Effect of a fortified maize-meal porridge on anemia, micronutrient status, and motor development of infants

BACKGROUND: Maize-meal porridge is used for infant feeding in many African countries, including South Africa. A low-cost, finely milled, maize-meal porridge was fortified with beta-carotene, iron, and zinc (100% of recommended dietary allowance), as well as ascorbic acid, copper, selenium, riboflavin, vitamin B-6, vitamin B-12, and vitamin E. OBJECTIVE: We assessed whether the fortified porridge could reduce anemia and improve the micronutrient status and motor development of infants. DESIGN: Infants aged 6-12 mo (n = 361) were randomly assigned to receive either the fortified or unfortified porridge for 6 mo. Primary outcomes were hemoglobin and serum retinol, zinc, and ferritin concentrations and motor development. Growth was assessed as a secondary outcome. Primary and secondary outcomes were assessed at baseline and 6 mo. RESULTS: Two hundred ninety-two infants completed the study. The fortified-porridge group had an intervention effect of 9.4 microg/L (95% CI: 3.6, 15.1 microg/L) for serum ferritin and 9 g/L (95% CI: 6, 12 g/L) for hemoglobin concentrations. The proportion of infants with anemia decreased from 45% to 17% in the fortified-porridge group, whereas it remained >40% in the control group. The fortified-porridge group achieved on average 15.5 of the 25 motor development score items, whereas the control group achieved 14.4 items (P = 0.007). Serum retinol concentration showed an inconsistent effect, and no intervention effect was observed for serum zinc concentrations. CONCLUSIONS: This low-cost fortified porridge can potentially have a significant effect in reducing anemia and improving iron status and motor development of infants in poor settings. The formulation needs some adjustment in terms of zinc fortification.     

营养强化辅助食品补充物对甘肃贫困农村婴幼儿体格生长的影响

目的探讨补充含有蛋白质、微量营养素的辅助食品对婴幼儿身长和体重的影响。方法从甘肃省5个贫困县选取1478名4~12个月的婴幼儿分成2组,所有儿童均在保持其家庭习惯辅助食品添加的前提下,每天再补充1包不同配方的营养补充物,其中配方1组补充了蛋白质和微量营养素,配方2组补充了与配方1组同等的能量,每隔6个月对全部儿童补充一次大剂量维生素A。补充期间,每3个月进行一次体格测量,两组儿童观察到满24个月为止。结果基线调查时,配方2组LAZ和WAZ要优于配方1组,配方1组儿童的营养不良率均高于配方2组,但差异无显著性(P>0.05)。补充12个月以后,配方1组和配方2组儿童LAZ、WAZ和营养不良率已经没有差别。如果比较同一个儿童随访调查与其基线调查时的LAZ差值、WAZ差值的变化,配方1的作用要优于配方2,效用尺度是0.17。对于基线调查不同营养状况的儿童,配方1组均有正的效用。所有儿童满24个月时,儿童身长和体重Z评分的变化值在配方1组和配方2组之间有显著意义(P<0.05),配方1组婴幼儿身长的变化值要显著大于配方2组(P<0.05),如果只分析基线调查时月龄小于7个月的儿童,配方1组儿童身长Z评分的变化值要显著优于配方2组(P<0.005),儿童平均身长要多增加1.3cm(P<0.005)。结论辅食补充物可以促进婴幼儿的体格发育,家庭水平强化辅食在中国贫困农村是可行的。     

营养强化辅食补充对甘肃贫困农村婴幼儿智力发育的影响

目的初步探讨辅食补充对贫困农村婴幼儿智力发育的影响。方法从甘肃省5个贫困县选取4~12个月的婴幼儿分成两组,所有儿童均在保持其家庭习惯的辅助食品添加的前提下,每天再补充1包不同配方的营养补充物,其中配方1组补充了蛋白质和微量营养素,配方2组补充能量达到配方1组的同等的能量。两组均补充维生素A。补充期间,儿童每3个月进行一次体格测量,每6个月进行一次血红蛋白测量,两组儿童观察到满24个月为止。儿童满24个月龄时进行智力发育的测定。结果24个月时配方1组、配方2组儿童的总发育商分别为97.2、95.5,有显著性差别(P<0.05),其中大运动区也有显著性差别(P<0.05)。两配方组儿童在辅食的补充时间、营养状况、性别构成、母亲文化程度等没有显著差别,但是24个月时儿童血红蛋白值两配方组有显著性差别(P=0.011)。结论补充营养素强化的辅助食品有利于贫困农村4~12个月婴儿的智力发育。     

