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: OBJECTIVE To evaluate the effectiveness of universal prophylactic targeting with iron sulfate on daily or weekly basis in the prevention of anemia in infants . METHODS R and omized clinical field trial with children between ages six and 12 months seen at primary health care units in the municipality of Rio de Janeiro , Brazil , between 2004 and 2005 . Three concurrent cohorts were compared : daily group ( n=150 ; 12.5 mg Fe/day ) ; weekly group ( n=147 ; 25 mg Fe/week ) and control group . The intervention consisted of universal supplementation with iron sulfate for 24 weeks , combined with educational adherence-promoting measures . OUTCOME mean serum hemoglobin concentration , distribution and prevalence of anemia ( Hb<110.0 g/l ) at age 12 months . Effectiveness was evaluated considering both intent to treat and adherence to protocol , using multiple regression analysis ( linear and Poisson ) . RESULTS Groups were homogeneous in terms of descriptive variables . The intervention was implemented successfully , with high adhesion to protocol in both groups , and no statistical difference between them . After adjustment , only the daily regimen showed a protective effect . Adherence analysis demonstrated an evident dose-response effect on mean Hb and prevalence of anemia only for the daily regimen . No protective effect was detected for the weekly regimen . CONCLUSIONS Universal supplementation with iron sulfate from six to 12 months of age was effective in increasing serum Hb and decreasing risk of anemia only when administered on a daily basis Pakistan lies in a zinc deficient area where oral zinc supplementation has been advocated for various reasons . A double blind , r and omised case-control study was carried out on pregnant women to evaluate the effects of  oral zinc supplementation  on the weights of newborns .  No significant difference was found in the birth weights between the cases supplemented with 20 mg elemental zinc and controls receiving oral placebos ( p = 0.57 ) Small-quantity lipid-based nutrient supplements ( SQ-LNS ) are promising home fortification products , but the optimal zinc level needed to improve growth and reduce morbidity is uncertain . We aim ed to assess the impact of providing SQ-LNS with varied amounts of zinc , along with illness treatment , on zinc-related outcomes compared with st and ard care . In a placebo-controlled , cluster-r and omized trial , 34 communities were stratified to intervention ( IC ) or non-intervention cohorts ( NIC ) . 2435 eligible IC children were r and omly assigned to one of four groups:1 ) SQ-LNS without zinc , placebo tablet ; 2 ) SQ-LNS containing 5 mg zinc , placebo tablet ; 3 ) SQ-LNS containing 10 mg zinc , placebo tablet ; or 4 ) SQ-LNS without zinc and 5 mg zinc tablet  from 9–18 months of age . During weekly morbidity surveillance , oral rehydration salts were provided for reported diarrhea and antimalarial therapy for confirmed malaria . Children in NIC ( n = 785 ) did not receive SQ-LNS , tablets , illness surveillance or treatment . At 9 and 18 months , length , weight and hemoglobin were measured in all children . Reported adherence was 97±6 % for SQ-LNS and tablets . Mean baseline hemoglobin was 89±15g/L. At 18 months , change in hemoglobin was greater in IC than NIC ( + 8 vs -1g/L , p<0.0001 ) , but 79.1 % of IC were still anemic ( vs. 91.1 % in NIC ) . Final plasma zinc concentration did not differ by group . During the 9-month observation period , the incidence of diarrhea was 1.10±1.03 and of malaria 0.54±0.50 episodes per 100 child-days , and did not differ by group . Length at 18 months was significantly greater in IC compared to NIC ( 77.7±3.0 vs. 76.9±3.4 cm ; p<0.001 ) and stunting prevalence was significantly lower in IC ( 29.3 % ) than NIC ( 39.3 % ; p<0.0001 ) , but did not differ by intervention group within IC . Wasting prevalence was also significantly lower in IC ( 8.7 % ) than in NIC ( 13.5 % ; p = 0.0003 ) . Providing SQ-LNS daily with or without zinc , along with malaria and diarrhea treatment , significantly increased growth and reduced stunting , wasting and anemia prevalence in young children . Trial Registration Clinical Trials.gov OBJECTIVE To determine whether prenatal vitamin A and /or Zn supplementation affects postnatal growth . DESIGN Follow-up of a r and omized controlled trial