{"id":"c3dec417-bca7-56bc-b330-f71e22c3acb3","stable_key":"548ab9d6-3a9b-5bed-879c-17d03813b636:b2-pregnancy-multiple-nutrients","predicate":"participated_in_multinutrient_hematologic_response","statement":"Adding retinol and/or riboflavin to iron-folic-acid treatment reduced anemia prevalence more than iron-folic-acid alone; the combined retinol-riboflavin arm gained 5.4±1.1 g/L more hemoglobin than the reference arm.","claim_class":"observational","status":"source_derived_draft","evidence_grade":"ungraded","direction":"context_dependent","is_public":true,"mechanism_event_id":"5dd3c5d1-59f7-5c44-8721-6ce4fca41140","mechanism_event_label":"Several nutrients were limiting in this population; the combination helped more than iron and folic acid alone.","subject":{"id":"86eb1eee-a8d1-539c-8c17-0911f69b6f1b","slug":"riboflavin","display_name":"Riboflavin (vitamin B2)","entity_type_key":"small_molecule"},"object":{"id":"2f3a8d0b-7b92-58d2-afc9-dd26a7cd1e0e","slug":"blood-hemoglobin-concentration","display_name":"Blood hemoglobin concentration","entity_type_key":"cellular_process"},"evidence_count":1,"mechanism_event":{"id":"5dd3c5d1-59f7-5c44-8721-6ce4fca41140","stable_key":"548ab9d6-3a9b-5bed-879c-17d03813b636:b2-pregnancy-multiple-nutrients-event","event_type":"observed_intervention","label":"Several nutrients were limiting in this population; the combination helped more than iron and folic acid alone.","description":"Adding retinol and/or riboflavin to iron-folic-acid treatment reduced anemia prevalence more than iron-folic-acid alone; the combined retinol-riboflavin arm gained 5.4±1.1 g/L more hemoglobin than the reference arm.","status":"provisional","compartment":null,"participants":[{"entity":{"id":"89bcaf42-b4ab-5760-8c2e-44eace10cee0","slug":"iron","display_name":"Iron","entity_type_key":"nutrient_element"},"role":"background_nutrient","stoichiometry":null,"state_label":"","sequence_order":0,"notes":""},{"entity":{"id":"d322bfef-5135-599f-82e6-0aa58748dc8b","slug":"folic-acid","display_name":"Folic acid","entity_type_key":"small_molecule"},"role":"background_nutrient","stoichiometry":null,"state_label":"","sequence_order":1,"notes":""},{"entity":{"id":"148c57d8-c658-5769-89e8-1194cef2a782","slug":"retinol","display_name":"All-trans-retinol","entity_type_key":"small_molecule"},"role":"cointervention","stoichiometry":null,"state_label":"","sequence_order":2,"notes":""},{"entity":{"id":"86eb1eee-a8d1-539c-8c17-0911f69b6f1b","slug":"riboflavin","display_name":"Riboflavin (vitamin B2)","entity_type_key":"small_molecule"},"role":"subject","stoichiometry":null,"state_label":"","sequence_order":3,"notes":""},{"entity":{"id":"2f3a8d0b-7b92-58d2-afc9-dd26a7cd1e0e","slug":"blood-hemoglobin-concentration","display_name":"Blood hemoglobin concentration","entity_type_key":"cellular_process"},"role":"target","stoichiometry":null,"state_label":"","sequence_order":4,"notes":""}]},"contexts":[{"dimension":"cross_nutrient","value_text":"Direct clinical comparison involving B2, vitamin A, iron and folic acid.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"experimental_model","value_text":"366 anemic pregnant women in rural China randomized among four groups for two months; all received iron and folic acid.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"exposure","value_text":"All arms: 60 mg/day iron plus 400 micrograms/day folic acid; added retinol 2000 micrograms/day, riboflavin 1 mg/day, both, or neither. Trial exposures, not recommendations.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"limitations","value_text":"Combination effect cannot be assigned solely to B2 or assumed to be biochemical synergy; anemic pregnant population, multiple co-deficiencies, two-month endpoint.