Home fortification of complementary foods with micronutrient supplements is well accepted and has positive effects on infant iron status in Ghana

Am J Clin Nutr. 2008 Apr;87(4):929-38. doi: 10.1093/ajcn/87.4.929.

Abstract

Background: Micronutrient deficiencies are common during infancy, and optimal approaches for their prevention need to be identified.

Objective: The objective was to compare the efficacy and acceptability of Sprinkles (SP), crushable Nutritabs (NT), and fat-based Nutributter (NB; 108 kcal/d), which provide 6, 16, and 19 vitamins and minerals, respectively, when used for home fortification of complementary foods.

Design: Ghanaian infants were randomly assigned to receive SP (n = 105), NT (n = 105), or NB (n = 103) daily from 6 to 12 mo of age. We assessed dietary intake, morbidity, and compliance weekly. Hemoglobin and plasma ferritin, TfR, C-reactive protein, and zinc were measured at 6 and 12 mo. We used an exit interview to assess acceptability. A randomly selected control group of infants who received no intervention (NI; n = 96) were assessed at 12 mo.

Results: All supplements were well accepted, and the mean percentage of days that supplements were consumed (87%) did not differ between groups. At 12 mo, all 3 intervention groups had significantly higher ferritin and lower TfR concentrations than did the NI control group. Mean (+/- SD) hemoglobin was significantly higher in NT (112 +/- 14 g/L) and NB (114 +/- 14 g/L) but not in SP (110 +/- 14 g/L) infants than in NI infants (106 +/- 14 g/L). The prevalence of iron deficiency anemia was 31% in the NI control group compared with 10% in the intervention groups combined (P < 0.0001).

Conclusion: All 3 options for home fortification of complementary foods are effective for reducing the prevalence of iron deficiency in such populations.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Anemia, Iron-Deficiency / blood
  • Anemia, Iron-Deficiency / epidemiology
  • Anemia, Iron-Deficiency / prevention & control*
  • C-Reactive Protein / metabolism
  • Female
  • Ferritins / blood
  • Food, Fortified*
  • Ghana / epidemiology
  • Growth / drug effects
  • Hemoglobins / metabolism
  • Humans
  • Infant
  • Infant Food
  • Infant Nutrition Disorders / prevention & control
  • Infant Nutritional Physiological Phenomena / drug effects
  • Infant Nutritional Physiological Phenomena / physiology*
  • Iron / blood*
  • Male
  • Micronutrients / administration & dosage*
  • Micronutrients / deficiency
  • Nutritional Status*
  • Prevalence
  • Transferrin / metabolism
  • Weaning
  • Zinc / blood

Substances

  • Hemoglobins
  • Micronutrients
  • Transferrin
  • C-Reactive Protein
  • Ferritins
  • Iron
  • Zinc