Lynch Sean R, Stoltzfus Rebecca J
Department of Internal Medicine, Eastern Virginia Medical School, Norfolk, VA 23501, USA.
J Nutr. 2003 Sep;133(9):2978S-84S. doi: 10.1093/jn/133.9.2978S.
An adequate supply of dietary iron during the 1st 24 mo of life is essential for preventing iron deficiency with its attendant negative effects on mental, motor and emotional development as well as later cognitive performance. Iron reserves and the small amount of highly bioavailable iron in human milk are adequate to satisfy the iron requirements of breast-fed infants of adequate birth weight for the 1st 6 mo of life. Thereafter, complementary foods, iron supplements or both are needed to meet this requirement. Complementary foods should not displace the consumption of human milk. The quantities eaten, particularly by younger infants, may therefore be quite small. As a consequence it is essential that the iron be supplied in a highly bioavailable form. This can be achieved by fortifying complementary foods with ferrous sulfate and ascorbic acid provided that the ascorbic acid is not lost during storage or meal preparation. Suggested fortification levels for ferrous sulfate and ascorbic acid for some types of complementary foods are given. The use of ferrous fumarate or an elemental iron powder instead of ferrous sulfate has not been evaluated adequately. There is a need to develop alternative strategies for improving iron bioavailability in complementary foods because it may not be possible to preserve ascorbic acid activity in many of them.
在生命的头24个月中,充足的膳食铁供应对于预防缺铁至关重要,缺铁会对心理、运动和情感发育以及后期的认知表现产生负面影响。铁储备以及母乳中少量高生物利用率的铁足以满足出生体重正常的母乳喂养婴儿在生命最初6个月的铁需求。此后,则需要补充食物、铁补充剂或两者兼用以满足这一需求。补充食物不应取代母乳的摄入。因此,尤其是较小婴儿的摄入量可能会相当少。因此,铁必须以高生物利用率的形式供应。如果在储存或准备膳食过程中抗坏血酸不损失,通过用硫酸亚铁和抗坏血酸强化补充食物就可以实现这一点。给出了某些类型补充食物中硫酸亚铁和抗坏血酸的建议强化水平。使用富马酸亚铁或元素铁粉代替硫酸亚铁尚未得到充分评估。由于在许多补充食物中可能无法保持抗坏血酸活性,因此有必要制定替代策略来提高补充食物中铁的生物利用率。