title: A micronutrient powder with low doses of highly absorbable iron and zinc reduces iron and zinc deficiency and improves weight-for-age Z-scores in South African children.
abstract: Micronutrient powders (MNP) are often added to complementary foods high in inhibitors of iron and zinc absorption. Most MNP therefore include high amounts of iron and zinc, but it is no longer recommended in malarial areas to use untargeted MNP that contain the Reference Nutrient Intake for iron in a single serving. The aim was to test the efficacy of a low-iron and -zinc (each 2.5 mg) MNP containing iron as NaFeEDTA, ascorbic acid (AA), and an exogenous phytase active at gut pH. In a double-blind controlled trial, South African school children with low iron status (n = 200) were randomized to receive either the MNP or the unfortified carrier added just before consumption to a high-phytate maize porridge 5 d/wk for 23 wk; primary outcomes were iron and zinc status and a secondary outcome was somatic growth. Compared with the control, the MNP increased serum ferritin (P < 0.05), body iron stores (P < 0.01) and weight-for-age Z-scores (P < 0.05) and decreased transferrin receptor (P < 0.05). The prevalence of iron deficiency fell by 30.6% (P < 0.01) and the prevalence of zinc deficiency decreased by 11.8% (P < 0.05). Absorption of iron from the MNP was estimated to be 7-8%. Inclusion of an exogenous phytase combined with NaFeEDTA and AA may allow a substantial reduction in the iron dose from existing MNP while still delivering adequate iron and zinc. In addition, the MNP is likely to enhance absorption of the high native iron content of complementary foods based on cereals and/or legumes.
authors.affiliation: Laboratory for Human Nutrition, ETH, Zurich, Switzerland. barbara.troesch@ilw.agrl.ethz.ch
authors.forename: Barbara
authors.initials: B
authors.lastname: Troesch
authors.forename: Martha E
authors.initials: ME
authors.lastname: van Stuijvenberg
authors.forename: Martha E
authors.initials: ME
authors.lastname: van Stujivenberg
authors.forename: Cornelius M
authors.initials: CM
authors.lastname: Smuts
authors.forename: H Salomè
authors.initials: HS
authors.lastname: Kruger
authors.forename: Ralf
authors.initials: R
authors.lastname: Biebinger
authors.forename: Richard F
authors.initials: RF
authors.lastname: Hurrell
authors.forename: Jeannine
authors.initials: J
authors.lastname: Baumgartner
authors.forename: Michael B
authors.initials: MB
authors.lastname: Zimmermann
mesh_terms: D010832:6-Phytase / Q000494:pharmacology; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000188:drug therapy*; D001205:Ascorbic Acid / Q000494:pharmacology; D001835:Body Weight / Q000187:drug effects*; D002648:Child; D003677:Deficiency Diseases / Q000097:blood / Q000188:drug therapy; D004311:Double-Blind Method; D004492:Edetic Acid / Q000494:pharmacology; D002523:Edible Grain; D005260:Female; D005290:Ferric Compounds / Q000494:pharmacology; D005293:Ferritins / Q000097:blood; D005527:Food, Fortified; D006801:Humans; D007408:Intestinal Absorption / Q000187:drug effects; D007501:Iron / Q000097:blood / Q000494:pharmacology / Q000627:therapeutic use*; D007502:Iron Chelating Agents / Q000494:pharmacology; D000090463:Iron Deficiencies; D008297:Male; D015995:Prevalence; D011990:Receptors, Transferrin / Q000378:metabolism; D013019:South Africa; D014131:Trace Elements / Q000097:blood / Q000494:pharmacology / Q000627:therapeutic use*; D003313:Zea mays; D015032:Zinc / Q000097:blood / Q000172:deficiency / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D005290:Ferric Compounds; D007502:Iron Chelating Agents; D011990:Receptors, Transferrin; D014131:Trace Elements; D005293:Ferritins; D004492:Edetic Acid; D007501:Iron; D010832:6-Phytase; D015032:Zinc; C019179:Fe(III)-EDTA; D001205:Ascorbic Acid