratory and gastrointestinal infections . These results suggest that iron supplementation of iron-replete children may retard their growth Background Musculoskeletal disorders ( MSDs ) are the leading cause of work disability and sickness absence worldwide . The prevalence of MSDs increases with age , consequently challenging sustainable employability among the growing ageing workforce . Knowledge of feasible and efficient workplace-based interventions to rehabilitate MSD or prevent its consequences is therefore warranted . This systematic review will evaluate the effectiveness of workplace-based interventions on MSDs and its consequences among adult workers with physical and sedentary work tasks , respectively . Methods We will search the following bibliographic data bases : PubMed ( including the data base ‘ MEDLINE ’ ) and Web of Science Core Collection ( including the data bases ‘ Science Citation Index Exp and ed ’ , ‘ Social Sciences Citation Index ’ and ‘ Arts & Humanities Citation Index ’ ) . Manual search es will also be performed . We will include r and omised controlled trials ( RCTs ) and non- RCTs reported in English in which ( 1 ) participants are adult workers with MSD , ( 2 ) interventions are aim ing at rehabilitating pain symptoms of MSD or preventing the consequences of MSD and ( 3 ) interventions are initiated and /or carried out at the workplace . The review will adhere to the ‘ Preferred Reporting Items for Systematic review s and Meta-Analyses ’ ( PRISMA ) guidelines for reporting systematic review s and the Institute for Work and Health ( IWH ) guidelines for workplace-based interventions . For the primary evaluation of the review , the quality assessment and evidence synthesis will conform to the IWH guidelines . Secondary evaluation will include a meta- analysis ( unless the included studies do not allow this due to heterogeneity ) and employ the risk of bias domains recommended by Cochrane along with the Grading of Recommendations , Assessment , Development and Evaluations ( GRADE ) approach on the studies with pain intensity as an outcome . Discussion This systematic review will provide knowledge on effective workplace-based interventions among physical and sedentary workers with MSD . RCTs are considered the most powerful experimental design in clinical trials , but solely including these may be too restrictive to underst and effective workplace-based interventions where r and omised and carefully controlled trials ( RCTs ) are not always possible . In order to maximize practical relevance , the selection process will , therefore , include both RCTs and non- RCTs and the quality assessment and evidence synthesis will conform to IWH guidelines focusing on developing practical guidelines for stakeholders . The result of this work will form the basis for industry-specific evidence -based recommendations on effective workplace-based interventions for rehabilitation of MSDs and its consequences that will later be operationalised into concrete and user-friendly practical tools for workplaces . Systematic review registration International Prospect i ve Register of Systematic Review s ( PROSPERO ) number CRD42018116752 To evaluate the effect of long-term oral iron supplementation on growth , 250 children aged 6 - 71 mo were studied in a r and omized double-blind controlled trial . The intervention group received 125 mg of ferrous gluconate ( 15 mg elemental iron ) plus multivitamins ( vitamins A , D and C ) ; the comparison group received only multivitamins daily for 12 mo .  Weight ( kg ) and height ( cm ) were measured every month . Eighty three percent of the children continued the treatment for one year . The weight increment over the 12-mo period was 1.35 + /- 0.65 kg ( mean + /- SD ) in the intervention group and 1.39 + /- 0.54 kg in the comparison group . The height increments were 6.01 + /- 1.47 and 6.18 + /- 1.58 cm in the intervention and comparison groups , respectively . Mean weight and height increments did not differ ; in an analysis stratified according to different age and nutritional categories , they also did not differ between the two groups , indicating that long-term iron supplementation does not increase growth in children Summary Background Recent data suggest that daily iron supplementation of iron-replete children could impair their growth . If verified for weekly iron supplementation these results would markedly complicate targeting and implementing school-based weekly iron supplementation programs . Aim of the study To ascertain the effect of weekly iron supplementation on the growth and hemoglobin status of non-anemic school-age children . Subjects and methods 73 Bolivian non-anemic school-age children r and omly assigned to the treatment group ( n=37 ; receiving supplements containing FeSO4 during 18 weeks ) or the control group ( n=36 ; receiving a placebo during the same period ) . Hemoglobin concentration and anthropometric measures were determined for each child at the beginning ( T0 ) and the end ( T18 ) of the study . Results The treatment group did not show any significant variation in hemoglobin concentration between T0 and T18 ( −1.6±10.4 g/L ; P=0.40 ) whereas the control group showed a significant decrease in hemoglobin concentration ( −4.6±10.9 g/L ; P=0.03 ) . Anthropometric changes were not significantly different between the treatment and the control groups for weight , ( 1.63±1,11 kg vs 1.88±0.79 kg ; P=0.30 ) , height ( 2.35±0.94 cm vs 2.11±1.03 cm ; P=0.34 ) or mid-upper arm circumference ( 0.29±0.57 cm vs 0.22±0.54 cm ; P=0.64 ) . Conclusion In our study , weekly iron supplementation of non-anemic school-age children had no negative effect on their growth while having a positive effect in preventing significant decreases in hemoglobin concentration . These results suggest that in regions where iron deficiency anemia ( IDA ) is prevalent , a simple and cost-effective way to control IDA in school-age children is to give weekly iron supplements to all children at school Previous studies have found that there is a correlation between mothers ' haemoglobin concentration or packed cell volume and infants ' birth weight , and that iron supplementation increases mothers ' haemoglobin concentration . The purpose of this study , using the data of a large r and omised trial on iron prophylaxis during pregnancy , was to find out whether iron supplementation causes fetal growth to deteriorate . At their first antenatal visit , 2912 pregnant women were r and omised into non-routine iron and routine iron supplementation . The mean length of gestation was shorter in the non-routine group . Birth weight did not differ between the groups , but due to longer gestations boys in the group receiving routine iron were taller than in the non-routine group . In both groups , whether studied by various values of packed cell volume or correlation coefficients , the lower the packed cell volume , the heavier and taller the infant and heavier the placenta . These negative correlations could be seen even with a packed cell volume measured early in pregnancy . St and ardising for blood pressure did not influence the correlation coefficients . The correlation between a high ratio for packed cell volume and poor fetal growth thus may not be caused by iron supplementation , nor mediated by blood pressure , but by some other mechanism Background / Objectives : Little is known about the long-term effects of maternal multi-micronutrient supplementation on the growth of children during early childhood . In this follow-up study , the effects of maternal supplementation with multi-micronutrients in pregnancy on postnatal child growth are examined . Subjects/ Methods : A longitudinal follow-up of a subset of newborns ( n=1388 ) whose mothers were r and omly assigned to receive the supplements of folic acid , iron – folic acid or multi-micronutrients daily during pregnancy in the original trial was conducted . Children ’s weight and length were measured and assessed during monthly home visits from birth to 30 months of age . Results : The pooled prevalence rate of stunting over different time points during the first 30 months was 13.5 , 14.9 and 12.1 % for the folic acid group , iron – folic acid group and multi-micronutrient group , respectively . However , there were no significant differences in the pooled odds of stunting in children between the multi-micronutrient group and the folic acid ( odds ratio ( OR ) 0.97 , 95 % confidence interval ( CI ) : 0.74–1.26 ) , and between the multi-micronutrient group and the iron – folic acid group ( OR 0.82 , 95 % CI : 0.63–1.07 ) . Similar results for the three groups were found for the occurrences of underweight and wasting in children . Furthermore , no significant differences were observed in length , weight , length-for-age , weight-for-age and weight-for-length Z-scores among the three treatment groups . Conclusions : Currently , available evidence is insufficient to support a greater advantage of the effect of maternal multi-micronutrient supplementation on child growth over iron – folic acid or folic acid only supplementation during the first 30 months A r and omized , double-blind , placebo-controlled iron supplementation trial was conducted in Kenya to examine the effect of iron supplements on appetite and growth in 87 primary school children .  