Hanoi Medical University, Dong Da, Hanoi, Vietnam.
J Nutr. 2010 Dec;140(12):2241-7. doi: 10.3945/jn.110.123711. Epub 2010 Oct 27.
To investigate whether an intervention including micronutrient-fortified complementary foods can improve iron status, we conducted a randomized controlled trial in 5-mo-old Vietnamese infants (n = 246). Villages (n = 29) were randomly divided into those receiving instant flour (FF) or a food complement (FC) both fortified with micronutrients or nothing [control (C)]. FF and FC infants received daily for 6 mo at least 2 meals of fortified complementary foods. Micronutrient status was assessed by measurement of hemoglobin (Hb) and plasma ferritin (PF), transferrin receptor, zinc, and retinol. Final Hb (mean ± SD) was higher in the FF (112.5 ± 8.0 g/L) and FC (114.0 ± 7.0 g/L) groups compared with C (109.0 ± 8.0 g/L; P = 0.006). PF (geometric mean [95% CI]) was also higher in FF (19.8 μg/L [17.5-22.3]) and FC (20.8 μg/L [18.3-23.6]) compared with C (11.1 μg/L [9.8-12.5]; P < 0.0001). Anemia prevalence decreased more in the FC group (-43.6%) compared with C (-10.3%; P = 0.006). The change in prevalence of PF < 12 μg/L was different in the FF (-16.4%) and FC (-6.7%) groups compared with C (+30.4%; P < 0.01). Endpoint prevalence of iron deficiency (ID) and ID anemia (IDA) were lower in the FF (13.4 and 6.7%, respectively) and FC (15.2 and 3.8%) groups compared with C (57.5 and 37.5%) (P < 0.0001). Retinol and zinc concentrations did not differ among groups, but endpoint prevalence of zinc deficiency was lower in FF infants (36.1%) than in C infants (52.9%; P = 0.04). Micronutrient-fortified complementary foods significantly improved iron status and decreased the prevalence of anemia, ID, and IDA in Vietnamese infants and can be an important tool to reduce ID in infancy in developing countries.
为了研究包含强化微量营养素补充食品的干预措施是否能改善铁营养状况，我们在 5 月龄的越南婴儿中开展了一项随机对照试验（n = 246）。村庄（n = 29）被随机分为接受即时面粉（FF）或食物补充剂（FC）的组，两者均强化了微量营养素或不接受任何干预（对照组，C）。FF 和 FC 组婴儿在 6 个月期间每天至少接受 2 餐强化补充食品。通过测量血红蛋白（Hb）和血浆铁蛋白（PF）、转铁蛋白受体、锌和视黄醇来评估微量营养素状况。FF（112.5 ± 8.0 g/L）和 FC（114.0 ± 7.0 g/L）组的最终 Hb（平均值 ± 标准差）高于 C 组（109.0 ± 8.0 g/L；P = 0.006）。FF（19.8 μg/L [17.5-22.3]）和 FC（20.8 μg/L [18.3-23.6]）组的 PF（几何平均值 [95%CI]）也高于 C 组（11.1 μg/L [9.8-12.5]；P < 0.0001）。与 C 组（-10.3%；P = 0.006）相比，FC 组（-43.6%）的贫血患病率下降幅度更大。FF（-16.4%）和 FC（-6.7%）组的 PF < 12 μg/L 的患病率变化与 C 组（+30.4%）不同（P < 0.01）。FF（13.4% 和 6.7%）和 FC（15.2% 和 3.8%）组的铁缺乏症（ID）和缺铁性贫血（IDA）的终点患病率低于 C 组（57.5% 和 37.5%）（P < 0.0001）。各组的视黄醇和锌浓度没有差异，但 FF 组婴儿的锌缺乏症终点患病率（36.1%）低于 C 组（52.9%）（P = 0.04）。强化微量营养素的补充食品显著改善了越南婴儿的铁营养状况，降低了贫血、ID 和 IDA 的患病率，可作为发展中国家减少婴儿期 ID 的重要手段。