The effect of a micronutrient-fortified complementary food on micronutrient status,growth and development of 6- to 12-month-old disadvantaged urban South African infants

The study was conducted to look at the effectiveness of a multimicronutrient-fortified complementary food on the micronutrient status, linear growth and psychomotor development of 6- to 12-month-old infants from a black urban disadvantaged community in the Western Cape, South Africa. The study was designed as an intervention study. In both the experimental and control groups, serum retinol concentration showed a decline over the intervention period of 6 months. The decline was less pronounced in the experimental group. This resulted in a significantly (P<005) higher serum retinol concentration at 12 months in the experimental group (26.8+/-5.8 microg/dl) compared with the control group (21.4+/-5 microg/dl). Serum iron concentration also declined over the intervention period. The decline was less pronounced in the experimental group. No difference was observed in haemoglobin levels between the groups at 12 months. Serum zinc concentration did not differ significantly between the two groups at follow up. Weight gain over the 6 months period did not differ significantly between the experimental (2.1+/-0.9 kg) and control groups (2.1+/-1.2 kg). There was no difference in linear growth between the experimental (10.0+/-1.5 cm) and control group (10.1+/-2.1 cm) at the end of the follow-up period. Weight and length at 6 months significantly predicted weight and length at 12 months. No difference was observed in psychomotor developmental scores between the two groups after 6 months of intervention. Introducing a multimicronutrient-fortified complementary food into the diet of 6- to 12-month-old infants seemed to have an arresting effect on declining serum retinol and iron concentration in the experimental group. No benefit was observed in serum zinc concentration, linear growth and psychomotor development.     

The effect of a micronutrient-fortified complementary food on micronutrient status,growth and development of 6- to 12-month-old disadvantaged urban South African infants

The study was conducted to look at the effectiveness of a multimicronutrient-fortified complementary food on the micronutrient status, linear growth and psychomotor development of 6- to 12-month-old infants from a black urban disadvantaged community in the Western Cape, South Africa. The study was designed as an intervention study. In both the experimental and control groups, serum retinol concentration showed a decline over the intervention period of 6 months. The decline was less pronounced in the experimental group. This resulted in a significantly (P&lt;005) higher serum retinol concentration at 12 months in the experimental group (26.8±5.8 μg/dl) compared with the control group (21.4±5 μg/dl). Serum iron concentration also declined over the intervention period. The decline was less pronounced in the experimental group. No difference was observed in haemoglobin levels between the groups at 12 months. Serum zinc concentration did not differ significantly between the two groups at follow up. Weight gain over the 6 months period did not differ significantly between the experimental (2.1±0.9 kg) and control groups (2.1±1.2 kg). There was no difference in linear growth between the experimental (10.0±1.5 cm) and control group (10.1±2.1 cm) at the end of the follow-up period. Weight and length at 6 months significantly predicted weight and length at 12 months. No difference was observed in psychomotor developmental scores between the two groups after 6 months of intervention. Introducing a multimicronutrient-fortified complementary food into the diet of 6- to 12-month-old infants seemed to have an arresting effect on declining serum retinol and iron concentration in the experimental group. No benefit was observed in serum zinc concentration, linear growth and psychomotor development.     

46个农村贫困县婴幼儿辅食添加现状

目的 分析我国西部农村地区3岁以下儿童辅食添加现状，为政府制定相应的政策提供理论依据。方法 采用分层多阶段抽样的方法。进行横断面调查。以辅食添加率、辅食添加时间和辅食添加频率来分析辅食添加状况，用年龄别身高Z值(HAZ)和年龄别体重Z值(WAZ)判断婴幼儿生长发育水平。结果 所调查婴幼儿谷类辅食的添加率88％，植物蛋白添加率最低为44．7％。五大类辅食的添加率都随着婴幼儿年龄的增加而增加，每一个月龄段各类辅食的添加率都以谷类最高，依次为蔬菜，动物蛋白，蛋类和奶类，植物蛋白最低。辅食开始添加较迟，平均时间在6个月以后，鸡蛋、肉类和蔬菜在8个月左右，豆制品最晚，平均为10个月。4～6月龄每天吃鸡蛋和肉类的比例分别只有16．6％和15．4％，12个月龄以后每天能吃到鸡蛋的比例不到60％，肉类则更低不到50％，6个月龄以后五大类辅食添加组生长迟缓和低体重的发病率都低于未添加，12～24月龄段这种差别最大。结论我国西部农村要幼儿辅食添加存在的主要问题是添加时间不合理，品种单一和实际摄入量低。应该多渠道进行营养知识宣传，大力提倡添加鸡蛋，植物蛋白如豆制品以及蔬菜等，农村地区容易获取的营养丰富的食品，以满足要幼儿生长发育对蛋白质和多种维生素的需求。进而改善农村地区婴幼儿营养状况。     

