12 January - 20 June 2016

Improving the vitamin D and iron status of young European children

A study published in the The American Journal of Clinical Nutrition has investigated the effect of a micronutrient-fortified young child’s formula on the iron and vitamin D status of young European children. The Dutch team also established the effect of the intervention on the prevalence of iron deficiency (defined as serum ferritin <12 µg/L – WHO) and vitamin D deficiency (defined as serum 25(OH)D <50 nmol/L).

A study published in the The American Journal of Clinical Nutrition has investigated the effect of a micronutrient-fortified young child’s formula on the iron and vitamin D status of young European children.  The Dutch team also established the effect of the intervention on the prevalence of iron deficiency (defined as serum ferritin <12 µg/L – WHO) and vitamin D deficiency (defined as serum 25(OH)D <50 nmol/L).

Akkermans et al. state that “fortification produces a more gradual increase in serum micronutrient concentrations; in addition, if consumed on a regular and frequent basis, fortified products will maintain body stores of nutrients more efficiently and effectively than intermittent supplements.”

The researchers recruited 318 healthy, young children, who currently drank milk products, aged between 12 and 36 months. The children were recruited from a number of European countries including the UK.  The fortified formula contained 1.2 mg Fe/100 mL and 1.7 µg vitamin D/100 mL.  The control product contained 0.02 mg Fe/100 mL and no vitamin D.  Both products provided similar amounts of energy and were supplied in powder form and prepared in the same way.  After taking blood sample at baseline the children were randomly allocated to receive either product for 20 weeks, whilst still following the same dietary habits before the intervention period.   Blood samples were also taken after the intervention. Akkermans et al. note that the “primary and secondary outcomes were changes from baseline in serum ferritin and 25-hydroxyvitamin D, respectively.”

Baseline characteristic showed that the control groups had a higher iron intake from milk and higher vitamin D intake from food compared to the young child’s formula group.  After intervention the team report that they “observed a modest increase in serum ferritin among the children who consumed the young child formula.” The difference in serum ferritin and 25(OH)D change between the treatment group was 6.6 µg/L and 16.4 nmol/L respectively.  Those children who consumed cow’s milk before intervention showed a higher increase in serum ferritin than in those who consumed formula before intervention.  The team note that as the increase in serum ferritin was increased modestly in the young child’s formula group, “we suggest that the use of micronutrient-fortified young child’s formula preserves iron stores in the young European children.”  They state that normally they would “expect a decrease of serum ferritin over time because blood volume expands rapidly during growth, requiring increasing erythropoiesis  with the use of stored iron and subsequently decreasing serum ferritin concentrations.”

Regarding vitamin D status, the authors note that that the increase in serum 25(OH)D concentrations after intervention is similar to a study by Hower et al.  Vitamin D deficiency was found to decrease in the intervention group (from 25.3% to 13.5%) but increased in the cow’s milk group from 21.9% to 33.3%.  Akkermans et al note that around 30% of the children received vitamin D supplement, “although policies regarding vitamin D supplementation exist in all 3 participating countries.  This emphasizes the need for new strategies such as the use of fortified food products.” 

In conclusion the authors reiterate their findings stating “the current recommendations state that cow’s milk is acceptable after the age of 1 year, although the iron and vitamin D intake in these children, including the use of vitamin D supplementation, is insufficient for preventing iron deficiency and vitamin D deficiency.”

RSSL provides vitamin analysis in a wide range of matrices including drinks, fortified foods, pre-mixes and multi-vitamin tablets, including the analysis for vitamin D2 and vitamin D3.  For more information please contact Customer Services on +44 (0) 118 918 4076 or email enquiries@rssl.com

RSSL can analyse for a wide range of concentrations of iron including haem iron and other metals in foods, drinks and dietary supplements. For more information please contact Customer Services on +44 (0) 118 918 4076 or email enquiries@rssl.com

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