Nutritional assessment of iron status and anemia in children under 5 years old at public daycare centers

Vieira, Ana Cláudia F.; Diniz, Alcides S.; Cabral, Poliana Coelho; Oliveira, Reisla; Lola, M; Silva, Solange M. M.; Kolsteren, Patrick

doi:10.2223/jped.1680

Cited by 31 publications

(36 citation statements)

References 18 publications

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“…Dentre essas situações de risco, destaca-se a idade inferior a 17 meses, cujas análises (isolada e agregada) resultam nas maiores chances e probabilidades de ocorrência da anemia. A associação identificada indica que a menor idade é mais suscetível ao desenvolvimento da anemia, corroborando os achados de outros estudos 3,24,25 . Tal fato pode ser explicado pela alta demanda de ferro necessária para garantir o crescimento físico, que é acelerado, principalmente no primeiro ano de vida 3 .…”

Section: Discussionunclassified

Isolated and combined risks for anemia in children attending the nurseries of daycare centers

Konstantyner¹,

Taddei²,

Oliveira³

et al. 2009

J Pediatr (Rio J)

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Objective: To identify and quantify isolated and combined risk factors for anemia, providing a comprehensive view of the likelihood of its occurrence. Methods:Cross-sectional study with 482 children aged 4 to 29 months attending the nurseries of philanthropic and public daycare centers in the city of São Paulo, Brazil, who participated in two surveys (2004 and 2007). Mothers were interviewed, blood was collected using digital puncture, and anthropometry was performed. Anemia was characterized by hemoglobin levels below 11 g/dL. Unconditional logistic regression was adjusted for anemia risk factors. A value of p ≤ 0.05 indicated statistically significant associations. Post-test odds and likelihood ratios were calculated to define post-test probabilities. Epi-Info TM 2000 and Stata 10.0 software packages were used for statistical analysis.Results: Prevalence of anemia was 43.6% (95%CI 39.1-48.1). The final logistic model included five categorical variables: mother's age less than 28 years (OR = 1.50; p = 0.041), per capita income below half a minimum wage (OR = 1.56; p = 0.029), exclusive breastfeeding less than 2 months (OR = 1.71; p = 0.009), decrease in weight/age z score from birth to survey (OR = 1.47; p = 0.050), and age less than 17 months (OR = 2.44; p < 0,001). Post-test probabilities in the associations of isolated and combined risk factors for anemia ranged from 54.5 to 100%. Conclusions:The probability of anemia progressively increased as the identified risk factors were added. This calculation provides a simple and rapid tool for suspicion of anemia in children both in clinical practice and population screening. Resultados: A prevalência de anemia foi de 43,6% (IC95% -39,1 a 48,1%). O modelo logístico final incluiu cinco variáveis: idade materna inferior a 28 anos (OR = 1,50; p = 0,041), renda per capita inferior a meio salário mínimo (OR = 1,56; p = 0,029), aleitamento materno exclusivo inferior a 2 meses (OR = 1,71; p = 0,009), perda de escore z peso/idade do nascimento ao inquérito (OR = 1,47; p = 0,050) e idade inferior a 17 meses (OR = 2,44; p < 0,001). As probabilidades pós-teste nas associações de fatores de risco de anemia isolados e agregados apresentaram-se entre 54,5 e 100%. J Pediatr (Rio J) Conclusões:A probabilidade de anemia aumentou quanto mais agregados estiveram os cinco fatores de risco identificados. Esse cálculo disponibiliza instrumento simples e rápido de suspeição de anemia em crianças em triagem clínica ou populacional. Não foram declarados conflitos de interesse associados à publicação deste artigo. Artigo submetido em 31.10.08, aceito em 27.01.09. J Pediatr (Rio J)

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Section: Discussionunclassified

Isolated and combined risks for anemia in children attending the nurseries of daycare centers

Konstantyner¹,

Taddei²,

Oliveira³

et al. 2009

J Pediatr (Rio J)

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“…Como agravante da situação nutricional inadequada, foi demonstrado que famílias de baixa renda e mães com menor esco-laridade oferecem alimentos ricos em gordura e açúcar com mais frequência a seus filhos 22 . Essas práticas alimentares caracterizadas por ingestão insuficiente de micronutrientes e excessiva de alimentos altamente energéticos podem contribuir para explicar em parte a alta prevalência de anemia 23 , hipovitaminose A 24 e carência de outros micronutrientes, além da obesidade entre pré-escolares no Brasil 25 .…”

Section: Discussionunclassified

Nutritional quality and food expenditure in preschool children

Rauber¹,

Vítolo²

2009

J Pediatr (Rio J)

