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: BACKGROUND Dietary supplements providing physiologic amounts of several micronutrients simultaneously have not been thoroughly tested for combating micronutrient deficiencies . OBJECTIVE We determined whether a beverage fortified with 10 micronutrients at physiologic doses influenced the iron and vitamin A status and growth of rural children ( aged 6 - 11 y ) attending primary schools . DESIGN In this r and omized , double-blind , placebo-controlled efficacy trial , children were assigned to receive the fortified beverage or an unfortified beverage at school for 6 mo . RESULTS There were nonsignificant differences at baseline between children in the fortified and nonfortified groups in iron status , serum retinol , and anthropometry . At the 6-mo follow-up , among children with anemia ( hemoglobin < 110 g/L ) , there was a significantly larger increase in hemoglobin concentration in the fortified group than in the nonfortified group ( 9.2 and 0.2 g/L , respectively ) . Of those who were anemic at baseline , 69.4 % in the nonfortified group and 55.1 % in the fortified group remained anemic at follow-up ( RR : 0.79 ) , a cure rate of 21 % . The prevalence of children with low serum retinol concentrations ( < 200 microg/L ) dropped significantly from 21.4 % to 11.3 % in the fortified group compared with a nonsignificant change ( 20.6 % to 19.7 % ) in the nonfortified group . At follow-up , mean incremental changes in weight ( 1.79 compared with 1.24 kg ) , height ( 3.2 compared with 2.6 cm ) , and BMI ( 0.88 compared with 0.53 ) were significantly higher in the fortified group than in the nonfortified group . CONCLUSION The fortified beverage significantly improved hematologic and anthropometric measurements and significantly lowered the overall prevalence of anemia and vitamin A deficiency The effects of supplementation of the diets of 6- to 12-year-old children in a village near Shiraz in Iran with  zinc plus iron or iron alone , together with the indispensable amino acids in the form of egg white protein , vitamins , minerals , and corn oil have been evaluated . Initially 48 of 59 children had zinc concentrations  below the minimum found in well-nourished persons . Eight months of supplementation with zinc plus iron ( 20 mg daily of elemental zinc as carbonate and 20 mg ferrous iron as fumarate ) failed to stimulate growth or bone development or to bring about an increase in plasma zinc concentrations . However , supplementation with iron in the above amount was associated with an acceleration of growth in height and weight . The persistence of low concentrations of zinc in plasma and the failure of supplemental zinc to stimulate growth are attributed to the poor availability of both dietary and supplemental zinc result ing from sequestering action of fiber and phytate present in large amounts in the unleavened whole meal bread consumed by villagers . In addition , the results suggest that simultaneous administration of iron and zinc supplements may impair utilization of the metals Growth faltering , anemia , and multiple micronutrient deficiency are common during infancy in developing countries . This South African trial was part of a multicenter study aim ed at testing the efficacy of multiple micronutrient supplementation on growth , anemia , micronutrient status , and morbidity during infancy across 4 countries . A total of 265 infants aged 6 - 12 mo were individually r and omized to 1 of 4 intervention groups : a daily multiple micronutrient supplement ( DMM ) , a daily placebo supplement ( P ) ; a multiple micronutrient supplement 1 d of the week and placebo supplement on the other days of the week ( WMM ) , and a daily iron supplement ( DI ) . For 6 mo , the blinded supplements were provided to mothers at monthly health clinic sessions , and consumption was verified during weekly household visits by community health workers , when morbidity was also checked . Weight and height of the infants were measured monthly , and blood sample s were taken at the beginning and at the end for assessing the infants micronutrient status . There were no significant differences in nutritional status of the groups at baseline with 40 % of infants with anemia ( hemoglobin < 110 g/L ) , 16 % vitamin A deficiency ( plasma retinol < 0.7 micromol/L ) , 47 % zinc deficiency ( plasma zinc < 10.7 micromol/L ) , 2 % underweight , and 11 % stunting . There was no difference in growth or morbidity between the micronutrient supplemented groups and the P group during the 6-mo study . The DMM was the most effective intervention tested , not only for improving anemia but also for improving iron , zinc , riboflavin , and tocopherol status BACKGROUND Micronutrient deficiencies remain common in preschool children in developing countries . Interventions focus on single micronutrients and often lack effectiveness . Weekly instead of daily supplementation may improve effectiveness . OBJECTIVE The efficacy of weekly and daily supplementation in reducing anemia prevalence and in improving the zinc , vitamin A , and growth status of 6 - 24-mo-old Vietnamese children was investigated . DESIGN In this double-blind , placebo-controlled trial , the daily group ( n = 55 ) received 8 mg elemental Fe ( as iron sulfate ) , 5 mg elemental Zn ( as zinc sulfate ) , 333 microg retinol , and 20 mg vitamin C 5 d/wk for 3 mo . The weekly group ( n = 54 ) received 20 mg Fe , 17 mg Zn , 1700 microg retinol , and 20 mg vitamin C once a week . A third group ( n = 54 ) received a placebo only .  Venous blood sample s were collected at the start and end of the supplementation period and anthropometric measurements were taken at the start and 3 mo after the end of supplementation . RESULTS At baseline , 45.6 % of subjects had hemoglobin concentrations < 110 g/L , 36.3 % had zinc concentrations < 10.71 micromol/L , and 45.6 % had retinol concentrations < 0.70 micromol/L. Hemoglobin , retinol , and zinc concentrations of both the weekly and daily groups increased similarly compared with the placebo group ( P < 0.001 ) . There was no significant difference in growth between the supplemented groups and the placebo group . However , the height-for-age of subjects stunted at baseline increased with z scores of 0.48 ( P < 0.001 ) and 0.37 ( P < 0.001 ) for the daily and weekly groups , respectively . CONCLUSIONS Weekly and daily supplementation improved hemoglobin , zinc , and retinol concentrations similarly . Neither intervention affected growth of the overall population , but growth of children stunted at baseline was improved through both types of supplementation The effects on  pregnancy outcome  and  maternal iron status of powdered milk ( PUR ) and a milk-based fortified product ( V-N ) were compared in a group of underweight gravidas . These take-home products were distributed during regular prenatal visits . Women in the V-N group had greater weight gain ( 12.29 vs 11.31 kg , p less than 0.05 ) and mean birth weights ( 3178 vs 3105 g , p less than 0.05 ) than those in the PUR group . Values for various indicators of maternal Fe status were also higher in the V-N group . Compared with self-selected noncompliers , similar in all control variables to compliers , children of women who consumed powdered milk or the milk-based fortified product had mean birth weights that were higher by 258 and 335 g , respectively . Data indicate a beneficial effect of the fortified product on both maternal nutritional status and fetal growth BACKGROUND Iron deficiency is the most common micronutrient deficiency and affects > 2 billion persons worldwide , leading to anemia in > 40 % of women of reproductive age in the developing world . OBJECTIVE The objective was to determine whether weekly supplementation with iron and folate would reduce the frequency of anemia in teenage women in urban Bangladesh before they became pregnant . DESIGN Participants with a hemoglobin concentration of 80 - 120 g/L were entered into a r and omized , double-blind , placebo-controlled trial and received supplements of placebo , vitamin A , iron + folic acid , or iron + folic acid + vitamin A weekly for 12 wk . The supplements contained 2.42 mg vitamin A ( retinol ) as retinyl palmitate , 120 mg elemental Fe as ferrous sulfate , and 3.5 mg folic acid . RESULTS Hemoglobin concentrations increased significantly more after supplementation with iron + folic acid or iron + folic acid + vitamin A than after either the placebo or vitamin A alone . There was a significantly greater increase in hemoglobin after iron + folic acid + vitamin A than after iron + folic acid , but the additional