Population prevalence and risk factors for iron deficiency in Auckland

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Authors:

Scragg R

August 28, 2007

Summary:

The authors aimed to provide an accurate estimate of the prevalence of iron deficiency (ID) in New Zealand children aged 6 to 23 months. Subjects were identified from a random, ethnically stratified sample. Children with 2 or more of the following abnormal values were considered to have ID: serum ferritin (< 10 μg/L); iron saturation (< 10%); mean cell volume (< 73 fl). Overall prevalence of ID was 14% (95% CI 9 to 17%). There were significant associations between ID and ethnicity (Mäori 20%, Pacific 17%, other 27%, New Zealand European 7%, p = 0.005). Social deprivation did not predict ID. Multivariate analysis found a correlation between ID and BMI > 18.5 kg/m2 (RR 4.34, 95% CI 1.08 to10.67) and with receiving no infant or follow-on formula (RR 3.60, 95% CI 1.56–6.49). Children at increased risk of ID include those with more rapid growth, and those who receive milk other than infant or follow-on formula. These results suggest that cultural practices may influence iron status.

Comment:

Vitamin C, when consumed at the same time as food containing iron, has been shown to improve iron absorption and therefore reduce the risk for iron deficiency (ID). The most common source for vitamin C in NZ is fruit and therefore people with ID are encouraged to eat fruit or drink fruit juice with their iron (meat, fish or other source). A recent study found that Mäori children were more likely to have fruit as snacks between meals whereas NZ European children had fruit with their meals. Given the increased risk for ID in Mäori children, well child/tamariki ora providers should encourage parents to include fruit with meals for their babies/toddlers. Formula milk is another important source of iron for babies up to one year old who are not breast fed. Barriers to formula milk such as cost must be addressed.

Reference: J Paediatrics & Child Health 2007; 43(7-8):532-538

Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

Population prevalence and risk factors for iron deficiency in Auckland

Independent commentary by Dr. Matire Hardwood

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Population prevalence and risk factors for iron deficiency in Auckland

Independent commentary by Dr. Matire Hardwood

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