Calcium, magnesium, phosphorus and vitamin D fortification of complementary foods

Effect of Dietary Supplementation with Calcium, Phosphorus and Vitamin D3 on Growth Performance, Nutrient Digestibility, and Serum Biochemical Parameters of Growing Blue Foxes

Based on the randomized design, a 3 × 3 factorial experiment was designed to examine the effects of dietary calcium (Ca), phosphorus (P), and vitamin D3 (VD3) supplemental levels with a fixed 1.5/1 ratio of Ca to P on the growth performance, nutrient digestibility, and serum biochemical indices blue foxes’ growth. In total, 135 male blue foxes with the age of 60 days were randomly divided into 9 groups each with 15 blue foxes. The blue foxes belonging to the nine treatment groups were fed Ca supplementation (0%, 0.4%, or 0.8%) and VD3 supplementation (1000, 2000, or 4000 IU/kg DM). The base diet contained 0.8% Ca and 327 IU/kg VD3. The dosage of VD3 in blue foxes showed a significant impact on their growth performance (p < 0.05). The Ca dosage had a linear effect on the digestibility of the CP and carbohydrates (CHO) (p < 0.05). In conclusion, the results indicated that the Ca and VD3 doses showed promising effects on growth performance and nutrient digestibility in growing blue foxes and could reduce fecal N and P via improvement in protein and P utilization.

Macrominerals and Trace Minerals in Commercial Infant Formulas Marketed in Brazil: Compliance With Established Minimum and Maximum Requirements, Label Statements, and Estimated Daily Intake

Infant formulas are the main nutritional source for infants when breastfeeding is not possible or recommended. The daily need for specific nutrients, such as essential minerals, in early stages of a child's life is high because of rapid infant growth and development, which impose metabolic flux increases on these pathways to support growth, physical activity, and defense against infections. In this context, this research aimed to determine macromineral and trace mineral contents in starting (phase 1) and follow-up (phase 2) infant formulas marketed in Brazil (n = 30) by inductively coupled plasma-mass spectrometry, calculate estimated daily intakes, and compare them to reference values regarding adequate intake and tolerable upper intake levels. The highest concentrations of macrominerals were observed in Ca, K, P, and Na, and trace minerals in Fe, Zn, Mn, and Cu. Certain homogeneity only to trace mineral contents was observed when analyzing inter-batch values from same manufacturers. In general, all phase 1 and phase 2 infant formula brands and batches met or exceeded Fe, Zn, Cu, Mo, and Se contents when compared to maximum limits established by Codex Alimentarius. In addition, Zn contents in eight phase 1 and in four phase 2 infant formulas were above the contents established by the tolerable upper intake level for children aged 0–6 and/or 7–12 months, respectively. These findings highlight the need to expand regular infant formula inspection concerning nutritional quality, as some composition aspects of these foods must be improved to follow international guidelines, since ideal requirements for infant formula composition, quality, and safety interfere in child development and adult health.

Influence of magnesium gluconate salt addition on mixing, pasting and fermentation properties of dough

The effect of magnesium ions from gluconate salt at the level of 100, 150 and 200 mg/100g addition on empirical dough rheological properties from the 550 wheat flour type was studied. Dough rheological properties during mixing (dough development time, dough stability, degree of softening), α amylase activity and gelatinization temperature were analyzed by using a Falling Number and Amylograph. During fermentation were analyzed the maximum height of gaseous production, total CO2 volume production, volume of the gas retained in the dough at the end of the test and the retention coefficient by using a Rheofermentograph device. By magnesium gluconate (Mg) salt addittion dough become more strength by an increase of stability and a decrease of the degree of softening. With Mg addittion wheat flour dough volumes were affected. Compared to the control sample, the dough volume decreased with the increased level of Mg. From the point of view of the α amylase activity, it decreases with the increase level of Mg whereas the gelatinization temperature increases.

