1
|
Iglesias Vázquez L, Canals J, Voltas N, Jardí C, Hernández C, Bedmar C, Escribano J, Aranda N, Jiménez R, Barroso JM, Ribot B, Arija V. Does the fortified milk with high iron dose improve the neurodevelopment of healthy infants? Randomized controlled trial. BMC Pediatr 2019; 19:315. [PMID: 31488098 PMCID: PMC6727503 DOI: 10.1186/s12887-019-1679-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 08/20/2019] [Indexed: 01/01/2023] Open
Abstract
Background Since iron plays an important role in several physiological processes, its deficiency but also overload may harm the development of children. The aim was to assess the effect of iron–fortified milk on the iron biochemical status and the neurodevelopment of children at 12 months of age. Methods Randomized controlled trial conducted in 133 Spanish children, allocated in two groups to receive formula milk fortified with 1.2 or 0.4 mg/100 mL of iron between 6 and 12 months of age. Psychomotor (PDI) and Mental (MDI) Development Index were assessed by the Bayley Scales before and after the intervention. Maternal obstetrical and psychosocial variables were recorded. The biochemical iron status of children was measured and data about breastfeeding, anthropometry and infections during the first year of life were registered. Results Children fortified with 1.2 mg/100 mL of iron, compared with 0.4 mg/100 mL, showed higher serum ferritin (21.5 vs 19.1 μg/L) and lower percentage of both iron deficiency (1.1 to 5.9% vs 3.8 to 16.7%, respectively, from 6 to 12 months) and iron deficiency anemia (4.3 to 1.1% vs 0 to 4.2%, respectively, from 6 to 12 months) at the end of the intervention. No significant differences were found on neurodevelopment from 6 to 12 months between children who received high dose of Fe compared with those who received low dose. Conclusion Despite differences on the iron status were observed, there were no effects on neurodevelopment of well–nourished children in a developed country after iron supplementation with doses within dietary recommendations. Follow–up studies are needed to test for long–term neurodevelopmental improvement. Trial registration Retrospectively registered in ClinicalTrials.gov with the ID: NCT02690675.
Collapse
Affiliation(s)
- Lucía Iglesias Vázquez
- Unit of Preventive Medicine and Public Health, Faculty of Medicine and Health Science, Universitat Rovira i Virgili, Reus, Spain
| | - Josefa Canals
- CRAMC (Centre de Recerca en Avaluació I Mesura de la Conducta), Unit of Psychology, Universitat Rovira i Virgili, Tarragona, Spain
| | - Núria Voltas
- CRAMC (Centre de Recerca en Avaluació I Mesura de la Conducta), Unit of Psychology, Universitat Rovira i Virgili, Tarragona, Spain
| | - Cristina Jardí
- Unit of Preventive Medicine and Public Health, Faculty of Medicine and Health Science, Universitat Rovira i Virgili, Reus, Spain
| | - Carmen Hernández
- CRAMC (Centre de Recerca en Avaluació I Mesura de la Conducta), Unit of Psychology, Universitat Rovira i Virgili, Tarragona, Spain
| | - Cristina Bedmar
- Unit of Preventive Medicine and Public Health, Faculty of Medicine and Health Science, Universitat Rovira i Virgili, Reus, Spain
| | - Joaquín Escribano
- Unit of Pediatrics, Faculty of Medicine and Health Science, Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili, Reus, Spain.,IISPV (Institut d'Investigació Sanitària Pere Virgili), Reus, Spain
| | - Núria Aranda
- Unit of Preventive Medicine and Public Health, Faculty of Medicine and Health Science, Universitat Rovira i Virgili, Reus, Spain.,IISPV (Institut d'Investigació Sanitària Pere Virgili), Reus, Spain
| | - Rosa Jiménez
- Unit of Pediatrics, Faculty of Medicine and Health Science, Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili, Reus, Spain
| | - Josep Maria Barroso
- Unit of Pediatrics, Faculty of Medicine and Health Science, Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili, Reus, Spain
| | - Blanca Ribot
- Unit of Preventive Medicine and Public Health, Faculty of Medicine and Health Science, Universitat Rovira i Virgili, Reus, Spain
| | - Victoria Arija
- Unit of Preventive Medicine and Public Health, Faculty of Medicine and Health Science, Universitat Rovira i Virgili, Reus, Spain. .,IISPV (Institut d'Investigació Sanitària Pere Virgili), Reus, Spain. .,IDIAP (Institut Universitari d'Investigació en Atenció Primària) Jordi Gol, Barcelona, Spain.