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Objective: To assess correlations between the cost and the nutritional quality of the diets of preschool children from low socioeconomic status families, taking into account intakes of micronutrients and foods with high concentrations of sugars and fats.Methods: This was a cross-sectional study undertaken with 346 children aged 3 to 4 years recruited for the "Ten steps in action" (BRATSA I) study, who comprise a nested cohort from the randomized field study. Two 24-hour dietary recall surveys were conducted. Expenditure on food was calculated by taking the price of each food, as verified at a number of different establishments, and adjusting it for the quantity eaten.Results: Mean expenditure on food for one child was R$ 100.17±34.1 per month. There was a positive correlation between intakes of iron (r = 0.115; p = 0.033), zinc (r = 0.214; p < 0.001), and vitamins A (r = 0.197; p < 0.001) and C (r = 0.162; p < 0.001), adjusted to 1,000 kcal, and expenditure on food/1,000 kcal. There were no significant relationships between expenditure on food/1,000 kcal and risk of overweight (p = 0.208) or intake of foods with a high fat or sugar content (p = 0.894 and p = 0.964). Conclusions:The study found that consumption of energy provided by fat and sugar-rich foods was not associated with expenditure on feeding these 3-to-4-year-olds. In contrast, nutritional quality, assessed in the form of essential micronutrient intakes, demonstrated a positive correlation with food costs.J Pediatr (Rio J). 2009;85(6):536-540: Costs and cost analysis, child nutrition, micronutrients. ResumoObjetivo: Avaliar a correlação dos gastos com a alimentação e a qualidade dietética de pré-escolares de baixa condição socioeconômica, considerando a ingestão de micronutrientes e alimentos de alta densidade de açúcar e gordura. Métodos:Estudo transversal realizado com 346 crianças de 3 a 4 anos de idade que participaram do estudo "Dez passos em ação I" (BRATSA I), uma coorte aninhada a um ensaio de campo randomizado. Foram realizados dois inquéritos recordatórios de 24 horas. Calculou-se o gasto com a alimentação utilizando o preço dos alimentos coletado em diferentes estabelecimentos e ajustado para as quantidades ingeridas.Resultados: A média de gasto com a alimentação das crianças estimada para um mês foi de R$ 100,17±34,1. A ingestão de ferro (r = 0,115; p = 0,033), zinco (r = 0,214; p < 0,001) e vitaminas A (r = 0,197; p < 0,001) e C (r = 0,162; p < 0,001), ajustada para 1.000 kcal, mostrou correlação positiva com os gastos com alimentação/1.000 kcal. Não houve diferença significativa nos gastos com alimentação/1.000 kcal em relação ao risco para excesso de peso (p = 0,208) e ao consumo de alimentos de alta concentração de açúcar e gordura (p = 0,894 e p = 0,964). Conclusões:O estudo mostrou que o consumo de energia fornecido por alimentos ricos em açúcar e gordura não está associado com os gastos com a alimentação de crianças de 3 a 4 anos; por outro lado, a qualidade nutricional, avaliada pela ingestão de micronutrientes essenciais,...

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“…[3456] About 1.2 billion people worldwide demonstrate varying levels of iron deficiency. [7] Prevalence rates vary among countries; it affects 2.4 million children in the USA,[8] 5.4% children in Spain,[9] 14.0% in Estonia,[10] 30.8% under five Brazilian children[11] and 22.3% under-five Nigerian children. [12]…”

Section: Introductionmentioning

confidence: 99%

Iron deficiency among non-anemic under-five children in Enugu, South-East, Nigeria

Ekwochi

Odetunde

et al. 2013

Ann Med Health Sci Res

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Background:Iron deficiency has been described as the world most common nutritional deficiency and the commonest cause of nutritional anemia in infancy and childhood. The deleterious behavioral and cognitive deficit associated with iron-deficiency anemia could be irreversible. Therefore, the latter should be prevented by early detection of iron deficiency in the non-anemic groups.Aim:To determine the prevalence of iron deficiency in the non-anemic under-five children and to document its variation among the age classes of these children.Subjects and Methods:Under-five children presenting at a tertiary hospital were consecutively enrolled, Serum ferritin levels of the subjects were used to assess the iron status and serum ferrritin level of less than 12 ng/ml was considered as iron deficiency. Data were analyzed using SPSS version 15.0. Chi-square tests were employed as necessary for test of significance in each of the characteristics of the population at P ≤ 0.05.Results:A total of 178 non anemic under-five children were studied, their mean hematocrit and serum ferrritin values were 35.5 (2.8%) and 54.9 (76.1) ng/ml respectively. Forty-nine (27.5% [49/178]) of the study population was iron deficient and there was no significant difference in the prevalence of iron deficiency among the age classes (P = 0.75).Conclusion:This study has documented a high prevalence of iron deficiency in non-anemic under-five children presenting at the outpatient department and emergency room of a tertiary health facility in Enugu. All the age classes were relatively affected. A further research into the causes of iron deficiency in this age group is recommended.

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Nutritional assessment of iron status and anemia in children under 5 years old at public daycare centers

Abstract: Iron deficiency and anemia appear to be an important public health problem among children less than 5 years old at public daycare centers in Recife. Therefore, effective actions aimed at the prevention and control of this deficiency are strongly recommended in this ecological context.

Cited by 31 publications

References 18 publications

Isolated and combined risks for anemia in children attending the nurseries of daycare centers

Isolated and combined risks for anemia in children attending the nurseries of daycare centers

Nutritional quality and food expenditure in preschool children

Iron deficiency among non-anemic under-five children in Enugu, South-East, Nigeria

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