Relation of complementary foods and anemia in urban underprivileged children in Surakarta
Keywords:
complementary food, iron deficiency, anemia
Abstract
Background Iron deficiency anemia (IDA) is still prevalent inIndonesian children. Attempt to treat patients with IDA with
iron supplementation has been difficult because of low
compliance.
Objective To determine the complementary foods that contributes
in the prevalence of anemia in children.
Methods A cross sectional study was conducted in three urban
underprivileged villages. Healthy children aged 6-23 months at
the time of interview were selected. The questionnaire was
specially developed for determining the risks of IDA. We took
blood sampling to measure the hemoglobin concentration.
Results A total of 86 children participated in the study; but only data
of 78 children were available for analysis. The prevalence of anemia
among those children was 35%. Most children (90%) consumed
animal protein inadequately. Rice-based diet was the main meal of
most children (97%). Analysis of possible factors associated with the
anemia showed that inadequate plant or animal protein consumption,
wasted children, less than 2 orange consumption, not consuming
iron fortified formula/cereal had OR 1.2 (95%CI 0.40; 3.61), 4.13
(95%CI 0.48;35.45), 4.67 (95%CI 1.04;20.04), 6.25 (95% CI
1.32;29.55) and 3.15 (95%CI 1.18;8.41), respectively. Logistic analysis
revealed that the factors associated with anemia were wasted children
(OR 9.10, 95%CI 1.38;60.18), low or no orange consumption (OR
7.86, 95%CI 1.36;45.40) and not consuming iron fortified formula/
cereal (OR 3.01, 95%CI 1.02;8.90).
Conclusion In children with rice-based diet as main meal,
consuming orange as an enhancing factor should also be addressed
in order to prevent anemia.
References
1. World Health Organization. Nutritional anaemias: report of
a WHO scientific group. Technical Report Series, no. 405.
Geneva: WHO, 1968. Available from URL: http://
whqlibdoc.who.int/trs/WHO_TRS_405.pdf
2. Grantham-McGregor S, Ani C. A review of studies on the
effect of iron deficiency on cognitive development in children.
J Nutr 2001;131:S649–68.
3. Konofal E, Lecendreux M, Arnulf I, Mouren MC. Iron
deficiency in children with attention-deficit/hyperactivity
disorder. Arch Pediatr Adolesc Med 2004;158:1113–5.
4. Algarin C, Peirano P, Garrido M, Pizarro F, Lozoff B. Iron
deficiency anemia in infancy: long-lasting effects on auditory
and visual system functioning. Pediatr Res 2003;53:217–23.
5. Saloojee H, Pettifor JM. Iron deficiency and impaired child
development. BMJ 2001;323:1377-8.
6. Center for Disease and Control Prevention. Recommendations
to prevent and control iron deficiency in the United States.
MMWR recomm Rep 1998;(RR-3):1-25.
7. Zlotkin S. Clinical nutrition: The role of nutrition in the
prevention of iron deficiency anemia in infants, children and
adolescents. CMAJ 2003;168:59-63.
8. Gokcay G. Strategies for the prevention of iron deficiency
anaemia in children. J Trop Pediatr 2006;52:75-7.
9. American Academy of Pediatrics, Committee on Nutrition.
Iron fortification of infant formulas. Pediatrics 1999;
104:119–23.
10. Yip R, Ramakrishnan U. Experiences and challenges in
developing countries. J Nutr 2002;132:S827-30.
11. Zimmermann MB, Chaouki N, Hurrell RF. Iron deficiency
due to consumption of a habitual diet low in bioavailable
iron: a longitudinal cohort study in Moroccan children. Am
J Clin Nutr 2005;81:115-21.
12. Center for Diseases Control and Prevention. Iron deficiency-
United States, MMWR morbidity and mortality weekly report
2002.
13. Meyerovitch J, Sherf M, Antebi F, Barhoum-Noufi M, Horev
Z, Jaber L, et al. The incidence of anaemia in an Israeli
population: A population analysis for anemia in 34512 Israeli
Infants aged 9 to 18 months. Pediatrics 2006;118:e1055-60.