Sustained-release ferrous sulfate ( 150 mg ) or placebo tablets were provided daily at school for 14 wk . Prior to tablet administration , baseline anthropometry , iron nutritional status ( hemoglobin and serum ferritin ) , parasitic infections and clinical indicators of morbidity were measured . A baseline appetite test was conducted twice on each child by quantitatively measuring the ad libitum consumption of a midmorning snack . In addition , each child was asked for a subjective assessment of his or her appetite . Follow-up exams and appetite tests were identical to those at baseline . Findings indicated that provision of iron supplements result ed in improved growth and improved appetite ( in terms of both energy intake of the snack and child report of appetite ) as compared with children receiving the placebo . The increased energy intake from the snack was 10 % of the daily estimated energy intake for children of this same age group living elsewhere in Kenya . Further research into the underlying physiological mechanisms may shed light on the relationship between iron nutritional status and appetite Abstract Objective : To measure the effects of iron supplementation and anthelmintic treatment on iron status , anaemia , growth , morbidity , and development of children aged 6–59 months . Design : Double blind , placebo controlled r and omised factorial trial of iron supplementation and anthelmintic treatment . Setting : Community in Pemba Isl and , Zanzibar . Participants : 614 preschool children aged 6–59 months . Main outcome measures : Development of language and motor skills assessed by parental interview before and after treatment in age appropriate subgroups . Results : Before intervention , anaemia was prevalent and severe , and geohelminth infections were prevalent and light — Plasmodium falciparum infection was nearly universal . Iron supplementation significantly improved iron status , but not haemoglobin status . Iron supplementation improved language development by 0.8 ( 95 % confidence interval 0.2 to 1.4 ) points on the 20 point scale . Iron supplementation also improved motor development , but this effect was modified by baseline haemoglobin concentrations ( P=0.015 for interaction term ) and was apparent only in children with baseline haemoglobin concentrations < 90 g/l . In children with a baseline haemoglobin concentration of 68 g/l ( one st and ard deviation below the mean value ) , iron treatment increased scores by 1.1 ( 0.1 to 2.1 ) points on the 18 point motor scale . Mebendazole significantly reduced the number and severity of infections caused by Ascaris lumbricoides and Trichuris trichiura , but not by hookworms . Mebendazole  increased development scores by 0.4 ( −0.3 to 1.1 ) points on the motor scale and 0.3 ( −0.3 to 0.9 ) points on the language scale . Conclusions : Iron supplementation improved motor and language development of preschool children in rural Africa . The effects of iron on motor development were limited to children with more severe anaemia ( baseline haemoglobin concentration < 90 g/l ) . Mebendazole had a positive effect on motor and language development , but this was not statistically significant . What is already known on this topic Iron is needed for development and functioning of the human brain Anaemic children show developmental delays , but it is not yet clear whether iron deficiency causes these deficits or whether iron supplementation can reverse them Helminth infections in schoolchildren are associated with cognitive deficits , but few studies have been made of helminth infection and early child development What this study adds Low doses of oral iron supplementation given daily improved language development in children aged 1–4 years in Zanzibar Iron supplementation improved motor development , but only in children with initial haemoglobin concentrations below 90 g/l The effects of routine anthelmintic treatment on motor and language milestones were positive , but non-significant , with our sample In rural Mexico and in many developing countries micronutrient deficiencies , growth stunting , and morbidity from infectious diseases are highly prevalent in young children . We assessed the extent to which growth stunting could be reversed and the number of infectious disease episodes reduced by zinc and /or iron supplementation . In a double-blind , r and omized community trial 219 Mexican preschoolers were supplemented with either 20 mg Zn as zinc methionine , 20 mg Fe as ferrous sulfate , 20 mg Zn + 20 mg Fe , or a placebo . After 12 mo , plasma zinc increased significantly in the two zinc-treated groups , and plasma ferritin was significantly higher in the two iron-treated groups . There was no effect of treatments on growth velocity or body composition . Children in both zinc-supplemented groups had fewer episodes of disease ( zinc alone , 3.9 + /- 0.3 ; zinc+iron , 3.7 + /- 0.4 ; placebo , 4.6 + /- 0.5 ; P < 0.03 ) , including diarrhea ( zinc alone , 0.7 + /- 0.1 ; zinc+iron , 0.8 + /- 0.1 ; placebo , 1.1 + /- 0.2 ; P < 0.01 ) . Zinc and zinc+iron supplements reduced morbidity but had no effect on growth or body composition BACKGROUND We previously reported that a r and omized controlled trial of antenatal micronutrient supplements in rural Nepal decreased the risk of low birth weight by approximately 15 % . OBJECTIVE The objective was to examine the effects of micronutrient supplementation on growth and body composition in children of supplemented mothers through school age . DESIGN Mothers received 1 of 5 micronutrient supplements daily : folic acid , folic acid + iron , folic acid + iron + zinc , multiple micronutrients , or a control . All of the supplements contained vitamin A.  Children born during this trial were revisited at age 6 - 8 y to measure height , weight , midupper arm circumference , waist circumference , and triceps and subscapular skinfold thicknesses . Arm fat and muscle area were estimated by using st and ard formulas , and height-for-age , weight-for-age , and body mass index-for-age z scores were calculated by using the World Health Organization growth st and ard . RESULTS Of the 3771 surviving children , 3324 were revisited and consented to anthropometric measurements . Maternal supplementation with folic acid + iron + zinc result ed in an increase in mean height ( 0.64 cm ; 95 % CI : 0.04 , 1.25 ) and a reduction in mean triceps skinfold thickness ( -0.25 mm ; 95 % CI : -0.44 , -0.06 ) , subscapular skinfold thickness ( -0.20 mm ; 95 % CI : -0.33 , -0.06 ) , and arm fat area ( -0.18 cm(2 ) ; -0.34 , -0.01 ) . No significant differences were found between groups in mean weight or body mass index-for-age z scores , waist circumference , or arm muscle area . Other micronutrient combinations including a multiple micronutrient formulation failed to show a growth benefit . CONCLUSION Antenatal supplementation with zinc may benefit child growth , particularly in areas where a deficiency of this nutrient is common Background Conduct problems are common , disabling and costly . The prognosis for children with conduct problems is poor , with outcomes in adulthood including criminal behaviour , alcoholism , drug abuse , domestic violence , child abuse and a range of psychiatric disorders . There has been a rapid expansion of group based parent-training programmes for the treatment of children with conduct problems  in a number of countries over the past 10 years . Existing review s of parent training have method ological limitations such as inclusion of non-r and omised studies , the absence of investigation for heterogeneity prior to meta- analysis or failure to report confidence intervals . The objective of the current study was to systematic ally review r and omised controlled trials of parenting programmes for the treatment of children with conduct problems .  Methods St and ard systematic review methods were followed including duplicate inclusion decisions , data extraction and quality assessment . Twenty electronic data bases from the fields of medicine , psychology , social science and education were comprehensively search ed for RCTs and systematic review s to February 2006 . Inclusion criteria were : r and omised controlled trial ; of structured , repeatable parenting programmes ; for parents/carers of children up to the age of 18 with a conduct problem ; and at least one measure of child behaviour . Meta- analysis and qualitative synthesis were used to summarise included studies . Results 57 RCTs were included . Studies were small with an average group size of 21 . Meta-analyses using both parent ( SMD -0.67 ; 95 % CI : -0.91 , -0.42 ) and independent ( SMD -0.44 ; 95 % CI : -0.66 , -0.23 ) reports of outcome showed significant differences favouring the intervention group . There was insufficient evidence to determine the relative effectiveness of different approaches to delivering parenting programmes . Conclusion Parenting programmes are an effective treatment for children with conduct problems . The relative effectiveness of different parenting programmes requires further research Background Eczema ( syn . Atopic Eczema or Atopic Dermatitis ) is a chronic , relapsing , itchy skin condition which probably results from a combination of genetic and environmental factors . The Global Re source of EczemA Trials ( GREAT ) is a collection of records of r and omised controlled trials ( RCTs ) for eczema treatment produced from a highly sensitive search of six reference data bases . We sought to assess the sensitivity of the GREAT data base as a tool to save future research ers repeating extensive bibliographic search es . Methods All Cochrane systematic review on treatments