In-home fortification with 2.5 mg iron as NaFeEDTA does not reduce anaemia but increases weight gain: a randomised controlled trial in Kenyan infants.

Abstract

In-home fortification of infants with micronutrient powders (MNPs) containing 12.5 mg iron may increase morbidity from infections; therefore, an efficacious low-dose iron-containing MNP might be advantageous. Effects of iron-containing MNPs on infant growth are unclear. We assessed the efficacy of a low-iron MNP on iron status and growth and monitored safety in a randomised, controlled, double-blind 1-year trial in 6-month-old infants (n = 287) consuming daily a maize porridge fortified with either a MNP including 2.5 mg iron as NaFeEDTA (MNP + Fe) or the same MNP without iron (MNP - Fe). At baseline, after 6 and 12 months, we determined haemoglobin (Hb), iron status [serum ferritin (SF), soluble transferrin receptor (sTfR) and zinc protoporphyrin (ZPP)], inflammation [C-reactive protein (CRP)] and anthropometrics. We investigated safety using weekly morbidity questionnaires asking for diarrhoea, cough, flu, bloody or mucus-containing stool and dyspnoea, and recorded any other illness. Furthermore, feeding history and compliance were assessed weekly. At baseline, 71% of the infants were anaemic and 22% iron deficient; prevalence of inflammation was high (31% had an elevated CRP). Over the 1 year, Hb increased and SF decreased in both groups, without significant treatment effects of the iron fortification. At end point, the weight of infants consuming MNP + Fe was greater than in the MNP - Fe group (9.9 vs. 9.5 kg, P = 0.038). Mothers of infants in the MNP + Fe group reported more infant days spent with cough (P = 0.003) and dyspnoea (P = 0.0002); there were no significant differences on any other of the weekly morbidity measures. In this study, low-dose iron-containing MNP did not improve infant's iron status or reduce anaemia prevalence, likely because absorption was inadequate due to the high prevalence of infections and the low-iron dose.

• Authors: Tanja Barth-Jaeggi, Diego Moretti, Jane Kvalsvig, Penny A Holding, Jane Njenga, Alice Mwangi, Meera K Chhagan, Christophe Lacroix, Michael B Zimmermann
• Journal: Maternal & child nutrition (Matern Child Nutr) Vol. 11 Suppl 4 Pg. 151-62 (Dec 2015) ISSN: 1740-8709 [Electronic] England
• PMID: 25420455 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: © 2014 John Wiley & Sons Ltd.

Chemical References

• Ferric Compounds
• Hemoglobins
• Micronutrients
• C-Reactive Protein
• Ferritins
• Edetic Acid
• Iron
• Fe(III)-EDTA

Topics

• Anemia, Iron-Deficiency (drug therapy, epidemiology)
• C-Reactive Protein (metabolism)
• Dietary Supplements
• Double-Blind Method
• Edetic Acid (administration & dosage)
• Female
• Ferric Compounds (administration & dosage)
• Ferritins (blood)
• Food, Fortified
• Hemoglobins (metabolism)
• Humans
• Infant
• Iron (blood)
• Kenya (epidemiology)
• Male
• Micronutrients (administration & dosage, analysis)
• Morbidity
• Patient Compliance
• Treatment Outcome
• Weight Gain (drug effects)
• Zea mays