Iron

Recommendations for iron intake in infancy and childhood are shown in Table 8. Term infants are born with sufficient stores of iron to last until they have approximately doubled their birth weight.

Table 8 Recommendations for iron intake in infants and children (mmol/day)

Age

Sex

UK RNI

EU PRI

USA RDA

FAO/ WHO RNI

0-3 months

M + F

30

105

4-6 months

M + F

80

105

150

7-12 months

M + F

140

105

180

150

1-2 years

M + F

120

70

130

90

2 years

M

120

70

120

70

F

120

70

128

70

3 years

120

70

135

70

F

120

70

130

70

4 years

110

70

140

75

F

110

70

145

75

5 years

110

70

145

75

F

110

70

150

75

6 years

110

70

170

75

F

110

70

160

75

7 years

160

107

185

105

F

160

107

180

105

8 years

160

107

200

105

F

160

107

190

105

9-10 years

M + F

160

107

140

105

11-14 years

200

180

140

270

F

260

320-

390

140

285

15-18 years

200

230

195

225

F

260

320-

390

270

370

There is controversy over whether healthy infants have a requirement for dietary iron until the age of 4-6 months. Although most infant formulas are fortified with iron, there are some unfortified ones reflecting the uncertainty over requirements in very young infants. After the age of 4-6 months or when birth weight has doubled, iron requirements are very high. Levels of iron in breast milk are low, although bioavailability is high. Nevertheless, infants exclusively breast-fed after the age of 6 months have lower iron stores than those who receive a fortified formula or iron-containing complementary foods. Cow's milk is low in iron and the iron is poorly absorbed. Infants fed on cow's milk as a main drink younger than the age of 1 year or who consume large quantities of cow's milk after the age of 1 year are at risk of developing iron deficiency. Iron is required in early life not only for adequate growth but also because it is important in brain growth, and iron deficiency during infancy may lead to irreversible changes in mental and motor development. It is estimated that 43% of infants and children worldwide suffer from iron deficiency in infancy and childhood, most commonly between the ages of 6 and 24 months. The problem is worse in developing countries: The prevalence in Western industrialized countries is

Table 9 Recommendations for trace minerals

Nutrient

Age

UK RNI

Europe PRI

USA RDA

FAO/WHO RDI

Zinc (mg/day)

0-6 months

4.0

5.0

3.1-5.3a

6-12 months

4.0

4.0

5.0

5.6

1-3 years

5.0

4.0

3.0

5.5

4-6 years

6.5

6.0

5.0

6.5

7-10 years

7.0

7.0

5.0-8.0

7.5

11-14 years

M

9.0

9.0

8.0

12.1

F

9.0

9.0

8.0

10.3

15-18 years

M

9.5

9.0

11.0

13.1

F

7.0

7.0

9.0

10.2

Copper (mg/day)

0-6 months

0.2-0.3

0.4-0.6b

0.33-0.62

6-12 months

0.3

0.3

0.6-1.0

0.6

1-3 years

0.4

0.4

1.0-1.5

0.56

4-6 years

0.6

0.6

1.0-2.0

0.57

7-10 years

0.7

0.7

1.0-2.0

0.75

11-14 years

M

0.8

0.8

1.5-2.5

1.0

F

0.8

0.8

1.5-2.5

1.0

15-18 years

M

1.0

1.0

1.5-3.0

1.33

F

1.0

1.0

1.5-3.0

1.15

Selenium (mg/day)

0-6 months

10-13

10

6-9

6-12 months

10

8

15

12

1-3 years

15

10

20

20

4-6 years

20

15

20

24

7-10 years

30

25

30

25

11-14 years

M

45

35

40

36

F

45

35

45

30

15-18 years

M

70

45

50

40

F

60

45

50

30

Iodine (mg/day)

0-6 months

56-60

40

50

6-12 months

60

50

50

50

1-3 years

70

70

70

90

4-6 years

100

90

90

90

7-10 years

110

100

120

120

11-14 years

M

130

120

150

150

F

130

120

150

150

15-18 years

M

140

130

150

150

F

140

130

150

150

aAssuming diets of moderate bioavailability. bUSA Adequate Intake (not RDA). F, female; M, male.

approximately 10% in children younger than the age of 2 years. Immigrant groups to Western countries, particularly those of Asian origin, have a higher prevalence rate than Caucasian children. This may in part be accounted for by differences in sources of dietary iron. Absorption varies according to the composition of the diet. Recommendations from FAO/WHO take this into consideration and give reference values for four absorption levels: 5, 10, 12, and 15%, with a 3fold difference in recommendations between the lowest and highest level. Throughout the world, there is considerable variation in iron intake recommendations, part of which is due to differences in dietary composition. Most countries include two reference intakes for adolescent girls, depending on whether or not they have reached menarche.

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