Food and nutrition insecurity indicators associated with iron deficiency anemia in Brazilian children: a systematic review.

Renata Lopes De Siqueira,Hercilio Paulino André,Silvia Eloiza Priore,Sylvia Do Carmo Castro Franceschini,Naiara Sperandio

doi:10.1590/1413-81232018234.16012016

Abstract

This study aimed to review food and nutrition insecurity indicators associated with iron deficiency anemia in Brazilian children below 5 years. We searched in electronic databases (SciELO, Lilacs, and Medline) and selected studies by titles, abstracts and full-text reading. Of the 1,023 studies analyzed, 11 fit the inclusion criteria. The results of the studies evidenced that iron deficiency anemia in Brazilian children was associated with sociodemographic and health indicators (male, age below 24 months, children of adolescent mothers, respiratory infections, diarrhea, low maternal schooling, parents' working conditions, nursery time, lack of basic sanitation, maternal anemia, lack of ferrous sulfate use by the mother and/or child and late onset of prenatal care), nutritional indicators (low birth weight, diet characteristics, such as the habit of milk consumption close to meals, low exclusive and full breastfeeding time) and economic indicators (low per capita income). The food and nutrition insecurity analyzed in this study from the perspective of different indicators is associated with iron deficiency anemia in children under 5 years in Brazil.

Highlights

Micronutrient deficiency is an important public health problem, especially in developing countries
The sociodemographic and health indicators described by studies, which were associated (p < 0.05) with iron deficiency anemia were: age less than 24 months[12,13,14,15,16], maternal age less than 20 years[17,18], male children[17,19], number of residents at home[2,15,20], low maternal schooling[13,15,20], geographical area[13], no home ownership[19], respiratory infections and diarrhea[2,19], parental work conditions[21], day-care time[2], lack of basic sanitation[2,15] and maternal anemia[19] (Chart 1)
Regarding economic indicators associated with iron deficiency anemia, in children under the age of five, low per capita income was unanimous among studies[17,20,21] (Chart 1)

Summary

Introduction

Micronutrient deficiency is an important public health problem, especially in developing countries. According to the World Health Organization (WHO), approximately 2 billion people worldwide suffer from hidden hunger, which is the subclinical deficiency of micronutrients, and the main ones ate vitamin A, iron, zinc and iodine[1]. Iron deficiency is a three-stage process that affects all cells of the human body. The first stage is iron stock depletion, followed by iron-deficient erythropoiesis and iron deficiency anemia, characterized by reduced hemoglobin levels. Iron deficiency anemia is a nutritional disorder that compromises the immune system and impairs children’s growth and development[3]. The children’s public is a group vulnerable to iron deficiency due to the increased demand of this mineral under the intense growth speed. Some negative childhood dietary factors may step up this vulnerability, such as insufficient ironsource food consumption (beef, liver, chicken, fish and dark green vegetables)[2,3] and intake of cow and goat milk in the first six months of life, which, in addition to low iron content, may cause gastrointestinal bleeding and lead to fecal blood loss[4]

Objectives

Methods

Results

Discussion

Conclusion