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Meta-Analysis
. 2020 Feb 28;2(2):CD008959.
doi: 10.1002/14651858.CD008959.pub3.

Home fortification of foods with multiple micronutrient powders for health and nutrition in children under two years of age

Parminder S Suchdev  1   2 , Maria Elena D Jefferds  2 , Erika Ota  3 , Katharina da Silva Lopes  4 , Luz Maria De-Regil  5
Affiliations
Meta-Analysis

Home fortification of foods with multiple micronutrient powders for health and nutrition in children under two years of age

Parminder S Suchdev et al. Cochrane Database Syst Rev. .

Abstract

Background: Vitamin and mineral deficiencies, particularly those of iron, vitamin A, and zinc, affect more than two billion people worldwide. Young children are highly vulnerable because of rapid growth and inadequate dietary practices. Multiple micronutrient powders (MNPs) are single-dose packets containing multiple vitamins and minerals in powder form, which are mixed into any semi-solid food for children six months of age or older. The use of MNPs for home or point-of-use fortification of complementary foods has been proposed as an intervention for improving micronutrient intake in children under two years of age. In 2014, MNP interventions were implemented in 43 countries and reached over three million children. This review updates a previous Cochrane Review, which has become out-of-date.

Objectives: To assess the effects and safety of home (point-of-use) fortification of foods with MNPs on nutrition, health, and developmental outcomes in children under two years of age. For the purposes of this review, home fortification with MNP refers to the addition of powders containing vitamins and minerals to semi-solid foods immediately before consumption. This can be done at home or at any other place that meals are consumed (e.g. schools, refugee camps). For this reason, MNPs are also referred to as point-of-use fortification.

Search methods: We searched the following databases up to July 2019: CENTRAL, MEDLINE, Embase, and eight other databases. We also searched four trials registers, contacted relevant organisations and authors of included studies to identify any ongoing or unpublished studies, and searched the reference lists of included studies.

Selection criteria: We included randomised controlled trials (RCTs) and quasi-RCTs with individual randomisation or cluster-randomisation. Participants were infants and young children aged 6 to 23 months at the time of intervention, with no identified specific health problems. The intervention consisted of consumption of food fortified at the point of use with MNP formulated with at least iron, zinc, and vitamin A, compared with placebo, no intervention, or use of iron-containing supplements, which is standard practice.

Data collection and analysis: Two review authors independently assessed the eligibility of studies against the inclusion criteria, extracted data from included studies, and assessed the risk of bias of included studies. We reported categorical outcomes as risk ratios (RRs) or odds ratios (ORs), with 95% confidence intervals (CIs), and continuous outcomes as mean differences (MDs) and 95% CIs. We used the GRADE approach to assess the certainty of evidence.

Main results: We included 29 studies (33,147 children) conducted in low- and middle-income countries in Asia, Africa, Latin America, and the Caribbean, where anaemia is a public health problem. Twenty-six studies with 27,051 children contributed data. The interventions lasted between 2 and 44 months, and the powder formulations contained between 5 and 22 nutrients. Among the 26 studies contributing data, 24 studies (26,486 children) compared the use of MNP versus no intervention or placebo; the two remaining studies compared the use of MNP versus an iron-only supplement (iron drops) given daily. The main outcomes of interest were related to anaemia and iron status. We assessed most of the included studies at low risk of selection and attrition bias. We considered some studies to be at high risk of performance and detection bias due to lack of blinding. Most studies were funded by government programmes or foundations; only two were funded by industry. Home fortification with MNP, compared with no intervention or placebo, reduced the risk of anaemia in infants and young children by 18% (RR 0.82, 95% CI 0.76 to 0.90; 16 studies; 9927 children; moderate-certainty evidence) and iron deficiency by 53% (RR 0.47, 95% CI 0.39 to 0.56; 7 studies; 1634 children; high-certainty evidence). Children receiving MNP had higher haemoglobin concentrations (MD 2.74 g/L, 95% CI 1.95 to 3.53; 20 studies; 10,509 children; low-certainty evidence) and higher iron status (MD 12.93 μg/L, 95% CI 7.41 to 18.45; 7 studies; 2612 children; moderate-certainty evidence) at follow-up compared with children receiving the control intervention. We did not find an effect on weight-for-age (MD 0.02, 95% CI -0.03 to 0.07; 10 studies; 9287 children; moderate-certainty evidence). Few studies reported morbidity outcomes (three to five studies each outcome) and definitions varied, but MNP did not increase diarrhoea, upper respiratory infection, malaria, or all-cause morbidity. In comparison with daily iron supplementation, the use of MNP produced similar results for anaemia (RR 0.89, 95% CI 0.58 to 1.39; 1 study; 145 children; low-certainty evidence) and haemoglobin concentrations (MD -2.81 g/L, 95% CI -10.84 to 5.22; 2 studies; 278 children; very low-certainty evidence) but less diarrhoea (RR 0.52, 95% CI 0.38 to 0.72; 1 study; 262 children; low-certainty of evidence). However, given the limited quantity of data, these results should be interpreted cautiously. Reporting of death was infrequent, although no trials reported deaths attributable to the intervention. Information on side effects and morbidity, including malaria and diarrhoea, was scarce. It appears that use of MNP is efficacious among infants and young children aged 6 to 23 months who are living in settings with different prevalences of anaemia and malaria endemicity, regardless of intervention duration. MNP intake adherence was variable and in some cases comparable to that achieved in infants and young children receiving standard iron supplements as drops or syrups.

Authors' conclusions: Home fortification of foods with MNP is an effective intervention for reducing anaemia and iron deficiency in children younger than two years of age. Providing MNP is better than providing no intervention or placebo and may be comparable to using daily iron supplementation. The benefits of this intervention as a child survival strategy or for developmental outcomes are unclear. Further investigation of morbidity outcomes, including malaria and diarrhoea, is needed. MNP intake adherence was variable and in some cases comparable to that achieved in infants and young children receiving standard iron supplements as drops or syrups.