monitoring growth in children from birth up to 24 months of age . SETTING Central Java , Indonesia . SUBJECTS Children ( n 343 ) of mothers participating in a double-blinded , r and omized controlled study of vitamin A and /or Zn supplementation during pregnancy . We report the effects of prenatal supplementation on infant growth , measured as weight-for-age Z-scores ( WAZ ) , height-for-age Z-scores ( HAZ ) and weight-for-height Z-scores ( WHZ ) , from 0 to 24 months , as well as differences in growth faltering among the supplementation groups . RESULTS For HAZ , the absolute differences between the vitamin A-only and vitamin A + Zn groups at 3 and 9 months were 0·34 SD and 0·37 SD , respectively , and the absolute difference between the vitamin A-only and Zn-only groups at 18 months was 0·31 SD . Compared with placebo , none of the supplements affected growth . Defining growth faltering as a downward crossing of two or more major percentile lines , 50 - 75 % of the children were found to be growth faltering within 9 months of age , whereas 17 % and 8 % scored < -2 SD for WAZ and HAZ , respectively . Prenatal supplementation did not reduce the prevalence of growth faltering . CONCLUSIONS Prenatal vitamin A supplementation had a small but significant effect on postnatal growth of children 's length until 18 months of age compared with supplementation with either vitamin A + Zn or Zn alone , but not compared with placebo . It had no effects on other anthropometric measures and did not reduce the prevalence of growth faltering . Future studies should duplicate these findings before recommendations can be made The study was aim ed to test whether zinc supplementation , if initiated early , can prevent stunting and promote optimum body composition in full term infants . For this , full term pregnant women from low income urban community were enrolled and were followed-up for 24 months postpartum . Body mass index ( BMI ) was calculated from maternal weight and height that were collected one month after delivery . Infants ' weight , and length , head , chest and mid upper arm circumferences and skin fold thicknesses at triceps , biceps and subscapular area were collected at baseline ( before r and omization ) and once in three months up till 24 months . Three hundred and twenty four infants were r and omized and allocated to zinc ( 163 ) or placebo ( 161 ) groups respectively . Supplementation of zinc was initiated from 4 months of age and continued till children attained 18 months . The control ( placebo ) group of children received riboflavin 0.5 mg/day , whereas the intervention ( zinc ) group received 5 mg zinc plus riboflavin 0.5 mg/day . When infants were 18 months old , dietary intakes ( in 78 children ) were calculated by 24 hour diet recall method and hemoglobin , zinc , copper and vitamin A were quantified in blood sample s collected from 70 children . The results showed prevalence of undernutrition ( body mass index < 18.5 ) in 37 % of the mothers . Mean±SD calorie consumption and zinc intakes from diets in infants were 590±282.8 Kcal/day and 0.97±0.608 mg/day respectively . Multiple linear regression models demonstrated maternal weight as a strong predictor of infants ' weight and length at 18 months of age . As expected , diarrhea duration impacted infants ' linear growth and weight gain adversely . Zinc supplementation for a mean period of 190 days , starting from 4 months up to 18 months of age , in full term normal infants , consuming an average energy of 590 Kcal/day , had significant effect on the skin fold thicknesses , but not on their linear growth . Trial Registration Clinical Trail Registration India ( CTRI ) As a follow-up of our study of pregnant women , we report effects of zinc supplementation during pregnancy in another population of 138 Hispanic teenagers in Los Angeles . Teenagers were r and omized ( double-blind ) to a control or zinc-supplemented group and received similar daily vitamin and mineral supplements except for 20 mg zinc added to the zinc-supplemented group 's capsules . Initially , mean dietary zinc intakes of both groups were about 50 % of the Recommended Dietary Allowance and their mean serum zinc levels did not differ significantly ( 69.8 + /- 11.2 micrograms/dl in control and 69.0 + /- 11.4 micrograms/dl in zinc-supplemented group ) . Zinc supplementation did not maintain mean serum zinc levels