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May 2012

Preschool Micronutrient Supplementation Effects on Intellectual and Motor Function in School-aged Nepalese Children

Author Affiliations

Author Affiliations: Departments of Nutritional Sciences (Drs Murray-Kolb, Katz, Tielsch, and Christian, Mr LeClerq, and Ms Morgan), Education/School Psychology (Dr Schaefer), and Psychology (Dr Cole), The Pennsylvania State University, University Park; Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland (Dr Murray-Kolb); and Nepal Nutrition Intervention Project, Sarlahi, Nepal Eye Hospital Complex, Tripureswor, Kathmandu (Dr Khatry and Mr LeClerq).

Arch Pediatr Adolesc Med. 2012;166(5):404-410. doi:10.1001/archpediatrics.2012.37

Objective To examine intellectual and motor functioning of children who received micronutrient supplementation from 12 to 35 months of age.

Design Cohort follow-up of children 7 to 9 years of age who participated in a 2 × 2 factorial, placebo-controlled, randomized trial from October 2001 through January 2006.

Setting Rural Nepal.

Participants A total of 734 children 12 to 35 months of age at supplementation and 7 to 9 years of age at testing.

Interventions Children received iron plus folic acid (12.5 mg of iron and 50 μg of folic acid); zinc (10 mg); iron plus folic acid and zinc; or placebo.

Main Outcome Measures Intellectual, motor, and executive function.

Results In both the unadjusted and adjusted analyses, iron plus folic acid supplementation had no effect overall or on any individual outcome measures being tested. In the unadjusted analysis, zinc supplementation had an overall effect, although none of the individual test score differences were significant. In the adjusted analysis, the overall difference was not significant.

Conclusion In rural Nepal, we found that iron plus folic acid or zinc supplementation during the preschool years had no effect on aspects of intellectual, executive, and motor function at 7 to 9 years of age, suggesting no long-term developmental benefit of iron or zinc supplementation during 12 to 35 months of age.