The Effect of Iron on Cognitive Development and Function in Infants, Children and Adolescents: A Systematic Review

A systematic review was conducted to summarize the evidence currently available from randomized controlled trials (RCTs) concerning the effect of iron intake of infants, children and adolescents on measures of cognitive development and function. The Cochrane Library, MEDLINE and Embase were searched up to and including February 2010. Studies were also identified by checking the bibliographies of the articles retrieved. All RCTs with an adequate control group in which iron supply was provided by natural food sources, fortified foods, formula or supplements to infants, children or adolescents until the age of 18 years were considered for inclusion. No language restrictions were applied. Fourteen studies met the selection criteria. Twelve out of these 14 studies had a high or moderate risk of bias. A large degree of heterogeneity of study populations, iron dosages and outcome measures precluded performing a quantitative meta-analysis. Overall, the studies suggest a modest positive effect of iron supplementation on cognition and psychomotor outcomes in anemic infants and children after supplementation periods of at least 2 months of duration. Copyright (C) 2011 S. Karger AG, Base

Critical Micronutrients in Pregnancy, Lactation, and Infancy: Considerations on Vitamin D, Folic Acid, and Iron, and Priorities for Future Research

The Early Nutrition Academy and the European Commission-funded EURRECA Network of Excellence jointly sponsored a scientific workshop on critical micronutrients in pregnancy, lactation, and infancy. Current knowledge and unresolved questions on the supply of vitamin D, folic acid, and iron for pregnant women, lactating women, and infants, and their health effects were discussed. The question was addressed of whether, and under which circumstances, supplementation with these micronutrients in addition to usual dietary intakes is advisable. The workshop participants concluded that public health strategies for improving supplementation with these micronutrients in pregnancy, lactation, and infancy are required. Further research priorities should focus on adequately powered human intervention trials to obtain a stronger evidence base for the amounts of vitamin D, folic acid, and iron that have optimal effects on health. The conclusions of the workshop should help to inform the scientific community as well as public health policy strategies. Copyright (C) 2011 S. Karger AG, Base

EURRECA-Estimating Zinc Requirements for Deriving Dietary Reference Values

Zinc was selected as a priority micronutrient for EURRECA, because there is significant heterogeneity in the Dietary Reference Values (DRVs) across Europe. In addition, the prevalence of inadequate zinc intakes was thought to be high among all population groups worldwide, and the public health concern is considerable. In accordance with the EURRECA consortium principles and protocols, a series of literature reviews were undertaken in order to develop best practice guidelines for assessing dietary zinc intake and zinc status. These were incorporated into subsequent literature search strategies and protocols for studies investigating the relationships between zinc intake, status and health, as well as studies relating to the factorial approach (including bioavailability) for setting dietary recommendations. EMBASE (Ovid), Cochrane Library CENTRAL, and MEDLINE (Ovid) databases were searched for studies published up to February 2010 and collated into a series of Endnote databases that are available for the use of future DRV panels. Meta-analyses of data extracted from these publications were performed where possible in order to address specific questions relating to factors affecting dietary recommendations. This review has highlighted the need for more high quality studies to address gaps in current knowledge, in particular the continued search for a reliable biomarker of zinc status and the influence of genetic polymorphisms on individual dietary requirements. In addition, there is a need to further develop models of the effect of dietary inhibitors of zinc absorption and their impact on population dietary zinc requirements.This is the peer-reviewed version of the article: Lowe Nicola M., Dykes Fiona C., Skinner Anna-Louise, Patel Sujata, Warthon-Medina Marisol, Decsi Tamas, Fekete Katalin, Souverein Olga W., Dullemeijer Carla, Cavelaars Adrienne E., Serra-Majem Lluis, Nissensohn Mariela, Bel Silvia, Moreno Luis A., Hermoso Maria, Vollhardt Christiane, Berti Cristiana, Cetin Irene, Gurinović Mirjana A., Novaković Romana, Harvey Linda, Collings Rachel, Hall-Moran Victoria, "EURRECA-Estimating Zinc Requirements for Deriving Dietary Reference Values" 53, no. 10 (2013):1110-1123, [https://doi.org/10.1080/10408398.2012.742863

