title: Dry cereals fortified with electrolytic iron or ferrous fumarate are equally effective in breast-fed infants.
abstract: Precooked, instant (dry) infant cereals in the US are fortified with electrolytic iron, a source of low reactivity and suspected low bioavailability. Iron from ferrous fumarate is presumed to be more available. In this study, we compared a dry infant rice cereal (Cereal L) fortified with electrolytic iron (54.5 mg iron/100 g cereal) to a similar cereal (Cereal M) fortified with ferrous fumarate (52.2 mg Fe/100 g) for efficacy in maintaining iron status and preventing iron deficiency (ID) in breast-fed infants. Ascorbic acid was included in both cereals. In this prospective, randomized double-blind trial, exclusively breast-fed infants were enrolled at 1 mo and iron status was determined periodically. At 4 mo, 3 infants had ID anemia and were excluded. Ninety-five infants were randomized at 4 mo, and 69 (36 Cereal L, 33 Cereal M) completed the intervention at 9 mo. From 4 to 9 mo, they consumed daily one of the study cereals. With each cereal, 2 infants had mild ID, a prevalence of 4.2%, but no infant developed ID anemia. There were no differences in iron status between study groups. Iron intake from the study cereals was (mean ± SD) 1.21 ± 0.31 mg⋅kg(-1)⋅d(-1) from Cereal L and 1.07 ± 0.40 mg⋅kg(-1)⋅d(-1) from Cereal M. Eleven infants had low birth iron endowment (plasma ferritin < 55 μg/L at 2 mo) and 54% of these infants had ID with or without anemia by 4 mo. We conclude that electrolytic iron and ferrous fumarate were equally efficacious as fortificants of this infant cereal.
authors.affiliation: Fomon Infant Nutrition Unit, Department of Pediatrics, University of Iowa, Iowa City, IA 52242, USA. ekhard-ziegler@uiowa.edu
authors.forename: Ekhard E
authors.initials: EE
authors.lastname: Ziegler
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: Fomon
authors.forename: Steven E
authors.initials: SE
authors.lastname: Nelson
authors.forename: Janice M
authors.initials: JM
authors.lastname: Jeter
authors.forename: Richard C
authors.initials: RC
authors.lastname: Theuer
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control*; D001942:Breast Feeding; D004311:Double-Blind Method; D002523:Edible Grain; D004572:Electrolysis; D005260:Female; D005293:Ferritins / Q000097:blood; D005296:Ferrous Compounds / Q000494:pharmacology / Q000627:therapeutic use*; D005527:Food, Fortified; D006801:Humans; D007223:Infant; D007501:Iron / Q000097:blood / Q000494:pharmacology / Q000627:therapeutic use*; D019266:Iron, Dietary / Q000008:administration & dosage*; D008297:Male; D012275:Oryza; D015995:Prevalence; D011446:Prospective Studies; D014131:Trace Elements / Q000097:blood / Q000494:pharmacology / Q000627:therapeutic use*; D014481:United States
chemical_list: D005296:Ferrous Compounds; D019266:Iron, Dietary; D014131:Trace Elements; D005293:Ferritins; D007501:Iron; C031621:ferrous fumarate