Haematological effects of multimicronutrient supplementation in non-pregnant Gambian women

Background/Objectives: The use of multimicronutrient (MMN) supplementation to reduce the burden of anaemia in nonpregnant women of reproductive age has been little studied, particularly in Africa. The objective of the study was to evaluate haematological outcomes in non-pregnant, rural Gambian women of reproductive age, receiving daily MMN supplements for 1 year. Subjects/Methods: The study in 293 women aged from 17 to 45 years old was nested within a double-blind, randomized placebo-controlled trial of periconceptional MMN supplementation [ISRCTN 13687662], using the United Nations International Multiple Micronutrient Preparation (UNIMMAP), received daily for 1 year or until conception. Red cell parameters and free erythrocyte protoporphyrin concentration were measured at baseline and after 12 months in those women who did not conceive. Results: Anaemic women (haemoglobin concentration <12 g per 100 ml) were more likely to be older and in economic deficit at baseline. Mean change in haemoglobin concentration was +0.6 +/- 1.4 g per 100 ml in the intervention arm and -0.2 +/- 1.2 g per 100 ml in the placebo arm (P<0.001). After supplementation with MMN, the relative risk of anaemia (<12 g per 100 ml) was 0.59 ( 0.46, 0.76) compared with placebo. Anaemic subjects at baseline showed an increase in mean haemoglobin from 10.6 g per 100 ml to 11.8 g/l (P<0.001) after MMN supplementation. Conclusions: MMN supplementation should be considered as a strategy for improving the micronutrient and haematological status of non-pregnant women of reproductive age. European Journal of Clinical Nutrition (2009) 63, 970-977; doi: 10.1038/ejcn.2009.11; published online 4 March 2009