Iron Status and Dietary Iron Intake of Vegetarian Children from Poland

Abstract

Background/Aim: In Poland, vegetarian diets are becoming more and more popular. The aim of this study was to examine the effect of iron intake on iron status in vegetarian children. Methods: Dietary iron intake, iron food sources, blood count, serum iron, ferritin level and total iron-binding capacity were estimated in two groups of children, namely vegetarians (n = 22) and omnivores (n = 18) of both sexes, aged from 2 to 18 years. Seven-day food records were used to assess their diet. Results: Dietary iron intake in vegetarians and omnivores was low (up to 65.0 and 60.1% of the recommended dietary allowance). A significantly higher intake of vitamin C was observed in vegetarians compared with omnivores (p = 0.019). The main sources of iron in vegetarians were cereal products, followed by vegetables and mushroom products, then fruit. The prevalence of iron deficiency (ID) was higher in the vegetarian group (p = 0.023). The serum ferritin level and mean corpuscular volume in the vegetarians were also lower than in the omnivores (p = 0.01 and p = 0.014, respectively). Conclusions: Children who follow a vegetarian diet may suffer from ID in spite of having a high vitamin C intake. This indicates the need to introduce dietary education and iron status monitoring.

Iron Status of Vegetarian Children: A Review of Literature

“…This was in part due to assessing the iron status among participants of different age and gender. For example, definitions of iron deficiency in different studies, using Hb were: <11.0 g/dL [9,10], <11.7 g/L [11], <12.0 g/L [12], <11.0 g/dL for 0.5-5 years and <11.5 g/dL for >5-11 years [13]. In one study, Hb below the 3rd percentile of the Dallman reference curves was used as a marker of deficiency [16].…”

“…In one study, Hb below the 3rd percentile of the Dallman reference curves was used as a marker of deficiency [16]. Similarly, the cutoff criteria for serum ferritin included <10.0 µg/L [9,17], <12.0 µg/L [9,11], <15.0 mg/L [18], <15.0 ng/mL [13,19], <12.0 µg/L for 1-3 years and <15.0 µg/L for >3 years [10], <15.0 µg/L for girls and <20.0 µg/L for boys [15]. The same inconsistencies were found for other markers of iron status.…”

“…However, Hb ranges and standard deviation of the mean indicate wide discrepancies among participants and they also indicate that some participants were significantly below the accepted normal values (e.g., 9.2 g/dL) [10]. …”

“…For example, in one Polish study the median ferritin concentration was just 9.61 µg/L, ranging from 1.6 to 54.1 µg/L [10]. However, in another study from Poland, the mean ferritin among vegetarian children was 31.2 ng/mL with a range of 13.2-76.4 ng/mL [19].…”

“…For serum iron, the deficiency prevalence ranged from 4.5% among Polish vegetarian children and teens to 58% among those from Slovakia [11,12]. Data based on TIBC showed the deficiency prevalence ranging from 6.6% in Sweden to 66.7% among lacto-ovo-vegetarians and 62.5% among semi-vegetarians in Canada [10,17]. Also, when transferrin saturation was used as a marker of iron status, the deficiency prevalence ranged from 6.6% in Sweden to 66.7% among lacto-ovo-vegetarian teens in Canada [10,17].…”