Efficacy and safety of twice-weekly administration of three RDAs of iron and folic acid with and without complement of 14 essential micronutrients at one or two RDAs: a placebo-controlled intervention trial in anemic Cambodian infants 6 to 24 months of age

Schümann, Klaus; Longfils, Philippe; Monchy, Didier; Xylander, S von; Weinheimer, Heike; Solomons, N. W.

doi:10.1038/sj.ejcn.1602930

Cited by 28 publications

(41 citation statements)

References 65 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…El nutriente asociado más corriente es el ácido fólico. Una tendencia creciente estriba en aportar hierro como parte de combinaciones más extensas de múltiples nutrientes [12,13] .…”

Section: Administración Parenteral De Hierrounclassified

“…Enriquecimiento casero con hierro En muchas partes del mundo, la transición a la alimentación casera durante el proceso de destete pasa a través de gachas a base de cereales, como papillad de maíz [46] o arroz [13] . Se ha confirmado que el hierro se encuentra entre los nutrientes problemáticos en la mayoría de los regímenes de alimentación complementaria [47] .…”

Section: Enriquecimiento De Alimentos Con Hierrounclassified

See 1 more Smart Citation

Eficacia y seguridad de la administración de hierro en poblaciones juveniles

Schümann¹,

Solomons²

2010

Ann Nestlé [Esp]

View full text Add to dashboard Cite

La anemia por carencia de hierro (ACH) del lactante reduce su capacidad cognitiva máxima de por vida y puede poner en riesgo la vida de una madre adolescente en el parto. La administración de hierro es un componente de las estrategias encaminadas a prevenir o invertir la carencia de hierro (CH), y el hierro puede administrarse por vía parenteral o mediante aportes complementarios o alimentos enriquecidos por vía oral. Pueden suscitarse problemas de seguridad en el lugar de administración, es decir, en la luz intestinal, que aparecerían a partir de las intervenciones como consecuencia de depósitos de hierro excesivos. Las mejoras recientes en la farmacología de los compuestos de hierro parenterales despejan el camino en terapia pediátrica e incluso en salud pública. El aporte complementario de hierro por vía oral, habitualmente junto al ácido fólico, es el tratamiento principal de la ACH en el entorno clínico. A menudo se combina con múltiples micronutrientes y se utiliza también para la resolución de la anemia grave en el ámbito extrahospitalario y para la profilaxis en la población no anémica. El enriquecimiento de alimentos básicos (como harina) o alimentos (leche para lactantes, alimentos complementarios) y bebidas específicos de la edad son los métodos habituales para la profilaxis de la CH. Se dispone de preparados especiales ricos en hierro (polvos, comprimidos disgregables, productos comestibles para untar) destinados al enriquecimiento casero. El bioenriquecimiento, es decir, el enriquecimiento del contenido en hierro de cosechas durante el cultivo es un abordaje novedoso que todavía tiene que ser puesto en práctica o evaluado íntegramente en relación con niños. En la luz intestinal se observan efectos secundarios y signos tóxicos tras la ingestión oral de hierro. Después de la administración oral y parenteral, el aumento del hierro circulatorio puede incrementar el riesgo de complicaciones a partir de infecciones coexistentes, especialmente en el caso del paludismo, y cuando el estado individual de hierro es suficiente. Se produce un deterioro del crecimiento en caso de exposición de niños con suficiencia de hierro a intervenciones con este nutriente, de manera que parece aconsejable orientar el hierro a individuos afectados de CH. Aparecen numerosas consecuencias adversas por la acumulación de depósitos de hierro excesivos en todo el cuerpo como resultado de la agresión oxidativa mediada por hierro. La maduración incompleta de la homeostasis del hierro puede permitir una mayor absorción de hierro antes de los 6 meses de edad.

show abstract

“…El nutriente asociado más corriente es el ácido fólico. Una tendencia creciente estriba en aportar hierro como parte de combinaciones más extensas de múltiples nutrientes [12,13] .…”

Section: Administración Parenteral De Hierrounclassified

Section: Enriquecimiento De Alimentos Con Hierrounclassified

Eficacia y seguridad de la administración de hierro en poblaciones juveniles

Schümann¹,

Solomons²

2010

Ann Nestlé [Esp]

View full text Add to dashboard Cite

show abstract

“…Offering oral iron and folic acid twice weekly (approx. 1 recommended daily allowance/day) to Cambodian infants increased the prevalence of fatigue, diarrhea, and upper respiratory infections as compared to controls [13] . Simultaneous co-administration of selenium, zinc, copper, iodine, and vitamins A, B 2 , B 6 , B 12 , C, and D reduced the prevalence of these symptoms to a lower level than in the placebo group [13] .…”

