Effect of Sprinkles With and w/o Fe on Zn Absorption in Kenyan Toddlers



Status:Completed
Healthy:No
Age Range:Any
Updated:5/23/2018
Start Date:April 2011
End Date:February 2016

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Effects of Sprinkles With and Without Iron on Zinc Absorption From Local Foods in Kenyan Toddlers, Including the Gut Microbiome

The investigators propose to study the effects of increased iron intake by home fortification
of complementary foods on the gastrointestinal microbial development, inflammatory responses,
and zinc (Zn) absorption. The proposed subjects are 9 month olds living in a malaria endemic
area of rural Kenya who are randomized at 6 months of age to one of three fortificant groups:
1) Sprinkles™ with 12mg Iron(Fe)/day + other micronutrients, including 5mg/d Zn (test);
Sprinkles™ with 0 mg/d Fe + other micronutrients, including 5mg/d Zn (control); Sprinkles™
with no micronutrients (placebo). The investigators hypothesize that the microbiome will be
significantly different in the three groups and that Zn absorption and status, in addition to
immune and oxidant status will be improved in the non-Fe fortified groups when compared to
the Fe-fortified group.

Specific aims include exploration of possible mechanisms of adverse events that have been
observed in iron supplementation trials in infants in malaria endemic regions by:

1. Characterizing the impact of enteral iron administration on the evolution of the
intestinal microbiome in infants from 6 to 9 months of age.

2. Characterizing iron administration-associated inflammatory responses and correlate these
with changes in the intestinal microbiome in infants from 6 to 9 months of age.
Specifically, changes in the microbiome will be correlated with biomarkers reflecting:

1. Intestinal inflammation;

2. Systemic inflammation, bacterial translocation, and oxidant stress;

3. Iron status and homeostasis

3. Quantify to what degree Fe interferes with Zn absorption (TAZ) and how it affects the
size of the infant's exchangeable zinc pool (EZP).

Inclusion Criteria:

- Term infant

- Birthweight > 2500 g

- Healthy with no apparent congenital anomalies

- Up-to-date with vaccinations

- Hb >10 g/dL

- Breastfeeding with intent to continue for duration of study

- Negative blood slide for malaria

- Written informed consent

Exclusion Criteria:

- Acute malnutrition

- Current or anticipated used of infant formula or other fortified products

- Current or planned use of iron (or zinc) supplements

- Previous hospitalization for malaria within the last four weeks

- Persistent diarrhea
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13001 E. 17th Pl
Aurora, Colorado 80045
303-724-5000
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