during pregnancy but , as in our earlier study , it reduced ( p = 0.018 ) the number of low serum zinc values ( less than or equal to 53 micrograms/dl ) in late pregnancy . Zinc supplementation did not affect outcome of pregnancy but serum zinc levels were lower ( p = 0.038 ) in teenagers with pregnancy-induced hypertension than in normotensives 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 Deficiencies of iron and vitamin A are prevalent worldwide . Single-micronutrient supplementation is widely used to combat these deficiencies . However , micronutrient deficiencies often occur concurrently , and there are many interactions between micronutrients . OBJECTIVE This study investigated interactions among 3 important micronutrients -- iron , vitamin A , and zinc -- when they are given as supplements . DESIGN In a r and omized , double-blind , placebo-controlled supplementation trial , 387 Indonesian infants aged 4 mo were supplemented 5 d/wk for 6 mo with 10 mg Fe , 10 mg Zn , 2.4 mg beta-carotene , 10 mg each of Fe and Zn , 10 mg Zn + 2.4 mg beta-carotene , or placebo . Complete data on micronutrient status , including hemoglobin , ferritin , retinol , zinc , and the modified relative dose response ( a measure of liver retinol stores ) , were available from 256 infants at the end of the study . RESULTS Iron-supplemented infants had significantly lower plasma retinol concentrations and a significantly higher prevalence of vitamin A deficiency , as defined by a plasma retinol concentration < 0.70 micromol/L , than did the non-supplemented infants . In contrast , the modified relative dose response of the iron-supplemented infants indicated greater liver stores of vitamin A.  Iron supplementation improved iron status , and zinc supplementation improved zinc status , but beta-carotene supplementation did not significantly improve vitamin A status . CONCLUSIONS In this study , iron supplementation in infants with marginal vitamin A status led to lower plasma vitamin A concentrations and simultaneously to greater vitamin A liver stores . This implies a redistribution of retinol after iron supplementation , which might induce vitamin A deficiency . Therefore , 
    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: OBJECTIVE To evaluate the effectiveness of universal prophylactic targeting with iron sulfate on daily or weekly basis in the prevention of anemia in infants . METHODS R and omized clinical field trial with children between ages six and 12 months seen at primary health care units in the municipality of Rio de Janeiro , Brazil , between 2004 and 2005 . Three concurrent cohorts were compared : daily group ( n=150 ; 12.5 mg Fe/day ) ; weekly group ( n=147 ; 25 mg Fe/week ) and control group . The intervention consisted of universal supplementation with iron sulfate for 24 weeks , combined with educational adherence-promoting measures . OUTCOME mean serum hemoglobin concentration , distribution and prevalence of anemia ( Hb<110.0 g/l ) at age 12 months . Effectiveness was evaluated considering both intent to treat and adherence to protocol , using multiple regression analysis ( linear and Poisson ) . RESULTS Groups were homogeneous in terms of descriptive variables . The intervention was implemented successfully , with high adhesion to protocol in both groups , and no statistical difference between them . After adjustment , only the daily regimen showed a protective effect . Adherence analysis demonstrated an evident dose-response effect on mean Hb and prevalence of anemia only for the daily regimen . No protective effect was detected for the weekly regimen . CONCLUSIONS Universal supplementation with iron sulfate from six to 12 months of age was effective in increasing serum Hb and decreasing risk of anemia only when administered on a daily basis Pakistan lies in a zinc deficient area where oral zinc supplementation has been advocated for various reasons . A double blind , r and omised case-control study was carried out on pregnant women to evaluate the effects of  oral zinc supplementation  on the weights of newborns .  