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Conflict of interest statement

Parminder Suchdev (PS)a receives partial salary support from the CDC for research activities in monitoring and evaluating nutrition interventions.

Luz Maria De‐Regil (LD‐R)b was a full‐time member of the staff of Nutrition International between December 2013 and December 2018. Some of the updates of this review took place during that period. Nutrition International is a non‐profit organization that receives and provides funds from or to different institutions to undertake research and implement nutrition programmes in which multiple micronutrient powders may be provided to different age groups. Some of those studies were eligible for inclusion in this review. LD‐R was not directly involved in any such studies and did not assess their eligibility for inclusion in this review. The time that LD‐R devoted to this review during her tenure at NI was partially covered with a grant from Global Affairs Canada to Nutrition International.

Maria Jefferds (MJ)a,b provides technical assistance to multiple countries for the design, implementation, monitoring, and evaluation of MNP programs. Multiple peer review and report publications have been disseminated or are under development based on that work. MJ has participated in UNICEF/CDC regional workshops on scaling up MNP interventions for young children aged 6 to 23 months. MJ is a co‐author for two publications included in a September 2013 Sight and Life supplement on MNP and was an Editor of that supplement. MJ was the co‐ordinator and writer of a monitoring manual for home fortification interventions, including micronutrient powders, for the Home Fortification Technical Advisory Group (HF‐TAG). With colleagues from CDC and UNICEF, MJ was an investigator on the first global assessment of home fortification interventions in 2011, which was published as an HF‐TAG report in 2013, and she wrote a summary journal article published in 2013. As part of UNICEF’s Nutridash System, MJ provided technical assistance in the development of an annual surveillance system of global MNP interventions. Collaborators with UNICEF and CDC also developed a home fortification toolkit and webinar series, which focused heavily on MNP. MJ has participated in executive committee meetings and strategic planning of the HF‐TAG historically and is a member of the Executive Committee.

Erika Ota ‐ none known.

Katharina da Silva Lopes ‐ none known.

aBoth PS and MJ were involved in Suchdev 2012 ‐ an study excluded from this update. They were not involved in assessing the eligibility of this study. LD‐R and EO assessed the study. bMJ and LD‐R are co‐authors on a Cochrane Review of MNP in children 2 to 12 years old (De‐Regil 2017).

Figures

1
1
Study flow diagram.
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
4
4
Funnel plot of comparison: 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, outcome: 1.1 Anaemia.
5
5
Funnel plot of comparison: 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, outcome: 1.21 Haemoglobin (g/L).
1.1
1.1. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 1 Anaemia.
1.2
1.2. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 2 Anaemia by baseline anaemia status.
1.3
1.3. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 3 Anaemia by baseline iron status.
1.4
1.4. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 4 Anaemia by age at the start of the intervention.
1.5
1.5. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 5 Anaemia by refugee status.
1.6
1.6. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 6 Anaemia by malaria endemicity in the study area.
1.7
1.7. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 7 Anaemia by frequency of intake.
1.8
1.8. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 8 Anaemia by duration of the intervention.
1.9
1.9. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 9 Anaemia by iron content.
1.10
1.10. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 10 Anaemia by zinc content.
1.11
1.11. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 11 Iron deficiency.
1.12
1.12. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 12 Iron deficiency by baseline anaemia status.
1.13
1.13. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 13 Iron deficiency by baseline iron status.
1.14
1.14. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 14 Iron deficiency by age at the start of the intervention.
1.15
1.15. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 15 Iron deficiency by refugee status.
1.16
1.16. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 16 Iron deficiency by malaria endemicity in the study area.
1.17
1.17. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 17 Iron deficiency by frequency of intake.
1.18
1.18. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 18 Iron deficiency by duration of the intervention.
1.19
1.19. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 19 Iron deficiency by iron content.
1.20
1.20. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 20 Iron deficiency by zinc content.
1.21
1.21. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 21 Haemoglobin (g/L).
1.22
1.22. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 22 Haemoglobin by baseline anaemia status.
1.23
1.23. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 23 Haemoglobin by baseline iron status.
1.24
1.24. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 24 Haemoglobin by age at the start of the intervention.
1.25
1.25. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 25 Haemoglobin by refugee status.
1.26
1.26. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 26 Haemoglobin by malaria endemicity in the study area.
1.27
1.27. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 27 Haemoglobin by frequency of intake.
1.28
1.28. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 28 Haemoglobin by duration of the intervention.
1.29
1.29. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 29 Haemoglobin by iron content.
1.30
1.30. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 30 Haemoglobin by zinc content.
1.31
1.31. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 31 Iron status (ferritin concentrations in μg/L).
1.32
1.32. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 32 Iron status (ferritin concentrations in μg/L) by baseline anaemia status.
1.33
1.33. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 33 Iron status (ferritin concentrations in μg/L) by baseline iron status.
1.34
1.34. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 34 Iron status (ferritin concentrations in μg/L) by age at the start of the intervention.
1.35
1.35. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 35 Iron status (ferritin concentrations in μg/L) by refugee status.
1.36
1.36. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 36 Iron status (ferritin concentrations in μg/L) by malaria endemicity in the study area.
1.37
1.37. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 37 Iron status by frequency of intake.
1.38
1.38. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 38 Iron status (ferritin concentrations in μg/L) by duration of the intervention.
1.39
1.39. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 39 Iron status (ferritin concentrations in μg/L) by iron content.
1.40
1.40. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 40 Iron status (ferritin concentrations in μg/L) by zinc content.
1.41
1.41. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 41 Weight‐for‐age (in z scores).
1.42
1.42. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 42 Length‐for‐age (in z scores).
1.43
1.43. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 43 Weight‐for‐length (in z scores).
1.44
1.44. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 44 All‐cause morbidity.
1.45
1.45. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 45 Diarrhoea.
1.46
1.46. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 46 Upper respiratory infections.
1.47
1.47. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 47 Retinol binding protein (μmol/L).
1.48
1.48. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 48 Retinol (μmol/L).
1.49
1.49. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 49 Serum zinc concentration.
1.50
1.50. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 50 Malaria infection.
1.51
1.51. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 51 Cognitive outcome: walking independently.
1.52
1.52. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 52 Cognitive outcome: language score (Bayley).
1.53
1.53. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 53 Cognitive outcome: HOME score.
1.54
1.54. Analysis
Comparison 1 Home (point‐of‐use) fortification of foods with MNP versus no intervention or placebo, Outcome 54 Cognitive outcome: language score (CDI).
2.1
2.1. Analysis
Comparison 2 Home (point‐of‐use) fortification of foods with MNP versus an iron‐only supplement, Outcome 1 Anaemia.
2.2
2.2. Analysis
Comparison 2 Home (point‐of‐use) fortification of foods with MNP versus an iron‐only supplement, Outcome 2 Haemoglobin (g/L).
2.3
2.3. Analysis
Comparison 2 Home (point‐of‐use) fortification of foods with MNP versus an iron‐only supplement, Outcome 3 Stained teeth (not pre‐specified).
2.4
2.4. Analysis
Comparison 2 Home (point‐of‐use) fortification of foods with MNP versus an iron‐only supplement, Outcome 4 Stool discolouration (not pre‐specified).
2.5
2.5. Analysis
Comparison 2 Home (point‐of‐use) fortification of foods with MNP versus an iron‐only supplement, Outcome 5 Cold (not pre‐specified).
2.6
2.6. Analysis
Comparison 2 Home (point‐of‐use) fortification of foods with MNP versus an iron‐only supplement, Outcome 6 Fever (not pre‐specified).
2.7
2.7. Analysis
Comparison 2 Home (point‐of‐use) fortification of foods with MNP versus an iron‐only supplement, Outcome 7 Cough (not pre‐specified).
2.8
2.8. Analysis
Comparison 2 Home (point‐of‐use) fortification of foods with MNP versus an iron‐only supplement, Outcome 8 Vomiting (not pre‐specified).
2.9
2.9. Analysis
Comparison 2 Home (point‐of‐use) fortification of foods with MNP versus an iron‐only supplement, Outcome 9 Diarrhoea.
2.10
2.10. Analysis
Comparison 2 Home (point‐of‐use) fortification of foods with MNP versus an iron‐only supplement, Outcome 10 Recurrent diarrhoea (3 or more episodes) (not pre‐specified).
2.11
2.11. Analysis
Comparison 2 Home (point‐of‐use) fortification of foods with MNP versus an iron‐only supplement, Outcome 11 Diarrhoea episodes (not pre‐specified).
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Update of

