Open AccessThe Effect of Iron Fortification on Iron (Fe) Status and Inflammation: A Randomized Controlled Trial
Author(s) -
Jingqiu Ma,
Qianqian Sun,
Jinrong Liu,
HU Yan-qi,
Shanshan Liu,
Jie Zhang,
Xia Sheng,
K. Michael Hambidge
Publication year - 2016
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0167458
Subject(s) - ferritin , iron deficiency , calprotectin , anemia , medicine , iron deficiency anemia , hemoglobin , randomized controlled trial , serum ferritin , gastroenterology , zoology , dietary iron , fortification , feces , iron status , iron supplement , physiology , food science , chemistry , biology , paleontology , disease , inflammatory bowel disease
Background Iron deficiency (ID) is common in toddlers in developing countries. Iron fortified or meat-based complementary foods may be effective to prevent ID. Objective Our objective was to compare iron status at 18 months and growth from 6 to 18 months in rural poor toddlers fed 3 different complementary foods. Methods The study was nested within a larger trial in which 6-month-old infants were randomized to receive 50g/d meat (MG), an equi-caloric fortified cereal supplement (FG) or local cereal supplement (LG) for 1 year. Hb, sTfR, HsCRP, ferritin and AGP were measured in 410 blood samples collected by a random sampling (MG, 137; FG, 140; LG, 133); calprotectin was measured in feces. Body iron = -[log (sTfR ×1000/ferritin)-2.8229] /0.1207. ID = ferritin<12ug/L. Results The toddlers in FG had the significantly highest levels in serum ferritin and body iron ( P = 0.043, 0.004), and the rates of both ID and iron deficiency anemia (IDA) were the lowest in FG ( P = 0.010, 0.021). The rate of systemic inflammation in FG was 30.71%, which was the highest among three groups ( P = 0.042). No intervention effects on either the rates of ID and IDA or iron stores (serum ferritin and body iron) were shown in MG. The change in length-for-age z scores (LAZ) from 6 to 18 months among three groups was significantly different ( P = 0.021) and a smaller decrease of LAZ in MG and a larger decrease of LAZ in FG were observed. Conclusion Iron fortified cereal improved iron status of poor rural toddlers but was also associated with systemic inflammation which was likely to impair their growth.