Continuing anemia prevention strategies are needed throughout early childhood in low-income preschool children

[Changes in anemia status in Mexican children: a longitudinal study]

Introduction

Objectives: to evaluate longitudinal change in anemia and its association with indigenous status, socioeconomic status (SES), and food insecurity (FI) in Mexican children. Methods: a longitudinal study in 1164 children under 18 months of age in rural communities. Hemoglobin concentration was measured in 2008 and 2012, and changes in anemia status were determined. Indigenous status, SES and FI were obtained in 2008, and their associations with four categories of change in anemia status were assessed through multinomial logistic regression models including adjustment covariates. Results: in 2008, 40.5 % of children had anemia, and 85.2 % of these did not have anemia in 2012, whereas 9.9 % of those who did not have anemia in 2008 had developed it in 2012. The distributions of the categories of change in anemia status were not associated with FI, while statistically significant differences were detected according to indigenism and NSE. Conclusions: the high prevalence of anemia that affects the child population justifies the implementation of interventions based on evidence, of proven effectiveness to combat it.

Persistence of anaemia among Samoan preschool age children: a longitudinal study

OBJECTIVE

To characterise the prevalence and persistence of anaemia among Samoan children over a 2-3-year period.

DESIGN

Data were from two consecutive waves (2015 and 2017-2018) of the Ola Tuputupua'e 'Growing up' study. Anaemia (Hb < 11·0 or 11·5 g/dl for 2-4 and ≥ 5 years old, respectively) was considered 'transient' when it occurred at only one wave or 'persistent' if it was present at two consecutive waves. Child, maternal and household correlates of anaemia were examined using log-binomial and modified Poisson regressions.

SETTING

Eleven Samoan villages.

PARTICIPANTS

Mother-child pairs (n 257) recruited in 2015 and reassessed in 2017-2018.

RESULTS

Anaemia prevalence was 33·9 % in 2015 and 28·0 % in 2017-2018; 35·6 % of cases identified in 2015 were persistent. Risk of anaemia at only one wave was lower among children who were older in 2015 (age 4 v. 2 years, adjusted relative risk (aRR) = 0·54, (95 % CI 0·35, 0·84), P = 0·007), had older mothers (≥ 40 v. 18-29 years, aRR = 0·61, (95 % CI 0·39, 0·95), P = 0·029) and had higher daily sodium intake (for every 100 mg/d, aRR = 0·97, (95 % CI 0·95, 0·99), P = 0·003) than children with no anaemia. Children whose anaemia persisted were more likely to have had a mother with anaemia (aRR = 2·13, (95 % CI 1·17, 3·89), P = 0·013) and had higher daily dietary iron intake (for every 10 mg/d, aRR = 4·69, (95 % CI 1·33, 16·49), P = 0·016) than those with no anaemia.

CONCLUSIONS

Alongside broadly targeted prevention efforts, which are warranted given the moderate-high anaemia prevalence observed, specific attention should be paid to children with risk factors for persistent anaemia. Routine screening of children whose mothers have anaemia should be encouraged.

Dynamic Anemia Status from Infancy to Preschool-Age: Evidence from Rural China

Anemia is a serious nutritional deficiency among infants and toddlers in rural China. However, it is unclear how the anemia status changes among China's rural children as they age. This study investigates the prevalence of anemia as children grow from infancy to preschool-age, as well as the dynamic anemia status of children over time. We conducted longitudinal surveys of 1170 children in the Qinba Mountain Area of China in 2013, 2015 and 2017. The results show that 51% of children were anemic in infancy (6-12 months), 24% in toddlerhood (22-30 months) and 19% at preschool-age (49-65 months). An even larger share of children (67%) suffered from anemia at some point over the course of study. The data also show that although only 4% of children were persistently anemic from infancy to preschool-age, 8% of children saw their anemia status deteriorate. We further found that children may be at greater risk for developing anemia, or for having persistent anemia, during the period between toddlerhood and preschool-age. Combined with the finding that children with improving anemia status showed higher cognition than persistently anemic children, there is an urgent need for effective nutritional interventions to combat anemia as children grow, especially between toddlerhood and preschool age.

Nutrient contribution of total and lean beef in diets of US children and adolescents: National Health and Nutrition Examination Survey 1999-2004

This study examined the nutritional contribution of total beef and lean beef (LB) to the diet of US children and adolescents using the US Department of Agriculture definition of LB as defined in MyPyramid. Twenty-four hour dietary recall data from children 4-8 years of age [y] (n=2474), 9-13 y (n=3273), and adolescents 14-18 y (n=4044) participating in the NHANES 1999-2004 were assessed. LB was defined as beef with ≤9.28 grams [g] fat/100 g (excess was discretionary fat). Means and standard errors were determined using appropriate sample weights. Consumption of LB contributed significantly to intake of protein and many key nutrients such as vitamins B6 and B12, zinc, iron, niacin, phosphorus, and potassium by US children and adolescents without providing significantly to intakes of total fat, saturated fatty acids, or sodium.

Nutritional deficiencies during normal growth

Nutritional deficiencies have always been a major consideration in pediatrics. Although the classic forms of many of the well-documented nutritional deficiencies are memorized during training as a physician, nutritional deficiencies that can occur in otherwise asymptomatic normally growing children are often overlooked. The two most common deficiencies seen in children who are growing normally are iron and vitamin D deficiencies. These deficiencies are surprisingly common and can have a significant impact on the overall health of a child. This article reviews these nutritional deficiencies and other less commonly seen deficiencies in children who are otherwise growing normally.

Household food insecurity is a risk factor for iron-deficiency anaemia in a multi-ethnic, low-income sample of infants and toddlers

OBJECTIVE

The present study examines the relationships of household food security status with Fe deficiency (ID) and Fe-deficiency anaemia (IDA) among children less than 3 years of age, and associated factors that contribute to ID and IDA.

DESIGN

Cross-sectional study and chart review. The US Food Security Survey Module was administered to adult caregivers as part of the Children's Sentinel Nutrition Assessment Project (C-SNAP). Haematological data were obtained from medical records.

SETTING

A large metropolitan medical centre in Minneapolis, Minnesota, USA.

SUBJECTS

A multi-ethnic sample of 2853 low-income children aged <36 months who received care at the medical centre.

RESULTS

Among the caregivers, 23.3 % reported low household food security and 11.6 % reported very low household food security (VLFS). After controlling for background factors, children from households with VLFS were almost twice as likely to have IDA than were children from households with high or marginal food security (OR = 1.98, 95 % CI 1.11, 3.53); the corresponding associations for ID were not statistically significant.

CONCLUSIONS

The prevalence of IDA in early childhood is significantly larger in low-income infants and toddlers living in VLFS households. Asian, Hispanic and African-American children have elevated prevalences of ID and IDA. Breast-feeding may be associated with elevated ID and IDA, while participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) may be protective for ID.