14. Domellof M, Cohen FJ, Dewey KG, Hermell O, Rivera LL,
Lonnerdal B. Iron supplementation of breastfed Honduran
and Swedish infants from 4-9 months of age. J Pediatr
2001;138:679-87.
15. Lind T, Lönnerdal B, Stenlund H, Ismail D, Seswandhana S,
Ekström EC, et al. A community-based randomized controlled
trial of iron and zinc supplementation in Indonesian infants:
interactions between iron and zinc. Am J Clin Nutr
2003;77:883–90.
16. Geltman PL, Meuers AF, Mehta SD, Brugnara C, Villon I,
Wu YA, et al. Daily multivitamins with iron to prevent anemia
in high-risk infants: a randomized clinical trial. Pediatrics
2004;114:86-93.
17. Allen LH. Iron supplements: scientific issues concerning
efficacy and implications for research and programs. J Nutr
2002;132: S813-9.
18. Amsel S, Boaz M, Ballin A, Filk D, Ore N. Low compliance of
iron supplementation in infancy in relation to socioeconomic
status in Israel. Pediatrics 2002;110:410–1.
19. Yip R. Iron supplementation: country level experiences and
lessons learned. J Nutr 2002;132:S859-61.
20. Olivares M, Walter T, Hertrampf E, Pizarro F. Anemia and iron
deficiency disease in children. Br Med Bull 1999;55:534–43.
21. Goddard WP, Murray I, Long RG, Scott B, Barton R, Salman
M, et al. Iron deficiency anaemia. BMJ 1997;314:1759.
22. Olivares M, Hertrampf E, Pizarro F. Effect of iron stores on
heme iron absorption. Nutr Res 1993;13:633-8.
23. Hallberg L, Bjorn-Rasmussen E, Howard L. Dietary heme
iron absorption. A discussion of possible mechanisms for the
absorption-promoting effect of meat and for the regulation
of iron absorption. Scand J Gastroenterol 1979;14:769-79.
24. Mannar V, Gallego EB. Iron fortification: country level
experiences and lessons learned. J Nutr 2002;32:S856-
8.
25. Uauy R, Hertrampf E, Reddy M. Iron fortification of foods:
overcoming technical and practical barriers. J Nutr
2002;132:S849-52.
26. Atamna H, Killilea DW, Killilea AN, Ames BN. Heme
deficiency may be a factor in the mitochondrial and neuronal
decay of aging. PNAS 2002;99:14807-12.
27. Morava E, Rodenburg R, van Essen ZH, Vries MD, Smeitink
J. Dietary intervention and oxidative phosphorylation
capacity. J Inherit Metab Dis 2006;29:589.
a WHO scientific group. Technical Report Series, no. 405.
Geneva: WHO, 1968. Available from URL: http://
whqlibdoc.who.int/trs/WHO_TRS_405.pdf
2. Grantham-McGregor S, Ani C. A review of studies on the
effect of iron deficiency on cognitive development in children.
J Nutr 2001;131:S649–68.
3. Konofal E, Lecendreux M, Arnulf I, Mouren MC. Iron
deficiency in children with attention-deficit/hyperactivity
disorder. Arch Pediatr Adolesc Med 2004;158:1113–5.
4. Algarin C, Peirano P, Garrido M, Pizarro F, Lozoff B. Iron
deficiency anemia in infancy: long-lasting effects on auditory
and visual system functioning. Pediatr Res 2003;53:217–23.
5. Saloojee H, Pettifor JM. Iron deficiency and impaired child
development. BMJ 2001;323:1377-8.
6. Center for Disease and Control Prevention. Recommendations
to prevent and control iron deficiency in the United States.
MMWR recomm Rep 1998;(RR-3):1-25.
7. Zlotkin S. Clinical nutrition: The role of nutrition in the
prevention of iron deficiency anemia in infants, children and
adolescents. CMAJ 2003;168:59-63.
8. Gokcay G. Strategies for the prevention of iron deficiency
anaemia in children. J Trop Pediatr 2006;52:75-7.
