Assessment of complementary feeding of Canadian infants: effects on microbiome & oxidative stress, a randomized controlled trial.

BACKGROUND: The World Health Organization recommends exclusive breastfeeding until 6 months followed by introduction of iron-rich complementary foods (CFs). The aim of this study was to determine the impact of different iron-rich CFs on infant gut inflammation and microbiota. METHODS: Eighty-seven exclusively breastfed infants were randomly assigned to receive one of the following as their first CF: iron-fortified cereal (Cer), iron-fortified cereal with fruit (Cer + Fr), or meat (M). Urine and stool samples were collected to assess reactive oxygen species (ROS) generation, gut microbiota and inflammation. RESULTS: Fecal iron differed across feeding groups (p < 0.001); levels were highest in the Cer group and lowest in M group. A significant increase of fecal ROS formation (p < 0.002) after the introduction of CFs was observed, but did not differ across feeding groups. Fecal calprotectin increased within all groups after the introduction of CFs (p = 0.004). Gut microbiota richness increased after introduction of M or Cer + Fr. Regardless of feeding group, Coriobacteriaceae were positively correlated with ROS and Staphylococcaceae were negatively correlated with calprotectin. CONCLUSIONS: Choice of first CF may influence gut inflammation and microbiota, potentially due to variations in iron absorption from different foods. Further research is warranted to fully characterize these associations and to establish implications for infant health. This study was registered in the ClinicalTrial.gov registry (Identifier No. NCT01790542 ). TRIAL REGISTRATION: This study was registered in the ClinicalTrial.gov registry under the name "Assessment of Complementary Feeding of Canadian Infants" (Identifier No. NCT01790542 ) February 6, 2013.

Effectiveness of iron-fortified infant cereals on hemoglobin levels of children aged 12-24 months: A cross-sectional study from New Delhi, India.

INTRODUCTION: Iron deficiency anemia represents 3rd largest disease burden, with an estimated 6.9 billion disability-adjusted life years. Iron-fortified cereals (IFIC) can contribute substantially in preventing iron deficiency anemia and maintaining an adequate body iron status. The aim of this study is to assess the effectiveness of IFIC intake along with other complementary food/s on the hemoglobin (hb) level of children from 12 to 24 months of age. MATERIALS AND METHODS: A cross-sectional study was conducted from November 2015 to February 2016 in three pediatric outpatient clinics of New Delhi, India. A predesigned questionnaire was used to elicit information on socio-demography, complementary feeding, and intake of IFIC from 66 mother and child pairs. Child's anthropometric measurement and hb levels were recorded by the pediatrician. Chi-square and Student's t-tests were used to compare the key study variables between IFIC (minimum 1-2 serving/day) and non-IFIC groups. Multiple logistic regression analysis was applied to explore the independent correlates of anemia in the study groups. RESULTS: Out of 66 children, 60.6% (n = 40) of children were boys. The prevalence of anemia (hb% <11 g/dl) was 42.4% (95% confidence interval (CI): 30.5%-55.2%, n = 28). Multiple logistic regression analysis revealed that the children in IFIC group were unlikely to be anemic (adjusted odds ratio (OR): 0.007, 95% CI: 0.001-0.079, P < 0.001). On the contrary, boys (adjusted OR: 11.6, 95% CI: 1.23-108.9, P = 0.032) and children with low birth weight (adjusted OR: 11.7, 95% CI: 1.23-111.76, P = 0.032) were associated with anemic status. CONCLUSION: Intake of IFIC (minimum 1-2 serving/day) was associated with the lesser chance of anemia in children of 12-24 months. However, gender and low birth weight were also associated with anemia. IFIC may have a role in mass fortification programs. However, further larger and controlled studies are recommended to test this hypothesis.