| |
Collapse
|
2
|
Iglesias Vázquez L, Canals J, Arija V. Review and meta-analysis found that prenatal folic acid was associated with a 58% reduction in autism but had no effect on mental and motor development. Acta Paediatr 2019; 108:600-610. [PMID: 30466185 DOI: 10.1111/apa.14657] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 10/29/2018] [Accepted: 11/19/2018] [Indexed: 12/31/2022]
Abstract
AIM The impact of prenatal folic acid on children's neurodevelopment and the risk of autism spectrum disorder (ASD) remain unclear and this review and meta-analysis aimed to quantify any associations. METHODS We systematically searched PubMed, Scopus and The Cochrane Library until June 2018 with no language restrictions. Standardised mean differences and odds ratio with 95% confidence intervals are used to describe any associations between folic acid and mental development, motor development and ASD. RESULTS The search strategy identified 647 papers and 16 were finally included in the meta-analysis after the application of the exclusion criteria. These provided a total cohort size of 756 365 children aged 11 months to 15 years from 10 countries. The main finding was that prenatal use of folic acid was associated with a 58% reduction in the risk of ASD in children. We were surprised that better scores for mental development were associated with low prenatal exposure to folic acid. CONCLUSION Although the results should be interpreted with caution, they showed that routine prenatal supplements of folic acid were associated with significantly lower levels of ASD. Further studies are needed to reach a firm conclusion, given the multifactorial aetiology of neurodevelopment.
Collapse
Affiliation(s)
- Lucía Iglesias Vázquez
- Department of Preventive Medicine and Public Health Faculty of Medicine and Health Science Universitat Rovira i Virgili Reus Spain
| | - Josefa Canals
- Centre de Recerca en Avaluació I Mesura de la Conducta (CRAMC) Department of Psychology Universitat Rovira i Virgili Tarragona Spain
| | - Victoria Arija
- Department of Preventive Medicine and Public Health Faculty of Medicine and Health Science Universitat Rovira i Virgili Reus Spain
| |
Collapse
|
3
|
Iglesias Vázquez L, Valera E, Villalobos M, Tous M, Arija V. Prevalence of Anemia in Children from Latin America and the Caribbean and Effectiveness of Nutritional Interventions: Systematic Review and Meta⁻Analysis. Nutrients 2019; 11:nu11010183. [PMID: 30654514 PMCID: PMC6356363 DOI: 10.3390/nu11010183] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 01/11/2019] [Accepted: 01/14/2019] [Indexed: 11/23/2022] Open
Abstract
Anemia affects 1.62 billion people worldwide. Latin America and the Caribbean (LAC) comprise several developing countries where children are a population at risk. This systematic review and meta-analysis aimed to estimate the prevalence of anemia in this population. Electronic databases, reference lists, and websites of health ministries were searched until December 2018. Stratified analyses were performed using RevMan5.3 to estimate the overall prevalence of anemia in preschool and school-age children. The effectiveness of nutritional interventions was also evaluated. We included 61 studies from the 917 reviewed, which included 128,311 preschool- and 38,028 school-age children from 21 LAC countries. The number of anemic children was 32.93% and 17.49%, respectively, demonstrating a significant difference according to age (p < 0.01). No difference was observed by gender and only school-age children from low/very low socioeconomic status (SES) (25.75%) were more prone to anemia than those from middle SES (7.90%). It was not a concern in the Southern Cone but constituted a serious public health problem in the Latin Caribbean. Nutritional interventions reduced the prevalence from 45% to 25% (p < 0.01). Anemia is still a public health problem for children in LAC countries. National surveys should include school-age children. Further nutritional interventions are required to control anemia.
Collapse
Affiliation(s)
- Lucía Iglesias Vázquez
- Department of Preventive Medicine and Public Health, Faculty of Medicine and Health Science, Universitat Rovira i Virgili, 43201 Reus, Spain.
| | - Edith Valera
- Department of Preventive Medicine and Public Health, Faculty of Medicine and Health Science, Universitat Rovira i Virgili, 43201 Reus, Spain.
| | - Marcela Villalobos
- Department of Preventive Medicine and Public Health, Faculty of Medicine and Health Science, Universitat Rovira i Virgili, 43201 Reus, Spain.
| | - Mónica Tous
- Department of Preventive Medicine and Public Health, Faculty of Medicine and Health Science, Universitat Rovira i Virgili, 43201 Reus, Spain.
| | - Victoria Arija
- Department of Preventive Medicine and Public Health, Faculty of Medicine and Health Science, Universitat Rovira i Virgili, 43201 Reus, Spain.
| |
Collapse
|