Red Meat and a Fortified Manufactured Toddler Milk Drink Increase Dietary Zinc Intakes without Affecting Zinc Status of New Zealand Toddlers1–4

Abstract

Evidence suggests that New Zealand (NZ) children are mildly zinc deficient and may respond to dietary change. A 20-wk randomized intervention trial was therefore conducted to determine whether an increased intake of red meat or consumption of a fortified manufactured toddler milk drink (FTMD, fortified with zinc and other micronutrients) would increase dietary zinc intakes and improve the biochemical zinc status of 12- to 20-mo-old NZ toddlers. Toddlers were randomized to a red meat intervention (n = 90), FTMD intervention (n = 45), or nonfortified milk placebo (n = 90). Study foods were provided. Adherence was assessed via monthly 7-d meat or milk recording diaries. Hair and serum zinc concentrations, and length and weight were measured at baseline and postintervention. Nutrient intakes were assessed via 3-d weighed food records at baseline, wk 4, and wk 18. At baseline, 38% of participants had low serum zinc concentrations despite seemingly adequate dietary zinc intakes (<4% below the Estimated Average Requirement). Dietary zinc intakes significantly increased by 0.8 mg/d (95% CI: 0.5, 1.1) in the meat group and 0.7 mg/d (95% CI: 0.2, 1.1) in the FTMD group compared with a decrease of -0.5 (95% CI: -0.8, -0.2) mg/d in the placebo group. No corresponding increases in serum or hair zinc concentrations were observed. Dietary zinc intakes achievable via interventions based on red meat or a FTMD are unlikely to improve biochemical zinc status in NZ toddlers. These results also question cutoffs used to define zinc deficiency in toddlers.

Mode of oral iron administration and the amount of iron habitually consumed do not affect iron absorption, systemic iron utilisation or zinc absorption in iron-sufficient infants: a randomised trial

“…The results of our study support the limited research that shows no evidence that consumption of foods fortified with Fe has a negative effect on Zn absorption (30,32) or Zn status (32,33) in young children. The absorption of Zn from the study formulae was similar to that previously reported in infants (36) .…”

“…Whether Fe supplements given alone compromise infant Zn nutrition is still unclear (21,(27)(28)(29) . When present as a fortificant, Fe does not appear to inhibit Zn absorption (30)(31)(32) , impair Zn status (32)(33)(34) or result in measurable circulating non-transferrin-bound Fe (16) . Few studies, however, have addressed this in infants.…”

Micronutrient fortification of food and its impact on woman and child health: a systematic review

“…A total of 34 studies were identified that reported outcomes on children [36-38,43,46,47,50,61-64],[67-69,71-76,82,86,87,92,93,98],[102,105,115,117,118,121,122,130]. Three of these were before-after studies and the rest were RCTs and quasi-experimental studies.…”

Is iron and zinc nutrition a concern for vegetarian infants and young children in industrialized countries?

“…Such relations may be apparent in older age groups because they consume larger portions of flesh foods compared with young children. However, even in meatbased randomized controlled trials in young children, no positive response in serum zinc has been reported (40,41).…”

“…The substitution of cow milk with these fortified milk drinks is likely to be an acceptable practice for young children following lactoovovegetarian diets, because it does not require any behavior change, can be used concurrently with breastfeeding, and could increase their intakes of iron and zinc substantially, given the large amounts of milk often consumed (23,82). Moreover, the consumption of fortified toddler milks has produced positive impacts on anemia rates and biomarkers of iron (83-85) but not zinc (41,83) status. Evidence for improvements in functional health outcomes such as growth, morbidity, and cognitive function from the consumption of milk and cereal foods cofortified with zinc and iron is, however, inconclusive on the basis of a systematic review (81); more long-term studies examining these functional health outcomes are required.…”