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A Randomized Multiple Micronutrient Powder Point-of-Use Fortification Trial Implemented in Indian Preschools
Maureen M Black1,2, Sylvia Fernandez-Rao3, Krishnapillai Madhavan Nair4
1Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA.
The Journal of Nutrition
|April 21, 2021
Summary
Multiple micronutrient powders (MNP) in preschool meals reduced anemia and iron deficiency in India. MNP improved development in low-quality preschools, highlighting the importance of nutrition and quality care for child development.
Area of Science:
- Public Health
- Nutrition Science
- Developmental Psychology
Background:
- Anemia is a significant global health issue impacting child development.
- Indian preschools offer integrated nutrition and child development programs.
Purpose of the Study:
- To assess the impact of multiple micronutrient powder (MNP) fortification in preschool meals on child development.
- To investigate if MNP effects differ based on preschool quality.
- To evaluate secondary outcomes including anemia, micronutrient biomarkers, growth, and morbidity.
Main Methods:
- A double-masked, cluster-randomized controlled trial involving 22 rural Indian preschools.
- Preschools received either MNP or placebo fortification for 8 months.
- Child development, anthropometry, morbidity, and biomarkers were assessed at baseline and endline.
Main Results:
- MNP significantly reduced anemia and iron deficiency compared to placebo.
- In low-quality preschools, MNP improved expressive language, inhibitory control, and social-emotional development.
- No significant effects on growth or morbidity were observed. Effects on development were not seen in high-quality preschools.
Conclusions:
- Fortifying preschool meals with MNP is feasible and effectively reduces anemia and iron deficiency.
- MNP can mitigate developmental disparities in low-quality preschool settings.
- Enhancing overall preschool quality, including nutrition, is crucial for optimal child development.
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