Reducing iron deficiency anemia in Bolivian school children: Calcium and iron combined versus iron supplementation alone

Miranda, Melissa; Olivares, Manuel; Brito, Alex; Pizarro, Fernando

doi:10.1016/j.nut.2013.12.008

Cited by 11 publications

(10 citation statements)

References 18 publications

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“…Also in Peru, an educational and nutritional project [69] was implemented at the regional level between 2004 and 2007 for the prevention of anemia in children under 5 years of age. Finally, randomized controlled trials conducted in Bolivia [70], Haiti [60,71], Brazil [72], and Mexico [73] acted as short-term nutritional interventions based on iron fortification in preschool and school-age children.…”

Section: Resultsmentioning

confidence: 99%

“…Following the nutritional intervention programs, some countries continued to have high rates of anemia [60,65], while others reduced its prevalence significantly [52,67,70,71,72,73]. Although similar actions were carried out in Haiti [60,71], Brazil [72], Bolivia [70], Peru [65,68], Ecuador [67], Mexico [73], and Chile [52], their effectiveness seems not to be the same. The success or failure of health and nutritional interventions, especially in populations with low or very low SES, has been related with multiple causes, including coverage, participant compliance, monitoring, and quality in reporting results [2,90].…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of Anemia in Children from Latin America and the Caribbean and Effectiveness of Nutritional Interventions: Systematic Review and Meta–Analysis

et al. 2019

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Anemia affects 1.62 billion people worldwide. Latin America and the Caribbean (LAC) comprise several developing countries where children are a population at risk. This systematic review and meta-analysis aimed to estimate the prevalence of anemia in this population. Electronic databases, reference lists, and websites of health ministries were searched until December 2018. Stratified analyses were performed using RevMan5.3 to estimate the overall prevalence of anemia in preschool and school-age children. The effectiveness of nutritional interventions was also evaluated. We included 61 studies from the 917 reviewed, which included 128,311 preschool- and 38,028 school-age children from 21 LAC countries. The number of anemic children was 32.93% and 17.49%, respectively, demonstrating a significant difference according to age (p < 0.01). No difference was observed by gender and only school-age children from low/very low socioeconomic status (SES) (25.75%) were more prone to anemia than those from middle SES (7.90%). It was not a concern in the Southern Cone but constituted a serious public health problem in the Latin Caribbean. Nutritional interventions reduced the prevalence from 45% to 25% (p < 0.01). Anemia is still a public health problem for children in LAC countries. National surveys should include school-age children. Further nutritional interventions are required to control anemia.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prevalence of Anemia in Children from Latin America and the Caribbean and Effectiveness of Nutritional Interventions: Systematic Review and Meta–Analysis

et al. 2019

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“…These were 12 randomized controlled trials(1, 10-12, 14, 22, 31-36) and 18 case-crossover studies(2, 23, 30, 36-48), including 1,623 and 592 participants respectively. The studies were conducted in Africa (14), Asia (10, 31, 36), Europe (1, 11, 12, 22, 23, 43), North America (2, 3, 13, 30, 34, 38, 39, 41, 44, 45, 47-49), and South America (32, 33, 42). Fourteen of the studies included women only (2, 3, 12-14, 22, 31, 32, 39, 41, 42, 45, 46, 48, 50, 51).…”

Section: Resultsmentioning

confidence: 99%

“…Fourteen of the studies included women only (2, 3, 12-14, 22, 31, 32, 39, 41, 42, 45, 46, 48, 50, 51). Almost all studies explicitly excluded pregnant or lactating women or both (11, 12, 14, 22, 32, 33, 36, 42, 48) and none of the studies examined pregnant women alone. One study did not report the sex of participants (48).…”

Section: Resultsmentioning

confidence: 99%

“…One study did not report the sex of participants (48). The interventions consisted of regular or low-calcium meals with or without calcium supplements (1-3, 11-14, 23, 30-33, 36, 39, 41, 42, 46, 48, 51), or high-calcium versus low-calcium meals (10, 22, 34, 38, 43-45, 47, 49, 52). The studies assessed iron absorption using radiolabeled iron (1, 2, 22, 32, 34, 36, 49) or gastrointestinal lavage and body scintillation procedures (30).…”

Section: Resultsmentioning

confidence: 99%

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Effect of calcium intake on iron absorption and hematologic status: A systematic review and dose-response meta-analysis of randomized trials and case-cross-over studies

