Effect of an Iron-Fortified Complementary Food on Anemia and Nutritional Status of Infants Aged 6–18 Months in Ghana (P10-103-19)

Abstract

Objectives. Anemia remains widely prevalent in Ghana, affecting about 75% of children aged 6-23 months, with iron deficiency a common cause. The objective of this study was to assess the effect of a micronutrient-fortified complementary food on hemoglobin, anemia prevalence, and growth of infants in the La Nkwantanang Municipality of the Greater Accra Region, Ghana. Methods. In this double-blind, cluster-randomized, controlled study, infants (aged 6-18 months) received either micronutrient-fortified infant cereal with iron (3.75 mg iron as ferrous fumarate/50 g cereal: INT, n = 107) or the same cereal without iron (CTL; n = 101) to complement other family foods and breast milk for a 6 month period. Recommended cereal intake differed by age (50 g/day for ages 6-8mo, 75 g/d for ages 9-11mo, and 100 g/d for ages 12-18mo). Hemoglobin (Hb), weight, height, and mid-upper arm circumference were assessed at baseline and every 2 months for 8 months. Infants' usual dietary intake was assessed using questionnaires. Differences between groups were analyzed using ANCOVA, adjusted for potential confounders such as child's age, socioeconomic background of caregivers, worm infestation, and malaria. Results. There were no significant differences between groups in maternal/household characteristics or infant baseline anthropometry. At 6 months, adjusted mean SE Hb change from baseline in CTL and INT was 1.16 0.21 and 1.97 0.19 g/dL, respectively (P< 0.01 for each); the increase over time was significantly larger in INT vs. CTL (0.68 0.30 g/dL; P = 0.02). Similar results were found in unadjusted models. Hb levels declined slightly in both groups in the 2 month period after the intervention but remained higher in INT (Figure). Prevalence of anemia declined in both groups (CTL: 89.1% to 62.8%, INT: 84.1% to 42.8%); the magnitude of decrease was 57% greater in INT. There was no significant difference between groups in length gain (CTL: 6.24 0.28, INT: 5.62 0.27 cm; P = 0.21) or weight gain (CTL: 1.03 0.24, INT: 1.31 0.24 kg; P = 0.41). Conclusions. Iron-fortified infant cereal consumed for 6 months promoted greater reductions in iron-deficiency anemia in infants aged 6-18 months, which is a public health concern in Ghana and most developing countries. Funding Sources. This study was sponsored by Nestle Company Limited (Ghana) in collaboration with the University of Ghana School of Biological Sciences. Copyright © American Society for Nutrition 2019.