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Iron Deficiency in Early Life: Challenges and Progress

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Iron Deficiency in Early Life: Challenges and Progress Report of the 2004 International nutritional Anemia consultative group symposium iron deficiency in early life: challenges and progress lima, peru 18 november 2004 International Nutritional Anemia Consultative Group • INACG The ILSI Research Foundation’s Human Nutrition Institute serves as the INACG Secretariat. Report of the 2004 International nutritional Anemia consultative group symposium iron deficiency in early life: challenges and progress lima, peru 18 november 2004 Rapporteurs: Ms. Hilary Creed-Kanashiro Ms. Boitshepo Giyose Photo Credits. Front cover and title page: The majestic flight of an Andean Condor, Colca Canyon, Arequipa. Heinz Plenge/PromPeru Flamingoes in Paracas Natural Reserve, a paradise for wildlife, Ica. Heinz Plenge/PromPeru Llanganuco Lake at 3,800 masl is part of the Northern White Range, where mountaineering is practiced. Carlos Sala/PromPeru Cheerful looms ancestrally used by women of the community of Llachon, Puno. Domingo Giribaldi/ PromPeru There are around 3,000 popular festivities in Peru the whole year round, each one with its own characteristics. Alejandro Balaguer/PromPeru Back cover: Offering to the Apus or mountain spirits, Cusco. Mylene D’Auriol/PromPeru Marinera is danced all over Peru, albeit with variations. Domingo Giribaldi/PromPeru The llamas, Andean camelids domesticated around 7,000 A.D., can be found on the whole Andean range. Alejandro Balaguer/PromPeru Colonial church of La Compañia, built by the Jesuits in 1576, Cusco. Carlos Sala/PromPeru Religious festivity in Paucartambo, Cusco. Mylene D’Auriol/PromPeru Additional copies of this and other INACG publications are available free of charge to developing countries and for US $3.50 to developed countries. Copies can be ordered from the INACG Secretariat: INACG Secretariat Tel: 202-659-9024 ILSI Human Nutrition Institute Fax: 202-659-3617 One Thomas Circle, NW, Ninth Floor E-mail: [email protected] Washington, DC 20005-5802, USA Internet: http://inacg.ilsi.org This report is the summary of the presentations and discussions that took place at the INACG Symposium and does not necessarily reflect the scientific recommendations or views of INACG, the U.S. Agency for International Development, or the International Life Sciences Institute. The publication of this report is made possible by support from Micronutrient Global Leadership, a project of the Office of Health, Infectious Diseases and Nutrition, Global Health Bureau, U.S. Agency for International Development, under Cooperative Agreement Number HRN-A-00-98-00027-00, and by support from Task Force SIGHT AND LIFE. September 2005 Printed in the United States of America ISBN 1-57881-193-7 Contents Symposium Organizers _________________________________________ 1 About INACG _________________________________________________ 2 Publications List ________________________________________________ 2 Acknowledgments ______________________________________________ 3 Program _______________________________________________________ 4 Report on Presentations ________________________________________ 13 Welcome _________________________________________________ 13 Keynote Address: Maternal Nutritional Status, Fetal Growth, and Iron Status during Infancy _____________________________ 13 Advances in Assessment ___________________________________ 16 Supplementation Trials ____________________________________ 19 Child Development _______________________________________ 27 Program Implementation __________________________________ 35 Closing Remarks _________________________________________ 45 References _______________________________________________ 46 Abstracts _____________________________________________________ 49 SYMPOSIUM ORGANIZERS Contributors to the INACG Symposium INACG Steering Committee The INACG Symposium was co-hosted Rosanna Agble, BSc by INACG and the Local Organizing Committee of the Peruvian Ministry Frances R. Davidson, PhD, of Health and representatives of United INACG Secretary Nations technical agencies, the private Lena Davidsson, DrMedSc, sector, multilateral agencies, and INACG Steering Committee Chair nongovernmental organizations in Peru, with funding from the Government of Peru. Sean Lynch, MD The Office of Health, Infectious Diseases H.P.S. Sachdev, MD and Nutrition, Global Health Bureau, U.S. Agency for International Development, and Rebecca J. Stoltzfus, PhD the Peruvian Ministry of Health assumed major responsibility for organizing the Local Organizing Committee in Peru symposium. Special thanks are given to Task Force SIGHT AND LIFE for their Luis Enrique Podestá, Chair contributions to the publishing of this Walter Vilchez, Secretary report. The INACG Secretariat and the Local