Iron content and fortification status of a sample of local and imported pre‐packaged baby foods available in Hong Kong

Abstract

Aim To examine the iron content and fortification status of pre‐packaged baby foods in Hong Kong. Methods Data of 472 pre‐packaged baby foods were collected from various distribution points in Hong Kong in July‐August 2018. Item descriptors, iron content, ingredients list, country of origin, organic status and iron‐related guidelines displayed on the package were recorded. Between group differences in the median (IQR) iron content were compared by the Mann‐Whitney U test; and by Pearson's χ2 test for the proportion of pre‐packaged baby foods that were iron‐fortified or displaying iron‐related guidelines, stratified by country of origin and organic status where appropriate. Results Only 79 out of 472 pre‐packaged baby foods displayed iron content on their labels, and their median iron content was 6.80 (1.3‐20.0) mg/100 g. Of these, cereals [14.0 (12.0‐32.0)] and snacks and finger foods [12.6 (1.4‐21.3)] had significantly higher iron content than other pre‐packaged baby foods. Less than 20% of pre‐packaged baby foods in Hong Kong were iron‐fortified. North American pre‐packaged baby foods (49.2%) were more likely than those from other places of origin (all P < .001) to be iron‐fortified, and marginally more non‐organic pre‐packaged baby foods were iron‐fortified products than organic (23.6% vs 16.2%, P = .043). Only 17.2% of products included iron‐related guidelines/cautions on their packaging. Conclusions The majority of pre‐packaged baby foods available in Hong Kong lacked iron fortification, and did not display iron‐related guidelines/cautions or their iron content on the package. Given the inconsistent fortification practices by manufacturers, labelling of iron content should be mandatory to assist parents in identifying iron‐rich pre‐packaged baby foods.

Effect of using commercial pre-packaged baby foods on the Fe intake of 7–8 months old infants

“…From a previously audited representative sample of 472 PBF (8) , 73 PBF were randomly selected using the 'RANDBETWEEN(1472)' function in MS Excel. They were then purchased from local brick and mortar stores in Hong Kong and analysed for their Fe content.…”

“…They were then purchased from local brick and mortar stores in Hong Kong and analysed for their Fe content. The PBF were categorised according to Dreyfuss et al (10) , with slight modifications to accommodate the types of PBF available in Hong Kong, as previously described (8) . In brief, the PBF were classified as cereals (n 8), snacks or finger foods (n 23; including nine biscuits or cookies or rolls or balls or rusks, two puffs or hoops, four crackers or wafers or rice cakes, two yoghurt or coconut milk, four juice or tea, one soft candy or candy, and one oat bar), sweet purees (n 24), savoury purees (n 16) and others (n 2; including one plain noodles and one non-pureed-form mixed meal).…”

“…While it is theoretically possible to provide adequate Fe to the infants by using foods or PBF naturally rich in Fe, in practice, the identification of Fe-rich foods may be difficult for parents, as the display of Fe content on the nutrition label of infant foods is not mandatory in Hong Kong, unless it is Fe-fortified (7) . Our previous audit of PBF available in Hong Kong showed that only <20 % of PBF were Fe-fortified, including approximately half of the cereals, which were a major source of Fe for infants first introduced to solids (8) . Frequent usage of PBF as complementary foods may therefore put infants at risk of inadequate Fe intake.…”

How prepared is the dietetic profession for today's wicked childhood nutrition problems?

“…This issue highlights the many challenges faced by dietitians and other public health professionals internationally to achieve healthy eating behaviours amidst a changing, unhealthy, food supply. Onifade et al, Leonard et al and Cheung et al remind us of the importance of optimising dietary intakes of infants 18‐20 . Their findings illustrate the influence of parental role modelling and consumption patterns on infant dietary exposure and the insidious availability of ultra‐processed foods marketed for the infant arena.…”

“…The replacement of breastfeeding with formula feeding, and the emergence of pre‐packaged baby foods, was a focus of Cheung et al who reviewed 472 pre‐packaged baby foods available in Hong Kong. They revealed a low proportion of iron‐fortified products and inconsistent practices across manufacturers, and call for mandatory labelling for easy identification of iron‐rich products 20 …”