effect disappeared after adjustment for baseline hemoglobin , serum vitamin A , and ferritin and the number of supplements taken . Those with the lowest baseline hemoglobin had the greatest increase in hemoglobin . Compared with the placebo , iron + folic acid + vitamin A reduced anemia by 92 % , iron deficiency by 90 % , and vitamin A deficiency by 76 % . CONCLUSION There may be significant health benefits from a program that enhances the nutritional status of iron , folate , and vitamin A in poor urban young women before they become pregnant Multiple micronutrient deficiencies are highly prevalent in Indonesia , but the interventions are still focused on single micronutrients . This study aim ed to investigate the efficacy of multiple micronutrient supplements for improving micronutrient status , anemia , growth , and morbidity of Indonesian infants . In this double-blind , placebo-controlled trial , 284 infants aged 6 - 12 mo were r and omly allocated to 4 treatment groups for 23 wk ; 260 ( 92 % ) infants completed the study . Group 1 ( DMM ) received one adequate intake of multiple micronutrient supplements daily ( n = 66 ) ; group 2 ( WMM ) received 2 adequate intakes of multiple micronutrient on 1d plus 6 d of placebo ( n = 60 ) ; group 3 ( DI ) received 10 mg of iron supplement daily ( n = 69 ) ; group 4 received a placebo supplement daily ( n = 65 ) . Blood sample s were collected at baseline and at posttreatment to assess anemia and micronutrient status . Anthropometric measurements were taken monthly , and morbidity was recorded daily . At baseline , 58.1 % of infants were anemic , 34.2 % were iron deficient , 21.3 % were vitamin A deficient , and 11 % were zinc deficient . The DMM and DI supplements both corrected iron deficiency , but DMM supplements were more efficacious in improving hemoglobin levels of anemic infants than the other supplements . However , anemia still persisted in one-third of DMM infants posttreatment . The DMM supplement was more efficacious than WMM or DI supplementation in improving infant status of other micronutrients , including zinc , tocopherol , and riboflavin , whereas DI exacerbated zinc deficiency . There were no significant differences in growth and morbidity among treatment groups , and growth faltering was not prevented BACKGROUND Iron and zinc deficiency are prevalent during infancy in low-income countries . OBJECTIVES The objectives were to examine whether a weekly supplement of iron , zinc , iron+zinc , or a micronutrient mix ( MM ) of 16 vitamins and minerals would alter infant development and behavior . DESIGN The participants were 221 infants from rural Bangladesh at risk of micronutrient deficiencies .  Development and behavior were evaluated at 6 and 12 mo of age by using the Bayley Scales of Infant Development II and the Home Observation Measurement of Environment ( HOME ) scale . In this double-blind trial , the infants were r and omly assigned to 1 of 5 treatment conditions : iron ( 20 mg ) , zinc ( 20 mg ) , iron+zinc , MM ( 16 vitamins and minerals , including iron and zinc ) , or riboflavin weekly from 6 to 12 mo . Multivariate analyses were conducted to examine the change in development and behavior for each supplementation group , with control for maternal education , HOME score , months breastfed , anemia , growth at 6 mo , and change in growth from 6 to 12 mo . RESULTS Iron and zinc administered together and with other micronutrients had a beneficial effect on infant motor development .  Iron and zinc administered individually and in combination had a beneficial effect on orientation-engagement . Two-thirds of the infants were mildly anemic , no treatment effects on hemoglobin concentration were observed , and hemoglobin was not associated with measures of development or behavior . CONCLUSION The beneficial effects of weekly iron and zinc supplementation on motor development and orientation-engagement suggest that infants benefit from these minerals when administered together Different supplementation schemes to build iron stores in female Indonesian adolescents were investigated . Subjects were 273 high 
    Output:
    
agent
Synthesized evidence indicates that addition of multiple micronutrients to Fe supplementation may only marginally improve Hb response compared with Fe supplementation alone .
