JOURNAL ARTICLE
RANDOMIZED CONTROLLED TRIAL

Home fortification of complementary foods with micronutrient supplements is well accepted and has positive effects on infant iron status in Ghana

Seth Adu-Afarwuah, Anna Lartey, Kenneth H Brown, Stanley Zlotkin, André Briend, Kathryn G Dewey
American Journal of Clinical Nutrition 2008, 87 (4): 929-38
18400716

BACKGROUND: Micronutrient deficiencies are common during infancy, and optimal approaches for their prevention need to be identified.

OBJECTIVE: The objective was to compare the efficacy and acceptability of Sprinkles (SP), crushable Nutritabs (NT), and fat-based Nutributter (NB; 108 kcal/d), which provide 6, 16, and 19 vitamins and minerals, respectively, when used for home fortification of complementary foods.

DESIGN: Ghanaian infants were randomly assigned to receive SP (n = 105), NT (n = 105), or NB (n = 103) daily from 6 to 12 mo of age. We assessed dietary intake, morbidity, and compliance weekly. Hemoglobin and plasma ferritin, TfR, C-reactive protein, and zinc were measured at 6 and 12 mo. We used an exit interview to assess acceptability. A randomly selected control group of infants who received no intervention (NI; n = 96) were assessed at 12 mo.

RESULTS: All supplements were well accepted, and the mean percentage of days that supplements were consumed (87%) did not differ between groups. At 12 mo, all 3 intervention groups had significantly higher ferritin and lower TfR concentrations than did the NI control group. Mean (+/- SD) hemoglobin was significantly higher in NT (112 +/- 14 g/L) and NB (114 +/- 14 g/L) but not in SP (110 +/- 14 g/L) infants than in NI infants (106 +/- 14 g/L). The prevalence of iron deficiency anemia was 31% in the NI control group compared with 10% in the intervention groups combined (P < 0.0001).

CONCLUSION: All 3 options for home fortification of complementary foods are effective for reducing the prevalence of iron deficiency in such populations.

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