human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: We conducted a r and omized controlled trial of the effects of dietary supplements on anemia , weight and height in 136 anemic school children from a low socioeconomic background in Bagamoyo District schools in Tanzania . The aim of the current study was to investigate the impact of dietary supplements on anemia and anthropometric indices of anemic school children . The supplements were vitamin A alone , iron and vitamin A , iron alone or placebo , administered in a double-blinded design for 3 mo . All supplements were provided with local corn meals .  Hemoglobin concentration , body weight and height were measured at baseline and at follow-up after supplementation . Vitamin A supplementation increased the mean hemoglobin concentration by 13.5 g/L compared with 3.5 g/L for placebo [ P < 0.0001 , 95 % confidence interval ( CI ) 6.19 - 13.57 ) , the mean body weight by 0.6 kg compared with 0.2 kg for placebo ( P < 0.0001 , 95 % CI 0.19 - 0.65 ) and the mean height by 0.4 cm compared with 0.1 cm for placebo ( P = 0.0009 , 95 % CI 0.08 - 0.42 ) . However , the group of children who received combined vitamin A and iron supplementation had the greatest improvements in all indicators compared with placebo ( 18.5 g/L , P < 0.0001 , 95 % CI 14.81 - 22.23 ; 0.7 kg , P < 0 . 0001 , 95 % CI 0.43 - 0.88 and 0.4 cm , P < 0.0001 , 95 % CI 0.22 - 0.56 for hemoglobin , weight and height , respectively ) . It is likely that vitamin A supplementation may have a useful role in combating the problems of vitamin A deficiency and anemia , as well as in improving children 's growth , in developing countries Intermittent iron supplementation has been suggested as a replacement for daily iron supplements for reducing anemia in developing countries . The effects of once weekly and daily iron supplementation on hemoglobin ( Hb ) , serum ferritin ( SF ) , prevalence of anemia , weight and height are compared in this study . Primary schoolchildren ( n = 397 ) from two selected schools in the Hat Yai rural area , southern Thail and , were recruited in 1999 . All children received Albendazole and then r and omly received ferrous sulfate ( 300 mg/tablet ) either daily or weekly , or a placebo for 16 wk . The average increase in Hb was not significantly different between the daily ( mean + /- SD ; 6.5 + /- 6.0 g/L ) and weekly ( 5.7 + /- 6.3 g/L ) groups . However , the average increase in SF was greater ( P < 0.01 ) in the daily ( mean + /- SD ; 39.8 + /- 30.3 microg/L ) than the weekly ( 13.4 + /- 17.3 microg/L ) group . All cases of iron deficiency anemia were abolished in both daily and weekly groups , whereas no reduction in prevalence occurred in the placebo group . Height gain was greater in children who received weekly ( mean + /- SD ; 2.6 + /- 0.9 cm ) than in those who received daily iron ( mean + /- SD ; 2.3 + /- 0.8 cm ) , ( P < 0.01 ) . Weight gain , weight-for-age and height-for-age were not significantly different among the intervention groups . It is concluded that a weekly iron dose is more effective than a daily dose in height gain but not in hematological improvement over 16 wk of supplementation Iron supplements are often prescribed during infancy but their benefits and risks have not been well documented . We examined whether iron supplements affect growth or morbidity of breast-fed infants . Full-term infants in Sweden ( n = 101 ) and Honduras ( n = 131 ) were r and omly assigned to three groups at 4 mo of age : 1 ) placebo from 4 to 9 mo ; 2 ) placebo from 4 to 6 mo and iron supplements [ 1 mg/(kg . d ) ] from 6 to 9 mo ; or 3 ) iron supplements from 4 to 9 mo . All infants were exclusively or nearly exclusively breast-fed to 6 mo and continued to be breast-fed to at least 9 mo . Growth was measured monthly and morbidity data were collected every 2 wk . Among the Swedish infants , gains in length and head circumference were significantly lower in those who received iron than in those given placebo from 4 to 9 mo . The same effect on length was seen in Honduras , but only at 4 - 6 mo among those with initial hemoglobin ( Hb ) > or = 110 g/L. There was no significant main effect of  iron supplementation on morbidity , nor any significant interaction between iron supplementation and