Nutrition News for Africa

Abstract - August 15, 2007

An article entitled “Randomized comparison of 3 types of micronutrient supplements for home fortification of complementary foods in Ghana : effects on growth and motor development” was published by Seth Adu-Afarwuah,et al.in the American Journal of Clinical Nutrition 2007;86:412–20.

 Introduction
The low micronutrient content of complementary foods in many disadvantaged populations has been associated with growth faltering, increased morbidity, and delayed motor milestone acquisition. A low-cost strategy to deal with this problem is in--home fortification of complementary foods with multiple micronutrient supplements. To that effect, three types of multiple micronutrient supplements were identified including Sprinkles SP, which provides the Recommended Nutrient Intake (RNI) of 6 vitamins and minerals; Nutritabs, NT, which provides the RNI of 14 vitamins and minerals plus some calcium and potassium; Nutributer NB, which provides the RNI of 14 vitamins and minerals plus some calcium, potassium, phosphorous, magnesium, and manganese as well as energy (108 kcal/d).The aim of the study was to compare the acceptability and the effects of these 3 supplements on the growth and micronutrient status of infants 6 to 12 mo of age  

Methods
The study was carried out in Koforidua, in the Eastern Region of Ghana, between February 2004 and June 2005. The principal complementary food in most households is a fermented maize-based porridge. Inclusion criteria were: 1) 5 mo of age, 2) receiving any breast milk, 3) not known to be asthmatic or allergic to peanuts, and 4) planning to stay at the study site during the next 7 mo. The study was designed as a community-based randomized trial involving 3 intervention groups and one non-intervention (NI) group. The primary outcome was growth; morbidity and energy intake from complementary foods were assessed and motor milestone acquisition at 12 mo observed.  

Results
During the intervention, infants in the NB group gained more weight ( 1.57 kg ) and length ( 8.3 cm ) than did those in the NT group ( 1.35 kg and 7.8 cm , respectively; the difference with the SP group ( 1.39 kg and 7.9 cm , respectively) was not significant. When all 4 groups were compared, weight-for-age z-score and weight-for-length z-score were significantly greater in the NB group than in the NT group after controlling for child sex and maternal height. The percentage of children able to walk independently was significantly lower in the NI group (25%) than in the SP (39%), NT (36%), and NB (49%) groups. Morbidity did not differ significantly between the 3 intervention groups. 

Discussion
The authors found that supplementation with SP and NT did not increase growth but the NB group had greater weight and length gains than did the other 2 supplementation groups. They concluded that the NB supplement, which provided a larger set of micronutrients plus some energy and fat, conferred greater benefits than did the SP and the NT supplements.