Peer-reviewed article
138 Preschooler Hemoglobin and Ferritin Concentrations Were Not Affected by Parenting and Multiple Micronutrient Supplementation Interventions in Southwest Guatemala
Kowalski A ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study tested whether responsive parenting training and multiple micronutrient supplementation could improve iron status in 387 malnourished preschoolers in Guatemala. While ferritin levels increased over time in all groups, there were no significant differences between children receiving the interventions and controls. Hemoglobin levels did not improve in any group. The findings suggest these interventions did not have the intended effect on children's iron status.
Key points
- At baseline, 14% of preschoolers were iron deficient and 11% were anemic
- Ferritin increased in most arms over the study period, with the largest increase in the combined intervention arm (95.6 µg/L), but rates of change did not differ between study arms (p = 0.16)
- Hemoglobin did not change over time in any group
- Study used a double-blind, 2x2 cluster randomized controlled trial design with 218 children in the final analysis
- The maize-soy supplement was fortified with 21 micronutrients and given daily for 6 months
Limitations
The analysis is based on a subsample of 218 children with blood specimens, smaller than the original 387 enrolled, which may affect the generalisability of findings. The document does not report on potential mechanisms explaining why interventions did not show differential effects, or whether compliance with interventions was adequate.
Abstract
OBJECTIVES/GOALS: Micronutrient deficiencies contribute to poor health and childhood development outcomes. The objective of this study was to examine the independent and combined effects of responsive parenting and multiple micronutrient supplementation interventions on preschooler hemoglobin and ferritin concentrations in southwestern Guatemala. METHODS/STUDY POPULATION: We enrolled 387 preschoolers (36-52 months) at nutritional risk (height-for-age z-score < -1) (51% male; 17% indigenous ethnicity) in a double blind, 2 x 2, cluster randomized controlled trial. Participants in the parenting intervention received culturally tailored responsive parenting or nutrition education (control) curriculum, delivered over 6 home visits. Participants in the nutrition supplementation group received daily supplementation with a maize-soy product fortified with 21 micronutrients for 6 months or a control product fortified with vitamin B2 only. Linear mixed models were used to estimate changes in hemoglobin and ferritin from baseline (2015) to endline (2017) in a subsample with blood specimens (n = 218). RESULTS/ANTICIPATED RESULTS: At baseline, 14% of preschoolers were iron deficient and 11% were anemic. Preschooler ferritin significantly increased over time in most arms, with the largest increase in the combined responsive parenting + multiple micronutrient supplementation arm (ferritin = 95.6 (95% CI 46.4, 144.74); rates of change did not differ between study arms (p = 0.16). Preschooler hemoglobin did not change over time. Further analysis will examine the moderation of intervention effects by pre-specified child and household factors. DISCUSSION/SIGNIFICANCE: Increases in preschooler ferritin did not differ between intervention and control arms. There was no effect of the intervention on hemoglobin. Future analyses will examine intervention effects on pre-specified subgroups including baseline micronutrient deficiencies.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Responsive parenting training delivered over 6 home visits combined with daily supplementation with a maize-soy product fortified with 21 micronutrients for 6 months
- Population
- 387 preschoolers aged 36-52 months at nutritional risk (height-for-age z-score < -1) in southwestern Guatemala; 51% male, 17% indigenous
Key finding
Ferritin increased over time in most arms with largest increase in combined intervention arm (95.6 µg/L, 95% CI 46.4-144.74), but rates of change did not differ between study arms (p=0.16)
A · PubMed Central (PMC) · 27 Apr 2023