Highly bioavailable nanocalcium from oyster shell for preventing osteoporosis in rats

Oyster shell is one of the foremost natural sources of calcium and is used as an alternative treatment for osteoporosis. In this study, we demonstrated that zinc-activated nanopowdered oyster shell (Zn-NPOS) effectively reduced bone loss compared with powdered oyster shell (POS) in an ovariectomized rat (OVX) model. As a result of nanosizing, the solubility and bioavailability of the oyster shell were greatly improved, and its effectiveness was further enhanced by zinc activation. Bone analysis indicated greater recovery from ovariectomy-induced bone loss following Zn-NPOS treatment. Moreover, Zn-NPOS treatment resulted in higher bone strength and superior trabecular architecture compared with NPOS and POS treatments. Furthermore, Zn-NPOS showed greater efficiency in increasing bone formation and reducing bone resorption markers. Therefore, nanosizing with zinc activation could be a viable strategy for improving the efficiency of oyster shells used for osteoporosis prevention.

The SHINE Trial Infant Feeding Intervention: Pilot Study of Effects on Maternal Learning and Infant Diet Quality in Rural Zimbabwe

The Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial is designed to measure the independent and combined effects of improved water, sanitation, and hygiene and improved infant feeding on child stunting and anemia in Zimbabwe. We developed and pilot-tested the infant feeding intervention delivered by 9 village health workers to 19 mothers of infants aged 7–12 months. Between September 2010 and January 2011, maternal knowledge was assessed using mixed methods, and infant nutrient intakes were assessed by 24-hour recall. We observed positive shifts in mothers' knowledge. At baseline, 63% of infants met their energy requirement and most did not receive enough folate, zinc, or calcium; none met their iron requirement. Postintervention, all infants received sufficient fat and vitamin A, and most consumed enough daily energy (79%), protein (95%), calcium (89%), zinc (89%), folate (68%), and iron (68%). The SHINE trial infant feeding intervention led to significant short-term improvements in maternal learning and infant nutrient intakes.

Calcium to phosphorus ratio, essential elements and vitamin D content of infant foods in the UK: Possible implications for bone health

Adequate intake of calcium and phosphorus in the appropriate ratio of 1-2:1 (Ca:P), in addition to magnesium and vitamin D, is vital for bone health and development of infants. In this feasibility study, the ratio of Ca:P in conjunction with vitamin D and other essential elements (Cu, Fe, K, Mg, Na, and Zn) in a range of commercial infant food products in the UK was investigated. The elemental analysis was carried out using inductively coupled plasma optical emission spectrometry, and vitamin D levels were determined using an enzyme-linked immunosorbent assay. The quantitative data were further evaluated, based on a standardised menu, to measure the total daily intake of an infant aged 7-12 months against the Reference Nutrient Intake. The results from the study show that the Ca:P ratio of the infant's total dietary intake was within the recommended range at 1.49:1. However, the level of intake for each of the nutrients analyzed, with the exception of sodium, was found to be above the Reference Nutrient Intake, which warrants further investigation in relation to both micronutrient interactions and in situations where the intake of fortified infant formula milk is compromised. Finally, as the study is the first to include consumption of infant snack products, the level of total calorie intake was also calculated in order to assess the total daily estimated energy intake; the results indicate that energy intakes exceed recommendations by 42%, which may have implications for obesity.

A comprehensive linear programming tool to optimize formulations of ready-to-use therapeutic foods: an application to Ethiopia

BACKGROUND

Ready-to-use therapeutic food (RUTF) is the standard of care for children suffering from noncomplicated severe acute malnutrition (SAM).

OBJECTIVE

The objective was to develop a comprehensive linear programming (LP) tool to create novel RUTF formulations for Ethiopia.

DESIGN

A systematic approach that surveyed international and national crop and animal food databases was used to create a global and local candidate ingredient database. The database included information about each ingredient regarding nutrient composition, ingredient category, regional availability, and food safety, processing, and price. An LP tool was then designed to compose novel RUTF formulations. For the example case of Ethiopia, the objective was to minimize the ingredient cost of RUTF; the decision variables were ingredient weights and the extent of use of locally available ingredients, and the constraints were nutritional and product-quality related.