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"nutrient_topic","value_text":"Riboflavin research collection; topical membership is not evidence of a direct dietary effect.","comparator":null,"unit":null,"notes":"","entity":{"slug":"riboflavin","display_name":"Riboflavin (vitamin B2)","entity_type_key":"small_molecule"}},{"dimension":"organism","value_text":"Homo sapiens","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"plain_language","value_text":"Several nutrients were limiting in this population; the combination helped more than iron and folic acid alone.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"primary_references","value_text":"[b2-ma2008] Retinol and riboflavin supplementation decreases the prevalence of anemia in Chinese pregnant women taking iron and folic Acid supplements (2008). https://pubmed.ncbi.nlm.nih.gov/18806105/ DOI: 10.1093/jn/138.10.1946","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"tissue_or_cell_type","value_text":"Human clinical setting","comparator":null,"unit":null,"notes":"","entity":null}],"evidence":[{"id":"e5b47c8e-82f8-5cae-97e0-edaa2152b462","evidence_kind":"source_excerpt","locator":"Lines 1604-1615","start_line":1604,"end_line":1615,"excerpt":"### b2-pregnancy-multiple-nutrients\nAdding retinol and/or riboflavin to iron-folic-acid treatment reduced anemia prevalence more than iron-folic-acid alone; the combined retinol-riboflavin arm gained 5.4±1.1 g/L more hemoglobin than the reference arm.\nCondition category: normal\nnutrient_topic: Riboflavin research collection; topical membership is not evidence of a direct dietary effect.\nplain_language: Several nutrients were limiting in this population; the combination helped more than iron and folic acid alone.\norganism: Homo sapiens\ntissue_or_cell_type: Human clinical setting\nexperimental_model: 366 anemic pregnant women in rural China randomized among four groups for two months; all received iron and folic acid.\nlimitations: Combination effect cannot be assigned solely to B2 or assumed to be biochemical synergy; anemic pregnant population, multiple co-deficiencies, two-month endpoint.\nexposure: All arms: 60 mg/day iron plus 400 micrograms/day folic acid; added retinol 2000 micrograms/day, riboflavin 1 mg/day, both, or neither. Trial exposures, not recommendations.\ncross_nutrient: Direct clinical comparison involving B2, vitamin A, iron and folic acid.\n[b2-ma2008] Retinol and riboflavin supplementation decreases the prevalence of anemia in Chinese pregnant women taking iron and folic Acid supplements (2008). https://pubmed.ncbi.nlm.nih.gov/18806105/ DOI: 10.1093/jn/138.10.1946","model_system":"366 anemic pregnant women in rural China randomized among four groups for two months; all received iron and folic acid.","directness":"author_interpretation","verification_status":"source_derived_draft","notes":"Exact curation-document quotation, not publisher quotation. Study references: [b2-ma2008] Retinol and riboflavin supplementation decreases the prevalence of anemia in Chinese pregnant women taking iron and folic Acid supplements (2008). https://pubmed.ncbi.nlm.nih.gov/18806105/ DOI: 10.1093/jn/138.10.1946","relationship":"supports","weight":1.0,"link_notes":"","source":{"id":"4f7c9578-82bf-5e2d-b5c4-72a79fb4f6af","stable_key":"import-548ab9d6-3a9b-5bed-879c-17d03813b636","title":"Riboflavin: mechanisms, deficiency and nutrient interactions (2026-09-17)","document_type":"imported_text","citation_label":"AI-assisted literature curation; primary study URLs and scope retained in the document and extraction. Not publisher full text.","file_path":"","sha256":"680cb6bc8249877f2410f551807f10d390fdd719014137d7414ba3420e29228d","revision_id":"7a61e299-908d-5372-860b-99ed190f9d7a","review_status":"unverified_draft","notes":""}}],"relations":[],"conflicts":[],"corrections":[],"research":null}