for eczema and five non-Cochrane systematic review s on eczema were identified as a reference set to assess the utility of the GREAT data base in identifying r and omised controlled trials ( RCTs ) . RCTs included in the systematic review s were checked for inclusion in the GREAT data base by two independent authors . A third author resolved any disagreements . Results Five Cochrane and six non-Cochrane systematic review s containing a total of 105 RCTs of eczema treatments were included . Of these , 95 fitted the inclusion criteria for the GREAT data base and 88 were published from 2000 onwards . Of the 88 eligible studies , 92 % were found in the GREAT data base . Seven trials were not included in the GREAT data base - two of these were reported within a review paper and one as an abstract with no trial results . Conclusions The sensitivity of the GREAT data base for trials from 2000 onwards was high ( 75/88 trials , 94 % ) . Sensitivity for the period prior to 2000 was less sensitive , due to differences in how the trials were identified prior to this time.‘Dual ’ filtering for new records has recently become part of the GREAT data base methodology and should further improve the sensitivity of the data base in time . The GREAT data base can be considered as a primary source for future systematic review s including r and omised controlled trials of eczema treatments , but search es should be supplemented by checking reference lists for eligible trials , search ing trial registries and contacting pharmaceutical companies for unpublished studies OBJECTIVES To examine the effectiveness of weekly iron supplements given for 10 weeks by teachers to children in rural schools in the Philippines . METHODS Forty-nine rural primary schools took part in the study and were r and omly assigned to two groups : children in 25 schools received a weekly tablet providing 108 mg iron while children in 24 schools acted as controls . All children were dewormed before the start of the iron supplementation . The haemoglobin concentration of a systematic sample of one in three children in two classes in each school was estimated before and 5 - 17 weeks after the end of the iron supplementation . RESULTS A total of 1510 children aged 7 - 12 years were studied at both surveys . The mean haemoglobin concentration of children in the intervention group did not change significantly ; in the untreated group it fell by 3.8 g/l and the prevalence of anaemia rose from 14.3 % to 25.6 % . The difference between study groups was significantly larger amongst the younger children ( 7 - 8 years ) , and was observed in both anaemic and non-anaemic children . CONCLUSION Even where anaemia is only a mild public health problem , weekly iron supplements given by teachers may prevent a fall in the haemoglobin concentration , and can benefit both anaemic and non-anaemic children Summary Background In 2002–04 , we did a r and omised controlled trial in southern Nepal , and reported that children born to mothers taking multiple micronutrient supplements during pregnancy had a mean birthweight 77 g greater than children born to mothers  taking iron and folic acid supplements . Children born to mothers in the study group were a mean 204 g heavier at 2·5 years of age and their systolic blood pressure was a mean 2·5 mm Hg lower than children born to mothers in the control group . We aim ed to follow up the same children to mid-childhood ( age 8·5 years ) to investigate whether these differences would be sustained . Methods For this follow-up study , we identified children from the original trial and measured anthropometry , body composition with bioelectrical impedance ( with population -specific isotope calibration ) , blood pressure , and renal dimensions by ultrasound . We documented socioeconomic status , household food security , and air pollution . Main outcomes of the follow-up at 8 years were Z scores for weight-for-age , height-for-age , and body-mass index ( BMI ) -for-age according to WHO Child Growth St and ards for children aged 5–19 years , and blood pressure . This study is registered with the International St and ard R and omised Controlled Trial register , number IS RCT N88625934 . Findings Between Sept 21 , 2011 , and Dec 7 , 2012 , we assessed 841 children ( 422 in the control group and 419 in the intervention group ) . Unadjusted differences ( intervention minus control ) in Z scores were 0·05 for weight-for-age ( 95 % CI −0·09 to 0·19 ) , 0·02 in height-for-age ( −0·10 to 0·15 ) , and 0·04 in BMI -for-age ( −0·09 to 0·18 ) . We recorded no difference in blood pressure . Adjusted differences were similar for all outcomes . Interpretation We recorded no differences in phenotype between children born to mothers who received antenatal