Iron intake and iron deficiency in young children

Abstract

INTRODUCTION: Iron deficiency anaemia is recognised as a common problem in young children in the UK (Department of Health, 1994), and even more in Saudi Arabia (Al-Fawaz, 1993 and Al-Hifzi, et al. 1996). However, there is a lack of studies showing how food intake affects iron status in young children in these countries. Such studies are urgently needed to develop informed prevention strategies.These studies have sought to assess iron intake in young children (8-36 months), to identify nutritional and other factors that may affect iron intake and iron status and to ascertain whether a food frequency questionnaire can be designed to identify those at risk due to their diet.METHODS: A 4-day weighed food inventory, a semi-quantitative food frequency and social questionnaire and anthropometric measurements were used.Haemoglobin (Hb ), mean corpuscular volume (MCV), serum ferritin (SF), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC) and haematocrit (Hct) were estimated in blood, Compeat-5, food analysis software was used to calculate nutrient intakes and SPSS and Excel for data analysis.STUDIES IN RIYADH, SAUDI ARABIA: 104 healthy children randomly chosen from eight different health centres have been studied either longitudinally (n=55) or cross-sectionally (n=49). The prevalence of iron deficiency anaemia was 36.3% in all children. Diet including iron intake has been compared to haematological data. Twenty four previously diagnosed iron deficient children from three hospitals were also studied.STUDIES IN EDINBURGH: 62 healthy children aged 9 and 36 months old were studied. They were those whose parents agreed to participate from a larger number chosen randomly from children registered at three health centres in Edinburgh using the Lothian Health Board list. Diet including iron intake has been compared to haematological data.ROYAL HOSPITAL FOR SICK CHILDREN (RHSC): Over a 2 months period, the prevalence of anaemia period in children whose blood samples were analysed in the Haematology Department was 28.3% in children aged between 8 months to 3 years of age. In 59 children, 45 with Hb below 11 g/dl, and 14 with normal Hb whose parents completed a semi-quantitative food frequency and social questionnaire, the iron intake and iron status was studied in detail, and the results related to the haematological parameters previously measured.CONCLUSIONS: Iron intakes less than both the Recommended Nutrient Intake (RNI) and the Lower Recommended Nutrient Intake (LRNI) have been shown to be common in the children studied in both Saudi Arabia and Edinburgh. Comparison of the haematological parameters with the iron intake enables certain definite statements to be made. Fortified breakfast cereals with iron and meat in addition to infant formula are important dietary factors which positively influence iron intake and iron status in this age group who are vulnerable to iron deficiency anaemia. These foods should be strongly recommended to parents for inclusion in the post-weaning diet of children of this age. In contrast, extended exclusive breast feeding, milk and some milk products and eggs have a negative influence on iron intake, and should be avoided as far as possible for at least the first year of life. The importance of haem iron as a component of the diet of children of the ages studied is evident from these studies. It has been shown that a food frequency questionnaire can be used to identify children at risk.