References

References to studies included in this review

Aboud 2011 (C) {published data only}
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Adu‐Afarwuah 2007 {published data only (unpublished sought but not used)}
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Esamai 2014 {published data only}
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Hirve 2007 (C) {published and unpublished data}
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Inayati 2012 (C) {published data only}
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    1. Scherbaum V. Your paper on MNP [personal communication]. Email to: L de Regil. 18 July 2012; 5 February 2013; 8 February 2013.
Jack 2012 (C) {published data only}
    1. Jack SJ, Ou K, Chea M, Chhin L, Devenish R, Dunbar M, et al. Effect of micronutrient sprinkles on reducing anemia: a cluster‐randomized effectiveness trial. Archives of Pediatrics & Adolescent Medicine 2012;166(9):842‐50. [DOI: 10.1001/archpediatrics.2012.1003; PUBMED: 22801933] - DOI - PubMed
Kounnavong 2011 {published data only}
    1. Kounnavong S, Sunahara T, Mascie‐Taylor CG, Hashizume M, Okumura J, Moji K, et al. Effect of daily versus weekly home fortification with multiple micronutrient powder on haemoglobin concentration of young children in a rural area, Lao People's Democratic Republic: a randomised trial. Nutrition Journal 2011;10:129. [DOI: 10.1186/1475-2891-10-129; PMC3266642 ; PUBMED: 22111770] - DOI - PMC - PubMed
Lanou 2019 (C) {published data only}
    1. Lanou HB, Osendarp SJM, Argaw A, Polnay K, Ouédraogo C, Kouanda S, et al. Micronutrient powder supplements combined with nutrition education marginally improve growth amongst children aged 6‐23 months in rural Burkina Faso: a cluster randomized controlled trial. Maternal & Child Nutrition 2019;15(4):12820. [DOI: 10.1111/mcn.12820; PUBMED: 30941887] - DOI - PMC - PubMed
Larson 2018 (C) {published data only}
    1. Larson LM, Young MF, Bauer PJ, Mehta R, Webb Girard A, Ramakrishnan U, et al. Effectiveness of a home fortification programme with multiple micronutrients on infant and young child development: a cluster‐randomised trial in rural Bihar, India. British Journal of Nutrition 2018;120(2):176‐87. [DOI: 10.1017/S000711451800140X; PMC6088539; PUBMED: 29947323] - DOI - PMC - PubMed
    1. Young MF. Bihar MNP results [personal communication]. Email to: P Suchdev. 5 December 2019.
    1. Young MF, Mehta R, Gosdin L, Kekre P, Verma P, Larson L, et al. Impact of home fortification of complementary foods program on child anemia and stunting in Bihar, India. FASEB Journal 2017;31(1 Suppl). [Abstract #165.7]
Lundeen 2010 (C) {published and unpublished data}
    1. Lundeen E, Schueth T, Toktobaev N, Zlotkin S, Hyder SM, Houser R. Daily use of Sprinkles micronutrient powder for 2 months reduces anemia among children 6 to 36 months of age in the Kyrgyz Republic: a cluster‐randomized trial. Food and Nutrition Bulletin 2010;31(3):446‐60. [DOI: 10.1177/156482651003100307; PUBMED: 20973465 ] - DOI - PubMed
Luo 2017 (C) {published data only}
    1. Luo R, Yue A, Zhou H, Shi Y, Zhang L, Martorell R, et al. The effect of a micronutrient powder home fortification program on anemia and cognitive outcomes among young children in rural China: a cluster randomized trial. BMC Public Health 2017;17(1):738. [DOI: 10.1186/s12889-017-4755-0; PMC5613507; PUBMED: 28946866] - DOI - PMC - PubMed
Macharia‐Mutie 2012 {published data only}
    1. Macharia‐Mutie CW, Moretti D, Briel N, Omusundi AM, Mwangi AM, Kok FJ, et al. Maize porridge enriched with a micronutrient powder containing low‐dose iron as NaFeEDTA but not amaranth grain flour reduces anemia and iron deficiency in Kenyan preschool children. Journal of Nutrition 2012;142(9):1756‐63. [DOI: 10.3945/jn.112.157578; PUBMED: 22810982] - DOI - PubMed
    1. Macharia‐Mutie CW, Omusundi AM, Mwai JM, Mwangi AM, Brouwer ID. Simulation of the effect of maize porridge fortified with grain amaranth or micronutrient powder containing NaFeEDTA on iron intake and status in Kenyan children. Public Health Nutrition 2013;16(9):1605‐13. [DOI: 10.1017/S1368980012005174; PUBMED: 23218415] - DOI - PMC - PubMed
Matias 2018 (C) {published data only}
    1. Matias SL, Mridha MK, Young RT, Khan MSA, Siddiqui Z, Ullah MB, et al. Prenatal and postnatal supplementation with lipid‐based nutrient supplements reduces anemia and iron deficiency in 18‐month‐old Bangladeshi children: a cluster‐randomized effectiveness trial. Journal of Nutrition 2018;148(7):1167‐76. [DOI: 10.1093/jn/nxy078; PUBMED: 29901736] - DOI - PubMed
Menon 2007 (C) {published and unpublished data}