multiple micronutrient or iron and folate supplements at age 8·5 years . Our findings did not extend to physiological differences or potential longer-term effects . Funding The Wellcome Trust In developing countries , low food intake is often reported in children < 5 y old . Reduced appetite may be a contributing factor . We investigated whether a combination of a multivitamin-multimineral supplement and additional iron treatment improved appetite and growth of 18- to 30-mo-old stunted and anemic Beninese children . The study was placebo-controlled using VITALIA tablets ( 11 vitamins and 10 minerals ) and ferrous fumarate tablets ( 66 mg of iron ) . One hundred fifty stunted ( height-for-age Z score < -2 ) and anemic children ( hemoglobin < 110 g/L ) were r and omly assigned to one of four groups : group 1 , multivitamin-multimineral plus iron ; group 2 , multivitamin-multimineral plus placebo ; group 3 , placebo plus placebo ; and group 4 , placebo plus iron . Supplementation was daily and supervised for 6 wk . Appetite , knee-heel length , dietary intakes and morbidity were assessed before and after supplementation . Length , weight , arm circumference and hemoglobin concentration were assessed before , just after supplementation and 4 mo after the intervention . Appetite was assessed by means of an appetite test using a test food , riz-au-gras , eaten ad libitum after an overnight fast . Dietary intakes were assessed during three consecutive days in a sub sample by means of the observed weighed record method . Energy intake from the habitual breakfast was significantly correlated with that from the test food ( r = 0.49 , n = 38 , P = 0.002 ) . There were no differences among groups in changes in appetite and growth performance . The habitual diet of the children was monotonous and contained only small amounts of animal products . The morbidity status of the children was comparable in all study groups , before as well as after supplementation . We conclude that the 6-wk multivitamin-multimineral supplementation with additional iron treatment failed to improve the appetite and growth of the children Background Over half of the world ’s children suffer from poor nutrition , and as a consequence they experience delays in physical and mental health , and cognitive development . There is little data evaluating the effects of delivery of lipid-based , nutrition supplementation on growth and development during pregnancy and early childhood within the context of a scaled-up program . Furthermore , there is limited evidence on effects of scaled-up , home-visiting programs that focus on the promotion of child development within the context of an existing , national nutrition program . Methods / Design The MAHAY ( " smart " in Malagasy ) study uses a multi-arm r and omized-controlled trial ( RCT ) to test the effects and cost-effectiveness of combined interventions to address chronic malnutrition and poor child development . The arms of the trial are : ( T0 ) existing program with monthly growth monitoring and nutritional/hygiene education ; ( T1 ) is T0 + home visits for intensive nutrition counseling within a behavior change framework ; ( T2 ) is T1 + lipid-based supplementation ( LNS ) for children 6–18 months old ; ( T3 ) is T2 + LNS supplementation of pregnant/lactating women ; and ( T4 ) is T1 + intensive home visiting program to support child development . There are anticipated to be n = 25 communities in each arm ( n = 1250 pregnant women , n = 1250 children 0–6 months old , and n = 1250 children 6–18 months old ) . Primary outcomes include growth ( length/height-for-age z-scores ) and child development ( mental , motor and social development ) . Secondary outcomes include care-giver reported child morbidity , household food security and diet diversity , micro-nutrient status , maternal knowledge of child care and feeding practice s , and home stimulation practice s. We will estimate unadjusted and adjusted intention-to-treat effects . Study protocol s have been review ed and approved by the Malagasy Ethics Committee at the Ministry of Health in Madagascar and by the institutional review board at the University of California , Davis . This study is funded by the Strategic Impact Evaluation Fund ( SIEF ) , the World Bank Innovation Grant , the Early Learning Partnership Grant , the Japan Scaling-up for Nutrition Trustfund , and Gr and Challenges Canada . The implementation of the study is financed by Madagascar 's National Nutrition Office . Trial registration Current Controlled Trials IS RCT N14393738 . Registered June 23 , 2015 Background / Objectives : Multiple micronutrient supplementation with Sprinkles powder and crushable Foodlets tablets may be effective means of controlling micronutrient