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Complementary food with low (8%) or high (12%) meat content as source of dietary iron: a double-blinded randomized controlled trial

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Abstract

Background

To investigate whether a low meat content of complementary food as accepted by EU law increases the risk of well-nourished infants to develop iron deficiency during the complementary feeding period.

Methods

Term born, healthy infants were randomized into a ‘High Meat’ Group (HM, n = 48) receiving commercial baby jars with a meat content of 12% by weight (according to pediatric guidelines), and a ‘Low Meat’ Group (LM, n = 49) receiving meals as marketed (meat 8% by weight, the lowest level of EU law). Intervention was from 4 to 10 months of age. Dietary intake was recorded continuously, repeated blood samples were collected.

Results

Estimated intake of bioavailable iron conformed to reference requirements. In the primary analysis of the total sample, iron status was adequate before (4 months), during (7 months), and after (10 months) the intervention. A secondary analysis in the subgroup of infants fully breast-fed for 4–6 months demonstrated an increased risk of low Hb values with 10 months of age in the LM group.

Interpretation

Present day low meat content of complementary food does not significantly impair iron status in well-nourished infants but may increase the risk of developing marginal iron status in older infants after fully breast-feeding for 4–6 months, i.e., in the subgroup of infants with the lowest habitual iron intake.

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Abbreviations

BA iron:

Bioavailable iron

BM:

Breast milk

DINO:

Dortmund Intervention Trial for Optimization of Infant Nutrition

DRI:

Dietary reference intake

Fer:

Serum-ferritin

Hb:

Hemoglobin

HM:

High-meat

ID:

Iron deficiency

IDA:

Iron deficiency anemia

LM:

Low-meat

MCH:

Mean cell hemoglobin

MCV:

Mean cell volume

RCT:

Randomized controlled trial

SD:

Standard deviation

TEE:

Total energy expenditure

TfR:

Soluble transferrin-receptor

ZPP:

Zinc protoporphyrin

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Acknowledgments

We thank the two pediatricians from Pediatric Clinic, Dortmund, Germany, for medical examination and blood sampling. The authors’ were responsible as follows: M.K. and H.K. for design of the study; K.D. and J.S. conduction of the study and data collection; K.D. draft of the manuscript and statistical analysis; M.K., H.K. and M.J.M. supervision. The study was supported by the Central Marketing Organization of German Agricultural Economics (CMA). Study food was provided by Hipp GmbH and Co. Vertrieb KG and Nestlé Nutrition GmbH. Laboratory analysis of iron biomarkers was performed at the Laborgemeinschaft Dr. Eberhard & Partner, Dortmund, Germany.

Conflict of interest statement

All authors have no conflict of interest.

Author information

Authors and Affiliations

  1. Research Institute of Child Nutrition Dortmund, University of Bonn, Heinstueck 11, 44225, Dortmund, Germany

    Katharina Dube, Jana Schwartz & Mathilde Kersting

  2. University of Kiel, Kiel, Germany

    Manfred J. Mueller

  3. Pediatric Clinic, Dortmund, Germany

    Hermann Kalhoff

Authors
  1. Katharina Dube
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  2. Jana Schwartz
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  3. Manfred J. Mueller
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  4. Hermann Kalhoff
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  5. Mathilde Kersting
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Corresponding author

Correspondence to Mathilde Kersting.

Additional information

Study registration number at http://www.clinicaltrials.gov: NCT00571948.

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Dube, K., Schwartz, J., Mueller, M.J. et al. Complementary food with low (8%) or high (12%) meat content as source of dietary iron: a double-blinded randomized controlled trial. Eur J Nutr 49, 11–18 (2010). https://doi.org/10.1007/s00394-009-0043-9

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  • DOI: https://doi.org/10.1007/s00394-009-0043-9

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