Iron profile and dietary pattern of primary school obese Egyptian children

Wahed, Mohamed Abdel; Mohamed, Maha H.; Ibrahim, Samia S.; El-Naggar, Wafaa A.

doi:10.1097/01.epx.0000451827.84315.5c

Cited by 4 publications

(5 citation statements)

References 26 publications

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“…Meta-analysis revealed that having obesity doubled the odds of iron deficiency diagnosis (OR 2.1; 95% CI 1.4–3.2). However, the removal of one study 56 with a large effect size during sensitivity analysis reduced the association (OR 1.8; 95% CI 1.3–2.6).…”

Section: Resultsmentioning

confidence: 99%

“…Of the 27 028 studies identified following database searches and de‐duplication, 41 met the inclusion criteria (Figure 1). These studies presented results investigating relationships between childhood obesity and five distinct health outcomes: asthma ( n = 16), 31–45 vitamin D deficiency ( n = 10), 46–55 iron deficiency ( n = 10), 34,56–64 flat‐footedness/pes planus ( n = 4) 65–68 and allergies ( n = 4) 34,39,69,70 . Two of the studies identified reported results for more than one of the outcomes.…”

Section: Resultsmentioning

confidence: 99%

“…Ten studies investigated the relationship between childhood obesity and iron deficiency 34,56–64 of which nine were appropriate for meta‐analysis (Figure 5). Two of these studies conducted separate analyses by sex, 34,59 with both subgroups included in the model individually.…”

Section: Resultsmentioning

confidence: 99%

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Obesity in young children and its relationship with diagnosis of asthma, vitamin D deficiency, iron deficiency, specific allergies and flat‐footedness: A systematic review and meta‐analysis

et al. 2020

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Summary There is evidence that a number of medical conditions and co‐morbidities are associated with obesity in young children. This review explored whether there is evidence of associations with other conditions or co‐morbidities. Observational studies of young children (mean age < 10 years) were identified using electronic searches of five databases (MEDLINE, Embase, CINAHL, AMED and SPORTDiscus). Of 27 028 studies screened, 41 (comprising 44 comparisons) met the inclusion criteria. These studies provided data on five distinct diseases/conditions: asthma (n = 16), vitamin D deficiency (n = 10), iron deficiency (n = 10), allergies (n = 4) and flat‐footedness (n = 4). Thirty‐two studies were appropriate for meta‐analysis using random‐effects models, and revealed obesity was significantly associated with having asthma (OR 1.5, 95% CI 1.3–1.7), vitamin D deficiency (OR 1.9, 95% CI 1.4–2.5) and iron deficiency (OR 2.1, 95% CI 1.4–3.2). Heterogeneity (I2) ranged from 57% to 61%. Narrative synthesis was conducted for all studies. There was no evidence of a consistent association between obesity in young children and eczema, dermatitis or rhinitis due to the low number of studies. However, there was an association with flat‐footedness. These results have implications for health policy and practice and families. Further research leading to a greater understanding of the associations identified in this review is suggested.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Obesity in young children and its relationship with diagnosis of asthma, vitamin D deficiency, iron deficiency, specific allergies and flat‐footedness: A systematic review and meta‐analysis

et al. 2020

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“…Although in favour of a direct relationship between VA status (n=10 of 17 studies, accounting for 19 443 participants), 5 found an inverse association and 2 found no association (figure 4C). In the 10 studies that found a direct relationship, these were reported in a variety of ways, such as, lower risk of VAD in the context of overweight or obese75 79–83 or elevated serum levels of VA or plasma retinol in children with overweight or obesity 73 84–86. Interestingly, of the five studies that concluded an inverse association between overnutrition and VA deficiency, four focused on Brazilian children.…”

Section: Resultsmentioning

confidence: 99%

Overnutrition is a risk factor for iron, but not for zinc or vitamin A deficiency in children and young people: a systematic review and meta-analysis

Tan,

Gong

et al. 2024

BMJ Glob Health

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IntroductionTraditionally associated with undernutrition, increasing evidence suggests micronutrient deficiencies can coexist with overnutrition. Therefore, this work aimed to systematically review the associations between iron, zinc and vitamin A (VA) status and weight status (both underweight and overweight) in children and young people.MethodsOvid Medline, Ovid Embase, Scopus and Cochrane databases were systematically searched for observational studies assessing micronutrient status (blood, serum or plasma levels of iron, zinc or VA biomarkers) and weight status (body mass index or other anthropometric measurement) in humans under 25 years of any ethnicity and gender. Risk of bias assessment was conducted using the American Dietetic Association Quality Criteria Checklist. Where possible, random effects restricted maximum likelihood meta-analyses were performed.ResultsAfter screening, 83 observational studies involving 190 443 participants from 44 countries were identified, with many studies having reported on more than one micronutrient and/or weight status indicator. Iron was the most investigated micronutrient, with 46, 28 and 27 studies reporting data for iron, zinc and VA status, respectively. Synthesising 16 records of OR from seven eligible studies, overnutrition (overweight and obesity) increased odds of iron deficiency (ID) (OR (95% CI): 1.51 (1.20 to 1.82), p<0.0001, I2=40.7%). Odds appeared to be higher for children living with obesity (1.88 (1.33 to 2.43), p<0.0001, I2=20.6%) in comparison to those with overweight (1.31 (0.98 to 1.64), p<0.0001, I2=40.5%), although between group differences were not significant (p=0.08).ConclusionsOvernutrition is associated with increased risk of ID, but not zinc or VA deficiencies, with an inverted U-shaped relationship observed between iron status and bodyweight. Our results highlight significant heterogeneity in the reporting of micronutrient biomarkers and how deficiencies were defined. Inflammation status was rarely adequately accounted for, and the burden of ID may well be under-recognised, particularly in children and young people living with overnutrition.PROSPERO registration numberCRD42020221523.

