RANDOMIZED COMPARISON OF 3 TYPES OF MICRONUTRIENT SUPPLEMENTS IN GHANAIAN INFANTS

Adu-Afarwuah, A Lartey, KH Brown, S Zlotkin, KG Dewey

Assuring adequate micronutrient status of infants is a challenge. We compared the efficacy and acceptability of "Sprinkles" (SP), "Nutritabs" (NT, a crushable tablet) and "Nutributter" ( NB, a peanut based spread), when added to home-prepared complementary foods in Ghana. All products contained iron (SP 12.5 mg Fe as ferrous fumarate; NT & NB 9 mg Fe as ferrous sulfate), zinc, vitamins A and C and folic acid but differed in the content of energy and other nutrients. Infants (n = 313) were randomly assigned to receive SP, NT or NB daily from 6 to 12 mo of age. At 6 and 12 mo, infants were measured and blood samples were collected. Non-Intervention (NI) infants, who were eligible but not randomly selected for the intervention (n=96), were assessed at 12 mo only. All of the supplements were well accepted, and compliance was similar among intervention groups. The 3 intervention groups did not differ in iron status or hemoglobin at 12 mo, but all 3 had significantly higher ferritin and lower transferrin receptor than the NI group. Mean (� SD) hemoglobin (g/L) was significantly higher in NT (112 � 14) and NB (114 � 14) but not in SP (110 � 14) infants, compared to NI infants (106 � 14). Results for other indices of micronutrient status are pending. Controlling for initial size, at 12 mo the NB group had significantly higher (effect size ~0.3) weight-for-age and length-for-age than the SP and NT groups, which were similar to the NI group. We conclude that all 3 supplements were well accepted and had a similar effect on iron status, but only NB increased infant growth. Supported by Nestle Foundation and USAID.