site , but for diarrhea ( with both sites combined ) , there was an interaction between iron supplementation and initial Hb . Among infants with Hb < 110 g/L at 4 mo , diarrhea was less common among those given iron than in those given placebo from 4 - 9 mo , whereas the opposite was true among those with Hb > or = 110 g/L ( P < 0.05 ) . We conclude that routine iron supplementation of breast-fed infants may benefit those with low Hb but may present risks for those with normal Hb A r and omized , double-blind , placebo-controlled iron supplementation trial was conducted in Kenya to examine the effect of iron supplements on appetite and growth in 87 primary school children .  Sustained-release ferrous sulfate ( 150 mg ) or placebo tablets were provided daily at school for 14 wk . Prior to tablet administration , baseline anthropometry , iron nutritional status ( hemoglobin and serum ferritin ) , parasitic infections and clinical indicators of morbidity were measured . A baseline appetite test was conducted twice on each child by quantitatively measuring the ad libitum consumption of a midmorning snack . In addition , each child was asked for a subjective assessment of his or her appetite . Follow-up exams and appetite tests were identical to those at baseline . Findings indicated that provision of iron supplements result ed in improved growth and improved appetite ( in terms of both energy intake of the snack and child report of appetite ) as compared with children receiving the placebo . The increased energy intake from the snack was 10 % of the daily estimated energy intake for children of this same age group living elsewhere in Kenya . Further research into the underlying physiological mechanisms may shed light on the relationship between iron nutritional status and appetite The effect of oral iron supplementation on blood Fe levels and physical growth in 119 rural Indonesian school children was assessed in this double-blind study . The children were classified into anemic and normal groups according to their initial hemoglobin and transferrin saturation levels and were r and omly assigned to either Fe or placebo treatment for 12 wk . Hematological , anthropometric , and morbidity data were collected before and after the treatment period . Before treatment , anemic subjects were smaller and had higher morbidity than normal subjects . Treatment with 10 mg ferrous sulfate.kg-1.d-1 for 12 wk result ed in a significant improvement in anemic subjects ' hematological status , growth velocity , and level or morbidity Ninety-nine anemic children aged 1 - 8 y were divided into four groups . Each group was supplemented for 2 mo with vitamin A , iron , vitamin A plus Fe , or a placebo .  Clinical , hematological , and Fe biochemical evaluations were performed at the beginning and end of the study . Vitamin A supplementation produced significant elevations in the serum levels of retinol , blood hemoglobin , hematocrit , erythrocytes , serum Fe , and percent transferrin saturation ( % TS ) and had no effect on total Fe binding capacity ( TIBC ) or serum ferritin . Fe supplementation did not affect serum retinol . However , it improved hematological and Fe nutrition indicators , including TIBC and serum ferritin . The simultaneous administration of vitamin A and Fe result ed in a better response of serum Fe and % TS than when the supplement consisted only of vitamin A or Fe alone . Vitamin A benefits hematological condition and Fe metabolism The effect of weekly iron supplementation with and without deworming on hemoglobin was investigated in a double-masked , placebo-controlled field trial . Subjects were 289 preschoolers who were r and omly divided into three groups . Groups 1 and 2 received 30 mg Fe once weekly and group 3 received a placebo . Group 1 additionally received anthelminthic treatment . Supplements were administered by the mothers , who were educated about iron deficiency beforeh and . In the iron-supplemented groups prevalence of anemia decreased from 37.2 % to 16.2 % ( P < 0.001 ) . Hemoglobin increased by an average of 6.9 + /- 9.8 g/L in the two iron-supplemented groups ( n = 191 ) , which was greater ( P < 0.001 ) than the increase of 1.9 + /- 8.0 g/L in the placebo group . None of the subjects had hookworm , and anthelminthic