A study suggests that drinking a micronutrient-fortified formula may be superior to drinking dairy in preventing iron and vitamin D deficiencies in young children.


In Western Europe, micronutrient deficiency is a leading factor in disease among young children. Among children worldwide, the most common micronutrient deficiencies are iron and vitamin D.

The brain needs adequate amounts of both iron and vitamin D in order to develop properly. In addition, vitamin D plays an important role in strengthening the immune system and in preventing cancers. Inadequate vitamin D levels can cause rickets, and low levels of iron can lead to anemia.

In Western Europe, parents are encouraged to nourish their children to meet minimum nutritional recommendations for vitamin D and for iron intake, but the intake of both nutrients is often insufficient to prevent deficiencies.  Although supplementing with vitamin D and iron has been shown to prevent deficiencies, few parents of young children comply with the recommendation to use supplements.

Previous studies have shown the benefits of fortifying milk and bread with vitamin D and with iron. The wide range in dosages and varying study parameters have made it difficult to evaluate the effects of the enriched food on vitamin D and iron levels in young children.

A recent study published in the American Journal of Clinical Nutrition examined the effect of a micronutrient-fortified formula on the vitamin D and iron status of young children in Western Europe.

The randomized, double-blind, controlled trial involved 325 healthy children between the ages of 1-3 years old from medical clinics in Germany, Netherlands, and the United Kingdom. The children were assigned to drink cow’s milk or a formula fortified with iron (1.2 mg Fe/100 ml) and vitamin D (1.7 mg vitamin D/100 ml) for 20 weeks. Blood samples were taken at the beginning and at the end of the study.  Parents kept detailed diaries about their child’s food intake, adverse effects, stool frequency, and consistency. Statistical adjustments were made for infections, sun exposure, baseline micronutrient status, and micronutrient intake. Iron deficiency was defined as serum ferritin of less than 12 mg/L, and vitamin D deficiency as 25(OH)D less than 50 nmol/L.

At the beginning of the study, 8.2% of the formula group and 5.6% of the cow milk group were iron and vitamin D deficient.  After 20 weeks, the deficiency decreased to 4.0% among the formula group, but increased to 15.3% in the cow milk group.

The fortified formula and the cow milk groups experienced dropout rates of 28% and 29%, respectively.  Parents stated poor taste as the main reason for not continuing the study. Both the fortified formula and the cow milk were supplied in powdered form.

Current European dietary recommendations suggest that children that are at least one years old drink cow milk.  According to this study, the micronutrient intake in young children drinking dairy may not be enough to prevent iron and vitamin D deficiencies.

The authors suggest that the daily use of a micronutrient-fortified formula may preserve the iron status and improve vitamin D status in young children. The long-term effects of a young child formula on brain development and overall health remain to be determined.


Written By: Lynn Kim

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