No significant difference was found in the birth weights between the cases supplemented with 20 mg elemental zinc and controls receiving oral placebos ( p = 0.57 ) Small-quantity lipid-based nutrient supplements ( SQ-LNS ) are promising home fortification products , but the optimal zinc level needed to improve growth and reduce morbidity is uncertain . We aim ed to assess the impact of providing SQ-LNS with varied amounts of zinc , along with illness treatment , on zinc-related outcomes compared with st and ard care . In a placebo-controlled , cluster-r and omized trial , 34 communities were stratified to intervention ( IC ) or non-intervention cohorts ( NIC ) . 2435 eligible IC children were r and omly assigned to one of four groups:1 ) SQ-LNS without zinc , placebo tablet ; 2 ) SQ-LNS containing 5 mg zinc , placebo tablet ; 3 ) SQ-LNS containing 10 mg zinc , placebo tablet ; or 4 ) SQ-LNS without zinc and 5 mg zinc tablet  from 9–18 months of age . During weekly morbidity surveillance , oral rehydration salts were provided for reported diarrhea and antimalarial therapy for confirmed malaria . Children in NIC ( n = 785 ) did not receive SQ-LNS , tablets , illness surveillance or treatment . At 9 and 18 months , length , weight and hemoglobin were measured in all children . Reported adherence was 97±6 % for SQ-LNS and tablets . Mean baseline hemoglobin was 89±15g/L. At 18 months , change in hemoglobin was greater in IC than NIC ( + 8 vs -1g/L , p<0.0001 ) , but 79.1 % of IC were still anemic ( vs. 91.1 % in NIC ) . Final plasma zinc concentration did not differ by group . During the 9-month observation period , the incidence of diarrhea was 1.10±1.03 and of malaria 0.54±0.50 episodes per 100 child-days , and did not differ by group . Length at 18 months was significantly greater in IC compared to NIC ( 77.7±3.0 vs. 76.9±3.4 cm ; p<0.001 ) and stunting prevalence was significantly lower in IC ( 29.3 % ) than NIC ( 39.3 % ; p<0.0001 ) , but did not differ by intervention group within IC . Wasting prevalence was also significantly lower in IC ( 8.7 % ) than in NIC ( 13.5 % ; p = 0.0003 ) . Providing SQ-LNS daily with or without zinc , along with malaria and diarrhea treatment , significantly increased growth and reduced stunting , wasting and anemia prevalence in young children . Trial Registration Clinical Trials.gov OBJECTIVE To determine whether prenatal vitamin A and /or Zn supplementation affects postnatal growth . DESIGN Follow-up of a r and omized controlled trial monitoring growth in children from birth up to 24 months of age . SETTING Central Java , Indonesia . SUBJECTS Children ( n 343 ) of mothers participating in a double-blinded , r and omized controlled study of vitamin A and /or Zn supplementation during pregnancy . We report the effects of prenatal supplementation on infant growth , measured as weight-for-age Z-scores ( WAZ ) , height-for-age Z-scores ( HAZ ) and weight-for-height Z-scores ( WHZ ) , from 0 to 24 months , as well as differences in growth faltering among the supplementation groups . RESULTS For HAZ , the absolute differences between the vitamin A-only and vitamin A + Zn groups at 3 and 9 months were 0·34 SD and 0·37 SD , respectively , and the absolute difference between the vitamin A-only and Zn-only groups at 18 months was 0·31 SD . Compared with placebo , none of the supplements affected growth . Defining growth faltering as a downward crossing of two or more major percentile lines , 50 - 75 % of the children were found to be growth faltering within 9 months of age , whereas 17 % and 8 % scored < -2 SD for WAZ and HAZ , respectively . Prenatal supplementation did not reduce the prevalence of growth faltering . CONCLUSIONS Prenatal vitamin A supplementation had a small but significant effect on postnatal growth of children 's length until 18 months of age compared with supplementation with either vitamin A + Zn or Zn alone , but not compared with placebo . It had no effects on other anthropometric measures and did not reduce the prevalence of growth faltering . Future studies should duplicate these findings before recommendations can be made The study was aim ed to test whether zinc supplementation , if initiated early , can prevent stunting and promote optimum body composition in full term infants . For this , full term pregnant women from low income urban community were enrolled and were followed-up for 24 months postpartum . Body mass index ( BMI ) was calculated from maternal weight and height that were collected one month after delivery . Infants ' weight , and length , head , chest and mid upper arm circumferences and skin fold thicknesses at triceps , biceps and subscapular area were collected at baseline ( before r and omization ) and once in three months up till 24 months . Three hundred and twenty four infants were r and omized and allocated to zinc ( 163 ) or placebo ( 161 ) groups respectively . Supplementation of zinc was initiated from 4 months of age and continued till children attained 18 months . The control ( placebo ) group of children received riboflavin 0.5 mg/day , whereas the intervention ( zinc ) group received 5 mg zinc plus riboflavin 0.5 mg/day . When infants were 18 months old , dietary intakes ( in 78 children ) were calculated by 24 hour diet recall method and hemoglobin , zinc , copper and vitamin A were quantified in blood sample s collected from 70 children . The results showed prevalence of undernutrition ( body mass index < 18.5 ) in 37 % of the mothers . Mean±SD calorie consumption and zinc intakes from diets in infants were 590±282.8 Kcal/day and 0.97±0.608 mg/day respectively . Multiple linear regression models demonstrated maternal weight as a strong predictor of infants ' weight and length at 18 months of age . As expected , diarrhea duration impacted infants ' linear growth and weight gain adversely . Zinc supplementation for a mean period of 190 days , starting from 4 months up to 18 months of age , in full term normal infants , consuming an average energy of 590 Kcal/day , had significant effect on the skin fold thicknesses , but not on their linear growth . Trial Registration Clinical Trail Registration India ( CTRI ) As a follow-up of our study of pregnant women , we report effects of zinc supplementation during pregnancy in another population of 138 Hispanic teenagers in Los Angeles . Teenagers were r and omized ( double-blind ) to a control or zinc-supplemented group and received similar daily vitamin and mineral supplements except for 20 mg zinc added to the zinc-supplemented group 's capsules . Initially , mean dietary zinc intakes of both groups were about 50 % of the Recommended Dietary Allowance and their mean serum zinc levels did not differ significantly ( 69.8 + /- 11.2 micrograms/dl in control and 69.0 + /- 11.4 micrograms/dl in zinc-supplemented group ) . Zinc supplementation did not maintain mean serum zinc levels during pregnancy but , as in our earlier study , it reduced ( p = 0.018 ) the number of low serum zinc values ( less than or equal to 53 micrograms/dl ) in late pregnancy . Zinc supplementation did not affect outcome of pregnancy but serum zinc levels were lower ( p = 0.038 ) in teenagers with pregnancy-induced hypertension than in normotensives 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 Deficiencies of iron and vitamin A are prevalent worldwide . Single-micronutrient supplementation is widely used to combat these deficiencies . However , micronutrient deficiencies often occur concurrently , and there are many interactions between micronutrients . OBJECTIVE This study investigated interactions among 3 important micronutrients -- iron , vitamin A , and zinc -- when they are given as supplements . DESIGN In a r and omized , double-blind , placebo-controlled supplementation trial , 387 Indonesian infants aged 4 mo were supplemented 5 d/wk for 6 mo with 10 mg Fe , 10 mg Zn , 2.4 mg beta-carotene , 10 mg each of Fe and Zn , 10 mg Zn + 2.4 mg beta-carotene , or placebo . Complete data on micronutrient status , including hemoglobin , ferritin , retinol , zinc , and the modified relative dose response ( a measure of liver retinol stores ) , were available from 256 infants at the end of the study . RESULTS Iron-supplemented infants had significantly lower plasma retinol concentrations and a significantly higher prevalence of vitamin A deficiency , as defined by a plasma retinol concentration < 0.70 micromol/L , than did the non-supplemented infants . In contrast , the modified relative dose response of the iron-supplemented infants indicated greater liver stores of vitamin A.  Iron supplementation improved iron status , and zinc supplementation improved zinc status , but beta-carotene supplementation did not significantly improve vitamin A status . CONCLUSIONS In this study , iron supplementation in infants with marginal vitamin A status led to lower plasma vitamin A concentrations and simultaneously to greater vitamin A liver stores . This implies a redistribution of retinol after iron supplementation , which might induce vitamin A deficiency . Therefore , 
    Output:
    