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: In Cambodia , micronutrient deficiencies remain a critical public health problem . Our objective was to evaluate the impact of multi-micronutrient fortified rice ( MMFR ) formulations , distributed through a World Food Program school-meals program ( WFP-SMP ) , on the hemoglobin concentrations and iron and vitamin A ( VA ) status of Cambodian schoolchildren . The FORISCA-UltraRice+NutriRice study was a double-blind , cluster-r and omized , placebo-controlled trial . Sixteen schools participating in WFP-SMP were r and omly assigned to receive extrusion-fortified rice ( UltraRice Original , UltraRice New ( URN ) , or NutriRice ) or unfortified rice ( placebo ) six days a week for six months . Four additional schools not participating in WFP-SMP were r and omly selected as controls . A total of 2440 schoolchildren ( 6–16 years old ) participated in the biochemical study . Hemoglobin , iron status , estimated using inflammation-adjusted ferritin and transferrin receptors concentrations , and VA status , assessed using inflammation-adjusted retinol-binding protein concentration , were measured at the baseline , as well as at three and six months . Baseline prevalence of anemia , depleted iron stores , tissue iron deficiency , marginal VA status and VA deficiency were 15.6 % , 1.4 % , 51.0 % , 7.9 % , and 0.7 % , respectively . The strongest risk factors for anemia were hemoglobinopathy , VA deficiency , and depleted iron stores ( all p < 0.01 ) . After six months , children receiving NutriRice and URN had 4 and 5 times less risk of low VA status , respectively , in comparison to the placebo group . Hemoglobin significantly increased ( + 0.8 g/L ) after three months for the URN group in comparison to the placebo group ; however , this difference was no longer significant after six months , except for children without inflammation . MMFR containing VA effectively improved the VA status of schoolchildren . The impact on hemoglobin and iron status was limited , partly by sub- clinical inflammation . MMFR combined with non-nutritional approaches addressing anemia and inflammation should be further investigated Background Anemia continues to be a major public health problem among children in many regions of the world , and it is still not clear which strategy to treat it is most effective . Objective To evaluate the efficacy and children 's acceptance of several recognized strategies to treat anemia . Methods Non-breastfed children ( n = 577 ) , 6 to 43 mo of age , were screened for the trial ; 267 were anemic ( hemoglobin < 11.7 g/dL ) , and 266 of those were r and omized into 1 of 5 treatments to received daily either : an iron supplement ( IS ) , an iron+folic acid supplement ( IFS ) , a multiple micronutrient supplement ( MMS ) , a micronutrient-fortified complementary food as porridge powder ( FCF ) , or zinc+iron+ascorbic acid fortified water ( FW ) . The iron content of each daily dose was 20 , 12.5 , 10 , 10 and 6.7 mg respectively . Hemoglobin ( Hb ) , ferritin , total iron , weight and height were measured at baseline and after 4 months of treatment . Morbidity , treatment acceptability and adherence were recorded during the intervention . Results All treatments significantly increased Hb and total iron concentration ; ferritin did not change significantly . Groups MMS , IS and IFS  increased Hb ( g/dL ) [ 1.50 ( 95%CI : 1.17 , 1.83 ) , 1.48 [ ( 1.18 , 1.78 ) and 1.57 ( 1.26 , 1.88 ) , respectively ] and total iron ( ( μg/dL ) [ 0.15 ( 0.01 , 0.29 ) , 0.19 ( 0.06 , 0.31 ) and 0.12(-0.01 , 0.25 ) , respectively ] significantly more than FCF [ 0.92 ( 0.64 , 1.20 ) ] but not to FW group [ 0.14 ( 0.04 , 0.24 ) ] . The prevalence of anemia was reduced to a greater extent in the MMS and IFS groups ( 72 % and 69 % , respectively ) than in the FCF group ( 45 % ) ( p < 0.05 ) . There were no significant differences in anthropometry or in the number of episodes of diarrhea and respiratory infections among treatment groups . The supplements MMS and IS were less acceptable to children , than IFS , FCF and FW . Conclusion The three supplements IS , ISF and MMS  increased Hb more than the FCF ; the supplements that contained micronutrients ( IFS and MMS ) were more effective for reducing the prevalence of anemia . In general , fortified foods were better accepted by the study participants than supplements . Clinical Trial.gov BACKGROUND Provision of fortified juices may provide a convenient method to maintain and increase blood fat-soluble vitamins . OBJECTIVE To determine whether children consuming orange juice fortified with calcium and combinations of vitamins D , E , and A  could increase serum 25-hydroxyvitamin D [ 25(OH)D ] , α-tocopherol , and retinol levels . DESIGN A 12-week r and omized , double-blind , controlled trial . PARTICIPANTS / SETTING One hundred eighty