Role of Micronutrient Supplementation and Fortification Interventions among Children Under-Five

Micronutrient deficiencies remain still prevalent among children under five in low- and middle-income countries (LMICs), even though several effective strategies now exist to prevent them. Malnutrition may induce several acute and long-term consequences, like stunted growth, a higher risk of acquiring infections, and poor development outcomes, which all may subject the child not to achieving his or her full potential. 

The present study scrutinized the available evidence for the therapies used to prevent micronutrient malnutrition among children under five in LMICs, including single and multiple micronutrients (MMN) supplementation, lipid-based nutrient supplementation (LNS), targeted and large-scale fortification, and point-of-use-fortification with micronutrient powders (MNPs). 

It searched relevant databases and grey literature, retrieved 35,924 papers, and finally included 197 unique studies. It also examined the efficacy and effectiveness of interventions. The study found that certain outcomes, like anemia, responded to several intervention types. The risk of anemia was documented to be reduced with iron alone, iron-folic acid, MMN supplementation, MNPs, targeted fortification, and large-scale fortification. Stunting and underweight got improved only among children who were provided with LNS, though MMN supplementation also slightly increased length-for-age z-scores. Vitamin A supplementation probably reduced all-cause mortality, while zinc supplementation decreased the incidence of diarrhea. Notably, many effects of LNS and MNPs were held when pooling data from effectiveness studies. 

Altogether, this evidence supports the importance of these strategies in reducing the burden of micronutrient malnutrition in children. 

Tam E, Keats EC, Rind F, Das JK, Bhutta ZA. Micronutrient Supplementation and Fortification Interventions on Health and Development Outcomes among Children Under-Five in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis. Nutrients. 2020; 12(2):289. https://doi.org/10.3390/nu12020289