The Efficacy of Iron-Fortified Weaning Food in Improving Iron Status of Infants and Young Children

ABSTRACT
Iron deficiency is the most widespread nutritional problem in the world. It is common throughout childhood and prevalent among 6-12 month olds or 1 - 2 year olds when 70% and 50% of the respective requirements arise from the rapid rate of tissue growth. Despite large-scale iron supplementation programmes, the prevalence of iron deficiency anaemia remains high especially in developing countries. Low iron intake and poor absorption or bioavailability of iron in the diet can cause negative iron balance in children. This study involved the use of cowpea-fortified fermented maize flour as a vehicle for iron fortification. The efficacy of iron-fortified maize-cowpea flour in improving iron status was investigated in fifty-six (56) infants and young children aged between 6 and 18 months in two peri-urban communities. In addition the effect of treatment on physical growth was measured. Subjects were randomly assigned to one of the two project foods: (i) iron-fortified food (18.4mg Fe/lOOg; n=29) and (ii) non-iron fortified food (7.5mg Fe/lOOg; n=27). The foods were fed daily for six months. Haemoglobin concentrations, serum iron, total iron-binding-capacity, weight, length and mid upper arm circumference (MUAC) were measured at baseline and at the end of the study. The study revealed that about 70% of the subjects were anaemic (defined as haemoglobin concentration < 1 lg/dl) at baseline. Prevalence of malnutrition (defined as Z-scores < - 2 SD for weight-for-length/height, length/height-for-age, weight-for-age, and MUAC < 13.5 cm) was low; stunting was about 11% and wasting 20%. At the end of the intervention period, there was a decrease in the prevalence of anaemia in the iron-fortified group. Significantdifferences were observed in gain in haemoglobin concentration (1.08 ± 1.43 compared with -0.40 ± 1.72g/dL, p= 0.0009), length gain (5.11 ± 2.13 compared with 3.73 ± 2.18cm, p=0.020) and MUAC gain (0.37 ± 0.93 compared with -0.004 ± 0.71, p=0.048) between the iron-fortified and non-iron-fortified groups respectively. There however were no significant differences in serum iron, total iron-binding-capacity, plasma transferrin saturation and weight gain. It could be concluded that the iron fortified maize-cowpea flour is efficacious in controlling anaemia, and in improving linear growth.