title: Effect of Home-Based Complementary Food Fortification on Prevalence of Anemia Among Infants and Young Children Aged 6 to 23 Months in Poor Rural Regions of China.
abstract: Following the 2008 Wenchuan earthquake, the Chinese government instituted an infant and young and child nutrition program that included promotion of in-home fortification of complementary food with ying yang bao (YYB), a soy-based powder containing iron, 2.5 mg as iron-EDTA and 5 mg as ferrous fumarate, and other micronutrients. Ying yang bao was provided to participating families in 8 poor rural counties in Sichuan, Shaanxi, and Gansu provinces by the Ministry of Health. We assessed hemoglobin levels among infants and young children (IYC) aged 6 to 23 months at baseline in May 2010 (n = 1290) and during follow-up in November 2010 (n = 1142), May 2011 (n = 1118), and November 2011 (n = 1040), using the Hemocue method. Interviewers collected basic demographic information and child feeding practices from the children's caretakers. Altitude-adjusted hemoglobin level averaged 10.8 g/dL, and total anemia prevalence was 49.5% at baseline. Average hemoglobin was 11.3 g/dL at 6 months, 11.6 g/dL at 12 months, and 11.7 g/dL at 18 months after introduction of YYB. Moderate anemia (hemoglobin: 70-99 g/dL) decreased from 20.3% at baseline to 7.5%, 5.8%, and 7.3% after 6, 12, and 18 months of home fortification, respectively (P < .001), whereas mild anemia (hemoglobin: 100-110 g/dL) decreased from 29.0% to 16.7%, 18.1%, and 15.4%, respectively (P < .001). Among infants aged 6 to 23 months, 95% had regularly been fed YYB during the observation period. Regression analysis showed that the duration of YYB consumption and number of sachets consumed per week correlated positively with hemoglobin levels and negatively with anemia rates. Home food fortification with YYB is feasible and effective for nutrition promotion among IYC in high-risk regions of China.
authors.affiliation: Institute for Nutrition and Health, China Center for Disease Control and Prevention, Beijing, China.
authors.forename: Junsheng
authors.initials: J
authors.lastname: Huo
authors.affiliation: Institute for Nutrition and Health, China Center for Disease Control and Prevention, Beijing, China sjing@263.net.
authors.forename: Jing
authors.initials: J
authors.lastname: Sun
authors.affiliation: Food Fortification Office, China Center for Disease Control and Prevention, Beijing, China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Fang
authors.affiliation: UNICEF Office for China, Beijing, China schang@unicef.org.
authors.forename: Suying
authors.initials: S
authors.lastname: Chang
authors.affiliation: Institute for Nutrition and Health, China Center for Disease Control and Prevention, Beijing, China.
authors.forename: Liyun
authors.initials: L
authors.lastname: Zhao
authors.affiliation: Institute for Nutrition and Health, China Center for Disease Control and Prevention, Beijing, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Fu
authors.affiliation: Institute for Nutrition and Health, China Center for Disease Control and Prevention, Beijing, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Wang
authors.affiliation: Institute for Nutrition and Health, China Center for Disease Control and Prevention, Beijing, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Huang
authors.affiliation: Institute for Nutrition and Health, China Center for Disease Control and Prevention, Beijing, China.
authors.forename: Lijuan
authors.initials: L
authors.lastname: Wang
authors.affiliation: UNICEF, New York, NY, USA.
authors.forename: France
authors.initials: F
authors.lastname: Begin
authors.affiliation: UNICEF, New York, NY, USA.
authors.forename: David B
authors.initials: DB
authors.lastname: Hipgrave
authors.affiliation: Institute for Nutrition and Health, China Center for Disease Control and Prevention, Beijing, China.
authors.forename: Guansheng
authors.initials: G
authors.lastname: Ma
mesh_terms: D000740:Anemia / Q000453:epidemiology* / Q000517:prevention & control; D018798:Anemia, Iron-Deficiency / Q000453:epidemiology / Q000517:prevention & control; D002681:China / Q000453:epidemiology; D019587:Dietary Supplements; D004492:Edetic Acid; D005296:Ferrous Compounds / Q000008:administration & dosage; D063105:Food Assistance; D005527:Food, Fortified; D006078:Government Programs; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D000090463:Iron Deficiencies; D019266:Iron, Dietary / Q000008:administration & dosage; D011203:Poverty; D012424:Rural Population; D013025:Glycine max
chemical_list: D005296:Ferrous Compounds; D006454:Hemoglobins; D019266:Iron, Dietary; D004492:Edetic Acid; C031621:ferrous fumarate
keywords: anemia; complementary feeding; complementary food supplement; hemoglobin; home food fortification; infant; young children