Home fortification of complementary foods with micronutrient supplements is well accepted and has positive effects on infant iron status in Ghana

Abstract

BackgroundMicronutrient deficiencies are common during infancy, and optimal approaches for their prevention need to be identified. ObjectiveThe objective was to compare the efficacy and acceptability of Sprinkles (SP), crushable Nutritabs (NT), and fat-based Nutributter (NB; 108 kcal/d), which provide 6, 16, and 19 vitamins and minerals, respectively, when used for home fortification of complementary foods. DesignGhanaian infants were randomly assigned to receive SP (n = 105), NT (n = 105), or NB (n = 103) daily from 6 to 12 mo of age. We assessed dietary intake, morbidity, and compliance weekly. Hemoglobin and plasma ferritin, TfR, C-reactive protein, and zinc were measured at 6 and 12 mo. We used an exit interview to assess acceptability. A randomly selected control group of infants who received no intervention (NI; n = 96) were assessed at 12 mo. ResultsAll supplements were well accepted, and the mean percentage of days that supplements were consumed (87%) did not differ between groups. At 12 mo, all 3 intervention groups had significantly higher ferritin and lower TfR concentrations than did the NI control group. Mean (± SD) hemoglobin was significantly higher in NT (112 ± 14 g/L) and NB (114 ± 14 g/L) but not in SP (110 ± 14 g/L) infants than in NI infants (106 ± 14 g/L). The prevalence of iron deficiency anemia was 31% in the NI control group compared with 10% in the intervention groups combined (P < 0.0001). ConclusionAll 3 options for home fortification of complementary foods are effective for reducing the prevalence of iron deficiency in such populations.