Iron-Fortified vs Low-Iron Infant Formula

Lozoff, Betsy; Castillo, Marcela; Clark, Kathy; Smith, Julia B.

doi:10.1001/archpediatrics.2011.197

Cited by 119 publications

(81 citation statements)

References 37 publications

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“…In this study, there was an increased likelihood of diarrhoea in a sub-group of infants with adequate iron status. In a follow-up of the study by Walter et al (1998) at 10 years of age (Lozoff et al, 2012), scores on tests for spatial memory and visual motor integration, but not on tests for IQ, visual perception, motor coordination and arithmetic achievement, were statistically significantly lower in the group who had received high-iron formula (1.95 mg/100 kcal). Effects were generally small.…”

Section: Health Consequencesmentioning

confidence: 87%

Scientific Opinion on the essential composition of infant and follow-on formulae

Products¹

2014

EFSA Journal

280

124

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Following a request from the European Commission, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to deliver a scientific opinion on the essential composition of infant and follow-on formula. This opinion reviews the opinion provided by the Scientific Committee on Food in 2003 on the essential requirements of infant and follow-on formulae in light of more recent evidence and by considering the Panel's opinion of October 2013 on nutrient requirements and dietary intakes of infants and young children in the European Union. The minimum content of a nutrient in formula proposed in this opinion is derived from the intake levels the Panel had considered adequate for the majority of infants in the first six months of life in its previous opinion and an average amount of formula consumed during this period. From a nutritional point of view, the minimum contents of nutrients in infant and follow-on formula proposed by the Panel cover the nutritional needs of virtually all healthy infants born at term and there is no need to exceed these amounts in formulae, as nutrients which are not used or stored have to be excreted and this may put a burden on the infant's metabolism. Therefore, the Panel emphasises that maximum amounts should be interpreted not as target values but rather as upper limits of a range which should not be exceeded. There is scientific consensus that breast milk is the preferred food for all healthy infants and provides an adequate supply of all nutrients to support growth and development (with the exception of vitamin K during the first weeks of life and of vitamin D). Whereas the composition of infant formula remains stable over time, breast milk composition changes continuously and therefore infant formula cannot imitate breast milk. © EuropeanAll formulae intended for infants must be safe and suitable to meet the nutritional requirements and promote growth and development of infants born at term when used as a sole source of nutrition during the first months of life, and when used as the principal liquid element in a progressively diversified diet after the introduction of appropriate complementary feeding. Nutrients and substances should be added to formulae for infants only in amounts that serve a nutritional or other benefit. The addition in amounts higher than those serving a benefit or the inclusion of unnecessary substances in formulae may put a burden on the infant's metabolism and/or on other physiological functions, as substances which are not used or stored have to be excreted.The minimum content of a nutrient in formula proposed in this opinion is derived from the intake levels the Panel had considered adequate for the majority of infants in the first half of the first year of life in its previous opinion and an average amount of daily energy intake from formula during this period (500 kcal/day). These minimum amounts should be understood as target values which cover the nutritional needs of virtually all infants born at term for optimal growth and devel...

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Section: Health Consequencesmentioning

confidence: 87%

Scientific Opinion on the essential composition of infant and follow-on formulae

Products¹

2014

EFSA Journal

280

124

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“…Although the prevalence of IDA is relatively low in large parts of Europe, iron deficiency in infants and young children is still a public health priority as children with depleted iron stores but without anaemia at 1 year of age might have lower fine motor and mental development scores in later childhood than children with sufficient iron stores [10,79,80,81,82,83]. On the other hand, it has been suggested that supplemental iron in infants with high Hb levels may adversely affect neurodevelopmental outcome [84]. Defining optimal amounts of iron in iron-fortified milk and foods is therefore of upper most importance.…”

