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 Although iron deficiency is a major cause of anemia , other micronutrient deficiencies may also play a role . OBJECTIVE We examined whether multiple micronutrient supplementation is more efficacious than is supplementation with iron and folic acid alone for improving the hemoglobin and iron status of anemic adolescent girls in Bangladesh . DESIGN Anemic ( hemoglobin < 12.0 g/dL ) girls ( n = 197 ) aged 14 - 18 y from rural schools in Dhaka District were entered into a r and omized double-blind trial and received twice-weekly supplements of iron and folic acid ( IFA group ) or multiple micronutrients ( 15 micronutrients , including iron and folic acid ; MMN group ) for 12 wk . RESULTS At recruitment , the characteristics of the girls in the 2 groups were not significantly different , except for family size and body mass index . At the end of the study , although both groups benefited significantly from supplementation , mean changes in hemoglobin and serum ferritin concentrations were not significantly different between groups . Compared with the IFA group , girls in the MMN group had significantly greater increases in mean serum vitamin A , plasma vitamin C , red blood cell folic acid , and riboflavin concentrations ( assessed as erythrocyte glutathione reductase activation coefficient ) . After 12 wk of supplementation , only the prevalence of vitamins A and C and riboflavin deficiencies decreased more significantly in the MMN group than in the IFA group . CONCLUSIONS Twice-weekly MMN supplementation for 12 wk significantly improved the status of the micronutrients assessed but was not more efficacious than was supplementation with iron and folic acid alone in improving the hematologic status of anemic adolescent girls . More frequent doses may be needed to achieve full benefit The aim of this study was to determine whether iron deficiency anemia ( IDA ) in mothers alters their maternal cognitive and behavioral performance , the mother-infant interaction , and the infant 's development . This article focuses on the relation between IDA and cognition as well as behavioral affect in the young mothers . This prospect i ve , r and omized , controlled , intervention trial was conducted in South Africa among 3 groups of mothers : nonanemic controls and anemic mothers receiving either placebo ( 10 microg folate and 25 mg vitamin C ) or daily iron ( 125 mg FeS0(4 ) , 10 microg folate , 25 mg vitamin C ) . Mothers of full-term normal birth weight babies were followed from 10 wk to 9 mo postpartum ( n = 81 ) . Maternal hematologic and iron status , socioeconomic , cognitive , and emotional status , mother-infant interaction , and the development of the infants were assessed at 10 wk and 9 mo postpartum . Behavioral and cognitive variables at baseline did not differ between iron-deficient anemic mothers and nonanemic mothers . However , iron treatment result ed in a 25 % improvement ( P < 0.05 ) in previously iron-deficient mothers ' depression and stress scales as well as in the Raven 's Progressive Matrices test . Anemic mothers administered placebo did not improve in behavioral measures . Multivariate analysis showed a strong association between iron status variables ( hemoglobin , mean corpuscular volume , and transferrin saturation ) and cognitive variables ( Digit Symbol ) as well as behavioral variables ( anxiety , stress , depression ) . This study demonstrates that there is a strong relation between iron status and depression , stress , and cognitive functioning in poor African mothers during the postpartum period . There are likely ramifications of this poorer " functioning " on mother-child interactions and infant development , but the constraints around this relation will have to be defined in larger studies 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 Different supplementation schemes to build iron stores in female Indonesian adolescents were investigated . Subjects were 273 high-school girls allocated r and omly to four treatment groups . During a 3-mo period one group received 60 mg Fe , 750 micrograms retinol , 250 micrograms folic acid , and 60 mg vitamin C per day ; a second group received 60 mg Fe , 6000 micrograms retinol , 500 mg folic acid , and 60 mg vitamin C once a week ; a third group received 120 mg Fe and the same amount of the other three micronutrients as the second group once a week ; and a fourth group received only placebos . All subjects were dewormed and supplement allocation was double blind . Blood sample s were