铁强化婴儿谷物预防缺铁性贫血的有效性。

Effectiveness of iron-fortified infant cereal in prevention of iron deficiency anemia.

作者信息

Walter T, Dallman P R, Pizarro F, Velozo L, Peña G, Bartholmey S J, Hertrampf E, Olivares M, Letelier A, Arredondo M

机构信息

Hematology Unit, Instituto de Nutricion y Technologia de los Alimentos, Universidad de Chile, Santiago.

出版信息

Pediatrics. 1993 May;91(5):976-82.

PMID:8474819

Abstract

BACKGROUND

Iron deficiency continues to be a common problem among infants throughout the world. Iron-fortified formula is effective in preventing iron deficiency but the benefit of iron-fortified cereal is controversial.

METHODS

We compared iron-fortified rice cereal to unfortified rice cereal in infants who were exclusively breast-fed for more than 4 months and to iron-fortified formula in infants who were weaned to formula before 4 months of age. The design was double blind in respect to the presence or absence of fortification iron in the cereal or formula and included 515 infants who were followed on the protocol from 4 to 15 months of age. Rice cereal was fortified with 55 mg of electrolytic iron per 100 g of dry cereal and infant formula with 12 mg of ferrous sulfate per 100 g of dry powder, levels approximating those in use in the United States. Measures of iron status were obtained at 8, 12, and 15 months. Infants with hemoglobin levels of < 105 g/L were excluded from the study and treated.

RESULTS

Consumption of cereal reached plateaus at means of about 30 g/d after 6 months of age in the formula-fed groups and 26 g/d after 8 months in the breast-fed groups; these amounts are higher than the 19-g/d mean intake by the 73% of infants who consume such cereal in the United States. Among infants weaned to formula before 4 months, the cumulative percentages of infants excluded for anemia by 15 months were 8%, 24%, and 4%, respectively, in the fortified cereal, unfortified cereal and formula, and fortified formula groups (P < .01 unfortified vs either fortified group; the difference between the two fortified groups was not significant). In infants breast-fed for more than 4 months, the corresponding values were 13% and 27%, respectively, in the fortified and unfortified cereal groups (P < .05). Mean hemoglobin level and other iron status measures were in accord with these findings.

CONCLUSION

Iron-fortified infant rice cereal can contribute substantially to preventing iron deficiency anemia.

摘要

背景

缺铁仍是全球婴儿中的常见问题。铁强化配方奶粉对预防缺铁有效，但铁强化谷物的益处存在争议。

方法

我们将铁强化米粉与未强化米粉用于纯母乳喂养超过4个月的婴儿，并将铁强化配方奶粉与4个月前断奶改用配方奶粉的婴儿进行比较。该设计对谷物或配方奶粉中是否添加铁进行双盲处理，纳入了515名婴儿，按照方案从4个月至15个月进行随访。米粉每100克干谷物添加55毫克电解铁，婴儿配方奶粉每100克干粉添加12毫克硫酸亚铁，这些水平接近美国的使用量。在8个月、12个月和15个月时获取铁状态指标。血红蛋白水平<105 g/L的婴儿被排除在研究之外并接受治疗。

结果

配方奶喂养组6个月龄后谷物摄入量平均约为30克/天，母乳喂养组8个月龄后为26克/天，均达到平台期；这些摄入量高于美国73%食用此类谷物的婴儿19克/天的平均摄入量。在4个月前断奶改用配方奶粉的婴儿中，到15个月时因贫血被排除的婴儿累积百分比在强化谷物组、未强化谷物组、配方奶粉组和强化配方奶粉组中分别为8%、24%、4%和（强化配方奶粉组数据缺失）（未强化组与任何一个强化组相比，P<.01；两个强化组之间的差异不显著）。在纯母乳喂养超过4个月的婴儿中，强化谷物组和未强化谷物组的相应值分别为13%和27%（P<.05）。平均血红蛋白水平和其他铁状态指标与这些结果一致。