treatment did not have an additional effect . Iron supplements administered once weekly by mothers reduced anemia without major involvement of health staff BACKGROUND Iron deficiency anemia is the most prevalent nutrition problem in young children . One possible strategy to prevent iron deficiency anemia in this population group is the fortification of affordable food . OBJECTIVE This study was design ed to assess whether iron-fortified c and ies can improve iron status and are acceptable to children aged 4 - 6 y. DESIGN A double-blind , placebo-controlled intervention study was conducted in Jakarta , INDONESIA : The children were r and omly assigned to 1 of 2 treatment groups : a fortified group ( n = 57 ) and a placebo group ( n = 60 ) . Every week for 12 wk , 30 g ( 10 pieces ) c and y was given to the children . The c and y given to the fortified group contained 1 mg elemental Fe/g and very small amounts of other vitamins and minerals . RESULTS The hemoglobin concentration of the fortified group increased by 10.2 g/L ( 95 % CI : 8.3 , 12 g/L ) whereas that of the placebo group increased by 4.0 g/L ( 2.0 , 6.0 g/L ; P < 0.001 ) . Anemia prevalence decreased from 50.9 % at the start of the intervention to 8.8 % after 12 wk of intervention in the fortified group ( P < 0.001 ) and from 43.3 % to 26.7 % in the placebo group ( P < 0.05 ) . After 12 wk of intervention , the serum ferritin concentration was 71 % higher than at baseline in the fortified group and 28 % higher in the placebo group ( P < 0.001 ) . Acceptability of the iron-fortified c and ies was good . The per capita cost of the supplement was approximately US$ 0.96 - 1.20 for the 12 wk of intervention . CONCLUSION Iron-fortified c and ies were effective for improving the iron status  of young children and might be an affordable way to combat iron deficiency in children of low-to-middle income groups In this study the effects of supplementation of iron and zinc , alone or combined , on iron status , zinc status and growth in Indonesian infants is investigated . Micronutrient deficiencies are prevalent in infants in developing countries , and deficiencies often coexist ; thus , combined supplementation is an attractive strategy . However , little is known about interactions between micronutrients . In a r and omized , double-blind , placebo-controlled supplementation trial , 478 infants , 4 mo of age , were supplemented for 6 mo with iron ( 10 mg/d ) , zinc ( 10 mg/d ) , iron + zinc ( 10 mg of each/d ) or placebo . Anthropometry was assessed monthly , and micronutrient status was assessed at the end of supplementation . Supplementation significantly reduced the prevalence of anemia , iron deficiency anemia and zinc deficiency . Iron supplementation did not negatively affect plasma zinc concentrations , and zinc supplementation did not increase the prevalence of anemia or iron deficiency anemia . However , iron supplementation combined with zinc was less effective than iron supplementation alone in reducing the prevalence of anemia ( 20 % vs. 38 % reduction ) and in increasing hemoglobin and plasma ferritin concentrations . There were no differences among the groups in growth . The growth of all groups was insufficient to maintain the same Z-scores for height for age and weight for height . There is a high prevalence of deficiencies of iron and zinc in these infants , which can be overcome safely and effectively by supplementation of iron and zinc combined . However , overcoming these deficiencies is not sufficient to improve growth performance in these infants After 1 y of distributing a milk-based fortified weaning food provided by the Mexican social program PROGRESA , positive effects on physical growth , prevalence of anemia , and several vitamin deficiencies were observed . There was no effect on iron status , which we hypothesized was related to the poor bioavailability of the reduced iron used as a fortificant in PROGRE 
    Output:
    
agent
Significant heterogeneity was evident , and its predictors included greater weight-for-age in supplemented children in malaria hyperendemic regions and greater weight-for-height for children above 5 years of age , but a negative effect on linear growth in developed countries and with supplementation for 6 months or longer .
