Table 2.
Details of included studies for fortification of milk and cereal food
| Study | Population | Intervention | Control food | Outcome | Comment |
|---|---|---|---|---|---|
| Author, year: Brown, 2007 [29] Design: RCT |
Country: Peru Target population: periurban area; Age (mean; range): 0.6; 0.5 to 0.7 years Males (%): 46 Exclusion criteria: risk of acute malnutrition; chronic diseases |
Cereals, fortified (porridge); single MN strategy MN applied a: Zn Iron dosage b: n.a.c mg/day; Iron compound d: n.a. |
porridge, unfortified for zink |
After 0.5 year: plasma zinc; anthropometry; infections |
Both groups recieved iron fortification and vitamin supplements, thus net intervention was zinc fortification. |
| Author, year: Daly, 1996 [31] Design: RCT |
Country: UK (74% white; 24% Afro-Caribbean; 2% Asian) Target population: poor innerurban Age (mean; range): 0.65; 0.5 to 0.7 years Males (%): 47 Exclusion criteria: preterm at birth |
Milk, fortified; multi MN strategy MN applied: Fe, VitA, other Vitamins, other MN Iron dosage: 5.47 mg/day; Iron compound: no info |
milk, unfortified |
After 1 year: hematological parameters; anthropometry |
Functional outcome was extracted from related paper Williams_1999 [39]. |
| Author, year: Faber, 2005 [33] Design: RCT |
Country: South Africa Target population: rural area, low socio-economic status, Age (mean; range): 0.7; 0.6 to 0.9 years Males (%): 51 Exclusion criteria: birth weight <2500 g, severe anemia |
Cereals, fortified (porridge); multi MN strategy MN applied: Fe, Zn, other Vitamins Iron dosage: 27.5 mg/day; Iron compound: FeFu |
porridge, unfortified |
After 0.5 year: hematological parameters, serum retinol, zinc; growth; motor development |
Population baseline characteristics only for infants who completed the study. |
| Author, year: Gibson, 2011 [35] Design: RCT |
Country: Zambia Target population: middle income class Age (mean; range): 0.5; 0.5 to 0.5 years Males (%): 48 Exclusion criteria: "not in good health" |
Cereals, fortified (porridge); multi MN strategy MN applied: Fe, Zn, other Vitamins, other MN Iron dosage: 5.36 mg/day; Iron compound: no info |
porridge, unfortified |
After 1 year: hematological parameters; serum zink, anthropometry; hospital referral; death; diarrhea; pneumonia; mental and motor development |
All children received VitA and Iodine by a public supplementation program. Some outcomes extracted from related paper (Chilenje_2010) [40] and (Manno_2011) [41]. |
| Author, year: Gill, 1997 [24] Design: RCT |
Country: Ireland Target population: no info Age (mean; range): 0.5; 0.5 to 0.5 years Males (%): 51 Exclusion criteria: severe or chronic disaese, malnutrition; congenital anomalies |
Milk, fortified; single MN strategy MN applied: Fe Iron dosage: 6.54 mg/day; Iron compound: FeSu |
formula milk, unfortified for iron |
After 0.75 year: hematological parameters, anthropometry |
|
| Author, year: Lartey, 1999 [34] Design: RCT |
Country: Ghana Target population: urban area Age (mean; range): 0.5; 0.5 to 0.5 years Males (%): 48 Exclusion criteria: congenital abnormalities |
Cereals, fortified (porridge); multi MN strategy MN applied: Fe, Zn, VitA, other Vitamins, other MN Iron dosage: 14.25 mg/day; Iron compound: electrFe |
porridge, unfortified |
After 0.5 year: hematological parameters; anthropometry; diarrhea; fever; respiratory illness |
Intervention cereal with 2 formulations of fortification depending on daily cereal intake of infant to avoid potential toxicity problems. |
| Author, year: Liu, 1993 [37] Design: RCT |
Country: China Target population: all population classes (90% of all children) Age (mean; range): 0.8; 0.5 to 1.1 years Males (%): 55 Exclusion criteria: no info |
Cereals, fortified (rusk); multi MN strategy MN applied: Fe, Zn, VitA, other Vitamins, other MN Iron dosage: 5 mg/day; Iron compound: FeAmCi |
rusk, unfortified |
After 0.25 year: hematological paramters; MN-serum levels, anthropometry |
|
| Author, year: Maldonado Lonzano, 2007 [25] Design: RCT |
Country: Spain Target population: no info Age (mean; range): 1.9; (range: no info) years Males (%): 58 Exclusion criteria: iron supplementation |
Milk, fortified; multi MN strategy MN applied: Fe, other Vitamins, other MN Iron dosage: 5.9 mg/day; Iron compound: no info |
milk, unfortified (cows whole milk formula) |
After 0.33 year: hematological parameters |
No child with anemia at baseline. |
| Author, year: Morley, 1999 [26] Design: RCT |
Country: UK (Indian ethnicity) Target population: mother with higher eduction, non-manual social class Age (mean; range): 0.78; (range: no info) years Males (%): 50 Exclusion criteria: relevant disease; iron supplementation |
Milk, fortified; single MN strategy MN applied: Fe Iron dosage: 1.8 mg/day; Iron compound: FeSu |
formula, unfortified |
After 0.75 year: hematological parameters, antropometry, motor and mental development |
Only data from Norwich cohort blood samples could be taken at baseline and were extracted for Hb outcome. |
| Author, year: Nesamvuni, 2005 [36] Design: RCT |
