Fortified Biscuits Improve Nutrient Status

NAKHON PATHOM, Thailand—Researchers found multi-micronutrient fortification of biscuits to be an effective strategy to improve the micronutrient status of Vietnamese schoolchildren in addition to enhancing the effectiveness of deworming (J Nutr. 2009;139(5):1013-21). A school-based program providing food fortified with multiple micronutrients could be a cost-effective and sustainable strategy to improve health and cognitive function of school children. However, the efficacy of such an intervention may be compromised by the high prevalence of parasitic infestation. To evaluate the efficacy of a school-based intervention using multi-micronutrient–fortified biscuits with or without deworming on anemia and micronutrient status in Vietnamese schoolchildren, a randomized, double blind, placebo-controlled trial was conducted among 510 primary schoolchildren, aged 6 to 8 years, in rural Vietnam. Subjects received either 400 mg of Albendazole (Alb) or placebo at baseline. Nonfortified or multi-micronutrient–fortified biscuits including iron (6 mg), zinc (5.6 mg), iodine (35 µg) and vitamin A (300 µg retinol equivalents) were given 5 d/week for four months. Multi-micronutrient fortification significantly improved the concentrations of hemoglobin, plasma ferritin, body iron, plasma zinc, plasma retinol and urinary iodine. Fortification reduced the risk of anemia and deficiencies of zinc and iodine by more than 40 percent. Parasitic infestation did not affect fortification efficacy, whereas fortification significantly enhanced deworming efficacy, with the lowest reinfection rates in children receiving both micronutrients and Alb.