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.


METHODS
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.
Faber
Mieke
M
Nutritional Intervention Research Unit, Medical Research Council, Tygerberg, South Africa. mieke.faber@mrc.ac.za
Kvalsvig
Jane D
JD
Lombard
Carl J
CJ
Benadé
A J Spinnler
AJ
D018798:Anemia, Iron-Deficiency / Q000188:drug therapy*; D001205:Ascorbic Acid / Q000008:administration & dosage; D002657:Child Development / Q000187:drug effects* / Q000502:physiology; D003300:Copper / Q000008:administration & dosage; D005260:Female; D005527:Food, Fortified; D006801:Humans; D007223:Infant; D007225:Infant Food; D007227:Infant Nutritional Physiological Phenomena; D019266:Iron, Dietary / Q000008:administration & dosage; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage* / Q000378:metabolism; D009048:Motor Skills / Q000187:drug effects* / Q000502:physiology; D009753:Nutritive Value; D012643:Selenium / Q000008:administration & dosage; D014803:Vitamin B Complex / Q000008:administration & dosage; D014810:Vitamin E / Q000008:administration & dosage; D014815:Vitamins / Q000008:administration & dosage* / Q000378:metabolism; D014886:Weaning; D003313:Zea mays; D015032:Zinc / Q000008:administration & dosage; D019207:beta Carotene / Q000008:administration & dosage
D019266:Iron, Dietary; D018977:Micronutrients; D014815:Vitamins; D019207:beta Carotene; D014803:Vitamin B Complex; D014810:Vitamin E; D003300:Copper; D012643:Selenium; D015032:Zinc; D001205:Ascorbic Acid