However , addition of ' other micronutrients ' may have a negative effect .
Routine addition of unselected multiple micronutrients to Fe therefore appears unjustified for nutritional anaemia control programmes
***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: BACKGROUND Dietary supplements providing physiologic amounts of several micronutrients simultaneously have not been thoroughly tested for combating micronutrient deficiencies . OBJECTIVE We determined whether a beverage fortified with 10 micronutrients at physiologic doses influenced the iron and vitamin A status and growth of rural children ( aged 6 - 11 y ) attending primary schools . DESIGN In this r and omized , double-blind , placebo-controlled efficacy trial , children were assigned to receive the fortified beverage or an unfortified beverage at school for 6 mo . RESULTS There were nonsignificant differences at baseline between children in the fortified and nonfortified groups in iron status , serum retinol , and anthropometry . At the 6-mo follow-up , among children with anemia ( hemoglobin < 110 g/L ) , there was a significantly larger increase in hemoglobin concentration in the fortified group than in the nonfortified group ( 9.2 and 0.2 g/L , respectively ) . Of those who were anemic at baseline , 69.4 % in the nonfortified group and 55.1 % in the fortified group remained anemic at follow-up ( RR : 0.79 ) , a cure rate of 21 % . The prevalence of children with low serum retinol concentrations ( < 200 microg/L ) dropped significantly from 21.4 % to 11.3 % in the fortified group compared with a nonsignificant change ( 20.6 % to 19.7 % ) in the nonfortified group . At follow-up , mean incremental changes in weight ( 1.79 compared with 1.24 kg ) , height ( 3.2 compared with 2.6 cm ) , and BMI ( 0.88 compared with 0.53 ) were significantly higher in the fortified group than in the nonfortified group . CONCLUSION The fortified beverage significantly improved hematologic and anthropometric measurements and significantly lowered the overall prevalence of anemia and vitamin A deficiency The effects of supplementation of the diets of 6- to 12-year-old children in a village near Shiraz in Iran with  zinc plus iron or iron alone , together with the indispensable amino acids in the form of egg white protein , vitamins , minerals , and corn oil have been evaluated . Initially 48 of 59 children had zinc concentrations  below the minimum found in well-nourished persons . Eight months of supplementation with zinc plus iron ( 20 mg daily of elemental zinc as carbonate and 20 mg ferrous iron as fumarate ) failed to stimulate growth or bone development or to bring about an increase in plasma zinc concentrations . However , supplementation with iron in the above amount was associated with an acceleration of growth in height and weight . The persistence of low concentrations of zinc in plasma and the failure of supplemental zinc to stimulate growth are attributed to the poor availability of both dietary and supplemental zinc result ing from sequestering action of fiber and phytate present in large amounts in the unleavened whole meal bread consumed by villagers . In addition , the results suggest that simultaneous administration of iron and zinc supplements may impair utilization of the metals Growth faltering , anemia , and multiple micronutrient deficiency are common during infancy in developing countries . This South African trial was part of a multicenter study aim ed at testing the efficacy of multiple micronutrient supplementation on growth , anemia , micronutrient status , and morbidity during infancy across 4 countries . A total of 265 infants aged 6 - 12 mo were individually r and omized to 1 of 4 intervention groups : a daily multiple micronutrient supplement ( DMM ) , a daily placebo supplement ( P ) ; a multiple micronutrient supplement 1 d of the week and placebo supplement on the other days of the week ( WMM ) , and a daily iron supplement ( DI ) . For 6 mo , the blinded supplements were provided to mothers at monthly health clinic sessions , and consumption was verified during weekly household visits by community health workers , when morbidity was also checked . Weight and height of the infants were measured monthly , and blood sample s were taken at the beginning and at the end for assessing the infants micronutrient