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close this book4th Report on the World Nutrition Situation - Nutrition throughout the Life Cycle (SCN; 2000; 138 pages)
View the documentADMINISTRATIVE COMMITTEE ON COORDINATION/SUB-COMMITTEE ON NUTRITION - (ACC/SCN) THE UN SYSTEM’S FORUM FOR NUTRITION
View the documentINTERNATIONAL FOOD POLICY RESEARCH INSTITUTE
View the documentFOREWORD
View the documentHIGHLIGHTS
View the documentCONTRIBUTORS
View the documentACKNOWLEDGEMENTS
View the documentLIST OF ABBREVIATIONS
View the documentPREFACE
Open this folder and view contentsCHAPTER 1: NUTRITION THROUGHOUT THE LIFE CYCLE
close this folderCHAPTER 2: MICRONUTRIENT UPDATE
View the document2.1 Iron Deficiency Update
View the document2.2 Iodine Deficiency Disorders Update
View the document2.3 Vitamin A Deficiency Update
View the document2.4 Multiple Micronutrient Deficiencies
View the documentSummary
Open this folder and view contentsCHAPTER 3: BREASTFEEDING AND COMPLEMENTARY FEEDING
Open this folder and view contentsCHAPTER 4: NUTRITION AND HUMAN DEVELOPMENT
Open this folder and view contentsCHAPTER 5: NUTRITION OF REFUGEES AND DISPLACED POPULATIONS
Open this folder and view contentsAPPENDICES
View the documentREFERENCES
View the documentBACK COVER
 

2.4 Multiple Micronutrient Deficiencies

Many population groups in the developing world suffer from multiple nutrient deficiencies. The clustering of iron and vitamin A deficiencies has already been mentioned, but there are many more significant overlaps.

Moreover, deficiencies often interact. Vitamin A supplementation at appropriate levels has been found to improve not only vitamin A status but also iron metabolism in pregnant women and preschool and school-age children.28 It should be considered where iron deficiency is common. A combined iron and vitamin A supplement has been found to be more than 40% more effective in reducing anaemia than an iron supplement alone. Such findings are not specific to supplementation. A vitamin A sugar fortification programme in Guatemala resulted in improved iron status of the population,29 while a trial with vitamin A - fortified MSG in Indonesia increased haemoglobin levels among children.30

Given such frequent overlaps and given the fact that at certain stages of the life cycle - most notably during pregnancy - it may be difficult for dietary needs to be met through diet alone, multiple micro-nutrient supplementation holds clear potential to address multiple nutrient deficiencies in a cost-effective manner. Recent advances have been made in this area since 1998. One publication has addressed key issues concerning the design and implementation of such programmes.31 Also, a joint UNICEF/WHO/UNU workshop was convened in 1999 to consider the composition of a multi-micronutrient supplement to be used in forthcoming trials among pregnant women in developing countries.

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