deficiencies in infants . Their efficacy has not been tested in countries like Iran where wheat as the staple food may affect nutrient bioavailability . This study aim ed to compare the efficacy of Sprinkles , Foodlets and the current supplement ( Drops ) for improving micronutrient status and growth among Iranian infants . Subjects/ Methods : Infants of 6–18 months of age , living in an urban district of Iran were r and omised to receive daily Sprinkles ( n=120 ) , Foodlets ( n=121 ) or Drops ( n=121 ) for 4 months . Haemoglobin ( Hb ) , serum ferritin , serum retinol , serum zinc , 25(OH ) D concentration and anthropometry were assessed at baseline and at 4 months . Results : Iron status improved with all treatments . Drops showed significantly greater changes in Hb and serum ferritin , though changes in anaemia prevalence were not different across groups . Infants having Foodlets and Sprinkles had significantly greater reductions in proportion of children with zinc deficiency compared with Drops . No significant differences in treatment effects were observed for mean serum 25(OH ) D and retinol , or for growth of infants across groups . Conclusion : The study was the first efficacy trial with Sprinkles and Foodlets in the Middle East where wheat or rice is the principal complementary foods . Differences across treatment groups were largely consistent with supplement micronutrient composition for iron and zinc , with no benefit in this population for serum retinol , 25(OH ) D , growth or anthropometric status . The trial identified trade-offs in combining multiple micronutrients in a single delivery mechanism BACKGROUND Multiple sclerosis ( MS ) is a major cause of chronic , neurological disability , with a significant long-term disability burden , often requiring comprehensive rehabilitation . OBJECTIVES To systematic ally evaluate evidence from published Cochrane Review s of clinical trials to summarise the evidence regarding the effectiveness and safety of rehabilitation interventions for people with MS ( pwMS ) , to improve patient outcomes , and to highlight current gaps in knowledge . METHODS We search ed the Cochrane Data base of Systematic Review s up to December 2017 , to identify Cochrane Review s that assessed the effectiveness of organised rehabilitation interventions for pwMS . Two review ers independently assessed the quality of included review s , using the Revised Assessment of Multiple Systematic Review s ( R-AMSTAR ) tool , and the quality of the evidence for reported outcomes , using the GRADE framework . MAIN RESULTS Overall , we included 15 review s published in the Cochrane Library , comprising 164 r and omised controlled trials ( RCTs ) and four controlled clinical trials , with a total of 10,396 participants . The included review s evaluated a wide range of rehabilitation interventions , including : physical activity and exercise therapy , hyperbaric oxygen therapy ( HBOT ) , whole-body vibration , occupational therapy , cognitive and psychological interventions , nutritional and dietary supplements , vocational rehabilitation , information provision , telerehabilitation , and interventions for the management of spasticity . We assessed all review s to be of high to moderate method ological quality , based on R-AMSTAR criteria .Moderate- quality evidence suggested that physical therapeutic modalities ( exercise and physical activities ) improved functional outcomes ( mobility , muscular strength ) , reduced impairment ( fatigue ) , and improved participation ( quality of life ) . Moderate- quality evidence suggested that inpatient or outpatient multidisciplinary rehabilitation programmes led to longer-term gains at the levels of activity and participation , and interventions that provided information improved patient knowledge . Low-qualitty evidence suggested that neuropsychological interventions , symptom-management programmes ( spasticity ) , whole body vibration , and telerehabilitation improved some patient outcomes . Evidence for other rehabilitation modalities was inconclusive , due to lack of robust studies . AUTHORS ' CONCLUSIONS The evidence suggests that regular specialist evaluation and follow-up to assess the needs of patients with all types of MS for appropriate rehabilitation interventions may be of benefit , although the certainty of evidence varies across the different types of interventions evaluated by the review s. Structured , multidisciplinary rehabilitation programmes and physical therapy ( exercise or physical activities ) can improve functional outcomes ( mobility , muscle strength , aerobic capacity ) , and quality of life . Overall , the evidence for many rehabilitation interventions should be interpreted cautiously , as the majority of included