participants ( aged 8.04±1.42 years ) were recruited at Tufts ( n=70 ) and Boston University ( n=110 ) during 2005 - 2006 . Of those recruited , 176 children were r and omized into three groups : CaD ( 700 mg calcium+200 IU vitamin D ) , CaDEA ( 700 mg calcium+200 IU vitamin D+12 IU vitamin E+2,000 IU vitamin A as beta carotene ) , or Ca ( 700 mg calcium ) . Children consumed two 240-mL glasses of CaD , CaDEA , or Ca fortified orange juice daily for 12 weeks . MAIN OUTCOME MEASURES Serum 25(OH)D , α-tocopherol , and retinol concentrations . STATISTICAL ANALYSES Changes in 25(OH)D , α-tocopherol , retinol , and parathyroid hormone concentrations were examined . Covariates included sex , age , race/ethnicity , body mass index , and baseline 25(OH)D , α-tocopherol , retinol , or parathyroid hormone levels . Multivariate models and repeated measures analysis of variance tested for group differences with pre-post measures ( n=141 ) . RESULTS Baseline 25(OH)D was 68.4±27.7 nmol/L ( 27.4±11.10 ng/mL ) ) , with 21.7 % of participants having inadequate 25(OH)D ( < 50 nmol/L [ 20.03 ng/mL ] ) . The CaD group 's 25(OH)D increase was greater than that of the Ca group ( 12.7 nmol/L [ 5.09 ng/mL ] , 95 % CI 1.3 to 24.1 ; P=0.029 ) . The CaDEA group 's increase in α-tocopherol concentration was greater than that in the Ca or CaD groups ( 3.79 μmol/L [ 0.16 μg/mL ] , 95 % CI 2.5 to 5.1 and 3.09 μmol/L [ 0.13 μg/mL ] , 95 % CI -1.8 to 4.3 ) , respectively ( P<0.0001 ) . Retinol levels did not change , and body weight remained as expected for growth . CONCLUSIONS Daily consumption of orange juice providing 200 IU vitamin D and 12 IU vitamin E increased 25(OH)D and α-tocopherol concentrations in young children within 12 weeks This study evaluated the effects of a multi-micronutrient fortified juice drink given in different frequencies of consumption on hemoglobin ( Hb ) concentration of schoolchildren . Hb was measured in 2423 schoolchildren aged 6- to 9-years-old at baseline . All anemic children ( n = 246 ) were r and omly allocated into groups : Daily dose ( HD : high dose ) , 5X/week ( MD : Moderate Dose ) , 3X/week ( LD : Low Dose ) and unfortified ( Control ) . Pre- and post- study measurements of micronutrients were collected from 228 children . At the endpoint , significant Hb increases were observed in all groups , but there was no significant difference between groups . There was a significant reduction in anemia prevalence in all groups from 100 % to 36 % ( Control ) , 30 % ( LD ) , 23 % ( MD ) and 26 % ( HD ) . No dose-response effect was observed in Hb in this population . Most likely , this result ed from better than expected micronutrient status and lower than expected severity of anemia and micronutrient deficiencies in this cohort . It is unlikely that the addition of a fortified beverage to school feeding programs in this population would have a positive impact . Whether such an intervention would be cost-effective as a preventative approach needs to be assessed . This study demonstrates the importance of targeting such interventions to appropriate population Abstract Objectives : There is no m and atory folic acid fortification of food in Finl and . We investigated the effects of mineral water fortified with folic acid , vitamins B6 , B12 , D and calcium on serum and erythrocyte folate concentrations , serum vitamin B12 and plasma homocysteine concentrations in pregnancy . Design : A r and omized , controlled , double-blind , parallel-group intervention study . Methods : Seventy-four pregnant women were recruited from two health care units . The study began at the eleventh week with a two-week run-in period , followed by an eight-week intervention period . The diet was monitored by food records . During the intervention , subjects consumed 1000 mL/day fortified or normal mineral water . The pregnancies were monitored carefully . Results : The folate intake was 255 μg/day in the study group and 274 μg/day in the controls . Serum folate concentrations increased in the study group by 10.3 nmol/L and decreased in the controls by 2.7 nmol/L ( P<0.05 ) during the study . The erythrocyte folate concentrations increased in the study group by 360.9 nmol/L and in the controls by 195.6 nmol/L ( P=0.004 ) and serum homocysteine concentrations fell by 1.1 μmol/L and by 0.3 μmol/L , respectively ( P<0.05 ) . Conclusions : Finnish pregnant women have low dietary folate intake . Fortified mineral water  improved folate status and reduced plasma homocysteine concentrations in the pregnant subjects 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 BACKGROUND Improved complementary feeding is cited as a critical factor for reducing stunting . Consumption of meats has been advocated , but its efficacy in low-re source setting s has not been tested . OBJECTIVE The objective was to test the hypothesis that daily intake 
