Impact of fortified biscuits on micronutrient deficiencies among primary school children in Bangladesh
Impact of fortified biscuits on micronutrient deficiencies among primary school children in Bangladesh
复制标题
DOI：
10.1371/journal.pone.0174673
复制
发表时间：
2017-04-05
期刊：
影响因子：
3.7
通讯作者：
Faruque, A. S. G.
中科院分区：
文献类型：
--
作者：
Adams, Alayne M.;Ahmed, Rushdia;Faruque, A. S. G.
背景营养素缺乏会影响学龄儿童的发展潜力，以及他们成年后的健康和生产力。学校供餐和以学校为基础的强化方法已在全球范围内利用，以纠正营养不足，在这个年龄组。我们探讨了孟加拉国政府支持的以学校为基础的微量营养素强化计划的可接受性和影响的微量营养素在10个贫困sub-districts.MethodsWe应用混合方法的方法。定量部分采用队列前后研究设计和对照组评估了微量营养素强化对351名6-11岁儿童的影响。定性部分探讨了可接受的干预，使用焦点小组讨论，身体映射和半结构化的采访与教师，上学的孩子和学校authorison.ResultsDaily消费的强化饼干的小学生有一个显着的积极影响，平均水平的铁，叶酸，维生素B12，视黄醇和维生素D控制性别，基线缺乏状态，CRP和H。幽门。贫血和维生素D缺乏的水平也显著降低。定性研究结果表明，日常饼干的广泛接受。教师认为学生在课堂上更专心，不那么累，有些人把更好的学习成绩归功于饼干的消费。儿童报告类似的改善浓度和能量level.ConclusionsThis研究是第一次在孟加拉国全面评估以学校为基础的强化计划在其可接受性和影响的微量营养素状况的儿童6-11岁。虽然结果强烈支持这种学校供餐模式，但对微量营养素强化饼干认知影响的研究将有助于澄清孟加拉国和其他中低收入国家扩大对学校供餐计划投资的情况。
BackgroundMicronutrient deficiencies can compromise the development potential of school-aged children, and their later health and productivity as adults. School feeding and school-based fortification approaches have been utilized globally to redress nutritional deficiencies in this age group.ObjectiveWe explored the acceptability and micronutrient impact of a Bangladesh Government supported school-based micronutrient fortification program for children attending rural primary schools in 10 disadvantaged sub-districts.MethodsWe applied a mixed methods approach. The quantitative component assessed the impact of micronutrient fortification on 351 children aged 6-11 years using a cohort pre-post research design with a control group. The qualitative component explored the acceptability of the intervention using focus group discussions, body mapping and semi-structured interviews with teachers, school-going children and school authorities.ResultsDaily consumption of fortified biscuits by primary school children had a significant positive impact on mean levels of iron, folic acid, vitamin B12, retinol and vitamin D controlling for sex, baseline deficiency status, CRP, and H. pylori. Levels of anemia and vitamin D deficiency were also significantly reduced. Qualitative findings indicated the widespread acceptability of the daily biscuit. Teachers perceived students to be more attentive in class, less tired, and some attributed better school performance to biscuit consumption. Children reported similar improvements in concentration and energy levels.ConclusionsThis study is among the first in Bangladesh to comprehensively assess a school-based fortification program in terms of its acceptability and impact on micronutrient status of children aged 6-11 years of age. While results strongly support this modality of school feeding, research on the cognitive impacts of micronutrient fortified biscuits will help clarify the case for scaled-up investments in school-based feeding program in Bangladesh and other low and middle income countries.