A preliminary simulated iron fortification trial in South Indian preschool children. Effect of an improved local ingredient-based complementary food fortified or not with iron and selected multiple micronutrients on Hb concentration. Double-blind randomized controlled trial of rolls fortified with microencapsulated iron. Effect of iron fortification of nursery complementary food on iron status of infants in the DPRKorea. 10-year Cognition in Preterms After Random Assignment to Fatty Acid Supplementation in Infancy Effect of iron-fortified candies on the iron status of children aged 4-6 y in East Jakarta, Indonesia. Efficacy of iron-fortified rice in reducing anemia among schoolchildren in the Philippines. Iron fortification of infant milk formula: the effect on iron status and immune function. The use of iron-fortified wheat flour to reduce anemia among the estate population in Sri Lanka. Micronutrient Fortification to Improve Growth and Health of Maternally HIV-Unexposed and Exposed Zambian Infants: A Randomised Controlled Trial The impact of systematic dietary counseling during the first year of life on prevalence rates of anemia and iron deficiency at 12-16 months. Community-level micronutrient fortification of a food supplement in India: a controlled trial in preschool children aged 36-66 mo. The effects of regular consumption of a multiple micronutrient fortified milk beverage on the micronutrient status of school children and on their mental and physical performance. Iron Nutrition and Growth of Breast- and Formula‐Fed Infants During the First 9 Months of Life Iron Fortification Reduces Blood Lead Levels in Children in Bangalore, India Randomized Controlled Trial of Iron-Fortified Drinking Water in Preschool Children [Intake of an iron-supplemented milk formula as a preventive measure to avoid low iron status in 1-3 year-olds].
1 . The effect of fortification of food with iron to provide 10 mg elemental Fe/child per d was studied in preschool children maintained on a cereal diet , over a 5-month period . 2 . The absorption of 5 mg Fe as ferrous sulphate mixed in one meal was 3.3 % of the test dose and when 3.3 mg was given with each of three meals over a 2 d period the corresponding value was 4.8 % . 3 . The mean absorption of a test dose of ferrous ascorbate  studied in twenty-four children midway through the trial was 42 % . 4 . The only beneficial effect of Fe fortification in this time-period in the experimental group was the prevention of the decrease in packed cell volume which occurred in the control groups OBJECTIVE To assess the effect of an improved local ingredient-based gruel fortified or not with selected multiple micronutrients ( MM ) on  Hb concentration of young children . DESIGN In a nutrition centre that we opened in their villages , children received either MM supplement ( containing iron , zinc , vitamin A , vitamin C and iodine ) with the improved gruel ( MMGG ) or the improved gruel only ( GG ) , twice daily , 6 d/week , for 6 months . We assessed baseline and endpoint Hb concentration and anthropometric indices . SETTING Kongoussi , a rural and poor district of Burkina Faso . SUBJECTS In a community-based trial , we r and omly assigned 131 children aged 6 - 23 months with Hb concentrations in the range of 80 - 109 g/l into two groups . RESULTS The groups did not differ significantly at baseline . Mean baseline Hb concentration was 89·2 ( sd 6·5 ) g/l and 90·3 ( sd 8·4 ) g/l in the GG and the MMGG , respectively ( P = 0·42 ) . It increased to 104·1 ( sd 11·4 ) g/l in the GG ( P < 0·001 ) and 107·6 ( sd 14·7 ) g/l in the MMGG ( P < 0·001 ) . The between-group difference of 3·5 ( 95 % CI -1·0 , 8·1 ) g/l in mean ( sd ) endpoint Hb concentration was not significant ( P = 0·13 ) . The endpoint anthropometric indices were not different between the groups . CONCLUSIONS This MM supplement  had no additional effect on Hb concentration . Thorough studies are needed to evaluate the actual efficacy of the gruel before its introduction into household routine OBJECTIVE To evaluate the impact of the fortification of rolls with microencapsulated iron sulfate with sodium alginate on the hemoglobin levels in preschoolers as compared to controls . METHODS Double-blind r and omized