Factors associated with the iron nutritional status of Brazilian children aged 4 to 7 years

ABSTRACT Objective To evaluate factors associated with the iron nutritional status of Brazilian children aged 4 to 7 years in the city of Viçosa, Minas Gerais state, Brazil. Methods This is a cross-sectional study of 357 children aged 4-7 years who had been followed-up up for during their first six months of life by the Breastfeeding Support Program. Socioeconomic and demographic characteristics, feeding practices, nutritional status (height-for-age and body mass index-for-age), and serum ferritin and hemoglobin concentrations were evaluated. Multiple linear regression analysis was carried out to evaluate factors independently associated with iron nutritional status (hemoglobin and ferritin), considering α=0.05 as the significance level. Results The prevalence of anemia and iron deficiency was (34) 9.52% and (11) 11.00%, respectively. The factors independently associated with anemia were younger child age, low maternal education, low height-for-age Z-scores, and children of single and separated mothers or widows. Iron deficiency was associated with child younger age and consumption of chocolates and chocolate flavored milk. Conclusion The results obtained allow us to conclude that anemia among children 4-7 years of age is a public health problem in the city of Viçosa, Minas Gerais. Therefore, there is a need for intervention measures targeting children in this age group. These measures can be implemented through food and nutritional education by encouraging the consumption of iron-rich foods.

摘要
研究目的：评估巴西米纳斯吉拉斯州维索萨市4~7岁儿童的铁营养状况相关影响因素。
研究方法：本研究为横断面研究（cross-sectional study），纳入357名4~7岁儿童，这些儿童在出生后前6个月曾接受母乳喂养支持项目（Breastfeeding Support Program）的随访。本研究收集了受试者的社会人口学特征、喂养行为、营养状况（年龄别身高Z评分与年龄别体质指数Z评分）以及血清铁蛋白（serum ferritin）与血红蛋白（hemoglobin）浓度等指标。采用多元线性回归分析（multiple linear regression analysis），以α=0.05作为显著性检验水准，探究与铁营养状况（血红蛋白与血清铁蛋白）独立相关的影响因素。
研究结果：贫血与铁缺乏的患病率分别为9.52%（34例）与11.00%（11例）。与贫血独立相关的影响因素包括儿童年龄较小、母亲受教育程度偏低、年龄别身高Z评分较低，以及母亲为单身、离异或丧偶的儿童。铁缺乏则与儿童年龄较小及食用巧克力与巧克力风味牛奶相关。
研究结论：本研究结果表明，4~7岁儿童贫血是巴西米纳斯吉拉斯州维索萨市的一项公共卫生问题。因此，亟需针对该年龄段儿童制定干预措施，可通过开展食品与营养教育、鼓励儿童摄入富含铁的食物来落实相关干预方案。