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close this book4th Report on the World Nutrition Situation - Nutrition throughout the Life Cycle (ACC/SCN, 2000, 138 p.)
View the document(introduction...)
View the document2.1 Iron Deficiency Update
View the document2.2 Iodine Deficiency Disorders Update
View the document2.3 Vitamin A Deficiency Update
View the document2.4 Multiple Micronutrient Deficiencies
View the documentSummary

2.4 Multiple Micronutrient Deficiencies

Many population groups in the developing world suffer from multiple nutrient deficiencies. The clustering of iron and vitamin A deficiencies has already been mentioned, but there are many more significant overlaps.

Moreover, deficiencies often interact. Vitamin A supplementation at appropriate levels has been found to improve not only vitamin A status but also iron metabolism in pregnant women and preschool and school-age children.28 It should be considered where iron deficiency is common. A combined iron and vitamin A supplement has been found to be more than 40% more effective in reducing anaemia than an iron supplement alone. Such findings are not specific to supplementation. A vitamin A sugar fortification programme in Guatemala resulted in improved iron status of the population,29 while a trial with vitamin A - fortified MSG in Indonesia increased haemoglobin levels among children.30

Given such frequent overlaps and given the fact that at certain stages of the life cycle - most notably during pregnancy - it may be difficult for dietary needs to be met through diet alone, multiple micro-nutrient supplementation holds clear potential to address multiple nutrient deficiencies in a cost-effective manner. Recent advances have been made in this area since 1998. One publication has addressed key issues concerning the design and implementation of such programmes.31 Also, a joint UNICEF/WHO/UNU workshop was convened in 1999 to consider the composition of a multi-micronutrient supplement to be used in forthcoming trials among pregnant women in developing countries.