controlled trial comprised of children aged 2 to 6 years with initial hemoglobin exceeding 9 g/dL from four not-for-profit daycares r and omly selected in the city of São Paulo - Brazil . Children of 2 daycares ( n = 88 ) received rolls with fortified wheat flour as the exposed group ( EC ) and children of 2 daycares ( n = 85 ) received rolls without fortification as the control group ( CG ) over a 24-week period . Rolls with 4 mg iron each were offered once a day , five days a week . Hemoglobin concentrations were determined in capillary blood by HemoCue ® at three moments of trial : baseline ( Ml ) , after 12 and 24 weeks of intervention ( M2 , M3 ) . RESULTS Hemoglobin concentration presented significant increase up to M3 in EG ( 11.7 - 12.5 - 12.6 g/dL ) and in CG ( 11.1 - 12.4 - 12.3 g/dL ) with higher elevations in children initially with anemia . There was significant reduction in the occurrence of anemia from 22 % to 9 % in EG and from 47 % to 8.2 % in CG at M3 . CONCLUSION Rolls fortified with microencapsulated iron sulfate were well tolerated , increased hemoglobin levels and reduced the occurrence of anemia , but with no difference compared to the control group The aim of this study was to determine the iron status of infants who consumed porridge cooked in water with added ferrous sulphate .  A total of 234 infants , aged 6 - 12 months , were recruited from 36 nurseries in the Democratic Peoples Republic of Korea ( DPRK North Korea ) and r and omly divided into iron ( Fe ) and placebo groups . At baseline , almost half the children had Hb<110 g/L and no significant differences between the two groups were found with regard to hemoglobin concentration and anemia prevalence . The Fe group received rice porridge fortified with 10 mg of iron ( as ferrous sulfate ) per day , added to the water in which the rice was cooked and the placebo group non-fortified cereal for 6 months . After which , the hemoglobin ( Hb ) , serum ferritin ( SF ) and packed cell volume ( PCV ) were measured and it was found that the proportion of children with anemia ( Hb<110 g/L ) was lower ( 24.3 % v 48.1 % p<0.01 ) , the Hb levels ( 117.6 g/L v 109.8 g/L p<0.001 ) and serum ferritin were higher ( 40.7 v 26.8 mcg/L p<0.001 ) ; and iron deficiency anemia ( Hb<110 g/L , SF<12 mcg/L ) was lower in the Fe group ( 3 % v 22 % p<0.001 ) when compared to the placebo group . Ferrous sulphate , added to the water in which rice was cooked , lowered the prevalence of iron deficiency anemia of infants in the DPRK with no adverse reactions . This simple fortification would be suitable as a nationwide program in the DPRK and other countries with large infant nurseries OBJECTIVE : To test the hypothesis that long-chain polyunsaturated fatty acid ( LCPUFA ) supplementation in infancy would improve cognition into later childhood ( after 9 years ) at both general and specific levels . METHODS : A comprehensive cognitive battery was completed by 107 formerly preterm infants ( mean age : 128 months ) . As infants , they had been assigned r and omly to receive LCPUFA-supplemented ( N = 50 ) or control ( N = 57 ) formula , between birth and 9 months ; the docosahexaenoic acid level ( DHA ) in the supplemented formulas was 0.5 % . In addition to r and omized comparisons , we planned supplementary analyses to examine the effects of both gender and feeding group ( those receiving some maternal breast milk versus those receiving none ) . RESULTS : There were no significant differences between r and omized diet groups on any cognitive measure . There was significant interaction between gender and supplementation ; girls only showed beneficial effects of LCPUFAs on literacy . Significant interaction also occurred between feeding group and supplementation ; increases of 0.7 SD in verbal IQ , full-scale IQ , and memory scores were found for the LCPUFA group , but only for infants who received only formula and no maternal breast milk . CONCLUSIONS : The results of this post–9-year cognitive follow-up study in a r and omized trial of LCPUFA-supplemented formula for preterm infants suggest no overall group effects but indicate that gender-specific and diet-specific effects may exist . The data provide some evidence that LCPUFAs are a key factor in