This review did not document a positive effect of iron supplementation on the physical growth of children .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: We conducted a r and omized controlled trial of the effects of dietary supplements on anemia , weight and height in 136 anemic school children from a low socioeconomic background in Bagamoyo District schools in Tanzania . The aim of the current study was to investigate the impact of dietary supplements on anemia and anthropometric indices of anemic school children . The supplements were vitamin A alone , iron and vitamin A , iron alone or placebo , administered in a double-blinded design for 3 mo . All supplements were provided with local corn meals .  Hemoglobin concentration , body weight and height were measured at baseline and at follow-up after supplementation . Vitamin A supplementation increased the mean hemoglobin concentration by 13.5 g/L compared with 3.5 g/L for placebo [ P < 0.0001 , 95 % confidence interval ( CI ) 6.19 - 13.57 ) , the mean body weight by 0.6 kg compared with 0.2 kg for placebo ( P < 0.0001 , 95 % CI 0.19 - 0.65 ) and the mean height by 0.4 cm compared with 0.1 cm for placebo ( P = 0.0009 , 95 % CI 0.08 - 0.42 ) . However , the group of children who received combined vitamin A and iron supplementation had the greatest improvements in all indicators compared with placebo ( 18.5 g/L , P < 0.0001 , 95 % CI 14.81 - 22.23 ; 0.7 kg , P < 0 . 0001 , 95 % CI 0.43 - 0.88 and 0.4 cm , P < 0.0001 , 95 % CI 0.22 - 0.56 for hemoglobin , weight and height , respectively ) . It is likely that vitamin A supplementation may have a useful role in combating the problems of vitamin A deficiency and anemia , as well as in improving children 's growth , in developing countries Intermittent iron supplementation has been suggested as a replacement for daily iron supplements for reducing anemia in developing countries . The effects of once weekly and daily iron supplementation on hemoglobin ( Hb ) , serum ferritin ( SF ) , prevalence of anemia , weight and height are compared in this study . Primary schoolchildren ( n = 397 ) from two selected schools in the Hat Yai rural area , southern Thail and , were recruited in 1999 . All children received Albendazole and then r and omly received ferrous sulfate ( 300 mg/tablet ) either daily or weekly , or a placebo for 16 wk . The average increase in Hb was not significantly different between the daily ( mean + /- SD ; 6.5 + /- 6.0 g/L ) and weekly ( 5.7 + /- 6.3 g/L ) groups . However , the average increase in SF was greater ( P < 0.01 ) in the daily ( mean + /- SD ; 39.8 + /- 30.3 microg/L ) than the weekly ( 13.4 + /- 17.3 microg/L ) group . All cases of iron deficiency anemia were abolished in both daily and weekly groups , whereas no reduction in prevalence occurred in the placebo group . Height gain was greater in children who received weekly ( mean + /- SD ; 2.6 + /- 0.9 cm ) than in those who received daily iron ( mean + /- SD ; 2.3 + /- 0.8 cm ) , ( P < 0.01 ) . Weight gain , weight-for-age and height-for-age were not significantly different among the intervention groups . It is concluded that a weekly iron dose is more effective than a daily dose in height gain but not in hematological improvement over 16 wk of supplementation Iron supplements are often prescribed during infancy but their benefits and risks have not been well documented . We examined whether iron supplements affect growth or morbidity of breast-fed infants . Full-term infants in Sweden ( n = 101 ) and Honduras ( n = 131 ) were r and omly assigned to three groups at 4 mo of age : 1 ) placebo from 4 to 9 mo ; 2 ) placebo from 4 to 6 mo and iron supplements [ 1 mg/(kg . d ) ] from 6 to 9 mo ; or 3 ) iron supplements from 4 to 9 mo . All infants were exclusively or nearly exclusively breast-fed to 6 mo and continued to be breast-fed to at least 9 mo . Growth was measured monthly and morbidity data were collected every 2 wk . Among the Swedish infants , gains in length and head circumference were significantly lower in those who received iron than in those given placebo from 4 to 9 mo . The same effect on length was seen in Honduras , but only at 4 - 6 mo among those with initial