Distribution of Anemia Associated with Micronutrient Deficiencies Other than Iron in a Probabilistic Sample of Mexican Children

Abstract

Background: This investigation aims to explore the association among anemia and vitamins A, C, and folate deficiencies in a probabilistic sample of Mexican children. Methods: Data on hemoglobin, serum vitamins A and C and folate concentrations and percent transferrin saturation (PTS) in children 0.5–11 years (n = 1,770) were extracted from the database of the probabilistic Mexican National Nutrition Survey 1999 (NNS-99). Results: Overall, 16.6% of children were anemic. Iron deficiency children with or without anemia had more frequent low serum retinol (40.6 vs. 16% and 27.7 vs. 11.9%, p < 0.05, respectively) and lower hemoglobin folate (11.5 vs. 22%, p < 0.05) than their non-iron deficiency counterparts. Mean concentrations of serum iron (p < 0.01), folate (p < 0.001) and retinol (p < 0.0001), but not ascorbic acid (p < 0.6), were significantly lower in anemic than in nonanemic children. In a linear regression model, 15% of hemoglobin variation in children was explained by retinol, folate and PTS, but not vitamin C (p <0.0001). Conclusion: Anemia was mostly associated with iron deficiency and with a lesser proportion of folate and vitamin A deficiencies. Vitamin A deficiency might be overestimated since iron deficiency may lower serum retinol concentrations. Interventions aimed to reduce anemia in this population must consider interactions between those micronutrients in designing strategies.

Hemoglobin concentration is inversely associated with erythrocyte folate concentrations in Colombian school-age children, especially among children with low vitamin B12 status

“…fortification, 14% of children had low erythrocyte folate concentrations and anemic children had significantly lower folate concentrations compared with non-anemic children (Villalpando et al, 2006). The mechanisms to explain an inverse relation between folate and hemoglobin concentrations in the absence of folate deficiency, particularly in subjects with inadequate vitamin B12 status, are unclear.…”

“…The consequences of anemia include poor school performance, reduced work capacity, increased susceptibility to infections, and stunted growth (Stoltzfus, 2001). While iron deficiency is the cause of approximately one-half of all cases of anemia (Zimmermann and Hurrell, 2007), deficiencies of other micronutrients, including folate, vitamin B12, and vitamin A, have also been identified as causes of low hemoglobin concentrations and anemia (Majia et al, 1977;Villalpando et al, 2006;Jones et al, 2007) through diverse mechanisms. Folate is a carbon donor for purine and pyrimidine synthesis, which are needed for the rapidly developing erythroid cells (Scott, 1999).…”

Relação entre deficiência de ferro e anemia em crianças de até 4 anos de idade

“…Studies conducted with children in countries other than Brazil exhibited results similar to those presented in this article, with low serum retinol and folic acid levels being observed among children with anemia. 11,12 Research conducted in Northeast Brazil with pregnant women In Brazil, a recent nationwide study showed low frequency of sickle cell anemia in the population studied. 3 It is also noteworthy that microcytosis is not present in sickle cell anemia, except in cases of co-inheritance of thalassemia.…”

Iron availability in the presence of β-carotene in different mixtures

“…Studies (LAYRISSe et al, 1997;GARCíA-CASAL, 1998;GuNNARSSoN;ThoRSdoTTIR;PALSSoN, 2007;VILLALPANdo et al, 2006;zIMeRMANN, 2006) have observed that during the digestive process, iron and vitamin A form a new product or complex that keeps soluble iron at ph 6.0, hindering the inhibitory action of some anti-nutritional in the absorption of nonheme iron. β-carotene is more efficient than vitamin A to form a complex with iron because of its high stability during storage, handling and ph changes.…”