the cognitive benefits of breast milk . Caution is advised in data interpretation because of the small groups used BACKGROUND Iron deficiency anemia is the most prevalent nutrition problem in young children . One possible strategy to prevent iron deficiency anemia in this population group is the fortification of affordable food . OBJECTIVE This study was design ed to assess whether iron-fortified c and ies can improve iron status and are acceptable to children aged 4 - 6 y. DESIGN A double-blind , placebo-controlled intervention study was conducted in Jakarta , INDONESIA : The children were r and omly assigned to 1 of 2 treatment groups : a fortified group ( n = 57 ) and a placebo group ( n = 60 ) . Every week for 12 wk , 30 g ( 10 pieces ) c and y was given to the children . The c and y given to the fortified group contained 1 mg elemental Fe/g and very small amounts of other vitamins and minerals . RESULTS The hemoglobin concentration of the fortified group increased by 10.2 g/L ( 95 % CI : 8.3 , 12 g/L ) whereas that of the placebo group increased by 4.0 g/L ( 2.0 , 6.0 g/L ; P < 0.001 ) . Anemia prevalence decreased from 50.9 % at the start of the intervention to 8.8 % after 12 wk of intervention in the fortified group ( P < 0.001 ) and from 43.3 % to 26.7 % in the placebo group ( P < 0.05 ) . After 12 wk of intervention , the serum ferritin concentration was 71 % higher than at baseline in the fortified group and 28 % higher in the placebo group ( P < 0.001 ) . Acceptability of the iron-fortified c and ies was good . The per capita cost of the supplement was approximately US$ 0.96 - 1.20 for the 12 wk of intervention . CONCLUSION Iron-fortified c and ies were effective for improving the iron status  of young children and might be an affordable way to combat iron deficiency in children of low-to-middle income groups BACKGROUND Iron deficiency anemia ( IDA ) in the Philippines is a serious public health problem . Fortifying rice offers a great opportunity to control IDA . However , information on other types of fortificants that can be used is scarce . OBJECTIVE To compare the effects of two types of iron fortificants in rice in improving the hematological status of schoolchildren . DESIGN 180 r and omly selected 6-to 9-year-old anemic children were r and omly allocated to three groups in a double-blinded manner : One group received iron-enriched rice ( IER ) with extruded iron premix rice ( IPR ) using ferrous sulfate as fortificant ( ExFeSO4 ) ; the second group received IER with extruded IPR using micronized dispersible ferric pyrophosphate ( ExFeP80 ) ; and the third group received non-fortified rice ( Control ) . These were administered daily for 5 days a week for 6 months . Blood sample s were collected at baseline after 3 and 6 months . RESULTS At baseline , one child in the ExFeP80 group was suffering from IDA ; at 3 months , no IDA was found in any groups ; while at 6 months , one child in the ExFeP80 developed IDA . The baseline prevalence of anemia in all groups , which was 100 % , was significantly reduced to 51 % , 54 % , and 63 % in the ExFeSO4 , ExFeP80 and Control groups respectively . After 6 months , further significant reductions were observed in the ExFeSO4 ( 38 % ) and ExFeP80 ( 33 % ) but remained at 63 % in the Control group . Greater , significant increases were also observed in plasma ferritin in the fortified groups than in the Control group from baseline to 6 months . The predictors of change in hemoglobin ( Hb ) and plasma ferritin were group allocation and basal values . CONCLUSION The consumption of rice fortified with FeP80 using extrusion technology has similar effects as that of FeSO4 in reducing the prevalence of IDA among schoolchildren We conducted a r and omized double-blind trial of a cow 's milk infant formula with increased iron fortification in order to confirm its safety and to measure its effects on iron status and immune function .  A group of full-term , well nourished and healthy infants was followed from the age of 3 months to 1 year . A control group of 74 infants was given a commercially available infant formula containing 8.3 mg Fe/100 g . The test group of 75 infants received a similar formula with 40 mg Fe/100 g. The formula with the extra iron proved to be safe and , when compared with the control group , the children in the test group had significantly improved iron status as reflected by the proportion of children classed as normal ( 25 of 61 cf . 