RESULTS

Of the new RUTF formulations found by the LP tool for Ethiopia, 32 were predicted to be feasible for creating a paste, and these were prepared in the laboratory. Palatable final formulations contained a variety of ingredients, including fish, different dairy powders, and various seeds, grains, and legumes. Nearly all of the macronutrient values calculated by the LP tool differed by <10% from results produced by laboratory analyses, but the LP tool consistently underestimated total energy.

CONCLUSIONS

The LP tool can be used to develop new RUTF formulations that make more use of locally available ingredients. This tool has the potential to lead to production of a variety of low-cost RUTF formulations that meet international standards and thereby potentially allow more children to be treated for SAM.

Establishing desirable fortificant levels for calcium, iron and zinc in foods for infant and young child feeding: examples from three Asian countries

We used the World Health Organization's recommended procedures to establish desirable fortificant levels for three problem micronutrients in children's diets, based on dietary data collected earlier from Filipino (n = 1374; 6-36 months), Mongolian (n = 179; 12-36 months) and Cambodian (n = 177; 12-36 months) children. Prevalence of inadequate and excessive intakes of calcium and zinc (via cut-point method) and iron (via full-probability approach) was assessed after adjusting usual intake distributions with pc-side using internal or external within-person variances from Filipino (calcium and iron) and US National Health And Nutrition Examination Survey III (zinc) national surveys. Fortificant levels were determined by repositioning usual intake distributions so that the 2.5th percentile of the targeted populations equalled the estimated average requirement (calcium, zinc) or so that full-probability prevalence was no larger than 2.5% (iron). Prevalence of inadequate intakes was ≥70% for calcium and iron, except Filipino infants (30% for Ca) and Cambodian toddlers (41% for Fe); but <1% for zinc for toddlers in Mongolia and 20% in Cambodia. Prevalence of excessive intakes was <1% for zinc, calcium and iron, except for Mongolian toddlers (11% for Zn). Desirable fortificant levels, although apparently negligible for zinc, were 530-783 mg for calcium and 10.8-22.8 mg for iron (per 100 g). Fortificant levels can be estimated from 24-h recalls, preferably by applying internal within-person variances. Fortification with calcium and iron was necessary, but seemingly not for zinc, despite a high prevalence of low serum zinc, suggesting the need for better defined cut-offs for population risk of zinc deficiency based on dietary zinc intake and/or serum zinc.

Multi-micronutrient-fortified biscuits decreased the prevalence of anaemia and improved iron status, whereas weekly iron supplementation only improved iron status in Vietnamese school children

In Vietnam, nutrition interventions do not target school children despite a high prevalence of micronutrient deficiencies. The present randomised, placebo-controlled study evaluated the impact of providing school children (n 403) with daily multiple micronutrient-fortified biscuits (FB) or a weekly Fe supplement (SUP) on anaemia and Fe deficiency. Micronutrient status was assessed by concentrations of Hb, and plasma ferritin (PF), transferrin receptor (TfR), Zn and retinol. After 6 months of intervention, children receiving FB or SUP had a significantly better Fe status when compared with the control children (C), indicated by higher PF (FB: geometric mean 36·9 (95% CI 28·0, 55·4) μg/l; SUP: geometric mean 46·0 (95% CI 33·0, 71·7) μg/l; C: geometric mean 34·4 (95% CI 15·2, 51·2) μg/l; P < 0·001) and lower TfR concentrations (FB: geometric mean 5·7 (95% CI 4·8, 6·52) mg/l; SUP: geometric mean 5·5 (95% CI 4·9, 6·2) mg/l; C: geometric mean 5·9 (95% CI 5·1, 7·1) mg/l; P = 0·007). Consequently, body Fe was higher in children receiving FB (mean 5·6 (sd 2·2) mg/kg body weight) and SUP (mean 6·1 (sd 2·5) mg/kg body weight) compared with the C group (mean 4·2 (sd 3·3) mg/kg body weight, P < 0·001). However, anaemia prevalence was significantly lower only in the FB group (1·0%) compared with the C group (10·4%, P = 0·006), with the SUP group being intermediate (7·4%). Children receiving FB had better weight-for-height Z-scores after the intervention than children receiving the SUP (P = 0·009). Vitamin A deficiency at baseline modified the intervention effect, with higher Hb concentrations in vitamin A-deficient children receiving FB but not in those receiving the SUP. This indicates that vitamin A deficiency is implicated in the high prevalence of anaemia in Vietnamese school children, and that interventions should take other deficiencies besides Fe into account to improve Hb concentrations. Provision of biscuits fortified with multiple micronutrients is effective in reducing anaemia prevalence in school children.

