Effects of weaning cereals with different phytate content on growth, development and morbidity: a randomized intervention trial in infants from 6 to 12 months of age.
BACKGROUND
Phytate decreases iron and zinc bioavailability and contributes to deficiencies of iron and zinc, potentially causing anaemia, poor psychomotor development, impaired growth and increased risk of diarrhoea and respiratory infections.


OBJECTIVE
To investigate whether a reduced dietary intake of phytate, either via extensively phytate-reduced infant cereals [milk cereal drinks (MCDs) and porridge] or a milk-based infant formula, would improve growth and development and reduce morbidity in infants.


METHODS
Infants (n = 300) were, in a double-blind design, randomized to three diet intervention groups from 6 to 12 mo of age-commercial MCD and porridge (CC group), phytate-reduced MCD and phytate-reduced porridge (PR group), or milkbased infant formula and porridge with regular phytate content (IF group)-then followed until 18 mo. Dietary intake, anthropometry, development (Bayley Scales of Infant Development) and episodes of infectious diseases were registered.


RESULTS
There were no significant differences between study groups in growth, development or morbidity until 12 mo of age. The IF group had a 77% higher risk (95% CI: 1.05-2.97) of diarrhoea compared to the PR group during the 12-17-mo period. Infants with haemoglobin concentration (Hb) < 110 g/l at 12 mo had lower attained weight at 18 mo (11.14 kg vs 11.73 kg, p = 0.012). Infants with serum zinc (S-Zn) <10.7 pmol/l at 12 mo had higher risk of respiratory infections (RR = 1.74, 95% CI: 1.19-2.56) compared to controls.


CONCLUSIONS
Phytate reduction had no effect on growth, development or incidence of diarrhoeal or respiratory infections. Infants with low Hb or low S-Zn may be at higher risk of poor growth and respiratory infections, even in this high-income population.
Lind
T
T
Department of Clinical Sciences, Paediatrics, Umea University, Umea, Sweden. . torbjorn.lind@epiph.umu.se
Persson
L- A
L
Lönnerdal
B
B
Stenlund
H
H
Hernell
O
O
D000886:Anthropometry; D002657:Child Development / Q000187:drug effects*; D003967:Diarrhea / Q000097:blood / Q000453:epidemiology*; D004311:Double-Blind Method; D002523:Edible Grain / Q000737:chemistry*; D002149:Energy Intake; D004734:Energy Metabolism; D005527:Food, Fortified; D006130:Growth Disorders / Q000097:blood / Q000453:epidemiology*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D010833:Phytic Acid / Q000032:analysis* / Q000494:pharmacology*; D015995:Prevalence; D012141:Respiratory Tract Infections / Q000097:blood / Q000453:epidemiology*; D014886:Weaning; D015032:Zinc / Q000097:blood
D006454:Hemoglobins; D010833:Phytic Acid; D015032:Zinc