44 of 65 ; p less than 0.003 ) , and by the mean values of the haemoglobin concentration ( 11.5 cf . 11.9 g/dl ; p = 0.04 ) , red cell distribution width ( 15.5 % cf . 14.4 % ; p = 0.0005 ) , red cell zinc protoporphyrin ( 3.4 cf . 4.0 micrograms/g Hb ; p = 0.04 ) and ferritin ( 29 cf . 17.3 micrograms/l ; p = 0.004 ) . The extra iron fortification depressed zinc concentration in plasma ( 90.6 cf . 83.5 micrograms/l ; p = 0.05 ) . There was no significant difference between the two groups for laboratory measures of immune function or for incidence of infection . No adverse effects such as infection could be attributed to the increased iron . We conclude that iron fortification of cow 's milk infant formula may be safely increased to 40 mg/100 g ( i.e. by a factor of 4.8 over the common concentration of 8.3 mg/100 g ) , but that this has less than the expected effect on iron status . Further studies are required to define ( a ) the long-term role of facilitators of iron absorption such as ascorbic acid , ( b ) the interaction of iron with absorption of divalent trace elements such as zinc , and ( c ) the effect of iron status on immune function and susceptibility to infection The use of flour fortified with 66 mg/kg of electrolytic or reduced iron to reduce the prevalence of anemia was determined in a two-year , double-blind , controlled trial . The trial was conducted in Sri Lanka among preschoolers between 9 and 71 months old , primary schoolers 6 to 11 years old , and nonpregnant women . At baseline , 18.4 % of the preschoolers had low hemoglobin ( Hb ) concentrations .  Neither electrolytic nor reduced iron had an effect on Hb concentration among preschoolers . Only 7 % of the primary schoolers were anemic at the start of the trial and , again , fortification had no effect on Hb concentration . Twenty-nine percent of women had a low Hb at outset and there was no evidence that fortification had an effect on Hb in this group . The findings from this study suggest that fortification of flour with electrolytic iron or reduced iron was not beneficial in reducing anemia in this population . This was probably due to the low prevalence of anemia and low bioavailability of the fortificant iron . Fortification with either iron fortificant was acceptable Background The period of complementary feeding , starting around 6 months of age , is a time of high risk for growth faltering and morbidity . Low micronutrient density of locally available foods is a common problem in low income countries . Children of HIV-infected women are especially vulnerable . Although antiretroviral prophylaxis can reduce breast milk HIV transmission in early infancy , there are no clear feeding guidelines for after 6 months . There is a need for acceptable , feasible , affordable , sustainable and safe ( AFASS by WHO terminology ) foods for both HIV-exposed and unexposed children after 6 months of age . Methods and Findings We conducted in Lusaka , Zambia , a r and omised double-blind trial of two locally made infant foods : porridges made of flour composed of maize , beans , bambaranuts and groundnuts . One flour contained a basal and the other a rich level of micronutrient fortification .  Infants ( n = 743 ) aged 6 months were r and omised to receive either regime for 12 months . The primary outcome was stunting ( length-for-age Z<−2 ) at age 18 months . No significant differences were seen between trial arms overall in proportion stunted at 18 months ( adjusted odds ratio 0.87 ; 95 % CI 0.50 , 1.53 ; P = 0.63 ) , mean length-for-age Z score , or rate of hospital referral or death . Among children of HIV-infected mothers who breastfed < 6 months ( 53 % of HIV-infected mothers ) , the richly-fortified porridge  increased length-for-age and reduced stunting ( adjusted odds ratio 0.17 ; 95 % CI 0.04 , 0.84 ; P = 0.03 ) . Rich fortification improved iron status at 18 months as measured by hemoglobin , ferritin and serum transferrin receptors . Conclusions In the whole study population , the rich micronutrient