status . There were no significant differences in nutritional status of the groups at baseline with 40 % of infants with anemia ( hemoglobin < 110 g/L ) , 16 % vitamin A deficiency ( plasma retinol < 0.7 micromol/L ) , 47 % zinc deficiency ( plasma zinc < 10.7 micromol/L ) , 2 % underweight , and 11 % stunting . There was no difference in growth or morbidity between the micronutrient supplemented groups and the P group during the 6-mo study . The DMM was the most effective intervention tested , not only for improving anemia but also for improving iron , zinc , riboflavin , and tocopherol status BACKGROUND Micronutrient deficiencies remain common in preschool children in developing countries . Interventions focus on single micronutrients and often lack effectiveness . Weekly instead of daily supplementation may improve effectiveness . OBJECTIVE The efficacy of weekly and daily supplementation in reducing anemia prevalence and in improving the zinc , vitamin A , and growth status of 6 - 24-mo-old Vietnamese children was investigated . DESIGN In this double-blind , placebo-controlled trial , the daily group ( n = 55 ) received 8 mg elemental Fe ( as iron sulfate ) , 5 mg elemental Zn ( as zinc sulfate ) , 333 microg retinol , and 20 mg vitamin C 5 d/wk for 3 mo . The weekly group ( n = 54 ) received 20 mg Fe , 17 mg Zn , 1700 microg retinol , and 20 mg vitamin C once a week . A third group ( n = 54 ) received a placebo only .  Venous blood sample s were collected at the start and end of the supplementation period and anthropometric measurements were taken at the start and 3 mo after the end of supplementation . RESULTS At baseline , 45.6 % of subjects had hemoglobin concentrations < 110 g/L , 36.3 % had zinc concentrations < 10.71 micromol/L , and 45.6 % had retinol concentrations < 0.70 micromol/L. Hemoglobin , retinol , and zinc concentrations of both the weekly and daily groups increased similarly compared with the placebo group ( P < 0.001 ) . There was no significant difference in growth between the supplemented groups and the placebo group . However , the height-for-age of subjects stunted at baseline increased with z scores of 0.48 ( P < 0.001 ) and 0.37 ( P < 0.001 ) for the daily and weekly groups , respectively . CONCLUSIONS Weekly and daily supplementation improved hemoglobin , zinc , and retinol concentrations similarly . Neither intervention affected growth of the overall population , but growth of children stunted at baseline was improved through both types of supplementation The effects on  pregnancy outcome  and  maternal iron status of powdered milk ( PUR ) and a milk-based fortified product ( V-N ) were compared in a group of underweight gravidas . These take-home products were distributed during regular prenatal visits . Women in the V-N group had greater weight gain ( 12.29 vs 11.31 kg , p less than 0.05 ) and mean birth weights ( 3178 vs 3105 g , p less than 0.05 ) than those in the PUR group . Values for various indicators of maternal Fe status were also higher in the V-N group . Compared with self-selected noncompliers , similar in all control variables to compliers , children of women who consumed powdered milk or the milk-based fortified product had mean birth weights that were higher by 258 and 335 g , respectively . Data indicate a beneficial effect of the fortified product on both maternal nutritional status and fetal growth BACKGROUND Iron deficiency is the most common micronutrient deficiency and affects > 2 billion persons worldwide , leading to anemia in > 40 % of women of reproductive age in the developing world . OBJECTIVE The objective was to determine whether weekly supplementation with iron and folate would reduce the frequency of anemia in teenage women in urban Bangladesh before they became pregnant . DESIGN Participants with a hemoglobin concentration of 80 - 120 g/L were entered into a r and omized , double-blind , placebo-controlled trial and received supplements of placebo , vitamin A , iron + folic acid , or iron + folic acid + vitamin A weekly for 12 wk . The supplements contained 2.42 mg vitamin A ( retinol ) as retinyl palmitate , 120 mg elemental Fe as ferrous sulfate , and 3.5 mg folic acid . RESULTS Hemoglobin concentrations increased significantly more after supplementation with iron + folic acid or iron + folic acid + vitamin