Anne-Sylvia Sacri1, Alain Bocquet2, Mariane de Montalembert3, Serge Hercberg4, Laurent Gouya5, Béatrice Blondel6, Amandine Ganon7, Pascale Hebel8, Catherine Vincelet9, Franck Thollot10, Massimiliano Rallo11, Piotr Gembara12, Corinne Levy13, Martin Chalumeau3. 1. Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Inserm UMR 1153, Labex GR-Ex, Paris Descartes University, France; Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants Malades Hospital, AP-HP, Paris Descartes University, Paris, France. Electronic address: anne-sylvia.sacri@inserm.fr. 2. Association Française de Pédiatrie Ambulatoire (AFPA), Talence, France; Comité de Nutrition de la Société Française de Pédiatrie, Paris, France. 3. Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Inserm UMR 1153, Labex GR-Ex, Paris Descartes University, France; Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants Malades Hospital, AP-HP, Paris Descartes University, Paris, France. 4. Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, Nutritional Epidemiology Research Team (EREN), Inserm UMR 1153, Paris Descartes University, Sorbonne Paris Cité, France; Département de Santé Publique, AP-HP, Hôpital Avicenne, Bobigny, France. 5. Centre de Recherche sur l'inflammation, Inserm UMR 1149, Université Paris Diderot, ERL CNRS 8252, Faculté de Médecine Site Bichat, Paris, France. 6. Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Inserm UMR 1153, Labex GR-Ex, Paris Descartes University, France. 7. Laboratoire CERBA, Saint-Ouen l'Aumône, France. 8. Centre de Recherche pour l'Etude et l'Observation des Conditions de vie (CREDOC), Paris, France. 9. Centre Régional de Coordination des dépistages des Cancers Ile-de-France, Lieusaint, France. 10. AFPA, Essay Les Nancy, France. 11. AFPA, Nantes, France. 12. AFPA, Vichy, France. 13. Association Française de Pédiatrie Ambulatoire (AFPA), Talence, France; Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Saint-Maur des Fossés, France; Université Paris Est, IMRB- GRC GEMINI, 94000, Créteil, France.
Abstract
BACKGROUND & AIMS: Iron deficiency (ID) is considered the most frequent micronutrient deficiency in industrialized countries where strategies for its primary prevention vary widely and are insufficiently evaluated. We aimed to study the effectiveness for iron status of a national iron deficiency prevention strategy based on recommendations for young-child formula (YCF) use after age 12 months, taking into consideration other sources of iron and the family's socio-economic status. METHODS: In a cross-sectional observational study conducted in primary care pediatrician offices throughout France from 2016 to 2017, infants aged 24 months were consecutively included for a food survey and blood sampling. Associations between YCF consumption and serum ferritin (SF) level were studied by multivariable regression after adjustment on sociodemographic, perinatal and dietary characteristics, notably other intakes of iron. RESULTS: Among the 561 infants analyzed, the ID prevalence was 6.6% (37/561; 95% confidence interval [CI] 4.7-9.0). Daily iron intake excluding YCF and total daily iron intake including YCF were below the 5-mg/day recommended average requirements for 63% and 18% of children, respectively. ID frequency was significantly decreased (or SF level was independently higher) with any YCF consumption after age 10 months (odds ratio 0.15, 95% CI 0.07-0.31), current YCF consumption at age 24 months (median SF level 29 vs 21 μg/L if none), prolonged YCF consumption (28 μg/L if >12 months vs 17 μg/L if none), and increasing daily volume of YCF consumed at age 24 months from a small volume (e.g., 29 μg/L if <100 mL/day vs 21 μg/L if none). CONCLUSIONS: Current or past YCF use was independently associated with a better iron status at age 24 months than non-use. The strategy recommending YCF use at weaning after age 12 months seems effective in the general population. CLINICALTRIALS. GOV IDENTIFIER: NCT02484274.
BACKGROUND & AIMS:Iron deficiency (ID) is considered the most frequent micronutrient deficiency in industrialized countries where strategies for its primary prevention vary widely and are insufficiently evaluated. We aimed to study the effectiveness for iron status of a national iron deficiency prevention strategy based on recommendations for young-child formula (YCF) use after age 12 months, taking into consideration other sources of iron and the family's socio-economic status. METHODS: In a cross-sectional observational study conducted in primary care pediatrician offices throughout France from 2016 to 2017, infants aged 24 months were consecutively included for a food survey and blood sampling. Associations between YCF consumption and serum ferritin (SF) level were studied by multivariable regression after adjustment on sociodemographic, perinatal and dietary characteristics, notably other intakes of iron. RESULTS: Among the 561 infants analyzed, the ID prevalence was 6.6% (37/561; 95% confidence interval [CI] 4.7-9.0). Daily iron intake excluding YCF and total daily iron intake including YCF were below the 5-mg/day recommended average requirements for 63% and 18% of children, respectively. ID frequency was significantly decreased (or SF level was independently higher) with any YCF consumption after age 10 months (odds ratio 0.15, 95% CI 0.07-0.31), current YCF consumption at age 24 months (median SF level 29 vs 21 μg/L if none), prolonged YCF consumption (28 μg/L if >12 months vs 17 μg/L if none), and increasing daily volume of YCF consumed at age 24 months from a small volume (e.g., 29 μg/L if <100 mL/day vs 21 μg/L if none). CONCLUSIONS: Current or past YCF use was independently associated with a better iron status at age 24 months than non-use. The strategy recommending YCF use at weaning after age 12 months seems effective in the general population. CLINICALTRIALS. GOV IDENTIFIER: NCT02484274.