review s did not include data from current studies . More studies , with appropriate design , which report the type and intensity of modalities and their cost-effectiveness are needed to address the current gaps in knowledge BACKGROUND Zinc supplementation decreases morbidity from infections and increases growth of stunted children  , but there is little information on functional responses to zinc delivered in fortified foods . OBJECTIVE The aim was to examine the effects of zinc fortification on the growth , morbidity from infections , and plasma zinc concentrations of young children . DESIGN We compared the physical growth , morbidity , and micronutrient status of 6 - 8-mo-old Peruvian children with initial length-for-age z score ( LAZ ) < -0.50 who were r and omly assigned to receive one of the following treatments daily for 6 mo : 1 ) 30 g dry weight of an iron-fortified cereal porridge and a separate dose of an aqueous multivitamin ( MV ) supplement between meals ( control group ) , 2 ) the same porridge and MV with 3 mg Zn added to the supplement dose ( ZnSuppl group ) , or 3 ) the porridge with added zinc ( 150 mg/kg dry weight ) and MV without zinc ( ZnFort group ) . RESULTS The children consumed a mean of 22 - 26 g dry porridge/d and 96 % of the possible MV doses . After adjustment for small baseline differences in socioeconomic status and morbidity , no significant differences in weight or length increments were observed between the groups , even among the subset with an initial LAZ < -1.5 , and no significant differences in the rates of common illnesses were observed . Mean plasma zinc concentrations decreased in the control group ( -3.9 microg/dL ) , increased in the ZnSuppl group ( 4.3 microg/dL ) , and did not change significantly in the ZnFort group ( -1.5 microg/dL ; P < 0.001 for group-wise comparison ) . CONCLUSIONS Provision of additional zinc , either in an aqueous supplement or a fortified porridge , did not significantly affect the children 's physical growth or morbidity from infections , possibly because they were not sufficiently growth-restricted or zinc-deficient initially or because the level of zinc intake or absorption was inadequate . Additional studies of the functional effect of zinc-fortified foods are needed in population s that are known to respond to zinc supplements Objective : To assess the effects of iron and deworming on linear growth performance of preschoolers . Design : Three-month r and omized , double-blind and placebo-controlled trial . The children were allocated to four treatments : iron ( 60 mg elemental iron/day)+albendazole ( 200 mg/day for 3 consecutive days , repeated 1 month later ) , iron+albendazole-placebo , albendazole+iron-placebo or placebos . The supplementation was supervised . Subjects : A group of 177 children aged 3–5 y was selected from low-income households in a rural area in southern Bénin . A complete data set was analysed for 140 subjects . Many children were stunted ( 58 % had height-for-age Z-score < −2 ) , none were wasted ( 2 % had weight-for-height Z-score < −2 ) and 76 % were anemic ( Hb<110 g/l).Main outcome measures : Anthropometric parameters , hemoglobin and eggs per gram feces . Results : No significant difference in changes in anthropometric parameters was observed between study groups , and also not in a sub- sample of stunted and anemic subjects . Changes in hemoglobin were highest in the iron-treated subjects at the end of the 3-month intervention period ( P=0.032 ) . The difference between the iron and the placebo groups remained significant even 7 months later ( P=0.022 ) . The difference was 5 g/l in both periods . Ascaris lumbricoides and hookworm infections decreased significantly in albendazole-treated subjects ( P<0.05 ) . Conclusions : In addition to recurrent parasitic infection burden , the children may have multiple micronutrient deficiencies . Therefore , it may be interesting to study appetite and food intake of young toddlers in relation to health and linear growth performance in poor environments . Sponsorship : The Nestlé Foundation ( Lausanne , Switzerl and ) .European Journal of Clinical Nutrition ( 2001 ) 55 ,
Significant heterogeneity was evident , and its predictors included greater weight-for-age in supplemented children in malaria hyperendemic regions and greater weight-for-height for children above 5 years of age , but a negative effect on linear growth in developed countries and with supplementation for 6 months or longer .
This review did not document a positive effect of iron supplementation on the physical growth of children .
OBJECTIVE To evaluate the effect of iron supplementation on  physical growth in children through a systematic review of r and omised controlled trials ( RCTs ) .