Section: Iron Effects In the Tissuesmentioning

confidence: 99%

“…In many parts of the world, the transition to home diet during the weaning process passes through grain-based gruels such as maize [46] or rice [13] porridge. Iron has been documented to be among the problem nutrients in most complementary feeding regimens [47] .…”

Section: Home Fortification With Ironmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy and Safety of Iron Administration in Juvenile Populations

Schümann

Solomons²

2010

Ann Nestlé [Engl]

View full text Add to dashboard Cite

Infantile iron deficiency anemia (IDA) reduces maximal lifetime cognitive capacity and can threaten the life of an adolescent mother in childbirth. Administration of iron is a component of strategies for preventing or reversing iron deficiency (ID) and iron can be given parenterally or as oral supplements or fortified food. Safety issues can arise at the point of administration, i.e. in the gut lumen, and as a consequence of excessive iron stores arising from the interventions. Recent improvements in the pharmacology of parenteral iron compounds open the way to greater consideration of the intravenous route in pediatric therapy, and even public health. Oral iron supplementation, usually with folic acid, is the main treatment of IDA in the clinical setting. It is often combined with multiple micronutrients and is also used for resolution of severe anemia at the community level and for prophylaxis in the nonanemic population. Fortification of staple food (such as flour), or age-specific foods (infant formula, complementary foods) and beverages are the usual methods for ID prophylaxis. Special iron-rich preparations (powders, crushable tablets, edible spreads) are available for home fortification. Biofortification, i.e. enriching the iron content of crops during cultivation, is a novel approach, yet to be fully implemented or evaluated for children. Side effects and toxicity after oral iron intake are seen in the gut lumen. After oral and parenteral iron intake, the rise in circulating iron can increase the risk of complications from coexisting infections, notably with malaria, and when individual iron status is adequate. Growth impairment occurs with exposure of iron-sufficient children to iron interventions, so that targeting of iron to ID individuals seems advisable. Numerous adverse consequences from accumulation of excessive total body iron stores show up as a consequence of iron-mediated oxidative stress. Incomplete maturation of iron homoeostasis may permit higher iron absorption before 6 months of age.

show abstract

Effect of Micronutrient Sprinkles on Reducing Anemia

Jack¹,

Ou²,

Chea³

et al. 2012

Arch Pediatr Adolesc Med

View full text Add to dashboard Cite

To evaluate the effectiveness of Sprinkles alongside infant and young child feeding (IYCF) education compared with IYCF education alone on anemia, deficiencies in iron, vitamin A, and zinc, and growth in Cambodian infants.Design: Cluster-randomized effectiveness study.Setting: Cambodian rural health district.Participants: Among 3112 infants aged 6 months, a random subsample (n = 1350) was surveyed at baseline and 6-month intervals to age 24 months.Intervention: Daily micronutrient Sprinkles alongside IYCF education vs IYCF education alone for 6 months from ages 6 to 11 months.Main Outcome Measures: Prevalence of anemia; iron, vitamin A, and zinc deficiencies; and growth via biomarkers and anthropometry.Results: Anemia prevalence (hemoglobin level Ͻ11.0 g/dL [to convert to grams per liter, multiply by 10.0]) was reduced in the intervention arm compared with the control arm by 20.6% at 12 months (95% CI, 9.4-30.2; P = .001), and the prevalence of moderate anemia (hemoglobin level Ͻ10.0 g/dL) was reduced by 27.1% (95% CI, 21.0-31.8; PϽ .001). At 12 and 18 months, iron deficiency prevalence was reduced by 23.5% (95% CI, 15.6-29.1; PϽ.001) and 11.6% (95% CI, 2.6-17.9; P=.02), respectively. The mean serum zinc concentration was increased at 12 months (2.88 µg/dL [to convert to micromoles per liter, multiply by 0.153]; 95% CI, 0.26-5.42; P =.03). There was no statistically significant difference in the prevalence of zinc and vitamin A deficiencies or in growth at any time.Conclusions: Sprinkles reduced anemia and iron deficiency and increased the mean serum zinc concentration in Cambodian infants. Anemia and zinc effects did not persist beyond the intervention period.

show abstract

Efficacy and safety of twice-weekly administration of three RDAs of iron and folic acid with and without complement of 14 essential micronutrients at one or two RDAs: a placebo-controlled intervention trial in anemic Cambodian infants 6 to 24 months of age

Abstract: Supplementation of micronutrients along with iron and folic acid mitigates the excess morbidity of iron-folate alone, without reducing its efficacy in correcting anemia and building iron stores. FoodLETs are a suitable vehicle to provide micronutrient supplementation to infants.

Cited by 28 publications

References 65 publications

Eficacia y seguridad de la administración de hierro en poblaciones juveniles

Eficacia y seguridad de la administración de hierro en poblaciones juveniles

Efficacy and Safety of Iron Administration in Juvenile Populations

Effect of Micronutrient Sprinkles on Reducing Anemia

Contact Info

Product

Resources

About