Schauer Claudia, Zlotkin Stanley
The Hospital for Sick Children, Research Institute, Program in Metabolism, Toronto, Ontario.
Paediatr Child Health. 2003 Feb;8(2):87-90. doi: 10.1093/pch/8.2.87.
Despite global goals set by United Nations' agencies over the past decade for significant reductions in iron deficiency anemia (IDA), it remains a largely unaddressed public health problem affecting more than two billion people, one-third of the world's population. The negative impact of IDA on health and human potential are greatest in the developing world, where it is estimated that 51% of children younger than four years of age are anemic, mainly due to a diet that is inadequate in bioavailable iron. Studies in both developed and developing countries have consistently shown mental and motor impairments that may not be reversible in children younger than two years of age with IDA. From a public health standpoint there are four possible interventions for the prevention of anemia: dietary diversification to include foods rich in absorbable iron; fortification of staple foods including targeted fortification of complementary foods for infants and young children; the provision of iron supplements; and 'home-fortification'. In response to a United Nations Children's Fund (UNICEF) request to develop a new approach to IDA, our research group developed 'Sprinkles' for home-fortification of complementary foods. Sprinkles are single-dose sachets (like small packets of sugar) containing micronutrients in powder form (encapsulated iron, zinc, vitamins A, C and D, and folic acid), which are easily sprinkled onto any home-prepared complementary food. Sprinkles were developed to overcome many of the side effects and disadvantages of iron drops. We have demonstrated that Sprinkles are as effective as iron drops in the treatment and prevention of anemia. Sprinkles are easier to use and are, therefore, better accepted than iron drops, which may improve adherence to iron interventions.
尽管联合国各机构在过去十年设定了大幅减少缺铁性贫血(IDA)的全球目标,但它仍是一个基本未得到解决的公共卫生问题,影响着超过20亿人,占世界人口的三分之一。缺铁性贫血对健康和人类潜能的负面影响在发展中世界最为严重,据估计,那里51%的四岁以下儿童贫血,主要原因是饮食中可生物利用铁不足。发达国家和发展中国家的研究都一致表明,患有缺铁性贫血的两岁以下儿童可能会出现无法逆转的智力和运动障碍。从公共卫生的角度来看,预防贫血有四种可能的干预措施:饮食多样化,包括摄入富含可吸收铁的食物;主食强化,包括针对性地强化婴幼儿辅食;提供铁补充剂;以及“家庭强化”。应联合国儿童基金会(UNICEF)开发缺铁性贫血新方法的要求,我们的研究小组开发了用于家庭强化辅食的“营养撒剂”。营养撒剂是单剂量的小袋包装(类似小糖包),内装粉末状的微量营养素(包裹型铁、锌、维生素A、C、D和叶酸),可轻松撒在任何家庭自制的辅食上。开发营养撒剂是为了克服铁滴剂的许多副作用和缺点。我们已经证明,营养撒剂在治疗和预防贫血方面与铁滴剂一样有效。营养撒剂使用起来更方便,因此比铁滴剂更易被接受,这可能会提高对铁干预措施的依从性。