collected at baseline , after 2 and 3 mo of supplementation , and 6 mo after the last supplement . After 2 mo of supplementation , groups supplemented weekly and daily showed similar significant improvements ( P < 0.001 ) in hemoglobin and retinol concentrations , and supplementation for 3 instead of 2 mo did not significantly increase these two indicators . After 3 mo , the increase in ferritin was approximately equal to 27 micrograms/L in the daily and 14 - 15 micrograms/L in the weekly groups ( P < 0.001 ) , the latter having a final concentration of 42 - 45 micrograms/L. At 6 mo postsupplementation there were no significant differences among daily and weekly groups , but the ferritin concentration was still approximately equal to 10 - 12-micrograms/L higher ( P < 0.001 ) than in the placebo group . The group supplemented weekly with 60 mg Fe complained less about side effects than the other supplemented groups ( P < 0.05 ) . Weekly supplementation with 60 mg Fe and 6000 micrograms retinol for 3 mo was optimal for improving the iron status of the adolescents for approximately equal to 9 mo BACKGROUND Iron deficiency and its consequent anemia constitute the commonest micronutrient deficiency in the world . OBJECTIVE We investigated whether long-term , weekly iron-folate supplements administered at school would improve hemoglobin and ferritin concentrations in adolescent girls , including those with mild-to-moderate anemia and hemoglobin concentrations indicating borderline anemia . DESIGN Subjects were 266 girls with hemoglobin concentrations of 80 - 119.9 g/L ( group A ) and 358 girls with hemoglobin concentrations of 120 - 130 g/L ( group B ) who were otherwise healthy . Two hundred sixty-six girls in group A and 268 girls in group B were r and omly assigned to receive either 60 or 120 mg Fe plus 3.5 mg folic acid weekly for 22 wk . Ninety of the girls in group B were r and omly assigned to receive only 5 mg folic acid weekly . Capillary hemoglobin and plasma ferritin were measured at baseline and after 12 and 22 wk of supplementation . RESULTS By the end of the study , 2 % of the girls had dropped out and > 96 % had taken > or = 20 of the 22 tablets ; side effects were minimal . Mean plasma ferritin increased significantly in all iron-supplemented groups , independently of initial hemoglobin values and iron doses . Ferritin concentrations decreased in the girls supplemented with folic acid only . As expected , hemoglobin responses to iron were higher in group A than in group B and increases were positively correlated with initial plasma ferritin . Hemoglobin failed to respond to folate supplementation if initial plasma ferritin concentrations were low . Mean hemoglobin increased significantly and consistently in relation to the length of treatment . CONCLUSION Long-term , weekly iron-folate supplementation was found to be a practical , safe , effective , and inexpensive method for improving iron nutrition in adolescent schoolgirls A reduction in the frequency of iron supplement administration to once or twice weekly is being widely examined in developing countries on the assumption that the side effects of oral iron will decrease and that the reduction in administered iron will be offset by a lesser inhibition in absorption from iron taken on the previous day . We examined this premise by measuring iron absorption from 50 mg radiolabeled ferrous sulfate in 23 female volunteer subjects divided into two groups . In the first group , a labeled ferrous sulfate supplement was given with water , and in the second group it was given with a rice-based meal . In both groups , absorption was measured in a r and omized fashion twice in each subject , once with daily and once with weekly supplementation . Those tested for daily supplementation were given an iron supplement daily for 6 d before testing whereas those tested for weekly supplementation were given no iron for 6 d before testing . When the labeled iron supplement was given with water only , absorption averaged 8.5 % with daily and 9.8 % with weekly administration compared with 2.3 % and 2.6 % , respectively , when given with food . The 13 % lower absorption observed with daily administration in both groups was not statistically significant ( P > 0.20 ) . These results indicate that there is no significant absorptive advantage in giving iron less often than once daily Daily folic acid ( FA ) supplementation improves folate status , lowers circulating homocysteine ( Hcy ) concentrations , and reduces the risk of neural tube defects . Little is known