Iron deficiency in healthy 18-month-old Danish children is associated with no oral iron supplementation in infancy and prolonged exclusive breast-feeding

Abstract

Fe deficiency (ID) defined as plasma ferritin <12 µg/l is associated with delayed cognitive development in early childhood and increased incidence of infections; however, the longitudinal association between early-life factors and ID in 18-month-old children in Denmark is unknown. The present study aimed to determine the prevalence of ID and to describe risk factors associated with ID in healthy 18-month-old Danish children. Blood samples, anthropometric measurements and self-reported questionnaire data had been obtained in the birth cohort, Odense Child Cohort. The questionnaires were modified from those used in the Danish National Birth Cohort. Plasma ferritin and C-reactive protein in venous, non-fasting samples were analysed in the final sample size of 370 children after exclusion of seventy-nine children due to chronic disease, acute infection, C-reactive protein >10 mg/l, twin birth or prematurity. Associations with ID were analysed by logistic regression, adjusting for sex, maternal education, duration of partial breast-feeding and current intake of milk, fish and meat. Overall, fifty-six children had ID (15·1 %). Factors associated with increased risk were exclusive breast-feeding beyond 4 months (OR 5·97; 95 % CI 1·63, 21·86) and no intake of oral Fe supplements from 6 to 12 months (OR 3·99, 95 % CI 1·33, 11·97. Duration of partial breast-feeding and current diet was not associated with ID. In conclusion, the ID prevalence was 15·1 %, and both exclusive breast-feeding beyond 4 months and no intake of oral Fe supplements from 6 to 12 months were associated with increased risk of ID in 18-month-old children.

Iron status in early childhood is modified by diet, sex and growth: Secondary analysis of a randomized controlled vitamin D trial

“…Iron intake was lower in ID and IDA infants than non-ID and non-IDA, however, this attenuated after correction for energy intake. The weak correlation between iron intake and iron status may be due to poor bioavailability of dietary iron [6,23,30]. Nevertheless, higher iron intake per body weight was an independent determinant of iron status in our study.…”

“…Although iron from breastmilk is efficiently absorbed and breastmilk enhances the absorption of iron from other foods [36], exclusive breastfeeding for more than 4e6 months results in increased risk of ID [28,30]. The Committee of Nutrition of the American Academy of Pediatrics (AAP) recommended that those infants who are exclusively breastfed more than 4 months should receive supplemental iron 1 mg/kg daily until introduction of ironcontaining complementary foods [4].…”

Micronutrient homeostasis in plants for more sustainable agriculture and healthier human nutrition

“…For example, Fe deficiency was found to be prevalent among 12- to 36-month-old children in Germany, the Netherlands, and the UK ( Akkermans et al , 2016 ). Similarly, Fe deficiency was reported in 18-month-old children in Denmark and in children aged 1–11 years in Spain ( Andersen et al , 2019 ; López-Ruzafa et al , 2021 ). Based on an extensive literature review, Eussen et al (2015) evaluated the relevance of Fe deficiency in European children aged 6–36 months, and showed that it ranged between 3% and 48%, with children living in eastern Europe having a higher prevalence of Fe deficiency than those living in western Europe ( Eussen et al , 2015 ).…”

Prevalensi dan Faktor Risiko Anemia pada Anak di Negara Maju

“…Berdasarkan tabel 1 dapat dilihat bahwa prevalensi anemia pada anak di beberapa negara maju di dunia masih cukup tinggi sehingga dapat disimpulkan bahwa anemia masih menjadi permasalah kesehatan pada anak di berbagai negara maju di dunia. Hasil penelitian dari beberapa artikel yang ditelaah didapatkan beberapa faktor risiko yang dapat mempengaruhi terjadinya anemia pada anak di negara maju antara lain adalah kekurangan serum zinc [6], rendahnya kadar 25 (OH) D [20,22], pemberian ASI eksklusif tanpa fortifikasi zat besi [7], [23], Berat Badan Lahir Rendah (BBLR) [26], faktor asupan makanan [5,11], serta pendidikan ibu [29].…”

“…Penelitian di Denmark menyebutkan bahwa faktor yang terkait dengan peningkatan risiko kekurangan zat besi pada anak adalah pemberian ASI eksklusif setelah 4 bulan tanpa asupan suplemen zat besi [23]. Pemberian ASI eksklusif tanpa fortifikasi zat besi diidentifikasi sebagai faktor risiko anemia berat [7].…”