Abioye

Okuneye²,

Odesanya

et al. 2020

Preprint

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Background: The interaction between dietary (and supplementary) divalent ions has been a long-standing issue in human nutrition research. Developing optimal calcium and iron supplementation recommendation needs detailed knowledge of the potential trade-offs between: a) the clinical effects of concurrent intake on iron absorption and hematological indices, and b) the potentially negative effects of separated ingestion on adherence to either or both iron and calcium supplements. Human clinical studies have examined the effects of calcium intake on iron status, but there are no meta-analyses or recent reviews summarizing the findings. Objective: We aimed to summarize the literature on the effect of calcium consumption from meals and supplements on iron indices in humans, and quantify the pooled effects. Design: Peer-reviewed randomized and case-cross-over studies were included in this review. Result: The negative effect of calcium intake was statistically significant in short-term iron absorption studies but the effect magnitude was low (weighted mean difference (WMD) = -5.57%, (95% CI: -7.09, -4.04)). The effect of calcium on iron status was mixed. There was a quadratic dose-response relationship between calcium intake and serum ferritin concentration. Higher daily calcium intake was associated with a modest reduction in serum ferritin concentration. There was, however, no reduction in hemoglobin concentration (WMD = 1.22g/L, 95% CI: 0.37, 2.07). Conclusion: The existing body of studies is insufficient to make recommendations with high confidence due to heterogeneity in design, limitations of ferritin as an iron biomarker and lack of intake studies in pregnant women. Prescribing separation of prenatal calcium and iron supplements in free living individuals is unlikely to affect the anemia burden. There is a need for effectiveness trials comparing the effects of prescribing separated intake to concurrent intake, with functional end-points as primary outcomes, and adherence to each supplement as intermediate outcomes.

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Pilot Study of the Association of Anemia with the Levels of Zinc, Copper, Iron, Calcium, and Magnesium of Children Aged 6 Months to 3 Years in Beijing, China

Yin

Sun

et al. 2015

Biol Trace Elem Res

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This study sought to explore the relationship between anemia in children and levels of five minerals in blood. A sample consisted of 242 normal and 304 anemic children paired by sex and age. Hematological parameters were assessed using the Sysmex xs-800i hematology analyzer. Levels of zinc (Zn), copper (Cu), iron (Fe), magnesium (Mg), and calcium (Ca) were measured by polarographic analysis. Differences in these elements between the anemic and normal groups were compared by ANOVA. Relationships between Ca, Zn, Fe, Cu, Mg, and Hb levels were tested by Pearson's correlation analysis. The Mg level (1.51 ± 0.30 mmol/L) of the moderately anemic group (≤90 g/L) was significantly higher than that (1.36 ± 0.30 mmol/L) of the mildly anemic (90 g/L ≤Hb <110 g/L) and normal groups (1.31 ± 0.30 mmol/L) (p < 0.05). The rate of moderate anemia (13.7 %) in the higher Mg group (Mg >1.57 mmol/L) was higher than that (5.3 %) of the lower Mg group (Mg ≤1.57 mmol/L) (p < 0.01). The rate of moderate anemia (12.8 %) in the lower Fe group (≤78.4 umol/L) was higher than that (6.2 %) of the higher Fe group (>78.4 umol/L) (p < 0.05). Hemoglobin was inversely correlated with Mg levels in the anemic group (p < 0.05). These results indicate that blood levels of Mg and Fe were correlated with anemic children aged 6 months to 3 years. To prevent and treat anemia better, a combination of the levels of Hb, Mg, and Fe in whole blood is required.

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Reducing iron deficiency anemia in Bolivian school children: Calcium and iron combined versus iron supplementation alone

Cited by 11 publications

References 18 publications

Prevalence of Anemia in Children from Latin America and the Caribbean and Effectiveness of Nutritional Interventions: Systematic Review and Meta–Analysis

Prevalence of Anemia in Children from Latin America and the Caribbean and Effectiveness of Nutritional Interventions: Systematic Review and Meta–Analysis

Effect of calcium intake on iron absorption and hematologic status: A systematic review and dose-response meta-analysis of randomized trials and case-cross-over studies

Pilot Study of the Association of Anemia with the Levels of Zinc, Copper, Iron, Calcium, and Magnesium of Children Aged 6 Months to 3 Years in Beijing, China

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