Potential for misclassification of micronutrient status in children participating in a Head Start program

OBJECTIVE: To evaluate relations among measures of iron and zinc status, C-reactive protein (CRP), and leukocytes in low-income children participating in the Head Start program. DESIGN: Cross-sectional correlational study with samples collected at Head Start centers in May 2003. SUBJECTS/SETTING: Forty-seven children (aged 3 to 5 years) attending Head Start centers in three rural communities. MEASURES: Zinc, ferritin, CRP, and complete blood count were analyzed in nonfasting blood samples. STATISTICAL ANALYSES: Correlations were computed among leukocyte levels, CRP levels, and measures of micronutrient status. Children having two abnormal measures (ie, leukocytes and CRP) were compared by univariate analysis of variance with children having zero or one abnormal measure. RESULTS: Most (72%) of the children had elevated CRP levels. Four percent were anemic (hemoglobin<11.0 g/dL [<110 g/L]); 11% had low iron stores (serum ferritin相似文献   

An energy-dense complementary food is associated with a modest increase in weight gain when compared with a fortified porridge in Malawian children aged 6-18 months

Poor complementary feeding practices are associated with stunting and growth faltering throughout the developing world. The objective was to compare the effect of using peanut-/soy-based fortified spread (FS) and corn porridge fortified with fish powder (FP) as complementary foods on growth in rural Malawian children. A total of 240 children were enrolled at the age of 6 mo and randomized to receive FS or FP. Both complementary foods provided 836 kJ/d from 6 to 9 mo of age and 1254 kJ/d from 9 to 18 mo of age. Children were followed monthly for anthropometry and fortnightly for the symptoms of fever, cough, or diarrhea until they were 18 mo old. Zn and Se status were assessed at 6 and 12 mo. The primary outcomes were the rates of weight and length gain from 6-12 mo and from 12-18 mo. Children who received FS gained 110 g more (95% CI 220 to 10) from 6-12 mo of age than children receiving FP. Weight gain did not differ between children receiving FS and FP between 12 and 18 mo of age, nor did statural growth from 6 to 12 mo or 12 to 18 mo. A total of 23% of all children were Zn deficient at 6 mo of age and this increased to 37% at 12 mo of age. Neither FS nor FP was associated with significantly improved Zn status. FS was associated with better weight gain from 6-12 mo of age and may be useful in conjunction with additional interventions to improve infant growth in the developing world.     

The effects of a multivitamin/mineral supplement on micronutrient status, antioxidant capacity and cytokine production in healthy older adults consuming a fortified diet

BACKGROUND: Inadequate micronutrient intake among older adults is common despite the increased prevalence of fortified/enriched foods in the American diet. Although many older adults take multivitamin supplements in an effort to compensate, studies examining the benefits of this behavior are absent. OBJECTIVE: To determine whether a daily multivitamin/mineral supplement can improve micronutrient status, plasma antioxidant capacity and cytokine production in healthy, free-living older adults already consuming a fortified diet. METHODS: An eight-week double-blind, placebo-controlled clinical trial among 80 adults aged 50 to 87 years (mean = 66.5 +/- 8.6 years). RESULTS: Multivitamin treatment significantly increased (p<0.01, compared to placebo) plasma concentrations of vitamins D (77 to 100 nmol/L), E (27 to 32 micromol/L), pyridoxal phosphate (55.1 to 75.2 nmol/L), folate (23 to 33 nmol/L), B12 (286 to 326 pmol/L)), C (55 to 71 micromol/L), and improved the riboflavin activity coefficient (1.23 to 1.15), but not vitamins A and thiamin. The multivitamin reduced the prevalence of suboptimal plasma levels of vitamins E (p=0.003), B12 (p=0.004), and C (p=0.08). Neither glutathione peroxidase activity nor antioxidant capacity (ORAC) were affected. No changes were observed in interleukin-2, -6 or -10 and prostaglandin E2, proxy measures of immune responses. CONCLUSIONS: Supplementation with a multivitamin formulated at about 100% Daily Value can decrease the prevalence of suboptimal vitamin status in older adults and improve their micronutrient status to levels associated with reduced risk for several chronic diseases.     

