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Interactions between infections, malnutrition and iron nutritional status in Pakistani infants. A longitudinal study
N Javaid1, F Haschke, B Pietschnig
1Allama Iqbal Medical College, Lahore, Pakistan.
Insights
Nutritional supplementation in Pakistani infants significantly reduced malnutrition and diarrhea. Iron fortification improved hemoglobin and ferritin levels, highlighting the impact of nutrient intake on infant health.
Area of Science:
- Pediatric Nutrition
- Public Health
- Iron Metabolism
Background:
- Interactions between infections, malnutrition, and iron deficiency in infants are not well understood.
- High incidence of malnutrition in infants at weaning age in Lahore, Pakistan.
Purpose of the Study:
- To investigate the effects of nutritional intervention, including iron fortification, on infant health.
- To assess the impact of supplementation on malnutrition, growth, and infection rates.
Main Methods:
- Prospective, randomized nutritional intervention study involving four groups of infants (122-365 days old).
- Intervention groups received milk cereal with or without iron fortification (ferrous fumarate or ferric-pyrophosphate).
- Control group received no nutritional supplement.
Main Results:
- Nutritional supplementation significantly reduced malnutrition incidence and improved weight gain.
- Supplemented groups showed a significantly lower incidence of acute diarrhea.
- Iron-fortified cereals led to higher hemoglobin and serum ferritin levels compared to non-fortified cereals.
- No significant difference in infection incidence was observed between supplemented groups.
Conclusions:
- Poor nutritional intake in infants (122-365 days) significantly contributes to high rates of diarrhea and malnutrition.
- Nutritional supplementation, particularly with iron, is crucial for improving infant health outcomes in high-risk populations.
Abstract:
The interactions between infections, malnutrition and poor iron nutritional status in infants at weaning ages are poorly defined. Therefore, four groups of infants from an area with a high incidence of malnutrition (Lahore, Pakistan) were enrolled in a prospective, randomized nutritional intervention study. Between 122 and 365 days of age, the infants from one community received either a milk cereal without iron fortification (n = 29), a milk cereal fortified with ferrous fumarate (7.5 mg/100 g; n = 30), or a milk cereal fortified with ferric-pyrophosphate (7.5 mg/100 g; n = 27). Forty-four infants from a neighbouring community did not receive a nutritional supplement and served as the control group. Calculated mean daily energy- and protein intake with the cereals was between 259-287 kcal, and 9.6-10.6 g at 12 months of age, respectively. Mean daily iron intake with the fortified cereals was between 4.1-5.1 mg at corresponding age. Nutritional supplementation resulted in significantly lower incidence of malnutrition and higher weight gain. Incidence of acute diarrhoea was significantly (p less than 0.05) lower in the supplemented groups. The infants fed the iron-fortified milk cereals had significantly higher hemoglobin (mean 10.4 vs. 9.8 g.dl-1) and serum ferritin (mean 13.3 vs. 8.5 ng.ml-1) values than the infants fed the non-fortified milk cereals. However, no differences in the incidence of infections were found between the supplemented groups. It is concluded that poor nutritional intake between 122 and 365 days of age substantially contributed to the high incidence of diarrhoea and malnutrition in Pakistani infants.