about the efficacy of weekly FA supplementation . The objective of this study was to compare the efficacy of weekly and daily FA supplementations in improving folate and vitamin B-12 status and lowering Hcy concentrations in healthy reproductive-aged women . A r and omized , double-blind supplementation trial was conducted in Guatemala . A total of 459 women were assigned r and omly to 4 groups to receive weekly ( 5000 or 2800 microg ) or daily ( 400 or 200 microg ) FA for 12 wk . Daily and weekly iron , zinc , and vitamin B-12 were also provided . We determined serum and RBC folate by microbiological assays , but the latter was available only at baseline . Serum Hcy and vitamin B-12 were also measured . We used generalized linear regression models to assess the effects of treatment on biochemical indicators . Supplementation improved folate status similarly across all 4 groups . Overall , mean serum folate concentrations increased by 15.4 nmol/L ( 95 % CI : 13.8 , 16.9 ) and the geometric mean serum Hcy concentration decreased by 9.8 % ( 95 % CI : -12.3 , -7.1 ) . Daily supplementation improved serum vitamin B-12 by 20 % ( 95 % CI : 8 , 33.2 ) , whereas weekly supplementation had no effect . In conclusion , weekly FA ( either high or low dose ) plus vitamin B-12 may be as efficacious as daily supplementation in improving serum folate and lowering Hcy concentrations in healthy women of reproductive age This 7-mo double-blind study compared the efficacy of two iron supplementation schemes in improving iron nutrition among 116 healthy fertile-age women . They were r and omly distributed in three groups , receiving : Group 1 , iron + folate ( 60 mg and 250 microg , respectively ) daily for 3 mo ( currently recommended scheme ) , and folate ( 250 microg ) weekly the subsequent 4 mo . Group 2 , folate daily , and 60 mg iron only once weekly for 3 mo , and then weekly iron + folate for 4 mo . Group 3 , folate daily for 3 mo and then weekly for 4 mo . At baseline , 16 % had depleted stores ( plasma ferritin < 15 microg/L ) and 16 % had hemoglobin levels < 125 g/L. Eight percent had hemoglobin levels < 120 g/L. In Group 1 hemoglobin and ferritin increased at 3 mo but returned to near basal conditions after 4 mo of weekly folate . In Group 2 , 
    Output:
    
agent
***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 Although iron deficiency is a major cause of anemia , other micronutrient deficiencies may also play a role . OBJECTIVE We examined whether multiple micronutrient supplementation is more efficacious than is supplementation with iron and folic acid alone for improving the hemoglobin and iron status of anemic adolescent girls in Bangladesh . DESIGN Anemic ( hemoglobin < 12.0 g/dL ) girls ( n = 197 ) aged 14 - 18 y from rural schools in Dhaka District were entered into a r and omized double-blind trial and received twice-weekly supplements of iron and folic acid ( IFA group ) or multiple micronutrients ( 15 micronutrients , including iron and folic acid ; MMN group ) for 12 wk . RESULTS At recruitment , the characteristics of the girls in the 2 groups were not significantly different , except for family size and body mass index . At the end of the study , although both groups benefited significantly from supplementation , mean changes in hemoglobin and serum ferritin concentrations were not significantly different between groups . Compared with the IFA group , girls in the MMN group had significantly greater increases in mean serum vitamin A , plasma vitamin C , red blood cell folic acid , and riboflavin concentrations ( assessed as erythrocyte glutathione reductase activation coefficient ) . After 12 wk of supplementation , only the prevalence of vitamins A and C and riboflavin deficiencies decreased more significantly in the MMN group than in the IFA group . CONCLUSIONS Twice-weekly MMN supplementation for 12 wk significantly improved the status of the micronutrients assessed but was not more efficacious than was supplementation with iron and folic acid alone in improving the hematologic status of anemic adolescent girls . More frequent doses may be needed to achieve full benefit The aim of this study was to determine whether iron deficiency anemia ( IDA ) in mothers alters their maternal cognitive and behavioral performance , the mother-infant interaction , and the infant 's development . This article focuses on the relation between IDA and cognition as well as behavioral affect in the young mothers . This prospect i ve , r and omized , controlled , intervention trial was conducted in South Africa