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Regular consumption of a complementary food fortified with ascorbic acid and ferrous fumarate or ferric pyrophosphate is as useful as ferrous sulfate in maintaining hemoglobin concentrations >105 g/L in young Bangladeshi children.
Am J Clin Nutr. 2009 Jun; 89(6):1815-20.AJ

Abstract

BACKGROUND

Non-water-soluble iron compounds have been reported to be less well absorbed than ferrous sulfate in young children, and concern has been raised about their usefulness as food fortificants.

OBJECTIVE

The objective was to evaluate the usefulness of ferrous fumarate and ferric pyrophosphate, compared with ferrous sulfate, in maintaining hemoglobin concentrations >105 g/L in Bangladeshi children.

DESIGN

Two hundred thirty-five children aged 7-24 mo (hemoglobin >105 g/L) were randomly assigned in a double-blind study to receive an infant cereal fortified with ferrous fumarate, ferric pyrophosphate, or ferrous sulfate. One serving of cereal (9.3 mg Fe; molar ratio of ascorbic acid to iron of 3:1) was consumed per day, 6 d/wk, for 9 mo. Blood samples were drawn at 4.5 and 9 mo.

RESULTS

Raw data were reformatted, and a "time to event" was calculated that corresponded to reaching the following thresholds: hemoglobin <105 g/L, plasma ferritin <12 microg/L, or plasma C-reactive protein >10 mg/L at baseline, 4.5 mo, or 9 mo. Data were censored when children did not reach the threshold or were lost to follow-up. A Kaplan-Meier approach was used to compare the 3 groups. No statistically significant differences were observed for hemoglobin <105 g/L (P = 0.943), plasma ferritin <12 microg/L (P = 0.601), or plasma C-reactive protein >10 mg/L (P = 0.508).

CONCLUSIONS

Contrary to earlier concerns, these results do not indicate differences in usefulness between water-soluble and non-water-soluble iron compounds in maintaining hemoglobin concentrations and preventing iron deficiency. These data will be important in the development of food-fortification strategies to combat anemia and iron deficiency in highly vulnerable population groups.

Authors+Show Affiliations

Laboratory for Human Nutrition, Swiss Federal Institute of Technology, ETH Zentrum, Zurich, Switzerland. davidssonlena@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19403640

Citation

Davidsson, Lena, et al. "Regular Consumption of a Complementary Food Fortified With Ascorbic Acid and Ferrous Fumarate or Ferric Pyrophosphate Is as Useful as Ferrous Sulfate in Maintaining Hemoglobin Concentrations >105 g/L in Young Bangladeshi Children." The American Journal of Clinical Nutrition, vol. 89, no. 6, 2009, pp. 1815-20.
Davidsson L, Sarker SA, Jamil KA, et al. Regular consumption of a complementary food fortified with ascorbic acid and ferrous fumarate or ferric pyrophosphate is as useful as ferrous sulfate in maintaining hemoglobin concentrations >105 g/L in young Bangladeshi children. Am J Clin Nutr. 2009;89(6):1815-20.
Davidsson, L., Sarker, S. A., Jamil, K. A., Sultana, S., & Hurrell, R. (2009). Regular consumption of a complementary food fortified with ascorbic acid and ferrous fumarate or ferric pyrophosphate is as useful as ferrous sulfate in maintaining hemoglobin concentrations >105 g/L in young Bangladeshi children. The American Journal of Clinical Nutrition, 89(6), 1815-20. https://doi.org/10.3945/ajcn.2008.27353
Davidsson L, et al. Regular Consumption of a Complementary Food Fortified With Ascorbic Acid and Ferrous Fumarate or Ferric Pyrophosphate Is as Useful as Ferrous Sulfate in Maintaining Hemoglobin Concentrations >105 g/L in Young Bangladeshi Children. Am J Clin Nutr. 2009;89(6):1815-20. PubMed PMID: 19403640.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Regular consumption of a complementary food fortified with ascorbic acid and ferrous fumarate or ferric pyrophosphate is as useful as ferrous sulfate in maintaining hemoglobin concentrations >105 g/L in young Bangladeshi children. AU - Davidsson,Lena, AU - Sarker,Shafiqual Alam, AU - Jamil,Kazi Asif, AU - Sultana,Shamima, AU - Hurrell,Richard, Y1 - 2009/04/29/ PY - 2009/5/1/entrez PY - 2009/5/1/pubmed PY - 2009/6/13/medline SP - 1815 EP - 20 JF - The American journal of clinical nutrition JO - Am J Clin Nutr VL - 89 IS - 6 N2 - BACKGROUND: Non-water-soluble iron compounds have been reported to be less well absorbed than ferrous sulfate in young children, and concern has been raised about their usefulness as food fortificants. OBJECTIVE: The objective was to evaluate the usefulness of ferrous fumarate and ferric pyrophosphate, compared with ferrous sulfate, in maintaining hemoglobin concentrations >105 g/L in Bangladeshi children. DESIGN: Two hundred thirty-five children aged 7-24 mo (hemoglobin >105 g/L) were randomly assigned in a double-blind study to receive an infant cereal fortified with ferrous fumarate, ferric pyrophosphate, or ferrous sulfate. One serving of cereal (9.3 mg Fe; molar ratio of ascorbic acid to iron of 3:1) was consumed per day, 6 d/wk, for 9 mo. Blood samples were drawn at 4.5 and 9 mo. RESULTS: Raw data were reformatted, and a "time to event" was calculated that corresponded to reaching the following thresholds: hemoglobin <105 g/L, plasma ferritin <12 microg/L, or plasma C-reactive protein >10 mg/L at baseline, 4.5 mo, or 9 mo. Data were censored when children did not reach the threshold or were lost to follow-up. A Kaplan-Meier approach was used to compare the 3 groups. No statistically significant differences were observed for hemoglobin <105 g/L (P = 0.943), plasma ferritin <12 microg/L (P = 0.601), or plasma C-reactive protein >10 mg/L (P = 0.508). CONCLUSIONS: Contrary to earlier concerns, these results do not indicate differences in usefulness between water-soluble and non-water-soluble iron compounds in maintaining hemoglobin concentrations and preventing iron deficiency. These data will be important in the development of food-fortification strategies to combat anemia and iron deficiency in highly vulnerable population groups. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/19403640/Regular_consumption_of_a_complementary_food_fortified_with_ascorbic_acid_and_ferrous_fumarate_or_ferric_pyrophosphate_is_as_useful_as_ferrous_sulfate_in_maintaining_hemoglobin_concentrations_>105_g/L_in_young_Bangladeshi_children_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.2008.27353 DB - PRIME DP - Unbound Medicine ER -