A micronutrient-fortified young-child formula improves the iron and vitamin D status of healthy young European children: a randomized, double-blind controlled trial

作者：Akkermans Marjolijn D^*; Eussen Simone R B M; van der Horst Graat Judith M; van Elburg Ruurd M; van Goudoever Johannes B; Brus Frank

来源：American Journal of Clinical Nutrition, 2017, 105(2): 391-399.

DOI：10.3945/ajcn.116.136143

• iron deficiency
• vitamin D deficiency
• cow milk
• young-child formula
• vitamin D supplements
• micronutrient fortification
• young children

Background: Iron deficiency (ID) and vitamin D deficiency (VDD) are common among young European children because of low dietary intakes and low compliance to vitamin D supplementation policies. Milk is 'a common drink for young European children. Studies evaluating the effect of milk fortification on iron and vitamin D status in these children are scarce.
Objective: We aimed to investigate the effect of a micronutrientfortified young-child formula (YCF) on the iron and vitamin D status of young European children.
Design: In this randomized, double-blind controlled trial, healthy German, Dutch, and English children aged 1-3 y were allocated to receive either YCF (1.2 mg Fe/100 mL; 1.7 tg vitamin D/100 mL) or nonfortified cow milk (CM) (0.02 mg Fe/100 mL; no vitamin D) for 20 wk. Blood samples were taken before and after the intervention. The primary and secondary outcomes were change from baseline in serum ferritin (SF) and 25-hydroxyvitamin D [25(OH)D], respectively. ID was defined as SF <12 mu g/ L in the absence of infection (high-sensitivity C-reactive protein <10 mg/L) and VDD as 25(OH)D <50 nmol/L. Statistical adjustments were made in intention-to-treat analyses for sex, country, age, baseline micronutrient status, and micronutrient intake from food and supplements (and sun exposure in the case of vitamin D outcomes).
Results: The study sample consisted of 318 predominantly Caucasian (similar to 95%) children. The difference in the SF and 25(OH)D change between the treatment groups was 6.6 mu g/L (95% CI: 1.4, 11.7 mu g/L; P = 0.013) and 16.4 nmol/L (95% CI: 9.5, 21.4 nmol/L; P < 0.001), respectively. The probability of ID (OR 0.42; 95% CI:0:18, 0.95; P = 0.036) and VDD (OR 0.22; 95% CI: 0.01, 0.51; P < 0.001) after the intervention was lower in the YCF group than in the CM group.
Conclusion: Micronutrient-fortified YCF use for 20 wk preserves iron status and improves vitamin D status in healthy young children in Western Europe.

• 出版日期2017-2