9. American Academy of Pediatrics, Committee on Nutrition.
Iron fortification of infant formulas. Pediatrics 1999;
104:119–23.
10. Yip R, Ramakrishnan U. Experiences and challenges in
developing countries. J Nutr 2002;132:S827-30.
11. Zimmermann MB, Chaouki N, Hurrell RF. Iron deficiency
due to consumption of a habitual diet low in bioavailable
iron: a longitudinal cohort study in Moroccan children. Am
J Clin Nutr 2005;81:115-21.
12. Center for Diseases Control and Prevention. Iron deficiency-
United States, MMWR morbidity and mortality weekly report
2002.
13. Meyerovitch J, Sherf M, Antebi F, Barhoum-Noufi M, Horev
Z, Jaber L, et al. The incidence of anaemia in an Israeli
population: A population analysis for anemia in 34512 Israeli
Infants aged 9 to 18 months. Pediatrics 2006;118:e1055-60.
14. Domellof M, Cohen FJ, Dewey KG, Hermell O, Rivera LL,
Lonnerdal B. Iron supplementation of breastfed Honduran
and Swedish infants from 4-9 months of age. J Pediatr
2001;138:679-87.
15. Lind T, Lönnerdal B, Stenlund H, Ismail D, Seswandhana S,
Ekström EC, et al. A community-based randomized controlled
trial of iron and zinc supplementation in Indonesian infants:
interactions between iron and zinc. Am J Clin Nutr
2003;77:883–90.
16. Geltman PL, Meuers AF, Mehta SD, Brugnara C, Villon I,
Wu YA, et al. Daily multivitamins with iron to prevent anemia
in high-risk infants: a randomized clinical trial. Pediatrics
2004;114:86-93.
17. Allen LH. Iron supplements: scientific issues concerning
efficacy and implications for research and programs. J Nutr
2002;132: S813-9.
18. Amsel S, Boaz M, Ballin A, Filk D, Ore N. Low compliance of
iron supplementation in infancy in relation to socioeconomic
status in Israel. Pediatrics 2002;110:410–1.
19. Yip R. Iron supplementation: country level experiences and
lessons learned. J Nutr 2002;132:S859-61.
20. Olivares M, Walter T, Hertrampf E, Pizarro F. Anemia and iron
deficiency disease in children. Br Med Bull 1999;55:534–43.
21. Goddard WP, Murray I, Long RG, Scott B, Barton R, Salman
M, et al. Iron deficiency anaemia. BMJ 1997;314:1759.
22. Olivares M, Hertrampf E, Pizarro F. Effect of iron stores on
heme iron absorption. Nutr Res 1993;13:633-8.
23. Hallberg L, Bjorn-Rasmussen E, Howard L. Dietary heme
iron absorption. A discussion of possible mechanisms for the
absorption-promoting effect of meat and for the regulation
of iron absorption. Scand J Gastroenterol 1979;14:769-79.
24. Mannar V, Gallego EB. Iron fortification: country level
experiences and lessons learned. J Nutr 2002;32:S856-
8.
25. Uauy R, Hertrampf E, Reddy M. Iron fortification of foods:
overcoming technical and practical barriers. J Nutr
2002;132:S849-52.
26. Atamna H, Killilea DW, Killilea AN, Ames BN. Heme
deficiency may be a factor in the mitochondrial and neuronal
decay of aging. PNAS 2002;99:14807-12.
27. Morava E, Rodenburg R, van Essen ZH, Vries MD, Smeitink
J. Dietary intervention and oxidative phosphorylation
capacity. J Inherit Metab Dis 2006;29:589.
Published
2007-10-31
How to Cite
1.
Lestari E, Moelya A, Rohana E, Wiboworini B. Relation of complementary foods and anemia in urban underprivileged children in Surakarta. PI [Internet]. 31Oct.2007 [cited 23Dec.2024];47(5):196-01. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/413
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Received 2016-09-01
Accepted 2016-09-01
Published 2007-10-31
Accepted 2016-09-01
Published 2007-10-31