    1. Loechl CU, Menon P, Arimond M, Ruel MT, Pelto G, Habicht JP, et al. Using programme theory to assess the feasibility of delivering micronutrient Sprinkles through a food‐assisted maternal and child health and nutrition programme in rural Haiti. Maternal & Child Nutrition 2009;5(1):33‐48. [DOI: 10.1111/j.1740-8709.2008.00154.x; PUBMED: 19161543] - DOI - PMC - PubMed
    1. Menon P, Ruel MT, Loechl CU, Arimond M, Habicht JP, Pelto G, et al. Micronutrient Sprinkles reduce anemia among 9‐ to 24‐mo‐old children when delivered through an integrated health and nutrition program in rural Haiti. Journal of Nutrition 2007;137(4):1023‐30. [DOI: 10.1093/jn/137.4.1023; PUBMED: 17374671] - DOI - PubMed
Mridha 2016 (C) {published data only}
    1. Dewey KG, Mridha MK, Matias SL, Arnold CD, Cummins JR, Khan MS, et al. Lipid‐based nutrient supplementation in the first 1000 d improves child growth in Bangladesh: a cluster‐randomized effectiveness trial. American Journal of Clinical Nutrition 2017;105(4):944‐57. [DOI: 10.3945/ajcn.116.147942; PUBMED: 28275125] - DOI - PubMed
    1. Matias SL, Mridha MK, Tofail F, Arnold CD, Khan MS, Siddiqui Z, et al. Home fortification during the first 1000 d improves child development in Bangladesh: a cluster‐randomized effectiveness trial. American Journal of Clinical Nutrition 2017;105(4):958‐69. [DOI: 10.3945/ajcn.116.150318; PUBMED: 28275128] - DOI - PubMed
    1. Mridha MK, Matias SL, Chaparro CM, Paul RR, Hussain S, Vosti SA, et al. Lipid‐based nutrient supplements for pregnant women reduce newborn stunting in a cluster‐randomized controlled effectiveness trial in Bangladesh. American Journal of Clinical Nutrition 2016;103(1):236‐49. [DOI: 10.3945/ajcn.115.111336; PMC6443293; PUBMED: 26607935] - DOI - PMC - PubMed
    1. Ullah MB, Mridha MK, Arnold CD, Matias SL, Khan MSA, Siddiqui Z, et al. Provision of pre‐ and postnatal nutritional supplements generally did not increase or decrease common childhood illnesses in Bangladesh: a cluster‐randomized effectiveness trial. Journal of Nutrition 2019;149(7):1271‐81. [DOI: 10.1093/jn/nxz059; PUBMED: 31162588] - DOI - PubMed
Olney 2018 (C) {published data only}
    1. Olney DK, Leroy J, Bliznashka L, Ruel MT. PROCOMIDA, a food‐assisted maternal and child health and nutrition program, reduces child stunting in Guatemala: a cluster‐randomized controlled intervention trial. Journal of Nutrition 2018;148(9):1493‐505. [DOI: 10.1093/jn/nxy138; PMC6118165; PUBMED: 30184223] - DOI - PMC - PubMed
Osei 2015 (C) {published data only}
    1. Osei KA, Pandey P, Spiro D, Adhikari D, Haselow N, Morais C, et al. Adding multiple micronutrient powders to a homestead food production programme yields marginally significant benefit on anaemia reduction among young children in Nepal. Maternal & Child Nutrition 2015;11(Suppl 4):188‐202. [DOI: 10.1111/mcn.12173; PUBMED: 25682798] - DOI - PMC - PubMed
Sazawal 2014 (C) {published data only}
    1. Sazawal S, Dhingra P, Dhingra U, Gupta S, Iyengar V, Menon VP, et al. Compliance with home‐based fortification strategies for delivery of iron and zinc: its effect on haematological and growth markers among 6‐24 months old children in north India. Journal of Health, Population and Nutrition 2014;32(2):217‐26. [PMC4216958; PUBMED: 25076659] - PMC - PubMed
Sharieff 2006a {published data only}
    1. Sharieff W, Bhutta Z, Schauer C, Tomlinson G, Zlotkin S. Micronutrients (including zinc) reduce diarrhoea in children: the Pakistan Sprinkles Diarrhoea Study. Archives of Disease in Childhood 2006;91(7):573‐9. [PMC2082848; PUBMED: 16556612] - PMC - PubMed
Somassè 2018 (C) {published data only}
    1. Somassè YE, Dramaix M, Traoré B, Ngabonziza I, Touré O, Konaté M, et al. The WHO recommendation of home fortification of foods with multiple‐micronutrient powders in children under 2 years of age and its effectiveness on anaemia and weight: a pragmatic cluster‐randomized controlled trial. Public Health Nutrition 2018;21(7):1350‐8. [DOI: 10.1017/S1368980017003858; PUBMED: 29352829] - DOI - PMC - PubMed
Soofi 2013 (C) {published data only}
    1. Soofi S, Cousens S, Iqbal SP, Akhund T, Khan J, Ahmed I, et al. Effect of provision of daily zinc and iron with several micronutrients on growth and morbidity among young children in Pakistan: a cluster‐randomised trial. Lancet 2013;382(9886):29‐40. [DOI: 10.1016/S0140-6736(13)60437-7; PUBMED: 23602230] - DOI - PubMed
Young 2018 (C) {published data only}
    1. Young MF, Girard AW, Mehta R, Srikantiah S, Gosdin L, Menon P, et al. Acceptability of multiple micronutrient powders and iron syrup in Bihar, India. Maternal & Child Nutrition 2018; Vol. 14, issue 2:e12572. [DOI: 10.1111/mcn.12572; PMC5900720; PUBMED: 29210507] - DOI - PMC - PubMed