among 3 groups of mothers : nonanemic controls and anemic mothers receiving either placebo ( 10 microg folate and 25 mg vitamin C ) or daily iron ( 125 mg FeS0(4 ) , 10 microg folate , 25 mg vitamin C ) . Mothers of full-term normal birth weight babies were followed from 10 wk to 9 mo postpartum ( n = 81 ) . Maternal hematologic and iron status , socioeconomic , cognitive , and emotional status , mother-infant interaction , and the development of the infants were assessed at 10 wk and 9 mo postpartum . Behavioral and cognitive variables at baseline did not differ between iron-deficient anemic mothers and nonanemic mothers . However , iron treatment result ed in a 25 % improvement ( P < 0.05 ) in previously iron-deficient mothers ' depression and stress scales as well as in the Raven 's Progressive Matrices test . Anemic mothers administered placebo did not improve in behavioral measures . Multivariate analysis showed a strong association between iron status variables ( hemoglobin , mean corpuscular volume , and transferrin saturation ) and cognitive variables ( Digit Symbol ) as well as behavioral variables ( anxiety , stress , depression ) . This study demonstrates that there is a strong relation between iron status and depression , stress , and cognitive functioning in poor African mothers during the postpartum period . There are likely ramifications of this poorer " functioning " on mother-child interactions and infant development , but the constraints around this relation will have to be defined in larger studies 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 Different supplementation schemes to build iron stores in female Indonesian adolescents were investigated . Subjects were 273 high-school girls allocated r and omly to four treatment groups . During a 3-mo period one group received 60 mg Fe , 750 micrograms retinol , 250 micrograms folic acid , and 60 mg vitamin C per day ; a second group received 60 mg Fe , 6000 micrograms retinol , 500 mg folic acid , and 60 mg vitamin C once a week ; a third group received 120 mg Fe and the same amount of the other three micronutrients as the second group once a week ; and a fourth group received only placebos . All subjects were dewormed and supplement allocation was double blind . Blood sample s were collected at baseline , after 2 and 3 mo of supplementation , and 6 mo after the last supplement . After 2 mo of supplementation , groups supplemented weekly and daily showed similar significant improvements ( P < 0.001 ) in hemoglobin and retinol concentrations , and supplementation for 3 instead of 2 mo did not significantly increase these two indicators . After 3 mo , the increase in ferritin was approximately equal to 27 micrograms/L in the daily and 14 - 15 micrograms/L in the weekly groups ( P < 0.001 ) , the latter having a final concentration of 42 - 45 micrograms/L. At 6 mo postsupplementation there were no significant differences among daily and weekly groups , but the ferritin concentration was still approximately equal to 10 - 12-micrograms/L higher ( P < 0.001 ) than in the placebo group . The group supplemented weekly with 60 mg Fe complained less about side effects than the other supplemented groups ( P < 0.05 ) . Weekly supplementation with 60 mg Fe and 6000 micrograms retinol for 3 mo was optimal for improving the iron status of the adolescents for approximately equal to 9 mo BACKGROUND Iron deficiency and its consequent anemia constitute the commonest micronutrient deficiency in the world . OBJECTIVE We investigated whether long-term , weekly iron-folate supplements administered at school would improve hemoglobin and ferritin concentrations in adolescent girls , including those with mild-to-moderate anemia and hemoglobin concentrations indicating borderline anemia . DESIGN Subjects were 266 girls with hemoglobin concentrations of 80 - 119.9 g/L ( group A ) and 358 girls with hemoglobin concentrations of 120 - 130 g/L ( group B ) who were otherwise healthy . Two hundred sixty-six girls in group A and 268 girls in group B were r and omly assigned to receive either 60 or 120 mg Fe plus 3.5 mg folic acid weekly for 22 wk . Ninety of the girls in group B were r and omly assigned to receive only 5 mg folic acid weekly . Capillary hemoglobin and plasma ferritin were measured at baseline and after 12 and 22 wk of supplementation . RESULTS By the end of the study , 2 % of the girls had dropped out and > 96 % had taken > or = 20 of the 22 tablets ; side effects were minimal . Mean plasma ferritin increased significantly in all iron-supplemented