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Sprinkles Global Health Initiative
Abstract

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.

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Sprinkles Global Health Initiative, 2009