Andang'o Pauline Ea, Osendarp Saskia Jm, Ayah Rosemary, West Clive E, Mwaniki David L, De Wolf Corine A, Kraaijenhagen Rob, Kok Frans J, Verhoef Hans
Kenya Medical Research Institute, Centre for Public Health Research, Nairobi, Kenya; Division of Human Nutrition, Wageningen University, Netherlands.
Unilever Food and Health Research Institute, Vlaardingen, Netherlands.
Lancet. 2007 May 26;369(9575):1799-1806. doi: 10.1016/S0140-6736(07)60817-4.
Sodium iron edetic acid (NaFeEDTA) might be a more bioavailable source of iron than electrolytic iron, when added to maize flour. We aimed to assess the effect, on children's iron status, of consumption of whole maize flour fortified with iron as NaFeEDTA or electrolytic iron.
516 children, aged 3-8 years, from four schools in Marafa, Kenya, were randomly assigned to four groups. All were given the same amount of porridge five times a week. The porridge for one group was made from unfortified whole maize flour; for the other three groups it was fortified with either high-dose NaFeEDTA (56 mg/kg), low-dose NaFeEDTA (28 mg/kg), or electrolytic iron (56 mg/kg). Concentrations of haemoglobin, plasma ferritin, and transferrin receptor were analysed in samples taken at baseline and at the end of the 5-month intervention. The primary outcome was iron-deficiency anaemia. We analysed data on an intention-to-treat basis. This trial is registered with ClinicalTrials.gov, number NCT00386074.
The prevalence of iron-deficiency anaemia in children given unfortified flour was 10%. Compared with placebo, the prevalence of iron-deficiency anaemia in children given flour fortified with high-dose NaFeEDTA, low-dose NaFeEDTA, and electrolytic iron changed by -89% (95% CI -97% to -49%), -48% (-77% to 20%), and 59% (-18% to 209%), respectively. Consumption of high-dose NaFeEDTA improved all measured iron-status indicators. Low-dose NaFeEDTA decreased the prevalence of iron deficiency but did not noticeably change the prevalence of anaemia. Electrolytic iron did not improve any of these iron-status indicators. Children who were iron-deficient at baseline benefited more from high-dose and low-dose NaFeEDTA than those with sufficient iron at baseline.
Consumption of whole maize flour fortified with NaFeEDTA caused modest, dose-dependent improvements in children's iron status. Fortification with electrolytic iron did not improve their iron status. Therefore, in high-phytate flours, NaFeEDTA is more suitable than electrolytic iron for supplementation of iron in the diet.
当添加到玉米粉中时,乙二胺四乙酸铁钠(NaFeEDTA)可能是比电解铁生物利用率更高的铁源。我们旨在评估食用添加了NaFeEDTA或电解铁的全玉米粉对儿童铁状态的影响。
来自肯尼亚马拉法四所学校的516名3至8岁儿童被随机分为四组。所有儿童每周五次食用相同量的粥。一组的粥由未强化的全玉米粉制成;其他三组的粥分别强化了高剂量NaFeEDTA(56毫克/千克)、低剂量NaFeEDTA(28毫克/千克)或电解铁(56毫克/千克)。在基线和5个月干预结束时采集的样本中分析血红蛋白、血浆铁蛋白和转铁蛋白受体的浓度。主要结局是缺铁性贫血。我们按意向性分析原则分析数据。本试验已在ClinicalTrials.gov注册,注册号为NCT00386074。
食用未强化面粉的儿童缺铁性贫血患病率为10%。与安慰剂组相比,食用强化高剂量NaFeEDTA、低剂量NaFeEDTA和电解铁面粉的儿童缺铁性贫血患病率分别变化了-89%(95%置信区间-97%至-49%)、-48%(-77%至20%)和59%(-18%至209%)。食用高剂量NaFeEDTA改善了所有测量的铁状态指标。低剂量NaFeEDTA降低了缺铁患病率,但未显著改变贫血患病率。电解铁未改善任何这些铁状态指标。基线时缺铁的儿童比基线时铁充足的儿童从高剂量和低剂量NaFeEDTA中获益更多。
食用添加NaFeEDTA的全玉米粉使儿童铁状态有适度的、剂量依赖性改善。添加电解铁未改善其铁状态。因此,在高植酸面粉中,NaFeEDTA比电解铁更适合用于饮食中铁的补充。