Section: Discussionmentioning

confidence: 99%

Iron Intake and Status of Children Aged 6-36 Months in Europe: A Systematic Review

et al. 2015

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Background: Iron deficiency is the most common nutritional disorder in the world. Young children are particularly vulnerable to the consequences of iron deficiency because of their rapidly developing brain. This review evaluates the prevalence of inadequate iron intake and iron deficiency (anaemia) in European children aged 6-36 months. Summary: Computerized searches for relevant articles were performed in November 2013. A total of 7,297 citations were screened and 44 studies conducted in 19 European countries were included in this review. In both infants (6-12 months) and young children (12-36 months), the mean value of iron intakes in most countries was close to the RDA. Nevertheless, proportions of inadequate intakes were considerable, ranging from about 10% in the Netherlands up to 50% in Austria, Finland and the United Kingdom. The prevalence of iron deficiency varied between studies and was influenced by children's characteristics. Two to 25% of infants aged 6-12 months were found to be iron deficient, with a higher prevalence in those who were socially vulnerable and those who were drinking cow's milk as a main type of drink in their first year of life. In children aged 12-36 months, prevalence rates of iron deficiency varied between 3 and 48%. Prevalence of iron deficiency anaemia in both age groups was high in Eastern Europe, as high as 50%, whereas the prevalence in Western Europe was generally below 5%. Key Messages: In most European countries, mean iron intakes of infants and children aged 6 to 36 months were found to be close to the RDA. Nevertheless, high proportions of inadequate intakes and high prevalence rates of iron deficiency were observed. Health programs should (keep) focus(ing) on iron malnutrition by educating parents on food choices for their children with iron-rich and iron-fortified foods, and encourage iron supplementation programmes where iron intakes are the lowest.

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“…Our studies on an adverse effect on linear growth of iron drops given to iron-replete infants (10) and observations by others caused Lozoff et al (32) to re-examine data from a previous large intervention study that they had conducted in Chilean infants who were given infant formula with 2 amounts of iron fortification (33).…”

Section: Effects Of Iron Excess On Cognitive Devel-opment Of Iron-repmentioning

confidence: 93%

Excess iron intake as a factor in growth, infections, and development of infants and young children

Lönnerdal

2017

The American Journal of Clinical Nutrition

121

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The provision of iron via supplementation or the fortification of foods has been shown to be effective in preventing and treating iron deficiency and iron deficiency anemia in infants and young children. However, iron is a pro-oxidative element and can have negative effects on biological systems even at moderate amounts. An increasing number of studies have reported adverse effects of iron that was given to infants and young-children populations who initially were iron replete. These effects include decreased growth (both linear growth and weight), increased illness (usually diarrhea), interactions with other trace elements such as copper and zinc, altered gut microbiota to more pathogenic bacteria, increased inflammatory markers, and impaired cognitive and motor development. If these results can be confirmed by larger and well-controlled studies, it may have considerable programmatic implications (e.g., the necessity to screen for iron status before interventions to exclude iron-replete individuals). A lack of understanding of the mechanisms underlying these adverse outcomes limits our ability to modify present supplementation and fortification strategies. This review summarizes studies on the adverse effects of iron on various outcomes; suggests possible mechanisms that may explain these observations, which are usually made in clinical studies and intervention trials; and gives examples from animal models and in vitro studies. With a better understanding of these mechanisms, it may be possible to find novel ways of providing iron in a form that causes fewer or no adverse effects even when subjects are iron replete. However, it is apparent that our understanding is limited, and research in this area is urgently needed.Am J Clin Nutr 2017;106(Suppl):1681S-7S.

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Iron-Fortified vs Low-Iron Infant Formula

Abstract: Objective: To assess long-term developmental outcome in children who received iron-fortified or lowiron formula.Design: Follow-up at 10 years of a randomized controlled trial (1991)(1992)(1993)(1994) of 2 levels of formula iron. Examiners were masked to group assignment.

Cited by 119 publications

References 37 publications

Scientific Opinion on the essential composition of infant and follow-on formulae

Scientific Opinion on the essential composition of infant and follow-on formulae

Iron Intake and Status of Children Aged 6-36 Months in Europe: A Systematic Review

Excess iron intake as a factor in growth, infections, and development of infants and young children

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