Objectives: To determine the prevalence of biochemical iron deficiency and identify factors associated with ferritin levels among 6-24-month-old urban South Island New Zealand children. Design: Cross-sectional survey conducted from May 1998 to March 1999. Setting: The cities of Christchurch, Dunedin and Invercargill. Subjects: A total of 323 randomly selected 6-24-month-old children participated (response rate 61%) of which 263 provided a blood sample. Methods: A complete blood cell count, zinc protoporphyrin, serum ferritin and C-reactive protein were measured on nonfasting venipuncture blood samples, 3-day weighed food records and general questionnaire data were collected. Results: Among children with C-reactive proteino10 mg/l (n ¼ 231), 4.3% had iron deficiency anaemia, 5.6% had iron deficiency without anaemia, and 18.6% had depleted iron stores, when a ferritin cutoff of r12 g/l was used. Age (negative), sex (girls4boys), ethnicity (Caucasian4non-Caucasian), weight-for-age percentiles (negative) and birth weight (positive) were associated with ferritin after adjusting for infection and socioeconomic status. When current consumption of iron fortified formula and 4500 ml of cows' milk per day were included, these were associated with a 22% increase and 25% decrease in ferritin, respectively (R 2 ¼ 0.28). Conclusions: The presence of suboptimal iron status (29%) among young New Zealand children is cause for concern, even though severe iron deficiency is rare, because children with marginal iron status are at risk of developing severe iron deficiency if exposed to a physiological challenge.
Objective: To investigate food sources and intakes of iron, and dietary factors associated with serum ferritin levels in 6-24-month-old children. Design: A cross-sectional survey employing proportionate cluster sampling was conducted in 1998/1999. Dietary intakes were assessed using a non-consecutive 3-day weighed food record. Serum ferritin and C-reactive protein were analysed from non-fasting venepuncture blood samples and general sociodemographic data were collected. Setting: Cities of Christchurch, Dunedin and Invercargill, New Zealand. Subjects: Randomly selected healthy 6-24-month-old non-breast-feeding children ðn ¼ 226Þ. Results: Total iron intakes (^standard deviation (SD)) among non-breast-feeding infants (,12 months old; n ¼ 42) and toddlers ($12 months old; n ¼ 184) were 8:4^2:9 mg day 21 and 5:0^2:5 mg day 21 ; respectively. Fifteen per cent of infants and 66% of toddlers were at risk of inadequate iron intakes. Main sources of dietary iron were infant formula (60%) for infants and cereals (31%) for toddlers. Meat contributed on average 2% and 10% of dietary iron in the infant and toddler diets, respectively. Dietary factors positively associated with serum ferritin were intakes of iron and vitamin C, whereas intakes of calcium and dietary fibre were negatively associated. For each 1% increase in percentage of energy from iron-fortified formula concomitant with a 1% decrease from dairy products, there was a 4.2% increased odds of replete iron stores (ferritin $20 mg l 21 ). Conclusions: Toddlers were at higher risk of sub-optimal iron intakes than infants. Results suggest that a diet high in bioavailable iron is important for optimising the iron stores of young children in New Zealand.
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