fortification did not reduce stunting or hospital referral but did improve iron status and reduce anemia . Importantly , in the infants of HIV-infected mothers who stopped breastfeeding before 6 months , the rich fortification improved linear growth . Provision of such fortified foods may benefit health of these high risk infants . Trial registration Controlled-Trials.com IS RCT OBJECTIVE To evaluate the impact that a program based on maternal dietary counseling covering breastfeeding and healthy complementary feeding had on the prevalence of  iron deficiency , anemia and iron deficiency anemia in children aged 12 to 16 months . METHODS Newborn infants were r and omized at birth to an intervention or a control group . Mothers in the intervention group received home visits during the children 's first year of life on a monthly basis up to 6 months , and at 8 , 10 and 12 months . The mothers in the control group received visits for data collection when children reached 6 and 12 months . All children were visited at ages between 12 and 16 months and 24-hour dietary recalls and hemoglobin and ferritin tests were conducted . RESULTS There was no evidence that the intervention had an effect on anemia incidence , which was 66.5 % in the intervention group and 61.8 % in the control group . There was also no evidence of any difference between the groups in the prevalence of iron deficiency anemia or of iron deficiency . However , a higher percentage of children in the intervention group were exclusively breastfed at 4 and 6 months , and breastfed at 6 and 12 months . Intervention group children also consumed more meat and were fed diets with better iron bioavailability and consumed less cow 's milk and calcium than children from the control group . CONCLUSION This intervention had no effect on the prevalence of anemia , iron deficiency or iron deficiency anemia . Clinical trial registry identification number : NCT00629629 BACKGROUND Children participating in the Integrated Child Development Service ( ICDS ) in India have high rates of iron and vitamin A deficiency . OBJECTIVE The objective was to assess the efficacy of a premix fortified with iron and vitamin A and added at the community level to prepared khichdi , a rice and dal mixture , in increasing iron and vitamin A stores and decreasing the prevalence of iron deficiency , anemia , and vitamin A deficiency . DESIGN This cluster , r and omized , double-blind , controlled trial was initiated in 30 Anganwadi centers ( daycare centers ) in West Bengal state , India . Children aged 36 - 66 mo ( n = 516 ) attending village-based ICDS centers were r and omly assigned to receive either a fortified or a nonfortified premix for 24 wk . Blood was drawn at 0 and 24 wk by venipuncture for the measurement of hemoglobin , serum ferritin , and serum retinol . RESULTS The change in the hemoglobin concentration of anemic children was significantly different between fortified and nonfortified khichdi groups ( P < 0.001 ) . Prevalence rates of anemia , iron deficiency , and iron deficiency anemia were significantly lower after 24 wk in the fortified-khichdi group than in the nonfortified-khichdi group ( P < 0.001 ) . There were no significant differences in serum retinol concentrations or in the prevalence of vitamin A deficiency between the fortified- and nonfortified-khichdi groups . CONCLUSION A premix fortified with iron , vitamin A , and folic acid and added to supplementary food at the community level can be effective at increasing iron stores and reducing the prevalence of iron deficiency and anemia Multiple micronutrient deficiencies exist in school going children in India and bridging the gap between nutrient intake and requirements is an effective way to combat the deficiencies . This study aim ed to test the effect of a multi-micronutrient fortified malt and cocoa based milk beverage on the micronutrient status , cognition , physical performance and nutritional deficiencies of 7 - 10 years old south Indian children . A r and omized , double blind placebo controlled study design was used with normal healthy children from low to middle income families , aged 7 - 10 years r and omly assigned to receive either a multi-micronutrient fortified or an unfortified milk