I am on a number of listserves that are not nearly as active as Lactnet.  I
found this post to be of some relevance and probable interest to this
group.  I assume it will stir up a lot of discussion about the implications
of these two studies.  Just to highlight something that might be missed if
you read this quickly or skim for the main points, study one found NO
association between iron deficiency and vegetarian diet. I'm currently
contemplating the implications myself and have not yet formulated my own
conclusions about these studies yet.

Susan Burger, PhD, MHS
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                              ARBOR CLINICAL NUTRITION UPDATES ©
             ____________________________________________________

        In this issue we consider what foods are relevant to the risk of
iron deficiency in young children.

Study one:
Overdependence on milk as a food source increases the risk of iron
deficiency, but not when the diet has plenty of foods which increase iron
status (such as meat and fruit). This is the conclusion of recent analysis
from a  national dietary survey in England.

        Subjects: 1,003 children from the National Diet and Nutrition
Survey

        Method: A weighed dietary record was made and blood taken for
measurement of haemoglobin (Hb) and serum ferritin.

        Results: Iron status - both Hb and serum ferritin - was
significantly lower in the younger age group (1.5 - 2.5 years) compared
with the older children (3.5 - 4.5 years). Surprisingly boys had
significantly lower ferritin levels than girls.

        Iron status was directly associated with consumption of meat and
fruit, and inversely associated with milk dairy consumption. This last
association remained true after adjusting for various factors, including
socioeconomic status.

        An explanation for this association may lie in the fact that the
children consuming >400 gm/day of milk and cream were less likely to
consume foods in other groups. The highest risk of iron deficiency was in
those who ate little meat, fish, fruit or nuts (but there was no
association with vegetarian diet).

        Reference: Public Health Nutrition, 2000;3:433-440


Study two :
Infants fed iron-fortified infant cereal and pureed meat are protected from
any extra risk of iron deficiency, even if they are on a whole cow's milk
diet as their primary food source, according to recent Canadian research.

        Subjects: 97 six month old infants.

        Method:  Randomised controlled trial in which the infants were
either given no dietary intervention or active intervention. This consisted
of being placed on a diet where whole cow's milk diet was the primary milk
source, but where the diet also included iron-fortified infant cereal (10.2
mg iron) and pureed meat (0.75-1.7 mg iron). Hb and serum ferritin were
measured every two months for 6 months.

        Results: There was no more anaemia in the active than the control
groups.

        Reference: Can J Public Health 2000;91:263-7

COMMENTS
        These two studies are important because iron deficiency is a major
problem in young children. It is both common (particularly amongst children
from poorer families) and from being a cause of anaemia, iron deficiency
can lead to developmental and cognitive delays, particularly during a
vulnerable period of growth from 6 to 24 months of age.

        It is known that over reliance on milk as a food source in this age
range is a risk factor for iron deficiency. This is because milk is a poor
source of bioavailable iron, and possibly also because whole milk in the
first year of life can cause GI bleeding.

        For this reason, many paediatricians and child health nurses
recommend avoiding dairy products as a main source of nutrition in that
first year. However, for some mothers it may not be so easy to find
substitute milks (such as formula or non-cow milks) to replace cow's milk.

        The first of these two studies confirms that milk consumption is a
risk factor for iron deficiency. However, it has a positive message as
well. It suggests that the main reason for this problem is not anything in
the milk itself, but the fact that it displaces other iron-rich foods in
the diet as a source of energy.

        By eating adequate amounts of meat (a rich source of bioavailable
iron - particularly red meat) and fruit (a source of vitamin C which
increases bioavailability of non-meat iron) this problem can be overcome.

        The second study from Canada is even more specific in showing that
dairy products do not necessarily have to be limited, provided the diet
contains plenty of iron-rich foods. Provided the infant consumes pureed
meat and iron-fortified cereal, their randomised, controlled trial
demonstrated that whole cow's milk does not increase the risk of iron
deficiency.

        These findings can increase the range of options available to
health professionals in advising mothers as to the source of milk.

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