Effects of multiple micronutrient supplementation on cognitive function in children: a systematic review and meta-analysis of randomized controlled trials.

Abstract

An updated and comprehensive understanding of the impact of multiple micronutrient (MMN) supplementation on cognitive function in children remains elusive. This study aimed to assess the effects of MMN supplementation on cognitive function in children under 18. We searched PubMed, Scopus, and WOS through May 11, 2025. Eligible randomized controlled trials in children and adolescents (&#x2264;18 years) comparing MMN supplementation (&#x2265;3 micronutrients) with placebo or control and assessing cognitive outcomes were included. Risk of bias was independently assessed by two reviewers using the Cochrane tool, with disagreements resolved by a third reviewer. Cognitive outcomes were divided into nine domains, and a meta-analysis using random-effects models was conducted. Thirty-five studies met the inclusion criteria, with a total of 19,343 participants. Based on the RoB assessment, only four studies were classified as low risk. Our analysis showed a significant positive effect of supplementation on memory (SMD: 0.22; 95% CI: 0.08 to 0.35, <i>P</i>&#x2009;=&#x2009;0.002) (<i>I</i>²&#x2009;=&#x2009;73.8%, <i>P</i>&#x2009;&lt;&#x2009;0.000; GRADE: very low) and language (SMD: 0.09; 95% CI: 0.03 to 0.16, <i>P</i>&#x2009;=&#x2009;0.006) (<i>I</i>²&#x2009;=&#x2009;39.0, <i>P</i>&#x2009;=&#x2009;0.067; GRADE: high). No significant effects were found in other cognitive domains. Overall, the meta-analysis suggests that the use of MMN supplements in children may result in slight improvements in language and memory domains. However, given the small effect sizes and considerable heterogeneity, the data are insufficient to support the regular intake of MMN for cognitive improvement in children.