Beyond food insecurity: how context can improve complementary feeding interventions

BACKGROUND

The role of context has not been elaborated with respect to current recommendations for complementary feeding interventions, apart from a gross distinction based on food security.

OBJECTIVE

Our objective was to compare two food-insecure settings in sub-Saharan Africa to determine how context (i.e., the set of local social, cultural, and physical circumstances) influences complementary feeding practices and nutrient intakes and how the results can help in the design of a suitable intervention strategy.

METHODS

We conducted formative research using 24-hour dietary recalls, household interviews, and focus group discussions with mothers of 6- to 12-month-old infants in rural Zimbabwe (n = 32) and Pemba Island, Zanzibar, Tanzania (n = 44).

RESULTS

In both settings, many infants had suboptimal nutrient intakes, poor dietary diversity, and poor hygiene. Breastfeeding practices were poor in Pemba, and the infants' diet had low energy density in Zimbabwe. Beyond food insecurity, contextual determinants of practices included inaccurate indigenous knowledge, time-consuming maternal livelihoods, family eating behaviors, local agriculture, and the local ecosystem. Both settings would require nutrition education, but it should target the broader indigenous ways of learning and family eating behaviors in order to achieve the necessary behavior change. A home-based fortificant would probably be enough for Pemban children, because the ecosystem of the island provides sufficient sources of macronutrients. However, Zimbabwean children appear to need a fortified food-based supplement to overcome the poor agricultural and economic context.

CONCLUSIONS

Assessing context was essential to intervention design. A framework to guide future formative research is proposed.

The inclusion of functional foods enriched in fibre, calcium, iodine, fat-soluble vitamins and n-3 fatty acids in a conventional diet improves the nutrient profile according to the Spanish reference intake

OBJECTIVE

The growing interest in maintaining good health status through optimal nutrition has boosted the launch of a number of functional foods on the market. The objective of the present study was to theoretically evaluate the nutritional relevance of incorporating selected enriched foods in the diet.

DESIGN

A 28 d dietary plan, designed to be balanced under the recommended macronutrients criteria, was used as a basal diet. Some conventional foods were exchanged with foods enriched in fibre, calcium, iodine, vitamins A, D, E or n-3 fatty acids.

SETTING

Nutritional composition of basal and modified diets was derived and compared to the Spanish recommended intakes (RI).

RESULTS

The basal diet covered the recommendations for fibre and calcium with mean intake of 28 g and 1241 mg, respectively. The current intake of salt, if iodized, or bread elaborated with this salt, allowed reaching the daily intake of iodine every day, with a mean supply of 216 μg/d and 278 μg/d, respectively. The deficient supply of vitamin E in the basal diet (mean = 8 mg/d) was covered by including enriched margarine and dairy products (mean = 15 mg/d). The low n-3 fatty acids intake in the basal diet (1·1 g/d) increased up to 1·9 g/d after the use of enriched margarine, butter and biscuits and soya drink instead of milk.

CONCLUSIONS

In order to improve the accomplishment of the RI iodine, vitamin E and n-3 fatty acids, interesting strategies dealing with the incorporation of enriched foods in the diet were successfully initiated.