    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: In Cambodia , micronutrient deficiencies remain a critical public health problem . Our objective was to evaluate the impact of multi-micronutrient fortified rice ( MMFR ) formulations , distributed through a World Food Program school-meals program ( WFP-SMP ) , on the hemoglobin concentrations and iron and vitamin A ( VA ) status of Cambodian schoolchildren . The FORISCA-UltraRice+NutriRice study was a double-blind , cluster-r and omized , placebo-controlled trial . Sixteen schools participating in WFP-SMP were r and omly assigned to receive extrusion-fortified rice ( UltraRice Original , UltraRice New ( URN ) , or NutriRice ) or unfortified rice ( placebo ) six days a week for six months . Four additional schools not participating in WFP-SMP were r and omly selected as controls . A total of 2440 schoolchildren ( 6–16 years old ) participated in the biochemical study . Hemoglobin , iron status , estimated using inflammation-adjusted ferritin and transferrin receptors concentrations , and VA status , assessed using inflammation-adjusted retinol-binding protein concentration , were measured at the baseline , as well as at three and six months . Baseline prevalence of anemia , depleted iron stores , tissue iron deficiency , marginal VA status and VA deficiency were 15.6 % , 1.4 % , 51.0 % , 7.9 % , and 0.7 % , respectively . The strongest risk factors for anemia were hemoglobinopathy , VA deficiency , and depleted iron stores ( all p < 0.01 ) . After six months , children receiving NutriRice and URN had 4 and 5 times less risk of low VA status , respectively , in comparison to the placebo group . Hemoglobin significantly increased ( + 0.8 g/L ) after three months for the URN group in comparison to the placebo group ; however , this difference was no longer significant after six months , except for children without inflammation . MMFR containing VA effectively improved the VA status of schoolchildren . The impact on hemoglobin and iron status was limited , partly by sub- clinical inflammation . MMFR combined with non-nutritional approaches addressing anemia and inflammation should be further investigated Background Anemia continues to be a major public health problem among children in many regions of the world , and it is still not clear which strategy to treat it is most effective . Objective To evaluate the efficacy and children 's acceptance of several recognized strategies to treat anemia . Methods Non-breastfed children ( n = 577 ) , 6 to 43 mo of age , were screened for the trial ; 267 were anemic ( hemoglobin < 11.7 g/dL ) , and 266 of those were r and omized into 1 of 5 treatments to received daily either : an iron supplement ( IS ) , an iron+folic acid supplement ( IFS ) , a multiple micronutrient supplement ( MMS ) , a micronutrient-fortified complementary food as porridge powder ( FCF ) , or zinc+iron+ascorbic acid fortified water ( FW ) . The iron content of each daily dose was 20 , 12.5 , 10 , 10 and 6.7 mg respectively . Hemoglobin ( Hb ) , ferritin , total iron , weight and height were measured at baseline and after 4 months of treatment . Morbidity , treatment acceptability and adherence were recorded during the intervention . Results All treatments significantly increased Hb and total iron concentration ; ferritin did not change significantly . Groups MMS , IS and IFS  increased Hb ( g/dL ) [ 1.50 ( 95%CI : 1.17 , 1.83 ) , 1.48 [ ( 1.18 , 1.78 ) and 1.57 ( 1.26 , 1.88 ) , respectively ] and total iron ( ( μg/dL ) [ 0.15 ( 0.01 , 0.29 ) , 0.19 ( 0.06 , 0.31 ) and 0.12(-0.01 , 0.25 ) , respectively ] significantly more than FCF [ 0.92 ( 0.64 , 1.20 ) ] but not to FW group [ 0.14 ( 0.04 , 0.24 ) ] . The prevalence of anemia was reduced to a greater extent in the MMS and IFS groups ( 72 % and 69 % , respectively ) than in the FCF group ( 45 % ) ( p < 0.05 ) . There were no significant differences in anthropometry or in the number of episodes of diarrhea and respiratory infections among treatment groups . The supplements MMS and IS were less acceptable to children , than IFS , FCF and FW . Conclusion The three supplements IS , ISF and MMS  increased Hb more than the FCF ; the supplements that contained micronutrients ( IFS and MMS ) were more effective for reducing the prevalence of anemia . In general , fortified foods were better accepted by the study participants than supplements . Clinical Trial.gov BACKGROUND Provision of fortified juices may provide a convenient method to maintain and increase blood fat-soluble vitamins . OBJECTIVE To determine whether children consuming orange juice fortified with calcium and combinations of vitamins D , E , and A  could increase serum 25-hydroxyvitamin D [ 25(OH)D ] , α-tocopherol , and retinol levels . DESIGN A 12-week r and omized , double-blind , controlled trial . PARTICIPANTS / SETTING One hundred eighty