Fatores socioeconômicos e dietéticos de risco para a anemia em crianças de 6 a 59 meses de idade

Abstract

Objective: The objective of this study was to use statistical modeling to identify risk factors for anemia in children aged 6 to 59 months in the state of Pernambuco, covering socioeconomic and dietary aspects. Methods:The sample comprised 746 children aged between 6 and 59 months from the state of Pernambuco.Their hemoglobin was assayed and a 24-hour dietary recall performed. Risk of anemia was analyzed with relation to socioeconomic variables and to dietary intakes, using multivariate analysis models. Results:The risk factors for anemia were: a high proportion of calories from cow's milk, low density of nonheme iron, low age and low maternal educational level; age was the most prominent factor, with children under 24 months exhibiting 3.61 times greater risk of being anemic than the older children.Conclusions: This study confirms the need for a clear picture of the dietary intake of children in Brazil, in order that associations with anemia can be better understood. Our results revealed that the dietary factors which were most responsible for risk of anemia were a greater proportion of calories from cow's milk and lower density of nonheme iron, in addition to age below 24 months and low maternal educational level.J Pediatr (Rio J). 2007;83(1):39-46: Iron deficiency anemia, epidemiology, risk factors, food intake, child nutrition.

Magnitude, tendência temporal e fatores associados à anemia em crianças do Estado da Paraíba

“…The prevalence of anemia observed in the State of Paraíba (36.5%) was similar to the prevalences described in studies conducted in States of the Northeast region of Brazil. 10,16 Analyzing the temporal trend of anemia in the studied ecological context, the stabilization in the prevalence of anemia in the period from 1992 to 2007 shows a trend profi le that is signifi cantly different from that of the period between 1982 and 1992, when there was a sharp increase in the problem, which has also been reported by Oliveira et al 17 This trend was somewhat unexpected, as its prevalence was expected to decrease, in consonance with what has been observed in temporal trend studies of other nutritional defi ciencies, like protein-energy malnutrition. A possible explanation for this unexpected behavior would be the fact that, although suffi ciently adequate in quantitative and energetic terms, these children's nutrition is defi cient in iron, mainly that of high bioavailability, to meet their physiological needs.…”

“…This process occurs simultaneously with the organism's greater requirement of an increased consumption of Studies have verifi ed the benefi cial effect of exclusive breastfeeding in the fi rst six months of life, as it increases the hemoglobin levels. 11,15,16 In addition, the association of breastfeeding with the use of cow's milk has caused a decline in children's hemoglobin levels due to occurrences of intestinal microhemorrhages. 11,15,16 As a preventive measure, combined with other interventions, it is necessary to implement actions to promote exclusive breastfeeding up to the sixth month of life and nutritional guidance about adequate complementation to breast milk up to two years, aiming to reduce the consumption of cow's milk and to stimulate the ingestion of foods with high density of heme iron.…”

“…11,15,16 In addition, the association of breastfeeding with the use of cow's milk has caused a decline in children's hemoglobin levels due to occurrences of intestinal microhemorrhages. 11,15,16 As a preventive measure, combined with other interventions, it is necessary to implement actions to promote exclusive breastfeeding up to the sixth month of life and nutritional guidance about adequate complementation to breast milk up to two years, aiming to reduce the consumption of cow's milk and to stimulate the ingestion of foods with high density of heme iron. 16 The greater risk of anemia in children with unfavorable housing conditions (number of co-inhabitants and number of rooms in the house) might be explained by the reduction in these families' economic accessibility, which leads to a per capita reduction in foods and to the consequent reduction in iron intake.…”

“…11,15,16 As a preventive measure, combined with other interventions, it is necessary to implement actions to promote exclusive breastfeeding up to the sixth month of life and nutritional guidance about adequate complementation to breast milk up to two years, aiming to reduce the consumption of cow's milk and to stimulate the ingestion of foods with high density of heme iron. 16 The greater risk of anemia in children with unfavorable housing conditions (number of co-inhabitants and number of rooms in the house) might be explained by the reduction in these families' economic accessibility, which leads to a per capita reduction in foods and to the consequent reduction in iron intake. 10 The fact that anemia is more prevalent in households with lower number of rooms might be associated with factors that contribute to a greater dissemination of infectious diseases and intestinal parasitosis.…”

Orientação nutricional do paciente com deficiência de ferro

“…Estudo realizado na cidade de São Leopoldo, Rio Grande do Sul, mostrou que, ao final do primeiro ano de vida, a ingestão de ferro foi de 4,39 ± 2,6 mg. E o percentual de ferro heme foi de aproximadamente 20%. 57 Monteiro, Szarfarc e Mondini 58 observaram que a média de consumo de ferro em crianças, em São Paulo, de 6 a 59 meses, foi de 7,6 mg. Outro estudo realizado em Pernambuco, por Oliveira, Osório e Raposo, 59 mostrou que a média do consumo de ferro por 1.000 calorias foi de 4,6 mg nas crianças de 6 a 12 meses, 4,8 mg nas crianças de 12 a 24 meses, 5,1 mg nas crianças de 24 a 26 meses e de 6,4 mg nas crianças de 36 a 48 meses, sendo baixa a proporção de ferro heme ingerida. O estudo Nutri Brasil Infância, que avaliou a dieta ingerida em mais de 3.000 crianças pré-escolares, de 2 a 6 anos de idade, em instituições públicas e privadas de todo o País (creches com pelo menos três refeições ao dia), não demonstrou variações regionais na ingestão de ferro ou por nível social e econômico.…”