hemoglobin ( Hb ) > or = 110 g/L. There was no significant main effect of  iron supplementation on morbidity , nor any significant interaction between iron supplementation and site , but for diarrhea ( with both sites combined ) , there was an interaction between iron supplementation and initial Hb . Among infants with Hb < 110 g/L at 4 mo , diarrhea was less common among those given iron than in those given placebo from 4 - 9 mo , whereas the opposite was true among those with Hb > or = 110 g/L ( P < 0.05 ) . We conclude that routine iron supplementation of breast-fed infants may benefit those with low Hb but may present risks for those with normal Hb A r and omized , double-blind , placebo-controlled iron supplementation trial was conducted in Kenya to examine the effect of iron supplements on appetite and growth in 87 primary school children .  Sustained-release ferrous sulfate ( 150 mg ) or placebo tablets were provided daily at school for 14 wk . Prior to tablet administration , baseline anthropometry , iron nutritional status ( hemoglobin and serum ferritin ) , parasitic infections and clinical indicators of morbidity were measured . A baseline appetite test was conducted twice on each child by quantitatively measuring the ad libitum consumption of a midmorning snack . In addition , each child was asked for a subjective assessment of his or her appetite . Follow-up exams and appetite tests were identical to those at baseline . Findings indicated that provision of iron supplements result ed in improved growth and improved appetite ( in terms of both energy intake of the snack and child report of appetite ) as compared with children receiving the placebo . The increased energy intake from the snack was 10 % of the daily estimated energy intake for children of this same age group living elsewhere in Kenya . Further research into the underlying physiological mechanisms may shed light on the relationship between iron nutritional status and appetite The effect of oral iron supplementation on blood Fe levels and physical growth in 119 rural Indonesian school children was assessed in this double-blind study . The children were classified into anemic and normal groups according to their initial hemoglobin and transferrin saturation levels and were r and omly assigned to either Fe or placebo treatment for 12 wk . Hematological , anthropometric , and morbidity data were collected before and after the treatment period . Before treatment , anemic subjects were smaller and had higher morbidity than normal subjects . Treatment with 10 mg ferrous sulfate.kg-1.d-1 for 12 wk result ed in a significant improvement in anemic subjects ' hematological status , growth velocity , and level or morbidity Ninety-nine anemic children aged 1 - 8 y were divided into four groups . Each group was supplemented for 2 mo with vitamin A , iron , vitamin A plus Fe , or a placebo .  Clinical , hematological , and Fe biochemical evaluations were performed at the beginning and end of the study . Vitamin A supplementation produced significant elevations in the serum levels of retinol , blood hemoglobin , hematocrit , erythrocytes , serum Fe , and percent transferrin saturation ( % TS ) and had no effect on total Fe binding capacity ( TIBC ) or serum ferritin . Fe supplementation did not affect serum retinol . However , it improved hematological and Fe nutrition indicators , including TIBC and serum ferritin . The simultaneous administration of vitamin A and Fe result ed in a better response of serum Fe and % TS than when the supplement consisted only of vitamin A or Fe alone . Vitamin A benefits hematological condition and Fe metabolism The effect of weekly iron supplementation with and without deworming on hemoglobin was investigated in a double-masked , placebo-controlled field trial . Subjects were 289 preschoolers who were r and omly divided into three groups . Groups 1 and 2 received 30 mg Fe once weekly and group 3 received a placebo . Group 1 additionally received anthelminthic treatment . Supplements were administered by the mothers , who were educated about iron deficiency beforeh and . In the iron-supplemented groups prevalence of anemia decreased from 37.2 % to 16.2 % ( P < 0.001 ) . Hemoglobin increased by an average of 6.9 + /- 9.8 g/L in the two iron-supplemented groups ( n = 191 ) , which was greater ( P < 0.001 ) than the increase of 1.9 + /- 8.0 g/L in the placebo group . None of the subjects had hookworm , and anthelminthic treatment did not have an additional effect . Iron supplements administered once weekly by mothers reduced anemia without major involvement of health staff BACKGROUND Iron deficiency anemia is the most prevalent nutrition problem in young children . One possible strategy to prevent iron deficiency anemia in this population group is the fortification of affordable food . OBJECTIVE This study was design ed to assess whether iron-fortified c and ies can improve iron status and are acceptable to children aged 4 - 6 y. DESIGN A double-blind , placebo-controlled intervention study was conducted in Jakarta , INDONESIA : The children were r and omly assigned to 1 of 2 treatment groups : a fortified group ( n = 57 ) and a placebo group ( n = 60 ) . Every week for 12 wk , 30 g ( 10 pieces ) c and y was given to the children . The c and y given to the fortified group contained 1 mg elemental Fe/g and very small amounts of other vitamins and minerals . RESULTS The hemoglobin concentration of the fortified group increased by 10.2 g/L ( 95 % CI : 8.3 , 12 g/L ) whereas that of the placebo group increased by 4.0 g/L ( 2.0 , 6.0 g/L ; P < 0.001 ) . Anemia prevalence decreased from 50.9 % at the start of the intervention to 8.8 % after 12 wk of intervention in the fortified group ( P < 0.001 ) and from 43.3 % to 26.7 % in the placebo group ( P < 0.05 ) . After 12 wk of intervention , the serum ferritin concentration was 71 % higher than at baseline in the fortified group and 28 % higher in the placebo group ( P < 0.001 ) . Acceptability of the iron-fortified c and ies was good . The per capita cost of the supplement was approximately US$ 0.96 - 1.20 for the 12 wk of intervention . CONCLUSION Iron-fortified c and ies were effective for improving the iron status  of young children and might be an affordable way to combat iron deficiency in children of low-to-middle income groups In this study the effects of supplementation of iron and zinc , alone or combined , on iron status , zinc status and growth in Indonesian infants is investigated . Micronutrient deficiencies are prevalent in infants in developing countries , and deficiencies often coexist ; thus , combined supplementation is an attractive strategy . However , little is known about interactions between micronutrients . In a r and omized , double-blind , placebo-controlled supplementation trial , 478 infants , 4 mo of age , were supplemented for 6 mo with iron ( 10 mg/d ) , zinc ( 10 mg/d ) , iron + zinc ( 10 mg of each/d ) or placebo . Anthropometry was assessed monthly , and micronutrient status was assessed at the end of supplementation . Supplementation significantly reduced the prevalence of anemia , iron deficiency anemia and zinc deficiency . Iron supplementation did not negatively affect plasma zinc concentrations , and zinc supplementation did not increase the prevalence of anemia or iron deficiency anemia . However , iron supplementation combined with zinc was less effective than iron supplementation alone in reducing the prevalence of anemia ( 20 % vs. 38 % reduction ) and in increasing hemoglobin and plasma ferritin concentrations . There were no differences among the groups in growth . The growth of all groups was insufficient to maintain the same Z-scores for height for age and weight for height . There is a high prevalence of deficiencies of iron and zinc in these infants , which can be overcome safely and effectively by supplementation of iron and zinc combined . However , overcoming these deficiencies is not sufficient to improve growth performance in these infants After 1 y of distributing a milk-based fortified weaning food provided by the Mexican social program PROGRESA , positive effects on physical growth , prevalence of anemia , and several vitamin deficiencies were observed . There was no effect on iron status , which we hypothesized was related to the poor bioavailability of the reduced iron used as a fortificant in PROGRE 
    Output:
    