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American Journal of Clinical Nutrition, Vol. 77, No. 1, 234-241, January 2003
© 2003 American Society for Clinical Nutrition


Original Research Communication

Iron supplementation improves iron status and reduces morbidity in children with or without upper respiratory tract infections: a randomized controlled study in Colombo, Sri Lanka1,2,3

Angela de Silva, Sunethra Atukorala, Irangani Weerasinghe and Namanjeet Ahluwalia

1 From the Departments of Physiology (AdS) and Biochemistry and Molecular Biology (SA), Faculty of Medicine, University of Colombo, Sri Lanka; the Lady Ridgeway Children’s Hospital, Colombo, Sri Lanka (IW); and the Nutrition Department, College of Health and Human Development, The Pennsylvania State University, University Park (NA).

Background: Iron deficiency anemia and recurrent infections are common among children of low socioeconomic status.

Objective: The objective was to evaluate the effects of iron supplementation on iron status and morbidity in children with or without infection.

Design: Children aged 5–10 y were recruited for a randomized, controlled, double-blind study from outpatients attending the Children’s Hospital, Colombo, Sri Lanka. Clinical, inflammatory, nutritional, and iron statuses were determined at baseline and after the intervention. Children with a history of recurrent upper respiratory tract infections (URTIs) and with laboratory and clinical evidence of a current URTI constituted the infection group (n = 179), and children without infection constituted the control group (n = 184). Subjects in both groups were supplemented with ferrous sulfate (60 mg Fe) or placebo once daily for 8 wk. Morbidity from URTIs, the number of gastrointestinal infections, and compliance were recorded every 2 wk.

Results: The overall prevalence of anemia was 52.6%. Iron supplementation significantly improved iron status by increasing hemoglobin (P < 0.001) and serum ferritin (P < 0.001) concentrations from baseline values in the children with or without infection. There was no significant improvement in iron status in the children who received placebo. In both the infection group and the control group, the mean number of URTI episodes and the total number of days sick with an URTI during the period of intervention were significantly lower (P < 0.005 and P < 0.001, respectively) in the children who received iron supplements than in those who received placebo.

Conclusion: Iron supplementation significantly improves iron status and reduces morbidity from URTIs in children with or without infection.Am J Clin Nutr 2003;77:–41.

Key Words: Anemia • iron status • inflammatory indicators • upper respiratory tract infections • iron supplementation • 5-10-y-old children, Sri Lanka




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