Helicobacter pylori infection does not influence the efficacy of iron and vitamin B(12) fortification in marginally nourished Indian children.
OBJECTIVE
Helicobacter pylori infection and iron and vitamin B(12) deficiencies are widespread in economically disadvantaged populations. There is emerging evidence that H. pylori infection has a negative effect on the absorption of these micronutrients. The aim of this study was to evaluate the effect of H. pylori infection on the efficacy of micronutrient (including iron and vitamin B(12))-fortified foods supplied for 1 year in marginally nourished children.


METHODS
In all, 543 Indian children, aged 6-10 years, participated in a double-blind, randomized controlled intervention trial, receiving foods fortified with either high (100% Recommended Dietary Allowances (RDA)) or low (15% RDA) amounts of iron, vitamin B(12) and other micronutrients. The presence of H. pylori infection was diagnosed by the (13)C-labeled urea breath test at 11 months after the start of the intervention. Blood hemoglobin, serum ferritin (SF), total body iron and plasma vitamin B(12) were estimated at baseline and 12 months, and differences between these time points were assessed using an independent t-test.


RESULTS
Overall, the prevalence of H. pylori infection in this group of children was 79%. Baseline hemoglobin, SF, body iron and vitamin B(12) concentrations were not associated with H. pylori infection. The response to the intervention (either high or low amounts of iron and vitamin B(12) fortification) in terms of change in iron markers and vitamin B(12) status did not differ between children with and without H. pylori infection.


CONCLUSIONS
This study shows that the presence of H. pylori infection did not affect the efficacy of long-term iron and vitamin B(12) fortification in these marginally nourished children.
Thankachan
P
P
Division of Nutrition, St John's Research Institute, St John's National Academy of Health Sciences, Bangalore, India. prashanth@sjri.res.in
Muthayya
S
S
Sierksma
A
A
Eilander
A
A
Thomas
T
T
Duchateau
G S
GS
Frenken
L G J
LG
Kurpad
A V
AV
D001944:Breath Tests; D002648:Child; D015362:Child Nutrition Disorders / Q000097:blood / Q000150:complications* / Q000178:diet therapy / Q000517:prevention & control*; D003677:Deficiency Diseases / Q000097:blood / Q000150:complications / Q000178:diet therapy / Q000517:prevention & control; D004311:Double-Blind Method; D005260:Female; D005293:Ferritins / Q000097:blood; D005527:Food, Fortified; D016481:Helicobacter Infections / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D016480:Helicobacter pylori; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007194:India / Q000453:epidemiology; D007501:Iron / Q000097:blood; D019266:Iron, Dietary / Q000008:administration & dosage*; D008297:Male; D018977:Micronutrients / Q000627:therapeutic use; D015995:Prevalence; D014805:Vitamin B 12 / Q000008:administration & dosage* / Q000097:blood
D006454:Hemoglobins; D019266:Iron, Dietary; D018977:Micronutrients; D005293:Ferritins; D007501:Iron; D014805:Vitamin B 12