Prevalence of iron deficiency in 12‐mo‐old infants from 11 European areas and influence of dietary factors on iron status (Euro‐Growth study)

Abstract

A prospective longitudinal cohort study was performed to assess the prevalence of iron deficiency in European infants at 12 mo of age, and to study the influence of socio‐economic status, dietary factors, growth and morbidity on iron status. The cohort consisted of 488 normal term infants from primary healthcare centres in 11 European areas. Assessed were socio‐economic variables, dietary intake, anthropometry and morbidity at regular intervals from birth to 12 mo, and haemoglobin, serum ferritin, mean corpuscular volume, transferrin saturation and serum transferrin receptor concentrations at age 12 mo. The prevalence of anaemia was 9.4%, of iron deficiency 7.2%, and of iron deficiency anaemia 2.3%. More than 40% of anaemia was associated with normal iron status and associated with an increased frequency of recent infections. Iron deficiency anaemia was significantly more frequent with low (5.1%) than high socio‐economic status (0%). Dietary factors accounted for most of this variation in multiple regression analysis. Early introduction of cows' milk was the strongest negative determinant of iron status. Feeding of iron‐fortified formula was the main factor positively influencing iron status. Other dietary factors, including breastfeeding, did not play a significant role as determinants of iron status at age 12 mo. Conclusion. Iron deficiency anaemia is present in 2.3% of 12‐mo‐old European infants. The prevalence of iron deficiency anaemia varies strongly with socio‐economic status. Avoidance of cows' milk feeding during the first year of life is the key measure in the prevention of iron deficiency.

Nutrient intakes of children aged 1–2 years as a function of milk consumption, cows’ milk or growing-up milk

“…This analysis is not supported by convincing research data arising from plasma measurements of nutrients of interest, with the notable exceptions of Fe (8) and vitamin D (9,10) . Energy and macronutrient consumption was identical in the two groups in the present study with the exception of protein, for which the consumption was higher in Group CM, cows' milk being one possible but not exclusive causative factor.…”

Diagnosis and Prevention of Iron Deficiency and Iron-Deficiency Anemia in Infants and Young Children (0–3 Years of Age)

“…These numbers are comparable to data collected in other industrialized countries. 13,14 Related to the problem of ID/IDA is the interaction of iron and lead. Results of both animal and human studies have confirmed that IDA increases intestinal lead absorption.…”

Orientação nutricional do paciente com deficiência de ferro

“…48 Na impossibilidade da continuidade do aleitamento materno, a substituição desse por leite de vaca é fator de risco para deficiência de ferro, e a substituição por fórmula infantil modificada é fator de proteção. [49][50][51][52][53] Entre 4 e 6 meses ocorre gradualmente o esgotamento das reservas de ferro, e a alimentação complementar passa a ter papel importante na prevenção da deficiência de ferro e outros micronutrientes. 26,40,50,[54][55][56] Os requerimentos de ferro em relação à energia ingerida, nessa idade, são os mais altos, com exceção do último trimestre gestacional.…”

“…[49][50][51][52][53] Entre 4 e 6 meses ocorre gradualmente o esgotamento das reservas de ferro, e a alimentação complementar passa a ter papel importante na prevenção da deficiência de ferro e outros micronutrientes. 26,40,50,[54][55][56] Os requerimentos de ferro em relação à energia ingerida, nessa idade, são os mais altos, com exceção do último trimestre gestacional. É possível atingir esse requerimento de ferro se a dieta contiver considerá-veis quantidades de carne, vitamina C e produtos enriquecidos; no entanto, em países em desenvolvimento, a alimentação complementar pode não fornecer o ferro suficiente e, assim, a criança precisar de alguma forma de complementação para prevenir a deficiência de ferro.…”