References to studies excluded from this review

Avula 2011 {published data only}
    1. Avula R, Frongillo EA, Arabi M, Sharma S, Schultink W. Enhancements to nutrition program in Indian integrated child development services increased growth and energy intake of children. Journal of Nutrition 2011;141(4):680‐4. [DOI: 10.3945/jn.109.116954; PUBMED: 21346106] - DOI - PubMed
Bagni 2009 {published data only}
    1. Bagni UV, Baiao MR, Souza Santos MMA, Luiz RR, Veiga GV. Effect of weekly rice fortification with iron on anaemia prevalence and haemoglobin concentration among children attending public daycare centres in Rio de Janeiro, Brazil [Efeito da fortificao semanel do arroz com ferro quelato sobre a frequencia de anemia e concentracao de hemoglobina em criancas de creches municipais de Rio de Janeiro, Brasil]. Cadernos de Saude Publica 2009;25(2):291‐302. [PUBMED: 19219236] - PubMed
Barth‐Jaeggi 2015 {published data only}
    1. Barth‐Jaeggi T, Moretti D, Kvalsvig J, Holding PA, Njenga J, Mwangi A, et al. In‐home fortification with 2.5 mg iron as NaFeEDTA does not reduce anaemia but increases weight gain: a randomised controlled trial in Kenyan infants. Maternal & Child Nutrition 2015;11(Suppl 4):151‐62. [DOI: 10.1111/mcn.12163; PUBMED: 25420455] - DOI - PMC - PubMed
Bilenko 2014 {published data only}
    1. Bilenko N, Belmaker I, Vardi H, Fraser D. Efficacy of multiple micronutrient supplementations on child health: study design and baseline characteristics. Israel Medical Association Journal 2010;12(6):342‐7. [PUBMED: 20928987] - PubMed
    1. Bilenko N, Fraser D, Vardy H, Belmaker I. Impact of multiple micronutrient supplementation ("sprinkles") on iron deficiency anemia in Bedouin Arab and Jewish infants. Israel Medical Association Journal 2014;16(7):434‐8. [PUBMED: 25167690] - PubMed
Cardoso 2016 {published data only}
    1. Cardoso MA, Augusto RA, Bortolini GA, Oliveira CS, Tietzman DC, Sequeira LA, et al. ENFAC Working Group. Effect of providing multiple micronutrients in powder through primary healthcare on anemia in young Brazilian children: a multicentre pragmatic controlled trial. PLoS One 2016;11(3):e0151097. [DOI: 10.1371/journal.pone.0151097; PMC4871551 ; PUBMED: 27192494] - DOI - PMC - PubMed
    1. Silva LLS, Augusto RA, Tietzmann DC, Sequeira LAS, Hadler MCCM, Muniz PT, et al. ENFAC Working Group. The impact of home fortification with multiple micronutrient powder on vitamin A status in young children: a multicenter pragmatic controlled trial in Brazil. Maternal & Child Nutrition 2017;13(4):e12403. [10.1111/mcn.12403; PUBMED: 27925426] - PMC - PubMed
Chen 2008 {published data only}
    1. Chen K, Li TY, Chen L, Qu P, Liu YX. Effects of vitamin A, vitamin A plus iron and multiple micronutrient‐fortified seasoning powder on preschool children in a suburb of Chongqing, China. Journal of Nutritional Science and Vitaminology 2008;54(6):440‐7. [PUBMED: 19155581] - PubMed
    1. Chen K, Zhang X, Li TY, Chen L, Wei XP, Qu P, Liu YX. Effect of vitamin A, vitamin A plus iron and multiple micronutrient‐fortified seasoning powder on infectious morbidity of preschool children. Nutrition 2011;27(4):428‐34. [DOI: 10.1016/j.nut.2010.04.004; PUBMED: 20605698] - DOI - PubMed
Geltman 2009 {published data only}
    1. Geltman PL, Hironaka LK, Mehta SD, Padilla P, Rodrigues P, Meyers AF, et al. Iron supplementation of low‐income infants: a randomized clinical trial of adherence with ferrous fumarate sprinkles versus ferrous sulfate drops. Journal of Pediatrics 2009;154(5):738‐43. [DOI: 10.1016/j.jpeds.2008.11.003; PUBMED: 19111318 ] - DOI - PubMed
Goyena 2019 {published data only}
    1. Goyena EA, Barba CVC, Talavera MTM, Paunlagui MM, Rola AC, Tandang NA. Acceptance and compliance with micronutrient powder and complementary food blend use by Filipino mothers and their promotion by community workers. Food and Nutrition Bulletin 2019;40(2):202‐20. [DOI: 10.1177/0379572119833853; PUBMED: 30866669] - DOI - PubMed
Ip 2009 {published data only}
    1. Ip H, Hyder SM, Haseen F, Rahman M, Zlotkin SH. Improved adherence and anaemia cure rates with flexible administration of micronutrient Sprinkles: a new public health approach to anaemia control. European Journal of Clinical Nutrition 2009;63(2):165‐72. [DOI: 10.1038/sj.ejcn.1602917; PUBMED: 17895911 ] - DOI - PubMed
Jaeggi 2015 {published data only}
    1. Jaeggi T, Kortman GA, Moretti D, Chassard C, Holding P, Dostal A, et al. Iron fortification adversely affects the gut microbiome, increases pathogen abundance and induces intestinal inflammation in Kenyan infants. Gut 2015;64:731‐42. [DOI: 10.1136/gutjnl-2014-307720; NCT01111864.; PUBMED: 25143342] - DOI - PubMed
Jyoti 2014 {published data only}
    1. Jyoti V, Sharma S. Impact of micronutrients sprinkle on weight and height of children aged 6‐36 months in Tonk district of Rajasthan state. Indian Journal of Community Health 2014;26:294‐9.
Khan 2014 {published data only}
    1. Khan WU, Shafique S, Shikder H, Shakur YA, Sellen DW, Chowdhury JS, et al. Home fortification with calcium reduces Hb response to iron among anaemic Bangladeshi infants consuming a new multi‐micronutrient powder formulation. Public Health Nutrition 2014;17:1578. [DOI: 10.1017/S1368980013001742; PUBMED: 23816321] - DOI - PMC - PubMed
Lemaire 2011 {published data only}
    1. Lemaire M, Islam QS, Shen H, Khan MA, Parveen M, Abedin F, et al. Iron‐containing micronutrient powder provided to children with moderate‐to‐severe malnutrition increases hemoglobin concentrations but not the risk of infectious morbidity: a randomized, double‐blind, placebo‐controlled, noninferiority safety trial. American Journal of Clinical Nutrition 2011;94(2):585‐93. [DOI: 10.3945/ajcn.110.009316; PUBMED: 21715512] - DOI - PubMed
Munayco 2013 {published data only}
