Food-based strategies improve iron status in toddlers: a randomized controlled trial12.
BACKGROUND
Nonanemic iron deficiency is common in toddlers in developed countries. Food-based strategies are safe methods to control and prevent mild micronutrient deficiencies.


OBJECTIVE
Our objective was to determine the efficacy of an increased intake of red meat, or the consumption of iron-fortified milk, in improvement of iron status in toddlers at a population level.


METHODS
In this 20-wk randomized placebo-controlled trial, 225 healthy nonanemic 12-20-mo-old children were assigned to 1 of 3 groups: red meat (toddlers encouraged to consume approximately 2.6 mg iron from red meat dishes daily), fortified milk [toddlers' regular milk replaced with iron-fortified (1.5 mg iron/100 g prepared milk) cow milk], or control [toddlers' regular milk replaced with nonfortified (0.01 mg iron/100 g prepared milk) cow milk]. Blood samples were collected at baseline and at 20 wk for hemoglobin, serum ferritin, serum transferrin receptor, and C-reactive protein. The prevalence of suboptimal iron status (ie, depleted iron stores, iron-deficient erythropoiesis, and iron deficiency anemia) was determined, and body iron was calculated.


RESULTS
No intervention effects were shown on the prevalence of suboptimal iron status. Serum ferritin increased by 44% (95% CI: 14%, 82%; P = 0.002) in the fortified milk group, did not change (+10%) in the red meat group (95% CI: -7%, 30%; P = 0.241), and tended to decrease (-14%) in the control group (95% CI: -27%, 1%; P = 0.063). By 20 wk, in comparison with the control group, serum ferritin and body iron were significantly higher in the fortified milk group (both P < 0.001), and serum ferritin was significantly higher in the red meat group (P = 0.033).


CONCLUSIONS
Consumption of iron-fortified milk can increase iron stores in healthy nonanemic toddlers, whereas increased intakes of red meat can prevent their decline. This trial was registered at actr.org.au as ACTRN12605000487617.
Szymlek-Gay
Ewa A
EA
Departments of Human Nutrition and Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
Ferguson
Elaine L
EL
Heath
Anne-Louise M
AL
Gray
Andrew R
AR
Gibson
Rosalind S
RS
D000818:Animals; D004311:Double-Blind Method; D005260:Female; D005293:Ferritins / Q000097:blood; D005527:Food, Fortified; D006801:Humans; D007223:Infant; D007225:Infant Food; D007501:Iron / Q000378:metabolism*; D000090463:Iron Deficiencies; D008297:Male; D008460:Meat; D008892:Milk
D005293:Ferritins; D007501:Iron