based control drink . The drinks were provided 6 days/week for 5 months . Assessment s included anthropometry , blood biochemistry , physical performance and cognition at baseline and endline . The baseline characteristics of the study groups were similar . The changes in body weight and height were similar between the groups at the end of the study . Levels of vitamin B12 , red cell folate and vitamin B2 significantly improved in the intervention group , while vitamin D , selenium and body iron showed no difference . The Hemoglobin ( Hb ) and serum ferritin levels of the control group decreased at endline , while those in the intervention group maintained their levels . The serum transferrin receptor levels increased in both the groups . The prevalence of iron deficiency and Vitamin B2 deficiency were significantly lower in the intervention group at endline . Overall improvement in cognitive and physical performance was seen in both the groups at endline , with no significant differences between the groups . The micronutrient fortified milk based drink was efficacious in improving the micronutrient status of Vitamin B2 , Vitamin B12 and red cell folate and in preventing a decline in Hb level compared to an unfortified milk based drink . It also reduced anemia and the risk of deficiencies of iron , and B12 , in apparently healthy children . Clinical Trials.gov IdentifierNCT01415557 . Clinical Trial RegistryIndia - REF/2012/12/004332 Feeding of iron (Fe)-fortified ( 12–15 mg/L ) infant formulas is an effective and convenient means to protect infants from Fe deficiency . To study lower levels of Fe fortification of infant formulas ( 3 or 6 mg/L ) compared with those currently in use , we compared Fe intake and Fe nutritional status of three groups of healthy , term infants between 90 and 274 days of age . One group received an Fe-fortified whey-predominant formula ( 3 mg/ L ) and the second group received the same formula with a higher Fe level ( 6 mg/L ) . A comparison group was breast-fed at least until 274 days of age . All infants received infant foods and cereals according to European Community recommendations . Mean Fe intake of infants fed formula fortified with 3 mg/L was significantly lower at 183 and 274 days of age ( p < 0.05 ) than that of infants fed formula fortified with 6 mg/L. None of the infants fed the formula fortified with 3 mg/L met the recommended daily allowance value ( 10 mg ) for infants between 6 and 12 months of age . Hemoglobin , hematocrit , mean corpuscular volume , free erythrocyte protoporphyrin , and serum ferritin levels were similar in the formula-fed groups ; none of the infants had depleted Fe stores ( ferritin < 10 μg/L ) at 183 and 274 days of age . Thirteen percent of breast-fed infants had depleted Fe stores at 183 days of age , but only 3 % were depleted at 273 days of age , when Fe-fortified beikost was already part of the diet . No influence of Fe nutritional status was found on zinc and copper nutritional status or on growth . We conclude that regular consumption of an infant formula fortified with 3 mg Fe/L , a level substantially below present recommendations , prevents healthy , term infants from developing Fe deficiency during the first 6 months of life . It is preferable that infants 6 months of age and older receive an Fe-fortified formula and a judicious selection of beikost to ensure an adequate dietary intake of Fe OBJECTIVE . Chronic lead poisoning and iron deficiency are concentrated in urban children from lower socioeconomic strata , and both impair neurocognitive development . Our study objective was to determine if iron fortification reduces blood lead levels in urban , lead-exposed , iron-deficient children in Bangalore , India . DESIGN , SETTING , AND PARTICIPANTS . A r and omized , double-blind , controlled school-based feeding trial was done in 5- to 13-year-old iron-deficient children ( n = 186 ) . At baseline , a high prevalence of lead poisoning was found in the younger children . Subsequently , all 5- to 9-year-old children participating in the trial ( n = 134 ) were followed to determine if iron fortification would affect their blood lead levels . INTERVENTION . Children were dewormed and fed 6 days/week for 16 weeks either an