A than after either the placebo or vitamin A alone . There was a significantly greater increase in hemoglobin after iron + folic acid + vitamin A than after iron + folic acid , but the additional effect disappeared after adjustment for baseline hemoglobin , serum vitamin A , and ferritin and the number of supplements taken . Those with the lowest baseline hemoglobin had the greatest increase in hemoglobin . Compared with the placebo , iron + folic acid + vitamin A reduced anemia by 92 % , iron deficiency by 90 % , and vitamin A deficiency by 76 % . CONCLUSION There may be significant health benefits from a program that enhances the nutritional status of iron , folate , and vitamin A in poor urban young women before they become pregnant Multiple micronutrient deficiencies are highly prevalent in Indonesia , but the interventions are still focused on single micronutrients . This study aim ed to investigate the efficacy of multiple micronutrient supplements for improving micronutrient status , anemia , growth , and morbidity of Indonesian infants . In this double-blind , placebo-controlled trial , 284 infants aged 6 - 12 mo were r and omly allocated to 4 treatment groups for 23 wk ; 260 ( 92 % ) infants completed the study . Group 1 ( DMM ) received one adequate intake of multiple micronutrient supplements daily ( n = 66 ) ; group 2 ( WMM ) received 2 adequate intakes of multiple micronutrient on 1d plus 6 d of placebo ( n = 60 ) ; group 3 ( DI ) received 10 mg of iron supplement daily ( n = 69 ) ; group 4 received a placebo supplement daily ( n = 65 ) . Blood sample s were collected at baseline and at posttreatment to assess anemia and micronutrient status . Anthropometric measurements were taken monthly , and morbidity was recorded daily . At baseline , 58.1 % of infants were anemic , 34.2 % were iron deficient , 21.3 % were vitamin A deficient , and 11 % were zinc deficient . The DMM and DI supplements both corrected iron deficiency , but DMM supplements were more efficacious in improving hemoglobin levels of anemic infants than the other supplements . However , anemia still persisted in one-third of DMM infants posttreatment . The DMM supplement was more efficacious than WMM or DI supplementation in improving infant status of other micronutrients , including zinc , tocopherol , and riboflavin , whereas DI exacerbated zinc deficiency . There were no significant differences in growth and morbidity among treatment groups , and growth faltering was not prevented BACKGROUND Iron and zinc deficiency are prevalent during infancy in low-income countries . OBJECTIVES The objectives were to examine whether a weekly supplement of iron , zinc , iron+zinc , or a micronutrient mix ( MM ) of 16 vitamins and minerals would alter infant development and behavior . DESIGN The participants were 221 infants from rural Bangladesh at risk of micronutrient deficiencies .  Development and behavior were evaluated at 6 and 12 mo of age by using the Bayley Scales of Infant Development II and the Home Observation Measurement of Environment ( HOME ) scale . In this double-blind trial , the infants were r and omly assigned to 1 of 5 treatment conditions : iron ( 20 mg ) , zinc ( 20 mg ) , iron+zinc , MM ( 16 vitamins and minerals , including iron and zinc ) , or riboflavin weekly from 6 to 12 mo . Multivariate analyses were conducted to examine the change in development and behavior for each supplementation group , with control for maternal education , HOME score , months breastfed , anemia , growth at 6 mo , and change in growth from 6 to 12 mo . RESULTS Iron and zinc administered together and with other micronutrients had a beneficial effect on infant motor development .  Iron and zinc administered individually and in combination had a beneficial effect on orientation-engagement . Two-thirds of the infants were mildly anemic , no treatment effects on hemoglobin concentration were observed , and hemoglobin was not associated with measures of development or behavior . CONCLUSION The beneficial effects of weekly iron and zinc supplementation on motor development and orientation-engagement suggest that infants benefit from these minerals when administered together Different supplementation schemes to build iron stores in female Indonesian adolescents were investigated . Subjects were 273 high 
    Output:
    