participants ( aged 8.04±1.42 years ) were recruited at Tufts ( n=70 ) and Boston University ( n=110 ) during 2005 - 2006 . Of those recruited , 176 children were r and omized into three groups : CaD ( 700 mg calcium+200 IU vitamin D ) , CaDEA ( 700 mg calcium+200 IU vitamin D+12 IU vitamin E+2,000 IU vitamin A as beta carotene ) , or Ca ( 700 mg calcium ) . Children consumed two 240-mL glasses of CaD , CaDEA , or Ca fortified orange juice daily for 12 weeks . MAIN OUTCOME MEASURES Serum 25(OH)D , α-tocopherol , and retinol concentrations . STATISTICAL ANALYSES Changes in 25(OH)D , α-tocopherol , retinol , and parathyroid hormone concentrations were examined . Covariates included sex , age , race/ethnicity , body mass index , and baseline 25(OH)D , α-tocopherol , retinol , or parathyroid hormone levels . Multivariate models and repeated measures analysis of variance tested for group differences with pre-post measures ( n=141 ) . RESULTS Baseline 25(OH)D was 68.4±27.7 nmol/L ( 27.4±11.10 ng/mL ) ) , with 21.7 % of participants having inadequate 25(OH)D ( < 50 nmol/L [ 20.03 ng/mL ] ) . The CaD group 's 25(OH)D increase was greater than that of the Ca group ( 12.7 nmol/L [ 5.09 ng/mL ] , 95 % CI 1.3 to 24.1 ; P=0.029 ) . The CaDEA group 's increase in α-tocopherol concentration was greater than that in the Ca or CaD groups ( 3.79 μmol/L [ 0.16 μg/mL ] , 95 % CI 2.5 to 5.1 and 3.09 μmol/L [ 0.13 μg/mL ] , 95 % CI -1.8 to 4.3 ) , respectively ( P<0.0001 ) . Retinol levels did not change , and body weight remained as expected for growth . CONCLUSIONS Daily consumption of orange juice providing 200 IU vitamin D and 12 IU vitamin E increased 25(OH)D and α-tocopherol concentrations in young children within 12 weeks This study evaluated the effects of a multi-micronutrient fortified juice drink given in different frequencies of consumption on hemoglobin ( Hb ) concentration of schoolchildren . Hb was measured in 2423 schoolchildren aged 6- to 9-years-old at baseline . All anemic children ( n = 246 ) were r and omly allocated into groups : Daily dose ( HD : high dose ) , 5X/week ( MD : Moderate Dose ) , 3X/week ( LD : Low Dose ) and unfortified ( Control ) . Pre- and post- study measurements of micronutrients were collected from 228 children . At the endpoint , significant Hb increases were observed in all groups , but there was no significant difference between groups . There was a significant reduction in anemia prevalence in all groups from 100 % to 36 % ( Control ) , 30 % ( LD ) , 23 % ( MD ) and 26 % ( HD ) . No dose-response effect was observed in Hb in this population . Most likely , this result ed from better than expected micronutrient status and lower than expected severity of anemia and micronutrient deficiencies in this cohort . It is unlikely that the addition of a fortified beverage to school feeding programs in this population would have a positive impact . Whether such an intervention would be cost-effective as a preventative approach needs to be assessed . This study demonstrates the importance of targeting such interventions to appropriate population Abstract Objectives : There is no m and atory folic acid fortification of food in Finl and . We investigated the effects of mineral water fortified with folic acid , vitamins B6 , B12 , D and calcium on serum and erythrocyte folate concentrations , serum vitamin B12 and plasma homocysteine concentrations in pregnancy . Design : A r and omized , controlled , double-blind , parallel-group intervention study . Methods : Seventy-four pregnant women were recruited from two health care units . The study began at the eleventh week with a two-week run-in period , followed by an eight-week intervention period . The diet was monitored by food records . During the intervention , subjects consumed 1000 mL/day fortified or normal mineral water . The pregnancies were monitored carefully . Results : The folate intake was 255 μg/day in the study group and 274 μg/day in the controls . Serum folate concentrations increased in the study group by 10.3 nmol/L and decreased in the controls by 2.7 nmol/L ( P<0.05 ) during the study . The erythrocyte folate concentrations increased in the study group by 360.9 nmol/L and in the controls by 195.6 nmol/L ( P=0.004 ) and serum homocysteine concentrations fell by 1.1 μmol/L and by 0.3 μmol/L , respectively ( P<0.05 ) . Conclusions : Finnish pregnant women have low dietary folate intake . Fortified mineral water  improved folate status and reduced plasma homocysteine concentrations in the pregnant subjects 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 BACKGROUND Improved complementary feeding is cited as a critical factor for reducing stunting . Consumption of meats has been advocated , but its efficacy in low-re source setting s has not been tested . OBJECTIVE The objective was to test the hypothesis that daily intake 
    Output:
    