Complementary feeding messages that target cultural barriers enhance both the use of lipid-based nutrient supplements and underlying feeding practices to improve infant diets in rural Zimbabwe

Supplementation with lipid-based nutrient supplements (LiNS) is promoted as an approach to prevent child undernutrition and growth faltering. Previous LiNS studies have not tested the effects of improving the underlying diet prior to providing LiNS. Formative research was conducted in rural Zimbabwe to develop feeding messages to improve complementary feeding with and without LiNS. Two rounds of Trials of Improved Practices were conducted with mothers of infants aged 6-12 months to assess the feasibility of improving infant diets using (1) only locally available resources and (2) locally available resources plus 20 g of LiNS as Nutributter®/day. Common feeding problems were poor dietary diversity and low energy density. Popular improved practices were to process locally available foods so that infants could swallow them and add processed local foods to enrich porridges. Consumption of beans, fruits, green leafy vegetables, and peanut/seed butters increased after counselling (P < 0.05). Intakes of energy, protein, vitamin A, folate, calcium, iron and zinc from complementary foods increased significantly after counselling with or without the provision of Nutributter (P < 0.05). Intakes of fat, folate, iron, and zinc increased only (fat) or more so (folate, iron, and zinc) with the provision of Nutributter (P < 0.05). While provision of LiNS was crucial to ensure adequate intakes of iron and zinc, educational messages that were barrier-specific and delivered directly to mothers were crucial to improving the underlying diet.

Development and biocompatibility of a novel corrodible fluoride-coated magnesium-calcium alloy with improved degradation kinetics and adequate mechanical properties for cardiovascular applications

Recently, corrodible magnesium-based alloys have been introduced for use as cardiovascular stents and orthopedic implants. However, rapid corrosion rates have raised questions about their biocompatibility. Therefore, we developed a binary fluoride-coated magnesium-calcium alloy with improved degradation kinetics. Biocompatibility of the alloys was evaluated with metabolic assays (colorimetric WST-1 test). Furthermore, five different probes of magnesium-calcium alloys (MgCa 0.4, 0.6, 0.8, 1.2, and 2.0 wt %) were cocultivated with human smooth muscle cells and endothelial cells. To investigate the decomposition kinetics in a physiological environment the alloys were used untreated and fluoride coated (MgF(2)). Mg and Ca decreased the metabolic activity in vascular cells dose-dependently, with cytotoxic effects only at unphysiological concentrations. Uncoated magnesium alloys showed signs of decomposition after a short incubation time of 24 h in contrast to MgF(2) coated alloys. After 10 days smooth muscle and endothelial cells around the alloys were still alive, whereas colonization of the surfaces was only observed for smooth muscle cells. The fluoride-coated MgCa alloys exhibited good results concerning mechanical properties, degradation kinetics, and biocompatibility in vitro. We conclude that a binary fluoride magnesium-calcium alloy is a promising candidate for the production of cardiovascular stents.

Does a higher ratio of serum calcium to magnesium increase the risk for postmenopausal breast cancer?

Breast cancer is the most commonly diagnosed cancer among United States (US) women. Established risk factors explain only about 13% of breast cancer incidence among women in the US. Thus, the cause of most cases of breast cancer remains unknown. In postmenopausal women, serum calcium (Ca) and serum magnesium (Mg) play an important role in skeletal health, cell proliferation and cancer. Mg is essential for DNA duplication and repair and Mg deficiency favors DNA mutations leading to carcinogenesis. Dietary intake of Mg in the US is less than the recommended amount, and the deficit is more pronounced in older individuals where gastrointestinal and renal mechanisms for Mg conservation are not as efficient. Furthermore, healthy postmenopausal women are frequently recommended to take supplemental Ca, but not Mg and vitamin D to maintain bone and overall health. Most women with hormone sensitive breast cancer are recommended to take aromatase inhibitors, which causes bone loss and thus are generally prescribed Ca and vitamin D, but not Mg. Although the association between serum Ca and breast cancer risk remains controversial, we hypothesize that this may be because Mg levels have not been accounted for. Mg level directly influences transient receptor potential melastatin 7 (TRPM7) related Ca influx, calcium-adenosine triphosphatase (Ca-ATP) levels, and cell proliferation, and thereby could lead to cancer. Thus a high serum Ca/Mg ratio is more appropriate and alterations in this ratio could lead to increased development of new and recurrent breast cancer.

