Evaluation of Body Iron Stores as Indicator of Iron Status in School-Age Children

Abstract

Objectives: To explore the application of the Cook method to estimate baseline Body Iron Stores (BIS) in children as well as change in BIS and safety following a one-year fortified food intervention. Methods: Data from two trials in Australia, Indonesia and India assessing the effect of a multiple micronutrient intervention with iron in a total of 1309 children 6-10y were used. Australian and Indonesian children received either 10 mg/d Fe (as EDTA) in a beverage or non-fortified beverage; Indian children received either 2.7 (control) or 18 mg/d Fe (as fumarate) in a drink and biscuit. Serum ferritin, transferrin receptor concentrations were measured at baseline and after 1y and subjects with CRP >5 mg/L were excluded. BIS were calculated following the Cook formula1 Results: Baseline BIS ranged from 2.55±3.00 mg/kg (mean±SD) in Indonesia and 3.22±3.20 mg/kg in India to 3.63±2.03 mg/kg in Australia. After one year, BIS significantly increased in intervention groups compared to controls (treatment effects (95%-CI) were 2.93 (2.53;3.33), 3.25 (2.93;357) and 0.87 (0.35;1.39) mg/kg, for countries respectively). BIS increase was higher in children with a low baseline BIS. In all intervention groups BIS did not exceed 12 mg/kg bodyweight. Conclusions: BIS calculated following the Cook formula seems a useful indicator for iron status in school-age children, as illustrated by the increase in BIS following the multiple micronutrient interventions with iron levels of 100%RDA. Graphs illustrating the relation between BIS at baseline and after one year intervention will be presented at the conference.