• Faruk Ahmed, Moududur Rahman Khan, Mohammad Akhtaruzzaman, Rezaul Karim, Geoffrey Christopher Marks, Cadi Parvin Banu, Badrun Nahar, and Gail Williams.
• Nutrition Program, School of Population Health, The University of Queensland, Queensland, Australia. f.ahmed@sph.uq.edu.au
• Am. J. Clin. Nutr. 2005 Oct 1;82(4):829-35.

BackgroundAlthough iron deficiency is a major cause of anemia, other micronutrient deficiencies may also play a role.ObjectiveWe examined whether multiple micronutrient supplementation is more efficacious than is supplementation with iron and folic acid alone for improving the hemoglobin and iron status of anemic adolescent girls in Bangladesh.DesignAnemic (hemoglobin < 12.0 g/dL) girls (n = 197) aged 14-18 y from rural schools in Dhaka District were entered into a randomized double-blind trial and received twice-weekly supplements of iron and folic acid (IFA group) or multiple micronutrients (15 micronutrients, including iron and folic acid; MMN group) for 12 wk.ResultsAt recruitment, the characteristics of the girls in the 2 groups were not significantly different, except for family size and body mass index. At the end of the study, although both groups benefited significantly from supplementation, mean changes in hemoglobin and serum ferritin concentrations were not significantly different between groups. Compared with the IFA group, girls in the MMN group had significantly greater increases in mean serum vitamin A, plasma vitamin C, red blood cell folic acid, and riboflavin concentrations (assessed as erythrocyte glutathione reductase activation coefficient). After 12 wk of supplementation, only the prevalence of vitamins A and C and riboflavin deficiencies decreased more significantly in the MMN group than in the IFA group.ConclusionsTwice-weekly MMN supplementation for 12 wk significantly improved the status of the micronutrients assessed but was not more efficacious than was supplementation with iron and folic acid alone in improving the hematologic status of anemic adolescent girls. More frequent doses may be needed to achieve full benefit.

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