Changing the zinc:iron ratio in a cereal-based nutritional supplement has no effect on percent absorption of iron and zinc in Sri Lankan children

The Thriposha programme is a community-level nutrition intervention in Sri Lanka that provides a combination of energy, protein and micronutrients as a ‘ready-to-eat’ cereal-based food. We measured the bioavailability of Fe and Zn from Thriposha formula at two different molar ratios of Zn:Fe in order to determine the effect on Fe and Zn absorption. Children 4–7 years (n 53) were given a meal prepared with 50 g Thriposha containing 1·5 mg Zn as zinc sulphate and either 9 mg (high Fe concentration (HiFe)) or 4·5 mg (low Fe concentration (LoFe)) Fe as ferrous fumarate. Zn and Fe percent absorption were measured using stable isotopes by tracer:tracee ratio and by incorporation of erythrocytes, respectively. Percent Fe absorption from the two meals was similar (6·6 % (4·8) v. 4·8 % (2·6); P = 0·15), but total Fe absorption was significantly higher from the HiFe meal (0·59 (0·43) mg) than the LoFe meal (0·20 (0·12) mg; P = 0·01). There was no significant difference between the two groups in Zn absorption (10·7 % (0·9) v. 8·8 % (1·4), P = 0·13, respectively). Decreasing the amount of Fe in Thriposha did not cause a significant change in the percent absorption of Fe and Zn, but significantly lowered the total amount of absorbed Fe. These results demonstrate the utility of maintaining a higher Fe content in this supplement. Further studies to increase Zn content are warranted while maintaining a HiFe.

Complementary feeding and growth of infant and young child in China

OBJECTIVE

To understand the status and problems of complementary feeding and to explore the strategy of improving complementary feeding for infants and young children in China.

METHOD

Data of urban and rural children were selected from the China Food and Nutrition Surveillance System (CFNSS) dataset to describe the status of complementary feeding and growth of children. Logistic Regression was used to analyze the relationship between child growth and the complementary feeding pattern.

RESULTS

Applications of foods that come from animals, vegetable/fruit and dairy product in complementary feeding were negatively correlated to the prevalence of stunting and underweight. Attributable risk (AR) of no application of vegetable/fruit in complementary feeding to stunting was 30.2%, to underweight 35.4%; AR of no application of foods from animal products in complementary feeding to stunting was 28.2%, to underweight 11.7%; and the AR of no application of diary products in complementary feeding to stunting was 27.4%, to underweight was 15.9%.

CONCLUSION

Complementary feeding contributed to the improvement of infants and young children growth in China. There is an urgent need to develop health education in the public on infants and young children complementary feeding, in the mean time, it is pressing to pay attention and take actions to develop and promote affordable, acceptable, and accessible fortified complementary food in rural areas of China.

Magnesium, zinc and copper status in osteoporotic, osteopenic and normal post-menopausal women

Serum concentrations of magnesium, zinc and copper were measured in postmenopausal women with osteoporosis (n = 40), osteopenia (n = 40) or normal bone mineral density (n = 40) as classified on the basis of the T-score of the femur neck and dual energy X-ray absorptiometry results. Mean concentrations of magnesium and zinc were significantly lower in osteoporotic women than in both osteopenic women and normal women. In addition, magnesium and zinc concentrations in osteopenic women were significantly lower than in normal women. There were no statistically significant differences observed between the osteopenic, osteoporotic and control groups with respect to copper levels. The clinical significance of these changes needs further elucidation, but trace element supplementation, especially with magnesium and zinc and perhaps copper, may have beneficial effects on bone density.

Beneficial Effect of Oral Bisphosphonate Treatment on Bone Loss Induced by Chronic Administration of Furosemide without Alteration of Its Administration and Urinary Calcium Loss

Bisphosphonate is widely used to treat patients with primary and secondary osteoporosis. The chronic administration of furosemide is considered a risk factor for osteoporosis mainly due to the increased urinary excretion of calcium, leading to a long-term negative balance of calcium. We describe two patients with mild heart failure who took furosemide for more than 5 yr and developed hyperparathyroidism and lumbago associated with low bone mineral density. Their serum levels of intact parathyroid hormone and bone mineral density (BMD) of the lumbar spine (L2-L4) were 180.8 and 144.3 pg/ml, and 71% and 80% of the mean of healthy women, respectively. The oral administration of alendronate or risedronate was effective for lumbago and improved BMD, although the urinary excretion of calcium and hyperparathyroidism were not changed. For the medical treatment of lumbago and decreased bone mass secondary to the long-term administration of furosemide, bisphosphonate is proposed when the dose of furosemide cannot be reduced. However, it may be important to give sufficient calcium and vitamin D to patients to improve secondary hyperparathyroidism.

