The therapeutic effects of multivitamins on growth in normal and malnourished children: A systematic review

Background: Micronutrient deficiencies are a significant contributor to growth failure in children worldwide, particularly in low- and middle-income countries. Multivitamin and Mult micronutrient (MMN) supplementation has gained attention as a low-cost intervention, but its impact on growth parameters—height, weight, and insulin-like growth factor-1 (IGF-1)—remains inconsistently reported.

Objectives: To evaluate the effect of multivitamin and MMN supplementation on child growth outcomes, including height standard deviation score (SDS), weight gain, and IGF-1 levels, and to explore subgroup differences based on formulation, intervention duration, and baseline nutritional status.

Methods: A PRISMA-compliant systematic review and meta-analysis was conducted, including 50 studies involving over 15,000 children. Data were extracted on anthropometric and biochemical responses to supplementation. Subgroup analyses examined effects by region (Africa, Asia, Latin America), supplement type (multivitamins, MMNs, fortified blends), and duration (≤3 months vs. >3 months). IGF-1 outcomes were stratified by assay method (ELISA vs. CLIA), and GRADE criteria were applied to assess evidence quality.

Results: Supplementation significantly improved height SDS (SMD: 0.52), weight (SMD: 0.47), and IGF-1 levels (SMD: 0.53). Effects were most pronounced in malnourished children and when interventions exceeded 3 months. South Asian and Sub-Saharan African populations showed stronger responses than those in Latin America. Fortified MMNs outperformed standard multivitamins. Heterogeneity in IGF-1 outcomes was higher with CLIA assays, prompting a GRADE downgrade from moderate to low certainty. Adverse events were infrequent and mild.

Public Health Implications: Multivitamin and MMN supplementation is effective and safe for promoting growth and metabolic health in nutritionally vulnerable children. Long-term programs using fortified blends should be prioritized in high-burden regions. Standardized outcome reporting and assay methods are essential for comparability.

Conclusion: Multivitamin supplementation offers measurable benefits in child growth and IGF-1 regulation and should be integrated into region-specific nutrition strategies.