Young children formula consumption and iron deficiency at 24 months in the general population: A national-level study

Anne-Sylvia Sacri (1, 2, 3) , Alain Bocquet (4, 5) , Mariane de Montalembert (1, 2, 3) , Serge Hercberg (1, 6) , Laurent Gouya (7) , Béatrice Blondel (1, 2) , Amandine Ganon (8) , Pascale Hebel (9) , Catherine Vincelet (10) , Franck Thollot (4) , Massimiliano Rallo (4) , Piotr Gembara (4) , Corinne Levy (11, 4, 12) , Martin Chalumeau (1, 2, 3)

1 EPOPé [CRESS - U1153 / UMR_A 1125] - Obstetrical, Perinatal and Pediatric Epidemiology | Épidémiologie Obstétricale, Périnatale et Pédiatrique
2 Labex Gr-Ex - Laboratoire d'Excellence : Biogenèse et pathologies du globule rouge
3 Hôpital Necker - Enfants Malades [AP-HP]
4 AFPA - Association Française de Pédiatrie Ambulatoire
5 SFP - Société Française de Pédiatrie
6 Hôpital Avicenne [AP-HP]
7 CRI (UMR_S_1149 / ERL_8252 / U1149) - Centre de recherche sur l'Inflammation
8 Laboratoire CERBA [Saint Ouen l'Aumône]
9 CREDOC - Centre de recherche pour l'étude et l'observation des conditions de vie
10 CRCDC-IDF - Centre Régional de Coordination du Dépistage des Cancers [Paris]
11 IMRB - Institut Mondor de Recherche Biomédicale
12 ACTIV - Association Clinique et Thérapeutique Infantile du Val de Marne

Background & aims: Iron deficiency (ID) is considered the most frequent micronutrient deficiency in industrialized countries where strategies for its primary prevention vary widely and are insufficiently evaluated. We aimed to study the effectiveness for iron status of a national iron deficiency prevention strategy based on recommendations for young-child formula (YCF) use after age 12 months, taking into consideration other sources of iron and the family's socio-economic status.Methods: In a cross-sectional observational study conducted in primary care pediatrician offices throughout France from 2016 to 2017, infants aged 24 months were consecutively included for a food survey and blood sampling. Associations between YCF consumption and serum ferritin (SF) level were studied by multivariable regression after adjustment on sociodemographic, perinatal and dietary characteristics, notably other intakes of iron.Results: Among the 561 infants analyzed, the ID prevalence was 6.6% (37/561; 95% confidence interval [CI] 4.7-9.0). Daily iron intake excluding YCF and total daily iron intake including YCF were below the 5-mg/day recommended average requirements for 63% and 18% of children, respectively. ID frequency was significantly decreased (or SF level was independently higher) with any YCF consumption after age 10 months (odds ratio 0.15, 95% CI 0.07-0.31), current YCF consumption at age 24 months (median SF level 29 vs 21 μg/L if none), prolonged YCF consumption (28 μg/L if >12 months vs 17 μg/L if none), and increasing daily volume of YCF consumed at age 24 months from a small volume (e.g., 29 μg/L if <100 mL/day vs 21 μg/L if none).Conclusions: Current or past YCF use was independently associated with a better iron status at age 24 months than non-use. The strategy recommending YCF use at weaning after age 12 months seems effective in the general population. CLINICALTRIALS.Gov identifier: NCT02484274.

Mots clés: Effectiveness; Iron deficiency; Nationwide cohort study; Primary prevention; Socio-economic factors; Young-child formula

Domaines: Sciences du Vivant [q-bio]

Anne-Sylvia Sacri, Alain Bocquet, Mariane de Montalembert, Serge Hercberg, Laurent Gouya, et al.. Young children formula consumption and iron deficiency at 24 months in the general population: A national-level study. Clinical Nutrition, 2021, 40, pp.166 - 173. ⟨10.1016/j.clnu.2020.04.041⟩. ⟨hal-03493162⟩