Accuracy and Reproducibility of Adipose Tissue Measurements in Young Infants by Whole Body Magnetic Resonance Imaging

<div><p>Purpose</p><p>MR might be well suited to obtain reproducible and accurate measures of fat tissues in infants. This study evaluates MR-measurements of adipose tissue in young infants <i>in vitro</i> and <i>in vivo</i>.</p><p>Material and Methods</p><p>MR images of ten phantoms simulating subcutaneous fat of an infant’s torso were obtained using a 1.5T MR scanner with and without simulated breathing. Scans consisted of a cartesian water-suppression turbo spin echo (wsTSE) sequence, and a PROPELLER wsTSE sequence. Fat volume was quantified directly and by MR imaging using k-means clustering and threshold-based segmentation procedures to calculate accuracy <i>in vitro</i>. Whole body MR was obtained in sleeping young infants (average age 67±30 days). This study was approved by the local review board. All parents gave written informed consent. To obtain reproducibility <i>in vivo</i>, cartesian and PROPELLER wsTSE sequences were repeated in seven and four young infants, respectively. Overall, 21 repetitions were performed for the cartesian sequence and 13 repetitions for the PROPELLER sequence.</p><p>Results</p><p><i>In vitro</i> accuracy errors depended on the chosen segmentation procedure, ranging from 5.4% to 76%, while the sequence showed no significant influence. Artificial breathing increased the minimal accuracy error to 9.1%. <i>In vivo</i> reproducibility errors for total fat volume of the sleeping infants ranged from 2.6% to 3.4%. Neither segmentation nor sequence significantly influenced reproducibility.</p><p>Conclusion</p><p>With both cartesian and PROPELLER sequences an accurate and reproducible measure of body fat was achieved. Adequate segmentation was mandatory for high accuracy.</p></div

<i>Absolute values</i> of the whole body fat measurements in the ten infants of the different sequences (prop: PROPELLER TSE; cart: cartesian TSE) and segmentation algorithms (k-means: k-means clustering; thr150, thr250: threshold-based with different threshold settings of 150 and 250)) for whole body adipose tissue (total), subcutaneous and intra-abdominal adipose tissue.

<p>The separation in intra-abdominal and subcutaneous fat was only possible with the k-means clustering segmentation algorithm.</p><p><i>Absolute values</i> of the whole body fat measurements in the ten infants of the different sequences (prop: PROPELLER TSE; cart: cartesian TSE) and segmentation algorithms (k-means: k-means clustering; thr150, thr250: threshold-based with different threshold settings of 150 and 250)) for whole body adipose tissue (total), subcutaneous and intra-abdominal adipose tissue.</p

Five representative slices of one infant.

<p>Left row: cartesian wsTSE sequence; middle row: original segmentation using the k-means clustering algorithm; right row: manually corrected segmentation with separation of internal (green) and external fat (red). This scan represents a case with insufficient water suppression at the arms, where the most user interaction among all scanned infants was required. The complete scan is available as (<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0117127#pone.0117127.s001" target="_blank">S1 Fig.</a>).</p

The phantom scanned by MR imaging with the cartesian wsTSE sequence without (A) and with breathing simulation (B) and the PROPELLER wsTSE sequence without (C) and with breathing simulation (D).

<p>The phantom scanned by MR imaging with the cartesian wsTSE sequence without (A) and with breathing simulation (B) and the PROPELLER wsTSE sequence without (C) and with breathing simulation (D).</p

Infant scans with the cartesian wsTSE sequence (A,B) and the PROPELLER wsTSE sequence (C,D) and the corresponding threshold-based segmentations using a threshold of 150.

<p>Infant scans with the cartesian wsTSE sequence (A,B) and the PROPELLER wsTSE sequence (C,D) and the corresponding threshold-based segmentations using a threshold of 150.</p

<i>Scan parameters of the wsTSE sequences used</i> (prop: PROPELLER; cart: cartesian).

<p><i>Scan parameters of the wsTSE sequences used</i> (prop: PROPELLER; cart: cartesian).</p