INACG Secretariat Staff Organizing Committee gratefully acknowledge the additional contributions of Carolyn Bethea the following organizations: Diane Dalisera, CMP The Micronutrient Initiative Suzanne S. Harris, PhD Unilever Health Institute Anita Johnson Nestlé S.A. Melinda Thomas H.J. Heinz Company Veronica I. Triana, MPH Additional Assistance: Laurie Lindsay, RD, LD, Consultant Maria Inez Sánchez-Griñan,MSc, Consultant 2004 INACG SYMPOSIUM 1 About INACG INACG is dedicated to reducing the prevalence of iron deficiency anemia and other nutritionally preventable anemias worldwide. It sponsors international meetings and scientific reviews and convenes task forces to analyze issues related to etiology, treatment, and prevention of nutritional anemias. Examination of these issues is important to the establishment of public policy and action programs. INACG Publications Efficacy and Effectiveness of Interventions to Control Iron Deficiency and Iron Deficiency Anemia (2004) (Available in English and French) The Role of Communication in Comprehensive Anemia Control: A Framework for Planning and Implementing a Strategic Communication Plan (2003) Adjusting Hemoglobin Values in Program Surveys (2002) Technical Brief on Iron Compounds for Fortification of Staple Foods (2002) Anemia, Iron Deficiency, and Iron Deficiency Anemia (2002) (Available in English, French, Spanish, and Portuguese) Iron Deficiency Anemia: Reexamining the Nature and Magnitude of the Public Health Problem (J Nutr Suppl 2001) The Effects of Iron Deficiency and Anemia on Mental and Motor Performance, Educational Achievement, and Behavior in Children - An Annotated Bibliography (1998) Iron/Multi-Micronutrient Supplements for Young Children (1997) The Oxford Brief - Child Development and Iron Deficiency (1997) Iron EDTA for Food Fortification (Fact Sheet) (1997) Iron EDTA for Food Fortification (1993) Combating Iron Deficiency Anemia through Food Fortification Technology: An Action Plan (1992) (Available in English, French, and Spanish) Guidelines for the Control of Maternal Nutritional Anemia (1989) (Available in English, French, and Spanish) La Lutte Contre la Carence en Fer: Etude de Cas Réalisé au Chili (1987) Prevención de la Deficiencia de Hierro: La Experiencia de Chile (1987) Measurements of Iron Status (1985) Design and Analysis of Iron Supplementation Trials (1984) Iron Deficiency in Women (1981) (Available in English, French, and Spanish) Iron Deficiency and Work Performance (1981) Iron Deficiency in Infancy and Childhood (1979) (Available in English, French, and Spanish) Guidelines for the Eradication of Iron Deficiency Anemia (1977) 2 2004 INACG SYMPOSIUM Acknowledgments The success of the INACG Symposium is The speakers contributed immeasurably due to the efforts of many individuals and to the symposium’s success. The INACG the sponsoring organizations. The primary Secretariat is grateful to them for the support for the INACG Symposium presentations and summary papers they was provided by the U.S. Agency for contributed to this report. The individuals International Development through who presented scientific and program the Micronutrient Global Leadership posters during the INACG Symposium cooperative agreement. The Peruvian contributed greatly to breadth and depth of Ministry of Health, through the Local the meeting discussions and facilitated the Organizing Committee, collaborated in the expansion of networks devoted to reducing organization of the symposium and helped iron deficiency anemia. to generate active participation from Peru. Ms. Hilary Creed-Kanashiro and Ms. The INACG Secretariat gratefully Boitshepo (“Bibi”) Giyose served ably acknowledges additional contributions from as the rapporteurs for the meeting, The Micronutrient Initiative, Unilever generously offering their skills to provide a Health Institute, Nestlé S.A., and H.J. comprehensive summary of the symposium Heinz Company. Special thanks are given for this publication. to Task Force SIGHT AND LIFE for their contributions to the symposium through Finally, the meeting attendees were the travel grants, simultaneous translation at true success of this event. Hopefully, they the symposium, and the publication of this gained new insights and information that report. will help foster vital iron deficiency and anemia control programs in their own The INACG Steering Committee, countries. composed of Mrs. Rosanna Agble; Dr. Frances R. Davidson, INACG Secretary; The Micronutrient Global Leadership Dr. Lena Davidsson, INACG Steering project is a cooperative agreement of the Committee Chair; Dr. Sean Lynch; Dr. Office of Health, Infectious Diseases and H.P.S. Sachdev; and Dr. Rebecca Stoltzfus, Nutrition, Global Health Bureau, U.S. gave generously of their time and expertise Agency for International Development with in planning the symposium program. the International
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