Iron-fortified and unfortified cow's milk: Effects on iron intakes and iron status in young children

Iron intakes and iron status were evaluated in 36 young Swedish children gi ven either iron-fortified or unfortified cow's milk. All children had good iron status and had received breast milk or iron-fortified formulae during infancy. Twenty 1-y-old children were randomized to a diet with iron-fortif ied milk (7.0 or 14.9 mg Fe l(-1)) and 16 to a diet with unfortified milk. The. iron intakes in the unfortified group at 15 and 18 mo (mean +/- SD 5.1 9 +/- 2.29 and 5.84 +/- 1.62 mg d(-1)) were, low in relation to Nordic Nutr ition Recommendations, while the intakes in the iron-fortified group (10.20 +/- 2.60 and 10.87 +/- 2.79 mg d-1) were normal in relation to recommendat ions. The gain (increase) from receiving fortified diet during the study pe riod was at most [upper limit for 95% confidence interval (CI)] 2.6 g l(-1) in blood haemoglobin, 1.9 fl in mean corpuscular volume, 2.7 mu mol in ser um iron and 4.5% in transferrin iron saturation, and the gain (decrease) wa s at most (lower limit for 95% Cl) 0.29 g l(-1) in serum transferrin and 0. 9 mg l(-1) in serum transferrin receptor (TfR). None of these differences w as statistically significant. There was an almost significantly higher incr ease in serum ferritin (1.4 times higher relation of values at the end comp ared with the beginning, p = 0.06) and a significantly higher (1.2; p = 0.0 47) decrease in TfR/log(10) ferritin ratio in the fortified group. Conclusion: One-year-old children starting out with good iron status given either iron-fortified or unfortified cow's milk from 12 to is mo maintain s ufficient iron status during this period. However, children fed unfortified cow's milk have an iron intake which is low in relation to recommendations and the quantitative development of their reserve iron in iron stores seem s to be weaker than that of the fortified group. The consequences of this r equire further study.