    1. Harding K, Zavaleta N, Roche M, Neufeld L. Caregiver perceptions, practices, and preferences relating to multiple micronutrient powders for children 6‐23 mo of age in the northern highlands of Peru. FASEB Journal 2014;28(1 Suppl). [Abstract #: 804.28]
    1. Munayco CV, Ulloa‐Rea ME, Medina‐Osis J, Lozano‐Revollar CR, Tejada V, Castro‐Salazar C, et al. Evaluation of the impact of multiple micronutrient powders on children anemia in three Andean regiones in Peru [Evaluación del impacto de los multimicronutrientes en polvo sobre la anemia infantil en tres regiones andinas del Perú]. Revista Peruana de Medicina Experimental y Salud Publica 2013;30(2):229‐34. [PUBMED: 23949507] - PubMed
    1. Trelles S, Munayco CV. Impact and adherence of multi‐micronutrient supplementation in Peruvian children [Impacto y adherencia de la suplementación con multimicronutrientes en niños de Perú]. Revista Peruana de Medicina Experimental y Salud Publica 2019;36(1):147‐8. [DOI: 10.17843/rpmesp.2019.361.4051; PUBMED: 31116330] - DOI - PubMed
Neufeld 2008 {unpublished data only}
    1. Aburto NJ, Ramirez‐Zea M, Neufeld LM, Flores‐Ayala R. The effect of nutritional supplementation on physical activity and exploratory behavior of Mexican infants aged 8‐12 months. European Journal of Clinical Nutrition 2010;64(6):644‐51. [DOI: 10.1038/ejcn.2010.52; PUBMED: 20354559] - DOI - PubMed
    1. Colchero A, Neufeld LM. Cost estimations of different types of micronutrient supplements for children and pregnant women. FASEB Journal 2008; Vol. 22, issue 1 Suppl. [Abstract #: 678.21]
    1. García‐Guerra A, Neufeld LM, Domínguez CP, García‐Feregrino R, Hernández‐Cabrera A. Effect of three supplements with identical micronutrient content on anemia in Mexican children. FASEB Journal 2008; Vol. 22, issue 1 Suppl. [Abstract #: 677.5]
Rawat 2015 {published data only}
    1. Rawat R, Saha K, Kennedy A, Ruel M, Menon P. Sale of micronutrient powders (MNPs) by frontline workers (FLWs) enables high reach, but low uptake limits impact on anemia and iron status: a cluster randomized study in Bangladesh. FASEB Journal 2015;29(1 Suppl):391.6.
Samadpour 2011 {published data only}
    1. Samadpour K, Long KZ, Hayatbakhsh R, Marks GC. Randomised comparison of the effects of Sprinkles and Foodlets with the currently recommended supplement (Drops) on micronutrient status and growth in Iranian children. European Journal of Clinical Nutrition 2011;65(12):1287‐94. [DOI: 10.1038/ejcn.2011.124; PUBMED: 21750564] - DOI - PubMed
Shafique 2014 {published data only}
    1. Shafique S, Singla D, Aboud F, Jolly S, Zlotkin S. Multiple micronutrient powders reduce stunting and anemia and improve language development among full‐term low birth weight children in Bangladesh (389.3). FASEB Journal 2014;28(1 Suppl):389.3.
Sharieff 2006b {published data only}
    1. Sharieff W, Yin SA, Wu M, Yang Q, Schauer C, Tomlinson G, et al. Short‐term daily or weekly administration of micronutrient Sprinkles has high compliance and does not cause iron overload in Chinese schoolchildren: a cluster‐randomized trial. Public Health Nutrition 2006;9(3):336‐44. [PUBMED: 16684385] - PubMed
Singla 2014 {published data only}
    1. Shafique S, Sellen DW, Lou W, Jalal CS, Jolly SP, Zlotkin SH. Mineral‐ and vitamin‐enhanced micronutrient powder reduces stunting in full‐term low‐birth‐weight infants receiving nutrition, health, and hygiene education: a 2 × 2 factorial, cluster‐randomized trial in Bangladesh. American Journal of Clinical Nutrition 2016;103:1357‐69. [DOI: 10.3945/ajcn.115.117770; PUBMED: 27053383] - DOI - PubMed
    1. Singla DR, Shafique S, Zlotkin SH, Aboud FE. A 22‐element micronutrient powder benefits language but not cognition in Bangladeshi full‐term low‐birth‐weight children. Journal of Nutrition 2014;144(11):1803‐10. [DOI: 10.3945/jn.114.193094; PUBMED: 25143374] - DOI - PubMed
Smuts 2005 {published data only}
    1. Smuts CM, Dhansay MA, Faber M, Stuijvenberg ME, Swanevelder S, Gross R, et al. Efficacy of multiple micronutrient supplementation for improving anemia, micronutrient status, and growth in South African infants. Journal of Nutrition 2005;135(3):653S‐9S. [DOI: 10.1093/jn/135.3.653S; PUBMED: 15735110] - DOI - PubMed
Suchdev 2012 {published and unpublished data}
    1. Centers for Disease Control and Prevention. Baseline data from the Nyando Integrated Child Health and Education Project ‐ Kenya, 2007. Morbidity and Mortality Weekly Report: MMWR 2007;56(42):1109‐13. [PUBMED: 17962803] - PubMed
    1. Suchdev PS, Addo OY, Martorell R, Grant FKE, Ruth LJ, Patel MK, et al. Effects of community‐based sales of micronutrient powders on morbidity episodes in preschool children in Western Kenya. American Journal of Clinical Nutrition 2016;103:934‐41. [DOI: 10.3945/ajcn.115.118000; NCT01088958; PUBMED: 26864367] - DOI - PMC - PubMed
    1. Suchdev PS, Addo Y, Martorell R, Grant FK, Ruth LJ, Patel M, et al. Effects of community‐based sales of micronutrient powders on morbidity episodes in preschool children in Western Kenya. American Journal of Clinical Nutrition 2016;103:934‐41. [DOI: 10.3945/ajcn.115.118000; PUBMED: 26864367 ] - DOI - PMC - PubMed
    1. Suchdev PS, Leeds IL, McFarland DA, Flores R. Is it time to change guidelines for iron supplementation in malarial areas?. Journal of Nutrition 2010;140(4):875‐6. [DOI: 10.3945/jn.109.118638; PUBMED: 20147465] - DOI - PubMed
    1. Suchdev PS, Ruth LJ, Woodruff BA, Mbakaya C, Mandava U, Flores‐Ayala R, et al. Selling Sprinkles micronutrient powder reduces anemia, iron deficiency, and vitamin A deficiency in young children in Western Kenya: a cluster‐randomized controlled trial. American Journal of Clinical Nutrition 2012;95(5):1223‐30. [DOI: 10.3945/ajcn.111.030072; NCT01088958; PUBMED: 22492366] - DOI - PMC - PubMed
