Effect of micronutrient supplement on health and nutritional status of schoolchildren: bone health and body composition

Objective: We investigated the effect of a micronutrient-enriched beverage on body composition, bone mineral content (BMC), bone area, and bone mineral density (BMD) at various sites in schoolchildren. Methods: A double-blind, placebo-controlled, matched-pair, cluster, randomization study was carried out in residential schoolchildren 6 to 16 y of age who lived near Hyderabad, India. Children (n = 268) were selected randomly from two classes of each grade (1 to 9) and were provided a micronutrient-enriched beverage (n = 146) or a placebo drink (n = 122). Bone parameters such as BMC, BMD, and bone area at various sites and the entire body were measured with dual-energy X-ray absorptiometry at the beginning and end of the study. Increments of outcome variables were subjected to paired t test with appropriate corrections to assess the effect of the supplement on bone health. Results: After 14 mo, increments for height, weight, fat-free mass, percentage of fat, whole-body BMC, whole-body bone area, and BMD at the neck of the femur were significantly greater (P < 0.05) in the supplemented group than in the placebo group. Conclusions: The micronutrient-rich supplement increased tissue growth and skeletal shell in apparently normal children in the 14-mo period. It did not increase whole-body or site-specific BMD except at the neck of the femur. Amounts of calcium and other nutrients contained in the supplement were inadequate for tissue growth with density increases. This study raises important questions about the nutrient requirements of Indian children who consume a diet of cereals and pulses

Relationship between women's occupational work and bone health: a study from India

Physical activity is known to influence the bone mass of an individual. Few studies have examined the effect of occupational activities on bone health. The present study investigated the relationship between occupational activities and the bone parameters measured by dual-energy X-ray absorptiometry in 158 women from a low-income group in India. Women involved in three occupations with different bone-loading patterns (beedi (cigarette) makers, sweepers and construction workers) were included in the study. Anthropometric parameters, parity and percentage of menopausal women did not differ significantly between the three groups and dietary intake of Ca was low in all the groups. Bone mineral density (BMD) values of the overall group at all the sites were much lower than those reported from developed countries, possibly due to different body sizes in these regions. Femoral neck and hip BMD were not different in the three groups in spite of marked differences in activity patterns. However, bone area in the femoral neck was higher in the beedi makers compared with sweepers probably due to the squatting position adopted by beedi makers. Lumbar spine BMD was significantly lower among the sweepers when compared with the beedi makers and the groups performing walking and weight-bearing activities (sweepers and construction workers) had a higher prevalence of osteoporosis in the lumbar spine. However, weight-bearing effects of the upper body due to a squatting position were associated with better lumbar spine BMD in the beedi makers. The present study thus indicates that undernutrition might affect the relationship between occupational activities and bone parameters. Bone mineral density: Physical activity: Occupational activity: Nutritio

Effect of micronutrient supplement on health and nutritional status of schoolchildren: study design

Objective We tested the hypothesis that supplementation with a micronutrient-fortified beverage improves micronutrient status and physical and mental development in apparently healthy schoolchildren. Methods The study was carried out in middle-income students in two residential schools that catered to children from a semi-urban population near Hyderabad, India. Included were 869 children who were 6 to 16 y of age in grades 1 to 10. Because children at each grade were distributed across two classrooms (clusters) and were homogeneous, each grade was considered to consist of a matched pair. There were thus 10 pairs available for the study. Classes in each grade were randomized to receive a micronutrient-enriched beverage or a placebo without added micronutrients. The study was double blinded and the duration was 14 mo, with supervised feeding of the micronutrient-enriched beverage. The effect of the micronutrients on the outcome variables growth, biochemical status, mental function, and bone health were assessed. Results The number of matched pairs varied between seven and eight, and the required number of children per treatment group ranged from 32 in the case of bone heath to 177 for body weight. The power of the outcome variables ranged from 74% to 100% and was adequate for successful pairing. The effect assessed at the end of supplementation showed that the intervention was beneficial. Conclusions Designing an intervention, choosing outcome variables, and implementing the protocol in a typical Indian school setting were achieved

Effectiveness of Zinc Supplementation to Full Term Normal Infants: A Community Based Double Blind, Randomized, Controlled, Clinical Trial

<div><p></p><p>The study was aimed to test whether zinc supplementation, if initiated early, can prevent stunting and promote optimum body composition in full term infants. For this, full term pregnant women from low income urban community were enrolled and were followed-up for 24 months postpartum. Body mass index (BMI) was calculated from maternal weight and height that were collected one month after delivery. Infants' weight, and length, head, chest and mid upper arm circumferences and skin fold thicknesses at triceps, biceps and subscapular area were collected at baseline (before randomization) and once in three months up till 24 months. Three hundred and twenty four infants were randomized and allocated to zinc (163) or placebo (161) groups respectively. Supplementation of zinc was initiated from 4 months of age and continued till children attained 18 months. The control (placebo) group of children received riboflavin 0.5 mg/day, whereas the intervention (zinc) group received 5 mg zinc plus riboflavin 0.5 mg/day. When infants were 18 months old, dietary intakes (in 78 children) were calculated by 24 hour diet recall method and hemoglobin, zinc, copper and vitamin A were quantified in blood samples collected from 70 children. The results showed prevalence of undernutrition (body mass index <18.5) in 37% of the mothers. Mean±SD calorie consumption and zinc intakes from diets in infants were 590±282.8 Kcal/day and 0.97±0.608 mg/day respectively. Multiple linear regression models demonstrated maternal weight as a strong predictor of infants' weight and length at 18 months of age. As expected, diarrhea duration impacted infants' linear growth and weight gain adversely. Zinc supplementation for a mean period of 190 days, starting from 4 months up to 18 months of age, in full term normal infants, consuming an average energy of 590 Kcal/day, had significant effect on the skin fold thicknesses, but not on their linear growth.</p><p>Trial Registration</p><p>Clinical Trail Registration India (CTRI) <a href="http://tinyurl.com/k3s8xu7" target="_blank">CTRI/2012/08/002884</a></p></div