iron-fortified rice meal ( ∼15 mg of iron per day as ferric pyrophosphate ) or an identical control meal without added iron . Feeding was directly supervised and compliance monitored . OUTCOME MEASURES . Hemoglobin , serum ferritin , C-reactive protein , transferrin receptor , zinc protoporphyrin , and blood lead concentrations were measured . RESULTS . The prevalence of iron deficiency was significantly reduced in the iron group ( from 70 % to 28 % ) compared with the control group ( 76 % to 55 % ) . There was a significant decrease in median blood lead concentration in the iron group compared with the control group . The prevalence of blood lead levels ≥10 μg/dL was significantly reduced in the iron group ( from 65 % to 29 % ) compared with the control group ( 68 % to 55 % ) . CONCLUSIONS . Our findings suggest providing iron in a fortified food to lead-exposed children may reduce chronic lead intoxication . Iron fortification may be an effective and sustainable strategy to accompany environmental lead abatement Objectives : To evaluate the effects of fortified drinking water , with different concentrations of iron added , on hemoglobin and hematocrit values in preschoolers . Methods : Double-blind , r and omized cluster clinical trial , with children aged 2 to 5 years of age , from 4 state-run schools , forming 1 group for each school . For fortification , ferrous sulphate in concentrations of 5 mg of elemental iron per liter of water ( group A ) , 7.5 mg ( group B ) , and 10 mg ( group C ) , was used during a period of 4 months . In group D , the control , a placebo ( Bixa orellana ) was added . Hemoglobin and hematocrit values were checked before and after intervention . Results : Before fortification , hemoglobin and hematocrit averages were below the reference values adopted in all groups . After fortification , the prevalence of anemia showed a reduction in the 4 groups , which was more pronounced in group B , at 48.3 % . The hemoglobin values in groups B ( 11.5 ) and C ( 11.4 ) were statistically similar . However , the average consumption of water/day/student was lower in group C. Comparison of hemoglobin values between groups A ( 11.2 ) and D ( 11.0 ) did not show a significant difference , suggesting insignificant efficacy with 5 mg Fe/L fortification . Conclusions : The consumption of drinking water fortified with 7.5 mg of elemental iron/L water result ed in greater adhesion and an increase in hemoglobin values , with a reduction in the prevalence of anemia OBJECTIVE Low iron status is a well known risk factor for iron deficiency anemia in infants and young children . The aim of the present study was to evaluate the influence of an iron-fortified toddler formula on iron status in 1 - 3 year-olds . PATIENTS AND METHODS Thirty-three healthy infants and young children were assigned to two groups that received 500 mL/day of and iron-fortified toddler formula or 500 mL/day of unmodified cow 's milk for 4 months . Allocation was r and om and double-blind . Daily dietary intake was calculated by dietary evaluation , and iron nutritional status was assessed ( hemoglobin , hematocrit , mean corpuscular volume , mean corpuscular hemoglobin , mean corpuscular hemoglobin concentration , serum iron , ferritin , and transferrin ) . RESULTS At enrollment , no anemia was found in either group , although hemoglobin concentration and hematocrit were significantly lower in the toddler formula group than in the unmodified cow 's milk group . However , these differences disappeared at the end of the intervention period . After 4 months , the toddler formula group showed significantly higher serum ferritin and lower serum transferrin concentrations than the cow 's milk group . CONCLUSION Intake of iron-supplemented toddler formula for 4 months in 1 - 3 year-olds is more effective in maintaining iron nutritional status than cow 's milk
We observed an association between intake of Fe-fortified foods  and Hb concentration in children aged < 10 years .
Fe-fortified foods could be an effective strategy for reducing Fe-deficiency anaemia in children
OBJECTIVE To combine evidence from r and omized controlled trials to assess the effect of Fe-fortified foods on mean Hb concentration in children ( < 10 years ) .