Effects of 1,25-dihydroxicolecalciferol and dietary calcium–phosphate on distribution of lead to tissues during growth

The susceptibility to the toxic effects of lead (Pb) is mainly mediated by age and nutritional and hormonal status, and children are among the most vulnerable to them. During growth, an increase in calcium, phosphate and vitamin D in diet is recommended to enhance calcium and phosphate intestinal absorption and bone deposit. Calcium and phosphate reduce lead intestinal absorption, and 1,25-dihydroxicolecalciferol (1,25(OH)2D3) (active metabolite of vitamin D) increases both lead and calcium intestinal absorption. However, the effects of 1,25(OH)2D3 on lead bone deposit and redistribution to soft tissues are not well known. In this study, we examined the effects of calcium-phosphate diet supplementation and the administration of 1,25(OH)2D3 on Pb distribution to soft tissue and bone in growing rats exposed to Pb. Rats (21 days old) were exposed for 28 days to 100 ppm of Pb solution in drinking water. Calcium and phosphate in diet were increased from 1 to 2.5% and from 0.65 to 1.8%, respectively, and 1,25(OH)2D3 was administrated by intraperitoneal injection of 7.2 ng/kg every 7 days. Between 21 and 49 days, the body weight increased about 5 times. The results showed that high calcium-phosphate diet led to lower Pb concentration in blood and in bone, but Pb liver and kidney concentrations increased, which indicates that absorption and bone deposit redistribution of Pb decreased. On the other hand, no effect of this diet rich in calcium-phosphate in Pb concentration was observed in brain. Blood and bone Pb concentrations increased even more when the high calcium-phosphate diet included 1,25(OH)2D3. In the rats treated only with 1,25(OH)2D3, blood and bone Pb concentrations were lower. Higher concentrations of lead in the soft organs were observed also in rats treated under a high calcium-phosphate diet plus 1,25(OH)2D3 administration. The above mentioned results suggested that 1,25(OH)2D3 induces an increased absorption and redistribution of Pb, and therefore, it may enhance systemic damage in Pb-exposed growing animals.

Proposed nutrient composition for fortified complementary foods

A proposed nutrient composition for fortified processed complementary foods (FPCF) is developed based on the other papers in this publication, which consider a number of factors such as age range, daily ration size, recommended nutrient requirements, contribution of human milk to these requirements, macronutrient interactions, compound bioavailability, methods of production and overage. The proposed fortification levels are based on a daily ration size of 40 g for infants aged 6-12 mo and 60 g for children aged 12-23 mo. A desired protein-energy ratio of 6-10% is used to estimate energy from protein. The desired percentage of energy from lipid is estimated at 24% for infants aged 6-11 mo and 28% for children aged 12-23 mo, with the remaining energy to be supplied from carbohydrate. An FPCF should provide a quantity of iron sufficient to meet the Recommended Dietary Allowance in the form of dried ferrous sulfate of small particle size. Ascorbic acid, 70-140 mg for infants aged 6-11 mo and 50-100 mg for children aged 12-23 mo, will enhance iron absorption. Because of the lower bioavailability of zinc in cereal-based diets in developing countries, 4-5 mg of zinc in the form of zinc oxide is recommended. Proposed fortification levels are also provided for copper, calcium, vitamin D, magnesium, phosphorus, vitamin A, the B vitamins and iodine. To prevent micronutrient losses, it is recommended that the FPCF be precooked. The knowledge base to develop an FPCF is quite limited, and much additional research is needed before an optimal formulation can be recommended.