Iron Absorption from Intrinsically Labeled Microencapsulated Ferrous Fumarate (Sprinkles) in Anemic and Non-anemic Infants
S. Zlotkin, C. Schauer, S. Newton, S. Owusu-Agyei, M. Tondeur: Departments of Paediatrics, Nutritional Sciences, and Centre for International Health, University of Toronto; The Hospital for Sick Children, Research Institute, Canada, Kintampo Health Research Centre, Ghana.
Microencapsulated ferrous fumarate (Sprinkles) is a new supplement for ‘home-fortification’. The contents of a sachet can be added to any complementary food without changing the colour or taste. We believe this intervention may decrease the burden of iron deficiency anemia (IDA) in the developing world. However, the most appropriate dose of iron (Fe) to include is not known since its bioavailability has not been studied. Aim: To determine the absorption of 2 doses of Sprinkles when added to a complementary food provided to anemic and non-anemic infants. Methods: In a prospective triple-masked, randomized trial, 39 anemic (hemoglobin (Hb) <100 g/L) and 40 non-anemic infants (Hb>100 g/L) aged 6-18 mo were studied in rural Ghana. Infants received either 30 or 45 mg of elemental Fe containing 6.15 or 9.22 mg respectively of intrinsically labeled 57Fe as microencapsulated ferrous fumarate plus ascorbic acid and vitamin A, added to a standardized maize porridge on 3 consecutive days. Blood was drawn at baseline and 14 days later to determine erythrocyte incorporation of 57Fe by ICP-MS. Fe absorption was calculated based on the assumption of 80% erythrocyte incorporation. Results: At baseline, the anemic group had a mean Hb level of 89.2±7.7g/L and geometric mean ferritin concentration (Fn) of 18.1µg/L; in the non-anemic group, Hb level was 108.0±7.2g/L and Fn 32.5µg/L. Fe absorption was found to be similar at both doses within groups (p>0.05): Mean absorption was 11.1 vs 9.1% in the anemic group and 6.6 vs 6.0% in the non-anemic group for the 30 and 45 mg Fe dose, respectively. Fe absorption at both doses was significantly higher in anemic infants (p<0.05). Conclusion: There was no effect of dose on Fe absorption. Percent absorption of Sprinkles was higher in anemic infants independent of the dose provided. These results will enable us to determine the optimal dose of Fe to safely treat and prevent IDA. (Supported by the CIHR, Particle Dynamics Inc. and the HJ Heinz Fdt.)