Virtanen M A, Svahn C J, Viinikka L U, Räihä N C, Siimes M A, Axelsson I E
Department of Clinical Chemistry, University of Helsinki, Finland.
Acta Paediatr. 2001 Jul;90(7):724-31.
Iron intakes and iron status were evaluated in 36 young Swedish children given either iron-fortified or unfortified cow's milk. All children had good iron status and had received breast milk or iron-fortified formulae during infancy. Twenty 1-y-old children were randomized to a diet with iron-fortified milk (7.0 or 14.9 mg Fe l(-1) and 16 to a diet with unfortified milk. The iron intakes in the unfortified group at 15 and 18 mo (mean +/- SD 5.19 +/- 2.29 and 5.84 +/- 1.62 mg d(-1)) were low in relation to Nordic Nutrition Recommendations, while the intakes in the iron-fortified group (10.20 +/- 2.60 and 10.87 +/- 2.79mg d(-1)) were normal in relation to recommendations. The gain (increase) from receiving fortified diet during the study period was at most [upper limit for 95% confidence interval (CI)] 2.6 g l(-1) in blood haemoglobin, 1.9 fl in mean corpuscular volume, 2.7 micromol in serum iron and 4.5% in transferrin iron saturation, and the gain (decrease) was at most (lower limit for 95% CI) 0.29g l(-1) in serum transferrin and 0.9mg l(-1) in serum transferrin receptor (TfR). None of these differences was statistically significant. There was an almost significantly higher increase in serum ferritin (1.4 times higher relation of values at the end compared with the beginning, p = 0.06) and a significantly higher (1.2; p = 0.047) decrease in TfR/ log10 ferritin ratio in the fortified group.
One-year-old children starting out with good iron status given either iron-fortified or unfortified cow's milk from 12 to 18 mo maintain sufficient iron status during this period. However, children fed unfortified cow's milk have an iron intake which is low in relation to recommendations and the quantitative development of their reserve iron in iron stores seems to be weaker than that of the fortified group. The consequences of this require further study.
对36名瑞典幼儿的铁摄入量和铁状态进行了评估,这些幼儿分别饮用了铁强化或未强化的牛奶。所有儿童铁状态良好,且在婴儿期均接受过母乳喂养或铁强化配方奶。20名1岁儿童被随机分配到饮用铁强化牛奶(7.0或14.9毫克铁/升,共16名)的饮食组,另外16名被分配到饮用未强化牛奶的饮食组。未强化组15个月和18个月时的铁摄入量(均值±标准差分别为5.19±2.29和5.84±1.62毫克/天)与北欧营养推荐相比偏低,而铁强化组的摄入量(10.20±2.60和10.87±2.79毫克/天)与推荐量相比正常。在研究期间,从接受强化饮食中获得的收益(增加量),血红蛋白最多增加[95%置信区间(CI)上限]2.6克/升,平均红细胞体积增加1.9飞升,血清铁增加2.7微摩尔,转铁蛋白铁饱和度增加4.5%;而血清转铁蛋白最多减少(95%CI下限)0.29克/升,血清转铁蛋白受体(TfR)最多减少0.9毫克/升。这些差异均无统计学意义。强化组血清铁蛋白的增加几乎具有显著性(与开始时相比,结束时的值高出1.4倍,p = 0.06),且TfR/ log10铁蛋白比值的降低具有显著性(降低1.2倍;p = 0.047)。
1岁时铁状态良好的儿童,在12至18个月期间饮用铁强化或未强化的牛奶,在此期间均能维持足够的铁状态。然而,饮用未强化牛奶的儿童铁摄入量与推荐量相比偏低,其铁储存中储备铁的定量发展似乎比强化组弱。对此的后果需要进一步研究。