groups , independently of initial hemoglobin values and iron doses . Ferritin concentrations decreased in the girls supplemented with folic acid only . As expected , hemoglobin responses to iron were higher in group A than in group B and increases were positively correlated with initial plasma ferritin . Hemoglobin failed to respond to folate supplementation if initial plasma ferritin concentrations were low . Mean hemoglobin increased significantly and consistently in relation to the length of treatment . CONCLUSION Long-term , weekly iron-folate supplementation was found to be a practical , safe , effective , and inexpensive method for improving iron nutrition in adolescent schoolgirls A reduction in the frequency of iron supplement administration to once or twice weekly is being widely examined in developing countries on the assumption that the side effects of oral iron will decrease and that the reduction in administered iron will be offset by a lesser inhibition in absorption from iron taken on the previous day . We examined this premise by measuring iron absorption from 50 mg radiolabeled ferrous sulfate in 23 female volunteer subjects divided into two groups . In the first group , a labeled ferrous sulfate supplement was given with water , and in the second group it was given with a rice-based meal . In both groups , absorption was measured in a r and omized fashion twice in each subject , once with daily and once with weekly supplementation . Those tested for daily supplementation were given an iron supplement daily for 6 d before testing whereas those tested for weekly supplementation were given no iron for 6 d before testing . When the labeled iron supplement was given with water only , absorption averaged 8.5 % with daily and 9.8 % with weekly administration compared with 2.3 % and 2.6 % , respectively , when given with food . The 13 % lower absorption observed with daily administration in both groups was not statistically significant ( P > 0.20 ) . These results indicate that there is no significant absorptive advantage in giving iron less often than once daily Daily folic acid ( FA ) supplementation improves folate status , lowers circulating homocysteine ( Hcy ) concentrations , and reduces the risk of neural tube defects . Little is known about the efficacy of weekly FA supplementation . The objective of this study was to compare the efficacy of weekly and daily FA supplementations in improving folate and vitamin B-12 status and lowering Hcy concentrations in healthy reproductive-aged women . A r and omized , double-blind supplementation trial was conducted in Guatemala . A total of 459 women were assigned r and omly to 4 groups to receive weekly ( 5000 or 2800 microg ) or daily ( 400 or 200 microg ) FA for 12 wk . Daily and weekly iron , zinc , and vitamin B-12 were also provided . We determined serum and RBC folate by microbiological assays , but the latter was available only at baseline . Serum Hcy and vitamin B-12 were also measured . We used generalized linear regression models to assess the effects of treatment on biochemical indicators . Supplementation improved folate status similarly across all 4 groups . Overall , mean serum folate concentrations increased by 15.4 nmol/L ( 95 % CI : 13.8 , 16.9 ) and the geometric mean serum Hcy concentration decreased by 9.8 % ( 95 % CI : -12.3 , -7.1 ) . Daily supplementation improved serum vitamin B-12 by 20 % ( 95 % CI : 8 , 33.2 ) , whereas weekly supplementation had no effect . In conclusion , weekly FA ( either high or low dose ) plus vitamin B-12 may be as efficacious as daily supplementation in improving serum folate and lowering Hcy concentrations in healthy women of reproductive age This 7-mo double-blind study compared the efficacy of two iron supplementation schemes in improving iron nutrition among 116 healthy fertile-age women . They were r and omly distributed in three groups , receiving : Group 1 , iron + folate ( 60 mg and 250 microg , respectively ) daily for 3 mo ( currently recommended scheme ) , and folate ( 250 microg ) weekly the subsequent 4 mo . Group 2 , folate daily , and 60 mg iron only once weekly for 3 mo , and then weekly iron + folate for 4 mo . Group 3 , folate daily for 3 mo and then weekly for 4 mo . At baseline , 16 % had depleted stores ( plasma ferritin < 15 microg/L ) and 16 % had hemoglobin levels < 125 g/L. Eight percent had hemoglobin levels < 120 g/L. In Group 1 hemoglobin and ferritin increased at 3 mo but returned to near basal conditions after 4 mo of weekly folate . In Group 2 , 
    Output:
    