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Nutrition and Iron Status of 1-Year Olds following a Revision in Infant Dietary Recommendations.

Thorisdottir AV, Thorsdottir I, Palsson GI - Anemia (2011)

Bottom Line: Iron status associated negatively with growth and breastfeeding duration and positively with meat and formula intake at 9-12 months, but not with cow's milk.Conclusion.Dietary changes altered associations between foods and iron status.

View Article: PubMed Central - PubMed

Affiliation: Unit for Nutrition Research, Landspitali-The National University Hospital of Iceland, Eiríksgata 29, 101 Reykjavik, Iceland.

ABSTRACT
A previous study showed low iron status in 12-month-old Icelandic infants associated most strongly with cow's milk intake and growth. Infant dietary recommendations were revised in 2003. This study investigated nutrition and iron status in a new infant cohort. Subjects/Methods. Randomly selected infants were prospectively investigated for diet, anthropometry, and iron status (n = 110-141). Results. Breastfeeding initiation rate was 98%; 38% of 5-month olds were exclusively and 20% of 12-month olds partially breastfed. Formula was given to 21% of 6-month olds and 64% of 12-month olds, but cow's milk to 2.5% and 54.4% of 6- and 12-month olds, respectively. Iron depletion (serum ferritin < 12 μg/L) affected 5.8%, 1.4% were also iron deficient (MCV < 74 fl), and none were anemic (Hb < 105 g/l). Iron status associated negatively with growth and breastfeeding duration and positively with meat and formula intake at 9-12 months, but not with cow's milk. Conclusion. Improved iron status might be explained by a shift from cow's milk to formula in the diet of Icelandic 6-12-month olds. Dietary changes altered associations between foods and iron status.

No MeSH data available.


Difference in milk consumption between previous, (1995–1997) and present (2005–2007) studies, showed as mean and SD.
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fig2: Difference in milk consumption between previous, (1995–1997) and present (2005–2007) studies, showed as mean and SD.

Mentions: In the present study the negative association between iron status and regular cow's milk seen in the 1995–1997 infant study had disappeared as the consumption had decreased and been replaced by the iron-fortified formula (Figure 2). Iron-fortified formula had a weak positive association with iron status. Breastfeeding rates have increased since the previous study, both partial and exclusive breastfeeding, but exclusive breastfeeding rates among 6-month olds are still low. That may partly be explained by the fact that the data for exclusive breastfeeding was collected from the recorded food intake at monthly birthdays. The value for exclusive breastfeeding among 5-month olds might therefore be more representative for exclusive breastfeeding rate for the first 6 months as the infants received complementary diet between the ages of 5 and 6 months. This has also been seen in other European countries with high initiation rates [23]. There are numerous benefits of long breastfeeding duration and it has even been associated with lower adiposity at 15 years of age [24]. Therefore, more attention has to be given to increase breastfeeding rates in accordance to WHO recommendations [12]. In the present study partial breastfeeding duration was negatively associated with both Hb and MCV in boys, and exclusive breastfeeding for 5 months or longer was also associated with lower Hb level, although within the normal range, this might support the suggestion about reconsideration of the optimal length of exclusive breastfeeding [25]. In the previous Icelandic study, longer duration of breastfeeding was positively associated with iron status. This can be explained by the change in the total diet. The main substitute for breast-milk in the previous study was regular cow's milk, but in the present study it was iron-fortified formula. Furthermore, low iron content of breast-milk and an insufficient additional source of iron in the diet have been shown to affect iron status negatively [26, 27]. Iron concentration of breast-milk has though been suggested to increase during the weaning period [28]. The breast-milk as such does not seem to be the important component in this context but the total diet; sufficient iron intake from the complementary diet and the substitute for breastfeeding, that is, milk or formula, are the most important factors for good iron status in infancy.


Nutrition and Iron Status of 1-Year Olds following a Revision in Infant Dietary Recommendations.

Thorisdottir AV, Thorsdottir I, Palsson GI - Anemia (2011)

Difference in milk consumption between previous, (1995–1997) and present (2005–2007) studies, showed as mean and SD.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3139868&req=5

fig2: Difference in milk consumption between previous, (1995–1997) and present (2005–2007) studies, showed as mean and SD.
Mentions: In the present study the negative association between iron status and regular cow's milk seen in the 1995–1997 infant study had disappeared as the consumption had decreased and been replaced by the iron-fortified formula (Figure 2). Iron-fortified formula had a weak positive association with iron status. Breastfeeding rates have increased since the previous study, both partial and exclusive breastfeeding, but exclusive breastfeeding rates among 6-month olds are still low. That may partly be explained by the fact that the data for exclusive breastfeeding was collected from the recorded food intake at monthly birthdays. The value for exclusive breastfeeding among 5-month olds might therefore be more representative for exclusive breastfeeding rate for the first 6 months as the infants received complementary diet between the ages of 5 and 6 months. This has also been seen in other European countries with high initiation rates [23]. There are numerous benefits of long breastfeeding duration and it has even been associated with lower adiposity at 15 years of age [24]. Therefore, more attention has to be given to increase breastfeeding rates in accordance to WHO recommendations [12]. In the present study partial breastfeeding duration was negatively associated with both Hb and MCV in boys, and exclusive breastfeeding for 5 months or longer was also associated with lower Hb level, although within the normal range, this might support the suggestion about reconsideration of the optimal length of exclusive breastfeeding [25]. In the previous Icelandic study, longer duration of breastfeeding was positively associated with iron status. This can be explained by the change in the total diet. The main substitute for breast-milk in the previous study was regular cow's milk, but in the present study it was iron-fortified formula. Furthermore, low iron content of breast-milk and an insufficient additional source of iron in the diet have been shown to affect iron status negatively [26, 27]. Iron concentration of breast-milk has though been suggested to increase during the weaning period [28]. The breast-milk as such does not seem to be the important component in this context but the total diet; sufficient iron intake from the complementary diet and the substitute for breastfeeding, that is, milk or formula, are the most important factors for good iron status in infancy.

Bottom Line: Iron status associated negatively with growth and breastfeeding duration and positively with meat and formula intake at 9-12 months, but not with cow's milk.Conclusion.Dietary changes altered associations between foods and iron status.

View Article: PubMed Central - PubMed

Affiliation: Unit for Nutrition Research, Landspitali-The National University Hospital of Iceland, Eiríksgata 29, 101 Reykjavik, Iceland.

ABSTRACT
A previous study showed low iron status in 12-month-old Icelandic infants associated most strongly with cow's milk intake and growth. Infant dietary recommendations were revised in 2003. This study investigated nutrition and iron status in a new infant cohort. Subjects/Methods. Randomly selected infants were prospectively investigated for diet, anthropometry, and iron status (n = 110-141). Results. Breastfeeding initiation rate was 98%; 38% of 5-month olds were exclusively and 20% of 12-month olds partially breastfed. Formula was given to 21% of 6-month olds and 64% of 12-month olds, but cow's milk to 2.5% and 54.4% of 6- and 12-month olds, respectively. Iron depletion (serum ferritin < 12 μg/L) affected 5.8%, 1.4% were also iron deficient (MCV < 74 fl), and none were anemic (Hb < 105 g/l). Iron status associated negatively with growth and breastfeeding duration and positively with meat and formula intake at 9-12 months, but not with cow's milk. Conclusion. Improved iron status might be explained by a shift from cow's milk to formula in the diet of Icelandic 6-12-month olds. Dietary changes altered associations between foods and iron status.

No MeSH data available.