Ten-year trends in vitamin and mineral intake from fortified food in German children and adolescents

OBJECTIVE: We investigated time trends in consumption patterns, and energy and nutrient intakes (protein, fat, carbohydrates, added sugars, vitamins A, E, C, B1, B2 and B6, niacin, folate, calcium and iron) from fortified food in children and adolescents between 1987 and 1996 in Germany. DESIGN: Mixed longitudinal survey (DONALD study) with 3 d weighed dietary records (n=2062 from 594 subjects), one subject per family per year chosen by random. SETTING: Dortmund (Western Germany) district cohort. SUBJECTS: 285 males, 309 females; mean age 6 y (2-13 y). RESULTS: Almost all children and adolescents consumed fortified food irrespective of the year studied. With the exception of vitamin E, significant time trends in the proportions of nutrient intakes from fortification were observed. The fortification of food with vitamins A, C, B1, B2 and B6 and niacin raised the already adequate intakes from non-fortified food (100% to 150% of reference intake values) by 20-50%. The fortification of food with vitamin E and folate raised the low intakes from non-fortified food (about 50% of reference intake values) to about 80% (folate) and 100% (vitamin E) of the references. Fortification of food with calcium and iron was not significant (<10%), but while total intake of calcium was adequate, total intake of iron remained critical. CONCLUSIONS: Since the nutrient intake of the population of children and adolescents studied is adequate with respect to vitamins A, C, B1, B2 and B6, niacin and calcium, fortification seems inefficient, while fortification of food with vitamin E and folate, but not iron, improves an inadequate intake. SPONSORSHIP: The DONALD study is supported by the German Federal Ministry of Health and the North-Rhine-Westphalian Ministry of Science and Research. European Journal of Clinical Nutrition (2000) 54, 81-86     

辅助食品补充物对婴幼儿贫血的影响

目的　探讨补充含有蛋白质、微量营养素的辅助食品对婴幼儿血红蛋白和贫血的影响。方法　从甘肃省 5个贫困县选取 4～ 12个月的婴幼儿分成两组 ,其中配方 1组补充了蛋白质和微量营养素 ,两组儿童均观察到 2岁为止。补充期间 ,每隔 6个月对儿童进行一次大剂量维生素A补充 ,并进行血红蛋白测量。结果　基线调查时 ,两组儿童的血红蛋白及贫血率没有显著性差别。补充了 12个月后 ,配方 1组儿童血红蛋白的增加值高于配方 2组 (P <0 0 0 0 5 ) ,儿童贫血率明显下降 ,两配方组之间贫血率有显著差别 ;所有儿童至满 2岁时 ,配方 1组的血红蛋白增加值大于配方 2组 ,有统计学显著意义 (P =0 0 0 6 )。结论　补充微量营养素和大剂量的维生素A可以增加婴幼儿的血红蛋白值 ,降低其贫血率。     

婴幼儿谷类辅助食品中砷形态分析

目的建立婴幼儿谷类辅助食品中砷形态的分析方法,对市售婴幼儿谷类辅助食品中砷的形态及含量进行调查,了解婴幼儿谷类辅助食品中砷的污染现状。方法建立高效液相色谱与电感耦合等离子体质谱联用技术(HPLC-ICP-MS)测定婴幼儿谷类辅助食品中砷形态,对市售婴幼儿谷类辅助食品进行砷形态分析。结果建立的砷形态分析方法在0~100μg/L范围内具有良好的线性关系,加标回收率在83.9%~94.4%,相对标准偏差(RSD)<5%。婴幼儿谷类辅助食品中砷形态以无机砷、二甲基砷酸(DMA)为主,无机砷与总砷含量存在正相关关系(r=0.636,P<0.001),无机砷检出率为90%,调查样品未见无机砷超标。结论建立的HPLC-ICP-MS测定婴幼儿谷类辅助食品中砷形态方法快速、准确,适用于婴幼儿谷类辅助食品中砷化合物的测定。