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Community and International Nutrition

Fortifying Milk with Ferrous Gluconate and Zinc Oxide in a Public Nutrition Program Reduced the Prevalence of Anemia in Toddlers¹

Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Publica, Cuernavaca, Morelos, México

^* To whom correspondence should be addressed. E-mail: svillalp{at}insp.mx.

We aimed to assess the efficacy of whole cow's milk fortified with ferrous gluconate and zinc oxide, along with ascorbic acid, in reducing the prevalence of anemia and improving iron status of low income children 10–30 mo of age. Healthy children were randomly assigned to drink 400 mL/d of cow's whole milk, either fortified milk (FM) with 5.8 mg/400 mL of iron as ferrous gluconate, 5.28 mg/400 mL of zinc as zinc oxide, and 48 mg/400 mL of ascorbic acid, or nonfortified milk (NFM) with 0.2 mg iron/400 mL, 1.9 mg zinc/400 mL, and 6.8 mg ascorbic acid/400 mL. Hemoglobin, serum ferritin, soluble transferrin receptors (TfR), and C-reactive protein concentrations were measured at baseline and 6 mo after intervention. The prevalence of anemia declined from 41.4 to 12.1% (P < 0.001), or 29 percentage points, in the FM group; there was no change in the NFM group. Hemoglobin (coefficient = 0.22, P < 0.01) was positively and TfR (coefficient = –0.29, P < 0.001) negatively associated with treatment, controlling for their respective baseline values, age, and gender. Treatment with FM was negatively associated with the likelihood of being anemic (pseudo R² = 0.085, P < 0.03) after 6 mo of intervention. Ferrous gluconate added to whole cow's milk as a fortificant along with ascorbic acid is efficacious in reducing the prevalence of anemia and in improving iron status of Mexican toddlers. The results of this study lead to broadening a subsidized FM distribution program to 4.2 million beneficiary children 1–11 y of age in Mexico.

This article has been cited by other articles:

				S. A. Bondi and K. Lieuw Excessive Cow's Milk Consumption and Iron Deficiency in Toddlers: Two Unusual Presentations and Review ICAN: Infant, Child, & Adolescent Nutrition, June 1, 2009; 1(3): 133 - 139. [Abstract] [PDF]

				Z. A Bhutta Iron and zinc deficiency in children in developing countries BMJ, January 20, 2007; 334(7585): 104 - 105. [Full Text] [PDF]