Iron fortified milk and red meat improve toddler's iron status

A New Zealand study, undertaken by the University of Otago and published on-line in the American Journal of Clinical Nutrition, has shown that a balanced diet including an iron fortified milk such as a toddler milk or red meat can prevent iron levels from falling (1). 

Non anaemic iron deficiency affects about 30% of toddlers in Australia and New Zealand in the second year of life, as iron stores decrease due to higher iron requirements and poor iron intakes. Iron is important for cognitive development and behaviour and signs of deficiency include tiredness, irritability, poor appetite, poor development and repeated infections. Correcting low iron stores before anaemia develops is important as any negative effects may not be reversed with supplements.

The aim of the 20 week randomized placebo-controlled trial was to determine the effect of increasing the intake of red meat or consuming iron fortified milk on toddler's iron status. Two hundred and twenty five toddlers aged 12 to 20 months and their families participated in the study. Toddlers were assigned to 3 groups :- 1. the red meat group in which a variety of  frozen red meat meals were provided and toddlers asked to consume  2 or more portions daily 2. the iron fortified milk group who were provided with iron fortified Heinz Nurture Toddler milk  and 3. the non iron fortified milk group, the control. In groups 2 and 3 the children replaced their regular milk with either iron fortified or non iron fortified powdered milk.  Blood measurements were taken at the beginning and end of the trial.

At the end of the trial, iron stores (concentration of ferritin) in the iron fortified milk group increased by 44%, remained unchanged in the red meat group but decreased in the non iron fortified milk group. During the study toddlers found it difficult to consume the required 2 or more portions of red meat daily, reflecting the fussiness of this age group. Compared to the control group ( non iron fortified milk) both the iron fortified milk group and red meat group had higher serum ferritin.

The authors concluded that iron fortified milk can increase iron stores in healthy non anaemic toddlers while red meat can prevent its decline. Correcting low iron stores with food is a better treatment option than supplements as it is generally less expensive, has less side effects, and is more sustainable.

Heinz Nurture Toddler Milk was the iron fortified milk used in the study. One 230ml serve provides 50% of a toddlers iron requirements(2). It also supplies other vitamins and minerals such as vitamin D and iodine. Toddlers require only 2 serves of dairy a day (or 500mls of milk) to meet calcium requirements. Toddler milks should be used in place of regular milk, not in addition to it. 

References.

1. Szymlek-Gay EA, Ferguson EL. Heath ALM et al. Food strategies improve iron status in toddlers: a randomised controlled trial. Published October 14 2009;doi:10.3945/ajcn.2009.27588  www.ajcn.org/papbyrecent.dtl

2. FSANZ. Food Standards Code 2009, Standard 2.9.3, Division 4 Formulated supplementary foods for young children . www.foodstandards.gov.au