Daily complementary food supplementation improves micronutrient status in 18 month old children in rural Bangladesh

Abstract Number Theme Presentation Type Cover Approved
0492 Efficacy or effectiveness of micronutrient interventions Poster Not Approved


Abstract Content


Inadequate dietary diversity during complementary feeding may cause micronutrient deficiencies. A cluster-randomized controlled trial of daily complementary food supplements (CFS) in rural Bangladesh improved linear growth and reduced stunting. Here we investigated CFS effects on micronutrient status.


Participants (n=5,449) were enrolled at age 6 months and received child feeding counseling only (control) or counseling and one of four micronutrient-fortified (to ~75% of daily requirements) CFS formulations as a daily snack for one year: lipid-based ready-to-use chickpea or rice-lentil, cooked wheat-soy blend++, or commercial Plumpy’doz. At age 18 months, blood was collected from a subset (n=754) balanced by group. Hemoglobin and serum ferritin, retinol, zinc, and inflammation markers C-reactive protein (CRP) and a-1 acid glycoprotein (AGP) were measured. Micronutrient status and inflammation were evaluated by group and as any CFS vs. control using GEE linear regression to account for cluster-randomization.


Prevalence of depleted iron stores (ferritin<12µg/L), anemia (hemoglobin<110g/L), hyporetinolemia (retinol<0.7µmol/L) and zinc deficiency (zinc<650µg/L) were 13.3%, 15.8%, 10.1% and 4.3%, respectively, among controls. Inflammation (CRP>5mg/L, AGP>1g/L or both) affected 60% of participants but did not differ by CFS group. Assignment to any CFS group versus control was associated with higher mean±SE ferritin (+7.8±2.9µg/L), hemoglobin (+2.2±0.9g/L) and retinol (+0.11±0.04µmol/L), all p<0.01, but no difference in serum zinc. Individual CFS vs. control differed only for ferritin for Plumpy'doz and rice-lentil.


Micronutrient deficiencies were uncommon in these rural Bangladeshi children despite prevalent inflammation. Daily food supplements improved iron and vitamin A status but did not measurably impact zinc status.

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