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“…Although in favour of a direct relationship between vitamin A status (n=10 of 17 studies, accounting for 19,443 participants), 5 found an inverse association and 2 found no association ( Figure 4C ). In the 10 studies that found a direct relationship, these were reported in a variety of ways, such as: lower risk of VAD in the context of overweight or obese 69 73–77 , or elevated serum levels of vitamin A or plasma retinol in children with overweight or obesity 67 78–80 . Interestingly, of the 5 studies that concluded an inverse association between overnutrition and vitamin A deficiency, 4 focused on Brazilian children.…”

Section: Resultsmentioning

confidence: 99%

Overnutrition is a risk factor for iron deficiency in children and young people: a systematic review and meta-analysis of micronutrient deficiencies and the double burden of malnutrition

Tan,

Gong

et al. 2024

Preprint

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IntroductionTraditionally associated with undernutrition, increasing evidence suggests micronutrient deficiencies can co-exist with overnutrition. Therefore, this work aimed to systematically review the associations between iron, zinc and vitamin A status and weight status (both under- and overweight) in children and young people.MethodsOvid Medline, Ovid Embase, Scopus, and Cochrane databases were systematically searched for observational studies assessing micronutrient status (blood, serum, or plasma levels of iron, zinc, or vitamin A biomarkers) and weight status (body mass index or other anthropometric measurement) in humans under 25 years of any ethnicity and gender. Risk of bias assessment was conducted using the American Dietetic Association Quality Criteria Checklist. Where possible, random effects restricted maximum likelihood (REML) meta-analyses were performed. PROSPERO (CRD42020221523).ResultsAfter screening, 83 observational studies involving 190,443 participants from 44 countries were identified, with many studies having reported on more than one micronutrient and/or weight status indicator. Iron was the most investigated micronutrient, with 46, 28, and 27 studies reporting data for iron, zinc, and vitamin A status, respectively. Synthesizing 16 records of odds ratio (OR) from 7 eligible studies, overnutrition (overweight and obesity) increased odds of iron deficiency (OR [95%CI]: 1.51 [1.20, 1.82], p<0.0001, I2=40.7%). Odds appeared to be higher for children living with obesity (1.88 [1.33, 2.43], p<0.0001 I2=20.6%) in comparison to those with overweight (1.31 [0.98, 1.64], p<0.0001 I2=40.5%), although between group differences were not significant (p=0.08).ConclusionsOvernutrition is associated with increased risk of iron deficiency, but not zinc or vitamin A deficiencies, with an inverted U-shaped relationship observed between iron status and bodyweight. Our results highlight significant heterogeneity in the reporting of micronutrient biomarkers and how deficiencies were defined. Inflammation status was rarely adequately accounted for, and the burden of iron deficiency may well be under-recognised, particularly in children and young people living with overnutrition.Key questionsWhat is already known on this topic-summarise the state of scientific knowledge on this subject before you did your study and why this study needed to be doneLow-and middle-income countries are increasingly facing a double burden of malnutrition; that is, the coexistence of undernutrition (stunting, wasting, underweight) with overnutrition (overweight and obesity).While the relationship between undernutrition and critical micronutrients for childhood growth and development (e.g., iron, zinc, and vitamin A) is well established, less is known about the risk of micronutrient deficiencies in children and adolescents with overweight or obese, a hidden form of malnutrition.There are limited data summarising associations between biomarkers of the most commonly limiting micronutrients and body weight status, particularly in children and young people.What this study adds-summarise what we now know as a result of this study that we did not know beforeOvernutrition increases the risk of iron deficiency, but not zinc or vitamin A deficiencies.There is an inverted U-shaped relationship observed between iron status and bodyweight in children and young people, with iron deficiencies observed more frequent in both under- and overnutrition.Studies done to date have been heterogeneous in terms of populations studied, diagnostic criteria, and approaches to data analysis; few followed current guidelines for measuring inflammation and defining micronutrient deficiencies.How this study might affect research, practice or policy-summarise the implications of this studyIncreased recognition by healthcare practitioners that children and young people living with overweight, or obesity are likely to be iron deficient; thereby improving clinical practice and care.The gaps in evidence highlighted are addressed, with more research from currently underrepresented counties examining micronutrient deficiencies and the double burden of malnutrition.The weaknesses in study design and reporting highlighted are addressed, with improved quality and reporting of micronutrient assessment in children and young people.

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Iron profile and dietary pattern of primary school obese Egyptian children

Cited by 4 publications

References 26 publications

Obesity in young children and its relationship with diagnosis of asthma, vitamin D deficiency, iron deficiency, specific allergies and flat‐footedness: A systematic review and meta‐analysis

Obesity in young children and its relationship with diagnosis of asthma, vitamin D deficiency, iron deficiency, specific allergies and flat‐footedness: A systematic review and meta‐analysis

Overnutrition is a risk factor for iron, but not for zinc or vitamin A deficiency in children and young people: a systematic review and meta-analysis

Overnutrition is a risk factor for iron deficiency in children and young people: a systematic review and meta-analysis of micronutrient deficiencies and the double burden of malnutrition

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