Trial study design
The study protocol has been previously published [Intervention and control supplements with similar sensory characteristics and packaged as a powder in sachets labeled with one of 4 nonspeaking codes were stored at 2 to 6°C until made up in 250 ml water and taken twice daily. Ingredients common to control and intervention formulations were folic acid 400 μg/day, iron 12 mg/day, calcium 150 mg/day, iodine 150 μg/day, and β-carotene 720 μg/day; the intervention additionally included riboflavin 1.8 mg/day, vitamin B6 2.6 mg/day, vitamin B12 5.2 μg/day, vitamin D 10 μg/day, zinc 10 mg/day, myo-inositol 4 g/day, and probiotics (The trial was approved by the UK, Singapore, and New Zealand research ethics services (Southampton: Health Research Authority NRES Committee South Central Research Ethics Committee, reference 15/SC/0142l; Singapore: the National Healthcare Group Domain Specific Review Board, reference 2015/00205; New Zealand: the Health and Disability Ethics Committee, reference 15/NTA/21). The relevant regulatory authorities confirmed that the formulation was not an investigational medicinal product. All participants gave written informed consent. Trial oversight and monitoring were provided by an independent data and safety monitoring committee. This trial was prospectively registered at 