Discipline of Nutrition and Dietetics.
Children's Nutrition Research Center, UQ Child Health Research Center, Faculty of Medicine, University of Queensland, Brisbane, Australia.
J Nutr. 2018 Oct 1;148(10):1570-1579. doi: 10.1093/jn/nxy167.
Iron deficiency (ID) and vitamin D deficiency (VDD) are significant pediatric health issues in New Zealand and Australia and remain prevalent micronutrient deficiencies in young children globally.
We aimed to investigate the effect of a micronutrient-fortified, reduced-energy growing-up milk (GUMLi) compared with cow milk (CM) consumed for 1 y on dietary iron and vitamin D intakes and the status of New Zealand and Australian children at 2 y of age.
The GUMLi Trial was a multicenter, double-blind, randomized controlled trial in 160 healthy 1-y-old New Zealand and Australian children conducted in 2015-2017. Participants were randomly assigned 1:1 to receive GUMLi (1.7 mg Fe/100 mL; 1.3 µg cholecalciferol/100 mL) or CM (0.02 mg Fe/100 mL; 0.06 µg cholecalciferol/100 mL) for 12 mo. Secondary outcomes, reported here, included change in dietary iron and vitamin D intakes, iron status, and 25-hydroxyvitamin D [25(OH)D] concentrations from blood samples at age 2 y. All regression models were adjusted for baseline outcome and study center.
GUMLi was a large contributor to dietary intakes of iron and vitamin D after 12 mo when compared with intakes from food and CM. The adjusted mean difference between groups for serum ferritin concentrations was 17.8 µg/L (95% CI: 13.6, 22.0 µg/L; P < 0.0001), and for 25(OH)D it was 16.6 nmol/L (95% CI: 9.9, 23.3 nmol/L; P < 0.0001). After 12 mo, ID was present in 16 (24%) participants in the CM group and 5 (7%) participants in the GUMLi group (P = 0.009), and the prevalence of VDD in the CM group increased to 14% (n = 10) and decreased to 3% (n = 2) (P = 0.03) in the GUMLi group.
In comparison with CM, GUMLi significantly improved dietary iron and vitamin D intakes and the iron and vitamin D status of healthy children at 2 y of age. This trial was registered with the Australian New Zealand Clinical Trials Registry (www.anzctr.org.au) as ACTRN12614000918628.
缺铁（ID）和维生素 D 缺乏（VDD）是新西兰和澳大利亚的重大儿科健康问题，也是全球幼儿普遍存在的微量营养素缺乏问题。
我们旨在研究与饮用牛奶（CM）相比，饮用强化微量营养素、低能量成长奶（GUMLi）对 1 岁儿童饮食中铁和维生素 D 的摄入量以及新西兰和澳大利亚儿童 2 岁时的状况的影响。
GUMLi 试验是 2015-2017 年在新西兰和澳大利亚进行的一项多中心、双盲、随机对照试验，共有 160 名健康 1 岁儿童参加。参与者被随机分配 1:1 接受 GUMLi（1.7 毫克铁/100 毫升；1.3 微克胆钙化醇/100 毫升）或 CM（0.02 毫克铁/100 毫升；0.06 微克胆钙化醇/100 毫升）12 个月。这里报告的次要结果包括从 2 岁时的血液样本中测量的饮食中铁和维生素 D 摄入量、铁状况和 25-羟维生素 D [25(OH)D]浓度的变化。所有回归模型均根据基线结果和研究中心进行了调整。
与食物和 CM 的摄入量相比，GUMLi 在 12 个月后大量增加了饮食中铁和维生素 D 的摄入量。血清铁蛋白浓度组间的调整平均差异为 17.8μg/L（95%CI：13.6, 22.0μg/L；P<0.0001），25(OH)D 为 16.6nmol/L（95%CI：9.9, 23.3nmol/L；P<0.0001）。12 个月后，CM 组中有 16 名（24%）参与者存在缺铁（ID），GUMLi 组中有 5 名（7%）参与者存在缺铁（ID）（P=0.009），CM 组中维生素 D 缺乏（VDD）的患病率增加到 14%（n=10），而 GUMLi 组则下降到 3%（n=2）（P=0.03）。
与 CM 相比，GUMLi 显著改善了健康儿童 2 岁时的饮食中铁和维生素 D 的摄入量以及铁和维生素 D 的状况。本试验在澳大利亚和新西兰临床试验注册中心（www.anzctr.org.au）注册，注册号为 ACTRN12614000918628。
