Efficacy of iron fortification compared to iron supplementation among Vietnamese schoolchildren

The effect of iron fortification is generally assumed to be less than iron supplementation; however, the magnitude of difference in effects is not known. The present study aims to compare the efficacy of these two strategies on anaemia and iron status. After screening on low Hb, 425 anaemic children in six primary schools in Tam Nong district of Phu Tho province were included in a randomized, placebo-controlled trial comparing two groups receiving iron fortified instant noodles or iron supplementation for 6 months and a control group, with children in all groups having been dewormed. Blood samples were collected before and after intervention for haemoglobin, serum ferritin (SF), serum transferrin receptor (TfR), C-reactive protein (CRP), and haemoglobinopathies analysis. Regression analysis was used to assess the effect of iron fortification and iron supplementation on haemoglobin concentration, SF, TfR, body iron, and anaemic status as outcome variables. The improvement of haemoglobin, SF, and body iron level in the group receiving iron fortification was 42% (2.6 g/L versus 6.2 g/L), 20% (23.5 μg/L versus 117.3 μg/L), and 31.3% (1.4 mg/kg versus 4.4 mg/kg) of that in the iron supplementation group. The prevalence of anaemia dropped to 15.1% in the control group, with an additional reduction of anaemia of 8.5% in the iron supplementation group. The additional reduction due to iron fortification was 5.4%, which amounts to well over 50% of the impact of supplementation. In conclusion, the efficacy of iron fortification based on reduction of prevalence of anaemia, and on the change in haemoglobin level, is about half of the maximum impact of supplementation in case of optimal compliance. Thus, in a population of anaemic children with mild iron deficiency, iron fortification should be the preferred strategy to combat anaemia

The Development of the Body Mass Index in Young Adults, II: Interrelationships of Level, Change and Fluctuation, a Four- Year Longitudinal Study

To investigate the development of the body mass index (BMI, weight/height2) in young adults, body height and weight of 518 men and 624 women, initially 19-31 years of age, were measured in spring 1980 and body weight was measured every six months from spring 1981 through spring 1984- The incidence of moderate overweight (BMI\u3e25kg/m2) increased with age from 4.8 %/4yr to 15.5 %/4yr in men and was more stable, 5.3 %/4yr to 5.7 %/4yr, in women. The rate of gain in BMI was not found to differ according to the initial BMI in men, whereas in women a slight negative association existed between the initial BMI and its subsequent change. The within-subject standard deviation of the yearly measured BMI was 0.69kg/m2 in men and 0.74kg/m2 in women, and was larger both at higher levels of the BMI and at both extremes of the distribution of the rate of change in BMI. The considerable fluctuation in BMI may mask the slight increment in BMI and may thus hinder young adults from being aware of their becoming overweight

The Development of the Body Mass Index in Young Adults, I: Age-Reference Curves Based on a Four-Year Mixed- Longitudinal Study

The development of the body mass index (BMI, weight/ height2) during young adulthood was studied in 518 men and 624 women, initially 19-21, 24-26, 29-31 years of age, in a four-year mixed-longitudinal study in the Netherlands. Body height and body weight were measured in spring 1980. Subsequently, body weight was measured every six months from spring 1981 through spring 1984. The BMI continued to increase after the termination of growth. From 19 to 35 years of age the median BMI increased from 22.1kg/m2 to 24.4kg/m2 in men and from 21.1kg/m2 to 23.0kg/m2 in women. All percentiles showed a comparable increment, resulting in an age-independent variation of the BMI. Since the NHANES I curves diverge with age, it is suggested that American and Dutch samples not only differ in the prevalence of overweight, but also in the incidence of overweight during young adulthood