- R.F. Hurrell (3)
- C. Lacroix (1)
- E.K. N'goran (1)
- C. Nindjin (1)
- F. Rohner (1)
- H. Salome Kruger (1)
- C.M. Smuts (1)
- M.E. Stuijvenberg van (1)
- B. Troesch (1)
- J. Utzinger (1)
- M.B. Zimmermann (3)
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
Troesch, B. ; Stuijvenberg, M.E. van; Smuts, C.M. ; Salome Kruger, H. ; Biebinger, R. ; Hurrell, R.F. ; Baumgartner, J. ; Zimmermann, M.B. - \ 2011
The Journal of Nutrition 141 (2011)2. - ISSN 0022-3166 - p. 237 - 242.
routine prophylactic supplementation - randomized controlled-trials - placebo-controlled trial - fortified fish sauce - ascorbic-acid - complementary foods - phytic acid - ferrous fumarate - home fortification - nutritional-status
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.
The effects of iron fortification on the gut microbiota in African children: a randomized controlled trial in Côte d'Ivoire
Zimmermann, M.B. ; Chassard, C. ; Rohner, F. ; N'goran, E.K. ; Nindjin, C. ; Dostal, A. ; Utzinger, J. ; Ghattas, H. ; Lacroix, C. ; Hurrell, R.F. - \ 2010
American Journal of Clinical Nutrition 92 (2010)6. - ISSN 0002-9165 - p. 1406 - 1415.
gradient gel-electrophoresis - 16s ribosomal-rna - routine prophylactic supplementation - inflammatory-bowel-disease - placebo-controlled trial - lactic-acid bacteria - fecal microbiota - fermented milk - folic-acid - pcr
Background: Iron is essential for the growth and virulence of many pathogenic enterobacteria, whereas beneficial barrier bacteria, such as lactobacilli, do not require iron. Thus, increasing colonic iron could select gut microbiota for humans that are unfavorable to the host. Objective: The objective was to determine the effect of iron fortification on gut microbiota and gut inflammation in African children. Design: In a 6-mo, randomized, double-blind, controlled trial, 6–14-y-old Ivorian children (n = 139) received iron-fortified biscuits, which contained 20 mg Fe/d, 4 times/wk as electrolytic iron or nonfortified biscuits. We measured changes in hemoglobin concentrations, inflammation, iron status, helminths, diarrhea, fecal calprotectin concentrations, and microbiota diversity and composition (n = 60) and the prevalence of selected enteropathogens. Results: At baseline, there were greater numbers of fecal enterobacteria than of lactobacilli and bifidobacteria (P <0.02). Iron fortification was ineffective; there were no differences in iron status, anemia, or hookworm prevalence at 6 mo. The fecal microbiota was modified by iron fortification as shown by a significant increase in profile dissimilarity (P <0.0001) in the iron group as compared with the control group. There was a significant increase in the number of enterobacteria (P <0.005) and a decrease in lactobacilli (P <0.0001) in the iron group after 6 mo. In the iron group, there was an increase in the mean fecal calprotectin concentration (P <0.01), which is a marker of gut inflammation, that correlated with the increase in fecal enterobacteria (P <0.05). Conclusions: Anemic African children carry an unfavorable ratio of fecal enterobacteria to bifidobacteria and lactobacilli, which is increased by iron fortification. Thus, iron fortification in this population produces a potentially more pathogenic gut microbiota profile, and this profile is associated with increased gut inflammation. This trial was registered at controlled-trials.com as ISRCTN21782274.
Nutritional iron deficiency
Zimmermann, M.B. ; Hurrell, R.F. - \ 2007
The Lancet 370 (2007)9586. - ISSN 0140-6736 - p. 511 - 520.
randomized controlled-trial - soluble transferrin receptor - folic-acid supplementation - routine prophylactic supplementation - reticulocyte hemoglobin content - helicobacter-pylori infection - placebo-controlled trial - reduced work capacity - task-force report
Iron deficiency is one of the leading risk factors for disability and death worldwide, affecting an estimated 2 billion people. Nutritional iron deficiency arises when physiological requirements cannot be met by iron absorption from diet. Dietary iron bioavailability is low in populations consuming monotonous plant-based diets. The high prevalence of iron deficiency in the developing world has substantial health and economic costs, including poor pregnancy outcome, impaired school performance, and decreased productivity. Recent studies have reported how the body regulates iron absorption and metabolism in response to changing iron status by upregulation or downregulation of key intestinal and hepatic proteins. Targeted iron supplementation, iron fortification of foods, or both, can control iron deficiency in populations. Although technical challenges limit the amount of bioavailable iron compounds that can be used in food fortification, studies show that iron fortification can be an effective strategy against nutritional iron deficiency. Specific laboratory measures of iron status should be used to assess the need for fortification and to monitor these interventions. Selective plant breeding and genetic engineering are promising new approaches to improve dietary iron nutritional quality.