Unit for Nutrition Research, Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland and Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland.
Eur J Nutr. 2013 Sep;52(6):1661-8. doi: 10.1007/s00394-012-0472-8. Epub 2012 Dec 2.
Studies on iron status in infancy and early childhood have shown contradicting results concerning prolonged breast-feeding and cow's milk intake. The aim of the present study was to investigate associations between iron status among one-year-olds and feeding, with focus on the type of milk.
Randomly selected healthy infants were prospectively investigated until 1 year of age in two cohorts born 1995-1996 (n = 114) and 2005 (n = 140). Information on birth data, feeding and growth until 12 months and iron status at 12 months was collected. Data from the two cohorts were pooled and the infants categorized into three groups according to their predominant milk consumption at 9 months of age, that is, breast milk, cow's milk or follow-on formula.
The prevalence of iron deficiency was highest in the cow's milk group and lowest in the follow-on formula group. According to a linear model, adjusted for gender, birth weight and exclusive breast-feeding duration, cow's milk consumption was negatively associated with serum ferritin (SF) and formula positively, but breast milk not. Predicted SF (μg/l) = 11.652(intercept) - 5.362(boy) + 0.005 × birth weight (g) + 2.826(exclusively breastfed ≥ 4 months) + 0.027 × formula (ml) - 0.022 × cow's milk (ml) + 0.005 × breast milk (ml). Correction for other dietary factors did not change these results.
In this pooled analysis, cow's milk intake in late infancy associated negatively, and follow-on formula positively, with iron status. Prolonged partial breast-feeding does not seem to be of importance for iron status. Fortified food seems to improve iron status in late infancy.
婴儿和幼儿期铁状况的研究表明,延长母乳喂养和牛奶摄入与铁状况之间存在矛盾的结果。本研究的目的是调查一岁儿童铁状况与喂养之间的关系,重点是牛奶的类型。
随机选择健康婴儿,在两个队列中进行前瞻性研究,直到 1 岁,队列 1 出生于 1995-1996 年(n=114),队列 2 出生于 2005 年(n=140)。收集了出生数据、12 个月前的喂养和生长情况以及 12 个月时的铁状况信息。将两个队列的数据合并,并根据 9 个月时主要的牛奶摄入量将婴儿分为三组,即母乳喂养、牛奶喂养或后续配方奶。
缺铁的患病率在牛奶组最高,在后续配方组最低。根据一个线性模型,调整性别、出生体重和纯母乳喂养时间后,牛奶摄入量与血清铁蛋白(SF)呈负相关,与配方呈正相关,但与母乳无关。预测 SF(μg/l)= 11.652(截距)-5.362(男)+0.005×出生体重(g)+2.826(纯母乳喂养≥4 个月)+0.027×配方(ml)-0.022×牛奶(ml)+0.005×母乳(ml)。纠正其他饮食因素并没有改变这些结果。
在这项综合分析中,婴儿晚期牛奶摄入与铁状况呈负相关,后续配方奶与铁状况呈正相关。延长部分母乳喂养对铁状况似乎并不重要。强化食品似乎能改善婴儿晚期的铁状况。