Patricia L East1, Brie Reid2, Estela Blanco1,3, Raquel Burrows4, Betsy Lozoff5, Sheila Gahagan1. 1. Department of Pediatrics, University of California, San Diego, La Jolla, CA, USA. 2. Department of Psychiatry and Human Behavior, Brown University Medical School, Providence, RI, USA. 3. Department of Public Health, Pontifical Catholic University of Chile, Santiago, Chile. 4. Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile. 5. Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA.
Abstract
OBJECTIVE: There is concern that high iron uptake during the critical period of early brain development carries potential risks, especially for nonanemic infants. This study examined the neurocognitive functioning of 16-year-olds who were nonanemic as infants and received iron supplementation. METHODS: We studied 562 Chilean adolescents (M 16.2 years; 52.7% female) who participated in a randomized controlled iron supplementation trial in infancy. Between 6 and 12 months, 346 consumed an iron-fortified formula (12.7 Fe mg/L) or, if primarily breastfed, liquid vitamins with 15 mg elemental iron as ferrous sulfate, and 216 consumed unmodified cow milk without iron or liquid vitamins without iron if primarily breastfed. RESULTS: Compared to adolescents in the no-added iron condition in infancy, those in the iron-supplemented condition had poorer visual-motor integration, quantitative reasoning skills, and incurred more errors on neurocognitive tasks. Consuming larger amounts of iron-fortified formula in infancy was associated with lower arithmetic achievement. Of adolescents who had high hemoglobin at 6 months (Hb ≥ 125 g/L), those in the iron supplemented condition had poorer performance on arithmetic, quantitative reasoning, and response inhibition tests than those in the no-added iron condition. Of adolescents who had marginally low 6-month hemoglobin (Hb > 100 and < 110 g/L), those who received no-added iron incurred more errors on a visual searching task than those in the iron-supplemented condition. CONCLUSION: The physiologic need for iron during the period of rapid and critical brain development in young infants should be considered vis-à-vis the risks associated with supplementing nonanemic infants with high levels of iron.Clinical Trials number: NCT01166451.
OBJECTIVE: There is concern that high iron uptake during the critical period of early brain development carries potential risks, especially for nonanemic infants. This study examined the neurocognitive functioning of 16-year-olds who were nonanemic as infants and received iron supplementation. METHODS: We studied 562 Chilean adolescents (M 16.2 years; 52.7% female) who participated in a randomized controlled iron supplementation trial in infancy. Between 6 and 12 months, 346 consumed an iron-fortified formula (12.7 Fe mg/L) or, if primarily breastfed, liquid vitamins with 15 mg elemental iron as ferrous sulfate, and 216 consumed unmodified cow milk without iron or liquid vitamins without iron if primarily breastfed. RESULTS: Compared to adolescents in the no-added iron condition in infancy, those in the iron-supplemented condition had poorer visual-motor integration, quantitative reasoning skills, and incurred more errors on neurocognitive tasks. Consuming larger amounts of iron-fortified formula in infancy was associated with lower arithmetic achievement. Of adolescents who had high hemoglobin at 6 months (Hb ≥ 125 g/L), those in the iron supplemented condition had poorer performance on arithmetic, quantitative reasoning, and response inhibition tests than those in the no-added iron condition. Of adolescents who had marginally low 6-month hemoglobin (Hb > 100 and < 110 g/L), those who received no-added iron incurred more errors on a visual searching task than those in the iron-supplemented condition. CONCLUSION: The physiologic need for iron during the period of rapid and critical brain development in young infants should be considered vis-à-vis the risks associated with supplementing nonanemic infants with high levels of iron.Clinical Trials number: NCT01166451.
Entities:
Keywords:
Chile; Iron supplementation; adolescents; cognitive flexibility; excess iron; executive function; iron deficiency; neurocognition
Authors: B N Axelrod; R S Goldman; R K Heaton; G Curtiss; L L Thompson; G J Chelune; G G Kay Journal: J Clin Exp Neuropsychol Date: 1996-06 Impact factor: 2.475
Authors: D T Stuss; B Levine; M P Alexander; J Hong; C Palumbo; L Hamer; K J Murphy; D Izukawa Journal: Neuropsychologia Date: 2000 Impact factor: 3.139
Authors: Dominic J Hare; Manish Arora; Nicole L Jenkins; David I Finkelstein; Philip A Doble; Ashley I Bush Journal: Nat Rev Neurol Date: 2015-06-23 Impact factor: 42.937
Authors: Griffin P Sutton; Kimberly A Barchard; Danielle T Bello; Nicholas S Thaler; Erik Ringdahl; Joan Mayfield; Daniel N Allen Journal: Psychol Assess Date: 2011-09