Teshome 2017 {published data only}
    1. Teshome EM, Andang'o PEA, Osoti V, Terwel SR, Otieno W, Demir AY, et al. Daily home fortification with iron as ferrous fumarate versus NaFeEDTA: a randomised, placebo‐controlled, non‐inferiority trial in Kenyan children. BMC Medicine 2017;15(1):89. [DOI: 10.1186/s12916-017-0839-z; PMC5408380; PUBMED: 28449690] - DOI - PMC - PubMed
    1. Teshome EM, Oriaro VS, Andango PEA, Prentice AM, Verhoef H. Adherence to home fortification with micronutrient powders in Kenyan pre‐school children: self‐reporting and sachet counts compared to an electronic monitoring device. BMC Public Health 2018;18(1):205. [DOI: 10.1186/s12889-018-5097-2; PMC5796300; PUBMED: 29391008] - DOI - PMC - PubMed
    1. Teshome EM, Otieno W, Terwel SR, Osoti V, Demir AY, Andango PEA, et al. Comparison of home fortification with two iron formulations among Kenyan children: rationale and design of a placebo‐controlled non‐inferiority trial. Contemporary Clinical Trials Communications 2017;7:1‐10. [DOI: 10.1016/j.conctc.2017.04.007; PMC5898495; PUBMED: 29696163] - DOI - PMC - PubMed
Troesch 2009 {published data only}
    1. Troesch B. Optimized micronutrient powder containing low levels of highly bioavailable iron and zinc together with EDTA, phytase and ascorbic acid improves the nutritional status of children. Sight and Life Magazine 2010, issue 3:9‐14.
    1. Troesch B, Egli I, Zeder C, Hurrell RF, Pee S, Zimmermann MB. Optimization of a phytase‐containing micronutrient powder with low amounts of highly bioavailable iron for in‐home fortification of complementary foods. American Journal of Clinical Nutrition 2009;89(2):539‐44. [DOI: 10.3945/ajcn.2008.27026; PUBMED: 19106242] - DOI - PubMed
Troesch 2011 {published data only}
    1. Troesch B, Stujivenberg ME, Smuts CM, Kruger HS, Biebinger R, Hurrell RF, et al. A micronutrient powder with low doses of highly absorbable iron and zinc reduces iron and zinc deficiency and improves weight‐for‐age Z‐scores in South African children. Journal of Nutrition 2011;141(2):237‐42. [DOI: 10.3945/jn.110.129247; PUBMED: 21178093] - DOI - PubMed
Van der Kam 2016a {published data only}
    1. Kam S, Salse‐Ubach N, Roll S, Swarthout T, Gayton‐Toyoshima S, Jiya NM, et al. Effect of short‐term supplementation with ready‐to‐use therapeutic food or micronutrients for children after illness for prevention of malnutrition: a randomised controlled trial in Nigeria. PLoS Medicine 2016;13(2):e1001952. [DOI: 10.1371/journal.pmed.1001952; PMC4747530; PUBMED: 26859559] - DOI - PMC - PubMed
Van der Kam 2016b {published data only}
    1. Kam S, Roll S, Swarthout T, Edyegu‐Otelu G, Matsumoto A, Kasujja FX, et al. Effect of short‐term supplementation with ready‐to‐use therapeutic food or micronutrients for children after illness for prevention of malnutrition: a randomised controlled trial in Uganda. PLoS Medicine 2016;13(2):e1001951. [DOI: 10.1371/journal.pmed.1001951; PMC4747529; PUBMED: 26859481] - DOI - PMC - PubMed
Wang 2017 {published data only}
    1. Trehan I. A combined package of micronutrients and albendazole does not improve environmental enteric dysfunction or stunting in rural Malawian children. Journal of Pediatric Gastroenterology and Nutrition 2016;63(Suppl 2):S38.
    1. Wang AZ, Shulman RJ, Crocker AH, Thakwalakwa C, Maleta KM, Devaraj S, et al. A combined intervention of zinc, multiple micronutrients, and albendazole does not ameliorate environmental enteric dysfunction or stunting in rural Malawian children in a double‐blind randomized controlled trial. Journal of Nutrition 2017;147(1):97‐103. [DOI: 10.3945/jn.116.237735; NCT02253095; PUBMED: 27807040] - DOI - PubMed
Wijaya‐Erhardt 2007 {published data only}
    1. Wijaya‐Erhardt M, Erhardt JG, Untoro J, Karyadi E, Wibowo L, Gross R. Effects of daily or weekly multiple‐micronutrient and iron foodlike tablets on body iron stores of Indonesian infants aged 6‐12 mo: a double‐blind, randomized, placebo‐controlled trial. American Journal of Clinical Nutrition 2007;86(6):1680‐6. [DOI: 10.1093/ajcn/86.6.1680; PUBMED: 18065586] - DOI - PubMed
Yousafzai 2014 {published data only}
    1. Yousafzai AK, Obradović J, Rasheed MA, Rizvi A, Portilla XA, Tirado‐Strayer N, et al. Effects of responsive stimulation and nutrition interventions on children's development and growth at age 4 years in a disadvantaged population in Pakistan: a longitudinal follow‐up of a cluster‐randomised factorial effectiveness trial. Lancet Global Health 2016;4(8):e548‐58. [DOI: 10.1016/S2214-109X(16)30100-0; PUBMED: 27342433] - DOI - PubMed
    1. Yousafzai AK, Rasheed MA, Rizvi A, Armstrong R, Bhutta ZA. Effect of integrated responsive stimulation and nutrition interventions in the lady health worker programme in Pakistan on child development, growth, and health outcomes: a cluster‐randomised factorial effectiveness trial. Lancet 2014;384(9950):1282‐93. [DOI: 10.1016/S0140-6736(14)60455-4.; PUBMED: 24947106] - DOI - PubMed
Zlotkin 2001 {published data only}
    1. Zlotkin S, Arthur P, Antwi KY, Yeung G. Treatment of anemia with microencapsulated ferrous fumarate plus ascorbic acid supplied as sprinkles to complementary (weaning) foods. American Journal of Clinical Nutrition 2001;74(6):791‐5. [DOI: 10.1093/ajcn/74.6.791; PUBMED: 11722961] - DOI - PubMed
Zlotkin 2003a {published data only}
    1. Zlotkin S, Antwi KY, Schauer C, Yeung G. Use of microencapsulated iron (II) fumarate sprinkles to prevent recurrence of anaemia in infants and young children at high risk. Bulletin of the World Health Organization 2003;81(2):108‐15. [PUBMED: 12756979 ] - PMC - PubMed
Zlotkin 2003b {published data only}
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Zlotkin 2013 {published data only}
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References to studies awaiting assessment

