Effects of micronutrient fortified milk and cereal food for infants and children: a systematic review

Abstract

BackgroundMicronutrient deficiency is a common public health problem in developing countries, especially for infants and children in the first two years of life. As this is an important time window for child development, micronutrient fortified complementary feeding after 6 months of age, for example with milk or cereals products, in combination with continued breastfeeding, is recommended. The overall effect of this approach is unclear.MethodsWe performed a Systematic Review and Meta-analysis to assess the impact of micronutrient fortified milk and cereal food on the health of infants and little children (aged 6 months to 5 years) compared to non-fortified food. We reviewed randomized controlled trials using electronic databases (MEDLINE and Cochrane library searches through FEB 2011), reference list screening and hand searches. Three reviewers assessed 1153 studies for eligibility and extracted data. One reviewer assessed risk of bias using predefined forms.ResultsWe included 18 trials in our analysis (n = 5’468 children; range of mean hemoglobin values: 9.0 to 12.6 g/dl). Iron plus multi micronutrient fortification is more effective than single iron fortification for hematologic outcomes. Compared to non-fortified food, iron multi micronutrient fortification increases hemoglobin levels by 0.87 g/dl (95%-CI: 0.57 to 1.16; 8 studies) and reduces risk of anemia by 57% (relative risk 0.43; 95%-CI 0.26 to 0.71; absolute risk reduction 22%; number needed to treat 5 [95%-CI: 4 to 6]; 6 Studies). Compared to non-fortified food, fortification increases serum levels of vitamin A but not of zinc. Information about functional health outcomes (e.g. weight gain) and morbidity was scarce and evidence is inconclusive. Risk of bias is unclear due to underreporting, but high quality studies lead to similar results in a sensitivity analysis.ConclusionsMulti micronutrient fortified milk and cereal products can be an effective option to reduce anemia of children up to three years of age in developing countries. On the basis of our data the evidence for functional health outcomes is still inconclusive.

Early feeding patterns among Mexican babies: findings from the 2012 National Health and Nutrition Survey and implications for health and obesity prevention

“…Thus, the low prevalence of iron-fortified infant cereals and meats is a concern given the high risk of inadequate iron intake among this age group and depending on whether older infants are fed breast milk or iron-fortified infant formula. Feeding iron-fortified complementary foods such as fortified infant cereals can be an effective strategy to prevent iron-deficiency in infants [16,19,66]. Pureed meats, especially beef, are recommended as a source of the highly bioavailable form of heme iron, and provide a developmentally-appropriate form for infants after age 6 months [19].…”

Evaluación Nutricional Y Sensorial De Un Alimento a Base De Atún Y Soya Enriquecido Con Vitaminas Y Minerales

“…Gilber Vela-Gutiérrez infantes y niños, debido a la ingesta inadecuada o utilización ineficiente de los alimentos (6). En el mundo existe alrededor de dos billones de personas que tienen alguna deficiencia de micronutrientes por ejemplo, anemia causada por deficiencia de hierro (6,7).…”

“…En el mundo existe alrededor de dos billones de personas que tienen alguna deficiencia de micronutrientes por ejemplo, anemia causada por deficiencia de hierro (6,7). También se presenta un incremento en la tasa de infección y mortalidad causado por la deficiencia de vitamina A y zinc, que son amenazas para el desarrollo de los niños (6). Según datos de la ENSANUT (8), la deficiencia de hierro y vitamina en niños menores de 5 años en México sigue siendo un problema de salud pública, debido a su contribución en los procesos de regulación metabólica.…”

“…Resultados similares al índicador P/T (figura 1) fueron presentados por Vela et al (11) y Vela-Gutiérrez et al (12), al evaluar el impacto nutricional de una papilla elaborada a base de frutas tropicales, y una galleta de harina trigo y soya, ambos alimentos adicionados con suero de leche en un grupos de niños en edad preescolar en dos comunidades de alta marginación del estado de Chiapas, México; respectivamente. En un estudio de intervención de consumo de leche fortificada con niños se demostró la mejora en peso (diferencia de 0,21 Kg/año) y aumento en talla (diferencia de 0,51 cm/año) comparado con el grupo control (6,13). Los problemas de desnutrición específicamente baja talla (desmedro) en menores de cinco años afecta alrededor de 200 millones de niños en el mundo; en México, el problema afecta alrededor de 1,5 millones de niños de la misma edad (7).…”

Multi-micronutrient Fortified Beverage Delivered through the School-Based System Improved Iron Status and Test Scores of Children

“…In the same manner, studies on multiple micronutrient-fortified beverages [18][19][20], iron-fortified candies [21], biscuits [22] and drinking water [23] showed positive response to intervention by increased hemoglobin levels, serum ferritin or decreased prevalence of anemia among subjects after the intervention period. The multiple micronutrient intervention was effective in reducing the prevalence of anemia in children [24][25][26][27][28][29].…”