TY - JOUR
T1 - Effect of nutritional interventions on micronutrient status in pregnant malawian women with moderate malnutrition
T2 - A randomized, controlled trial
AU - Glosz, Cambria M.
AU - Schaffner, Andrew A.
AU - Reaves, Scott K.
AU - Manary, Mark J.
AU - Papathakis, Peggy C.
N1 - Funding Information:
The Office of Global Health, Infectious Diseases, and Nutrition, Bureau for Global Health, United States Agency for International Development (USAID) under terms of Cooperative Agreement No. AID-OAA-A-12-00005, through the Food and Nutrition Technical Assistance III Project (FANTA), managed by FHI 360; Feed the Future (Peanut and Mycotoxin Innovation Lab); California Polytechnic State University, San Luis Obispo; California Agricultural Research Initiative; U.S. Dairy Export Council, Dairy Research Initiative; Sackler Institute; Hickey Family Foundation.
Funding Information:
Funding: The Office of Global Health, Infectious Diseases, and Nutrition, Bureau for Global Health, United States Agency for International Development (USAID) under terms of Cooperative Agreement No. AID-OAA-A-12-00005, through the Food and Nutrition Technical Assistance III Project (FANTA), managed by FHI 360; Feed the Future (Peanut and Mycotoxin Innovation Lab); California Polytechnic State University, San Luis Obispo; California Agricultural Research Initiative; U.S. Dairy Export Council, Dairy Research Initiative; Sackler Institute; Hickey Family Foundation.
Publisher Copyright:
© 2018 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2018/7/7
Y1 - 2018/7/7
N2 - Micronutrient deficiencies during pregnancy are common in Africa and can cause adverse outcomes. The objective was to measure micronutrient status and change in moderately malnourished pregnant Malawian women randomized to one of three nutritional interventions. Serum vitamin B12, 25-hydroxyvitamin D, folate, retinol, ferritin, zinc, albumin and C-reactive protein were measured in pregnant women with MUAC ≥20.6 cm and ≤23.0 cm at enrollment (n = 343) and after 10 weeks (n = 229) of receiving: (1) ready-to-use supplementary food (RUSF); (2) fortified corn-soy blend (CSB+) with multiple-micronutrient supplement (CSB+UNIMMAP); or (3) CSB+ with iron and folic acid (CSB+IFA). Each provided 100–300% Recommended Dietary Allowance of most micronutrients and 900 kcal/day. Birth length was measured in 272 infants. Enrollment measurements indicated deficiencies in vitamin B12 (20.9%) and zinc (22.3%), low values of ferritin (25.1%) and albumin (33.7%), and elevated CRP (46.0%). Vitamin B12 is known to decrease in the third trimester; the RUSF group had the smallest decrease from enrollment to week 10 (3%), compared to 20% decrease in the CSB+IFA group and 8% decrease in the CSB+UNIMMAP group (p = 0.001). Mean serum 25-hydroxyvitamin D increased most in the RUSF group (+6.4 ng/mL), compared to CSB+IFA (+1.7 ng/mL) and CSB+UNIMMAP (+2.7 ng/mL) (p < 0.001). Micronutrient deficiencies and inflammation are common among moderately malnourished pregnant women and had little improvement despite supplementation above the RDA, with the exception of vitamins B12 and D.
AB - Micronutrient deficiencies during pregnancy are common in Africa and can cause adverse outcomes. The objective was to measure micronutrient status and change in moderately malnourished pregnant Malawian women randomized to one of three nutritional interventions. Serum vitamin B12, 25-hydroxyvitamin D, folate, retinol, ferritin, zinc, albumin and C-reactive protein were measured in pregnant women with MUAC ≥20.6 cm and ≤23.0 cm at enrollment (n = 343) and after 10 weeks (n = 229) of receiving: (1) ready-to-use supplementary food (RUSF); (2) fortified corn-soy blend (CSB+) with multiple-micronutrient supplement (CSB+UNIMMAP); or (3) CSB+ with iron and folic acid (CSB+IFA). Each provided 100–300% Recommended Dietary Allowance of most micronutrients and 900 kcal/day. Birth length was measured in 272 infants. Enrollment measurements indicated deficiencies in vitamin B12 (20.9%) and zinc (22.3%), low values of ferritin (25.1%) and albumin (33.7%), and elevated CRP (46.0%). Vitamin B12 is known to decrease in the third trimester; the RUSF group had the smallest decrease from enrollment to week 10 (3%), compared to 20% decrease in the CSB+IFA group and 8% decrease in the CSB+UNIMMAP group (p = 0.001). Mean serum 25-hydroxyvitamin D increased most in the RUSF group (+6.4 ng/mL), compared to CSB+IFA (+1.7 ng/mL) and CSB+UNIMMAP (+2.7 ng/mL) (p < 0.001). Micronutrient deficiencies and inflammation are common among moderately malnourished pregnant women and had little improvement despite supplementation above the RDA, with the exception of vitamins B12 and D.
KW - Malawi
KW - Maternal malnutrition
KW - Micronutrient deficiency
KW - Pregnancy
KW - Supplementary foods
UR - http://www.scopus.com/inward/record.url?scp=85050032463&partnerID=8YFLogxK
U2 - 10.3390/nu10070879
DO - 10.3390/nu10070879
M3 - Article
C2 - 29986492
AN - SCOPUS:85050032463
VL - 10
JO - Nutrients
JF - Nutrients
SN - 2072-6643
IS - 7
M1 - 879
ER -