Fernandez‐Rao 2014 {published data only}
    1. Fernandeez‐Rao S, Hurley K, Nair M, Balakrishna N, Tilton N, Radhakrishna V, et al. Multiple micronutrients and early learning interventions promote Infant micronutrient status and development. FASEB Journal 2015;29(1 Suppl):28.2.
    1. Fernandez‐Rao S, Hurley KM, Nair KM, Balakrishna N, Radhakrishna KV, Ravinder P, et al. Integrating nutrition and early child‐development interventions among infants and preschoolers in rural India. Annals of the New York Academy of Sciences 2014;1308:218‐31. [DOI: 10.1111/nyas.12278; PUBMED: 24673168] - DOI - PubMed
Hasan 2017 {published and unpublished data}
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Islam 2018b {published data only}
    1. Islam MM, McDonald CM, Krebs NF, Westcott J, Rahman AE, Arifeen S, et al. Study protocol for a randomized, double‐blind, community‐based efficacy trial of various doses of zinc in micronutrient powders or tablets in young Bangladeshi children. Nutrients 2018;10(2):132. [DOI: 10.3390/nu10020132; PMC5852708; PUBMED: 30720778] - DOI - PMC - PubMed
ISRCTN39244429 {published and unpublished data}
    1. ISRCTN39244429. Nutritional supplement sprinkles with zinc and micronutrients [Efficacy of the nutritional supplement sprinkles with zinc and micronutrients on anaemia and acute diarrhoea in Peruvian children]. www.isrctn.com/ISRCTN39244429 (first received 12 February 2010).
    1. Warthon‐Medina M, Qualter P, Zavaleta N, Dillon S, Lazarte F, Lowe NM. The long term impact of micronutrient supplementation during infancy on cognition and executive function performance in pre‐school children. Nutrients 2015;7(8):6606‐27. [DOI: 10.3390/nu7085302; PMC4555141 ; PUBMED: 26262642] - DOI - PMC - PubMed
ISRCTN57594793 {unpublished data only}
    1. ISRCTN57594793. Multiple micronutrient supplementation improves growth and hemoglobin of infants in Gaza Strip, Palestine [Multiple micronutrient supplementation improves growth and hemoglobin of infants in Gaza Strip, Palestine: a randomized community trial]. www.isrctn.com/ISRCTN57594793 (first received 2 January 2018).

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References to other published versions of this review

De‐Regil 2011
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