Country: South Africa Target population: poor socio-economic status, undernourished children Age (mean; range): no info; 1 to 3 years Males (%): 0 Exclusion criteria: physical or mental disability, severe undernutrition |
Cereals, fortified (maize porridge); dual MN strategy MN applied: VitA, other Vitamins Iron dosage: n.a.mg/day; Iron compound: n.a. |
maize meal, unfortified |
After 1 year: hematological parameters, retinol level, anthropometry |
Children and family members received the food. |
| Author, year: Oelofse, 2003 [9] Design: RCT |
Country: South Africa Target population: urban disadvantaged black community (low socioeconomic status) Age (mean; range): 0.5; (range: no info) years Males (%): 0 Exclusion criteria: birth weight < 2.5 kg; congenital abnormalities |
Cereals, fortified (porridge); dual MN strategy MN applied: Zn, other Vitamins Iron dosage: -0.8 mg/day; Iron compound: FePP |
normal diet |
After 0.5 year: hematological parameters, zinc level, retinol level, anthropometry, psychomotor development |
90% of control group already recieved commercially prepared complementatry food. The food concentration of iron did not relevanlty differ between groups, but of Zinc and of VitA. |
| Author, year: Rivera, 2010 [10] Design: RCT (accounted for cluster randomisation) |
Country: Mexico Target population: households living in poverty Age (mean; range): no info; 1 to 2.5 years Males (%): 50 Exclusion criteria: no info |
Milk, fortified; multi MN strategy MN applied: Fe, Zn, other Vitamins, other MN Iron dosage: 7.82 mg/day; Iron compound: FeGlu |
milk, non-fortified |
After 1 year: hematological parameters |
Study results are adjusted for cluster effect. Evaluation of a large scale program (Leche Lincosa) in Mexico. |
| Author, year: Sazawal, 2010 [8] Design: RCT |
Country: India Target population: periurban area; illiteracy of parents Age (mean; range): 1.9; 1 to 3 years Males (%): 50 Exclusion criteria: severe malnutrition; severe illness |
Milk, fortified; multi MN strategy MN applied: Fe, Zn, VitA, other Vitamins, other MN Iron dosage: 8.3 mg/day; Iron compound: FeSu |
milk, unfortified |
After 1 year: hematological parameters, anthropometry, severe illnesses, diarrhoea, lower respiratory tract infections, pneumonia |
Some data extracted from relating paper: Sazawal_2006 [42] Completeness relates to hematologic parameters. |
| Author, year: Schümann, 2005 [38] Design: RCT |
Country: Guatemala Target population: low income; periurban settlement Age (mean; range): 1.7; 1 to 2 years Males (%): 52 Exclusion criteria: gastric or intestinal diseases; infections |
Cereals, fortified (bean paste); single MN strategy MN applied: Fe Iron dosage: 17.1 mg/day; Iron compound: FeSu |
beans, unfortified |
After 0.19 year: hematological parameters |
All children recieved anthelmintic treatment; all families were compensated. Three arm trial: Only data for FeSu group (n = 31) vs. control group (n = 30) extracted. |
| Author, year: Stevens, 1998 [32] Design: RCT |
Country: UK (mostly caucasian) Target population: lower social classes were overrepresented Age (mean; range): 0.5; 0 to 0 years Males (%): 0 Exclusion criteria: illness, major congenital malformation |
Milk, fortified; single MN strategy MN applied: Fe Iron dosage: 6.87 mg/day; Iron compound: FeSu |
milk, unfortified |
After 1 year: hematological parameters |
|
| Author, year: Villalpando, 2006 [27] Design: RCT |
Country: Mexico Target population: poor periurban community Age (mean; range): 1.8; 0.8 to 2.5 years Males (%): 50 Exclusion criteria: no info |
Milk, fortified; multi MN strategy MN applied: Fe, Zn, other Vitamins Iron dosage: 6.74 mg/day; Iron compound: FeGlu |
milk, unfortified |
After 0.5 year: hematological parameters |
The results of the study lead to broadening of a fortified milk distribution program in Mexico. |
| Author, year: Virtanen, 2001 [28] Design: RCT |
Country: Sweden Target population: urban area Age (mean; range): 1; 1 to 1 years Males (%): 39 Exclusion criteria: milk intolerance; poor health |
Milk, fortified; single MN strategy MN applied: Fe Iron dosage: 4.53 mg/day; Iron compound: FeGlu, FeLac |
milk, unfortified |
After 0.5 year: hematological parameters |
|
| Author, year: Walter, 1998 [30] Design: RCT | Country: Chile Target population: From four contiguos urban communities Age (mean; range): 0.5; 0 to 0 years Males (%): 52 Exclusion criteria: major birth or neonatal complications, chronic illness | Milk, fortified; single MN strategy MN applied: Fe Iron dosage: 6.5 mg/day; Iron compound: FeSu | formula, low iron fortifed | After 1 year: hematological parameters, anthropometry |
a MN (micronutrient) applied: Fe: iron; Zn: zinc; VitA: Vitamin A; other Vitamins: e.g. Vitamin C; other MN (micronutirents): e.g. selen, copper.
b Iron dosage: Determined as daily difference between intervention and control group.
c n.a.: not applicable
d Iron compound: FeSu: iron-sulfate; FePP: iron-pyrophosphate; NaFeEDTA: natrium-iron-EDTA; FeFu: iron-fumarate; FeGlu: iron-gluconate; FeAmCi: ferric-ammonium-citrate; FeLa: Ferrous lactate; electrFe: electrolytic iron.