Akkermans Marjolijn D, Eussen Simone Rbm, van der Horst-Graat Judith M, van Elburg Ruurd M, van Goudoever Johannes B, Brus Frank
Department of Pediatrics, Juliana Children's Hospital/Haga Teaching Hospital, The Hague, Netherlands;
Danone Nutricia Research, Utrecht, Netherlands.
Am J Clin Nutr. 2017 Feb;105(2):391-399. doi: 10.3945/ajcn.116.136143. Epub 2017 Jan 4.
Iron deficiency (ID) and vitamin D deficiency (VDD) are common among young European children because of low dietary intakes and low compliance to vitamin D supplementation policies. Milk is a common drink for young European children. Studies evaluating the effect of milk fortification on iron and vitamin D status in these children are scarce.
We aimed to investigate the effect of a micronutrient-fortified young-child formula (YCF) on the iron and vitamin D status of young European children.
In this randomized, double-blind controlled trial, healthy German, Dutch, and English children aged 1-3 y were allocated to receive either YCF (1.2 mg Fe/100 mL; 1.7 μg vitamin D/100 mL) or nonfortified cow milk (CM) (0.02 mg Fe/100 mL; no vitamin D) for 20 wk. Blood samples were taken before and after the intervention. The primary and secondary outcomes were change from baseline in serum ferritin (SF) and 25-hydroxyvitamin D [25(OH)D], respectively. ID was defined as SF <12 μg/L in the absence of infection (high-sensitivity C-reactive protein <10 mg/L) and VDD as 25(OH)D <50 nmol/L. Statistical adjustments were made in intention-to-treat analyses for sex, country, age, baseline micronutrient status, and micronutrient intake from food and supplements (and sun exposure in the case of vitamin D outcomes).
The study sample consisted of 318 predominantly Caucasian (∼95%) children. The difference in the SF and 25(OH)D change between the treatment groups was 6.6 μg/L (95% CI: 1.4, 11.7 μg/L; P = 0.013) and 16.4 nmol/L (95% CI: 9.5, 21.4 nmol/L; P < 0.001), respectively. The probability of ID (OR 0.42; 95% CI:0.18, 0.95; P = 0.036) and VDD (OR 0.22; 95% CI: 0.01, 0.51; P < 0.001) after the intervention was lower in the YCF group than in the CM group.
Micronutrient-fortified YCF use for 20 wk preserves iron status and improves vitamin D status in healthy young children in Western Europe. This trial was registered at www.trialregister.nl as NTR3609.
由于饮食摄入量低以及对维生素D补充政策的依从性差，缺铁（ID）和维生素D缺乏（VDD）在欧洲幼儿中很常见。牛奶是欧洲幼儿常见的饮品。评估牛奶强化对这些儿童铁和维生素D状况影响的研究很少。
我们旨在研究一种微量营养素强化的幼儿配方奶粉（YCF）对欧洲幼儿铁和维生素D状况的影响。
在这项随机、双盲对照试验中，将1 - 3岁健康的德国、荷兰和英国儿童分为两组，分别接受YCF（1.2毫克铁/100毫升；1.7微克维生素D/100毫升）或未强化的牛奶（CM）（0.02毫克铁/100毫升；不含维生素D），为期20周。在干预前后采集血样。主要和次要结局分别是血清铁蛋白（SF）和25 - 羟基维生素D [25(OH)D]相对于基线的变化。ID定义为在无感染（高敏C反应蛋白<10毫克/升）时SF<12微克/升，VDD定义为25(OH)D<50纳摩尔/升。在意向性分析中对性别、国家、年龄、基线微量营养素状况以及食物和补充剂中的微量营养素摄入量（维生素D结局还包括日照情况）进行了统计调整。
研究样本包括318名主要为白种人（约95%）的儿童。治疗组之间SF和25(OH)D变化的差异分别为6.6微克/升（95%置信区间：1.4，11.7微克/升；P = 0.013）和16.4纳摩尔/升（95%置信区间：9.5，21.4纳摩尔/升；P<0.001）。干预后，YCF组ID（比值比0.42；95%置信区间：0.18，0.95；P = 0.036）和VDD（比值比0.22；95%置信区间：0.01，0.51；P<0.001）的发生概率低于CM组。
在西欧，健康幼儿使用微量营养素强化的YCF 20周可维持铁状况并改善维生素D状况。该试验在www.trialregister.nl上注册，注册号为NTR3609。
