Document Detail

The effects of micronutrient-fortified complementary/replacement food on intestinal permeability and systemic markers of inflammation among maternally HIV-exposed and unexposed Zambian infants.
MedLine Citation:
PMID:  21899803     Owner:  NLM     Status:  MEDLINE    
The present randomised trial investigated the effects of feeding Zambian infants from 6 to 18 months old either a richly or basal micronutrient-fortified complementary/replacement food on gut integrity and systemic inflammation. Blood samples were obtained from all infants (n 743) at 6 and 18 months for the assessment of serum C-reactive protein (CRP) and α1-acid glycoprotein (AGP). A subsample of 502 infants, selected from the main cohort to include a larger proportion of infants with HIV-positive mothers, was assigned to lactulose/mannitol gut permeability tests. Lactulose:mannitol (L:M) ratio analyses were adjusted for baseline urinary L:M ratio, socio-economic status, mother's education, season of birth and baseline stunting, and stratified by maternal antenatal HIV status, child's sex, concurrent breast-feeding status and anaemia at baseline. There was no significant difference in geometric mean L:M ratio between the richly fortified and basal-fortified porridge arms at 12 months (0·47 (95 % CI 0·41, 0·55) v. 0·41 (95 % CI 0·34, 0·49); P = 0·16 adjusted). At 18 months, the richly fortified porridge group had a significantly higher geometric mean L:M ratio than the basal-fortified group (0·23 (95 % CI 0·19, 0·28) v. 0·15 (95 % CI 0·12, 0·19); P = 0·02 adjusted). This effect was evident for all stratifications, significantly among boys (P = 0·04), among the infants of HIV-negative mothers (P = 0·01), among the infants of HIV-negative mothers not concurrently breast-fed (P = 0·01) and among those who were not anaemic at baseline (P = 0·03). CRP, but not AGP, was positively associated with L:M ratio, but there were no significant effects of the diet on either CRP or AGP. In conclusion, a richly fortified complementary/replacement food did not benefit and may have worsened intestinal permeability.
Anne Mullen; Laura Gosset; Natasha Larke; Daniela Manno; Molly Chisenga; Lackson Kasonka; Suzanne Filteau
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2011-09-08
Journal Detail:
Title:  The British journal of nutrition     Volume:  107     ISSN:  1475-2662     ISO Abbreviation:  Br. J. Nutr.     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-22     Completed Date:  2012-04-16     Revised Date:  2013-09-20    
Medline Journal Info:
Nlm Unique ID:  0372547     Medline TA:  Br J Nutr     Country:  England    
Other Details:
Languages:  eng     Pagination:  893-902     Citation Subset:  IM    
London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
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MeSH Terms
Anemia / complications
C-Reactive Protein / analysis*
Cohort Studies
Food, Fortified* / analysis
HIV Seropositivity / congenital,  immunology,  physiopathology*
Infant Food* / analysis
Intestinal Absorption*
Intestines / immunology,  physiopathology
Lactulose / metabolism,  urine
Lost to Follow-Up
Malabsorption Syndromes / complications,  diet therapy*,  etiology,  physiopathology
Mannitol / metabolism,  urine
Micronutrients / therapeutic use*
Sex Characteristics
Grant Support
G0700837//Medical Research Council
Reg. No./Substance:
0/Micronutrients; 4618-18-2/Lactulose; 69-65-8/Mannitol; 9007-41-4/C-Reactive Protein

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