Effectiveness of various methods of home fortification in under-5 children: where they work, where they do not. A systematic review and meta-analysis

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#food-fortified #humans #malnutrition #micronutrients #randomized-controlled-trials-as-topic

Effectiveness of various methods of home fortification in under-5 children: where they work, where they do not. A systematic review and meta-analysis

Nikooyeh et al., 2021 | Nutr Rev | Meta Analysis

Citation

Nikooyeh Bahareh, Neyestani Tirang R. Effectiveness of various methods of home fortification in under-5 children: where they work, where they do not. A systematic review and meta-analysis. Nutr Rev. 2021-Mar-09;79(4):445-461. doi:10.1093/nutrit/nuaa087

Abstract

CONTEXT: The common approaches of home fortification (HF) for prevention and/or treatment of micronutrient deficiencies are micronutrient powders (MNPs), foodlets, and lipid-based nutrient supplements (LNSs). There are mixed results for the impact of HF on growth and nutritional status of young children. OBJECTIVE: This systematic review was prepared in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to evaluate current evidence from randomized controlled trials including children younger than 5 years to assess the effect of strategies of HF on growth and micronutrient status. METHODS: The MEDLINE, PubMed, Embase, Cochrane Library, and Google Scholar databases were searched to July 2018. A total of 1301 studies were found in a preliminary search. After screening of titles and abstracts, 30 studies were selected. RESULTS: Treatment with MNPs, foodlets, and LNSs effectively increased hemoglobin concentrations by at least 2.52 g/L, 4.59 g/L, and 4.4 g/dL, respectively, as compared with a control. There was a significant decrease in risk of anemia development after foodlet intervention compared with a control or iron drops (odds ratio, 0.27; 95%CI, 0.10-0.74; P = 0.01). However, these interventions did not result in any significant improvement in z-scores for changes of height for age, weight for age, and weight for height. The results indicated that MNP (7.16; 95%CI, 0.31-14.01; P = 0.04) and foodlet treatment (4.92; 95%CI, 0.28-9.57; P = 0.04) could increase serum zinc levels. However, none of the home fortification methods improved vitamin A status in the target group. CONCLUSION: Home fortification can be used as an effective method to improve hemoglobin, iron, and zinc status, although in this study it had no effect on vitamin A or anthropometric indicators of the target population. More investigations are warranted for newer approaches of HF to improve a broader range of micronutrients as well as child growth indices and for evaluation of the coverage, compliance, and consistency of such interventions at the population level. PROSPERO REGISTRATION NO: CRD42018109279.

Key Findings

Treatment with MNPs, foodlets, and LNSs effectively increased hemoglobin concentrations by at least 2.52 g/L, 4.59 g/L, and 4.4 g/dL, respectively, as compared with a control. There was a significant decrease in risk of anemia development after foodlet intervention compared with a control or iron drops (odds ratio, 0.27; 95%CI, 0.10-0.74; P = 0.01). However, these interventions did not result in any significant improvement in z-scores for changes of height for age, weight for age, and weight for

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population young children
Sample Size 1301
Age Range See abstract
Condition See abstract

MeSH Terms

  • Food, Fortified
  • Humans
  • Malnutrition
  • Micronutrients
  • Randomized Controlled Trials as Topic

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: vitamin-a

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09