Lower Prevalence Of Anemia Research Articles

Serum retinol is associated with hemoglobin concentration in infants who are not vitamin A deficient

There is evidence that vitamin A benefits hematopoiesis and iron metabolism. For this reason, we investigated the relationship of serum retinol concentration to hemoglobin concentration and biochemical indicators of iron status in Canadian aboriginal infants. No infant had biochemical evidence for vitamin A deficiency (serum retinol <0.35 μmol/L) although 25.6% had anemia (hemoglobin <110 g/L) and 20.4% had iron deficiency (serum ferritin <10 μg/L). Serum retinol concentration was significantly correlated with hemoglobin concentration (r = 0.30, p < 0.001, n = 185) and serum iron concentration (r = 0.44, p < 0.001, n = 166) but not with serum ferritin concentration. Anemic infants had lower serum retinol concentrations than those without anemia (1.09 ± 0.33 μmol/L vs. 1.36 ± 0.36 μmol/L, p < 0.01). Infants given vitamin supplements that contained vitamin A, ascorbic acid, and vitamin D 3 had a higher hemoglobin concentration than infants not given supplements (117 ± 11 vs. 113 ± 10 g/L, p = 0.04) and a lower prevalence of anemia (21.9% vs. 37.0%, p = 0.05). In conclusion, vitamin A was positively associated with hemoglobin concentration in this pediatric population of infants, many of whom had anemia and iron deficiency.

Iron supplementation of breast-fed Honduran and Swedish infants from 4 to 9 months of age

Objective: The objective was to study the effects of iron supplementation on hemoglobin and iron status in 2 different populations. Study design: In a randomized, placebo-controlled, masked clinical trial, we assigned term Swedish (n = 101) and Honduran (n = 131) infants to 3 groups at 4 months of age: (1) iron supplements, 1 mg/kg/d, from 4 to 9 months, (2) placebo, 4 to 6 months and iron, 6 to 9 months, and (3) placebo, 4 to 9 months. All infants were breast-fed exclusively to 6 months and partially to 9 months. Results: From 4 to 6 months, the effect of iron (group 1 vs 2 + 3) was significant and similar in both populations for hemoglobin, ferritin, and zinc protoporphyrin. From 6 to 9 months, the effect (group 2 vs group 3) was significant and similar at both sites for all iron status variables except hemoglobin, for which there was a significant effect only in Honduras. In Honduras, the prevalence of iron deficiency anemia at 9 months was 29% in the placebo group and 9% in the supplemented groups. In Sweden, iron supplements caused no reduction in the already low prevalence of iron deficiency anemia at 9 months (<3%). Conclusion: Iron supplementation from 4 to 9 months or 6 to 9 months significantly reduced iron deficiency anemia in Honduran breast-fed infants. The unexpected hemoglobin response at 4 to 6 months in both populations suggests that regulation of hemoglobin synthesis is immature at this age. (J Pediatr 2001;138:679-87)

Vitamin A deficiency and low prevalence of anemia in Yaqui Indian children in northwest Mexico.

A study of 296 school-age Yaqui Indian children (6-10 y) was conducted in 26 rural communities. Vitamin A status was determined by retinol and carotenoid serum levels according to a method described previously (IVACG, 1982). Serum retinol and carotenoids in children were analyzed according to community size. Vitamin A intake was assessed in a sub-sample by means of a 24 h recall questionnaire. Serum retinol distribution showed that 6.3% of the children were below 10 microg/100 mL (0.35 micromol/L) and 40% were in the range of 10-20 microg/100 mL (0.35-0.70 micromol/L). Differences (p < 0.02) were found between small and large communities (Median, 95% CI): 19.2 (17.1, 20.9) microg/100 mL and 22.9 (20.3, 24.1) microg/100 mL. Serum carotenoid levels were significantly higher in large than in small and medium communities: 72 (68.2, 77.8) microg/100 mL versus 62.4 (53.3, 68.2) and 62.4 (55.7, 69.6) microg/100 mL, respectively. Food staples were wheat flour tortillas, pinto beans, corn tortillas, few animal products and scarce fresh vegetables. Mean vitamin A consumption was 244+/-29 microg RE (34.9% of the US RDA). Iron status showed that only 4 children were classified as anemic, with two of them having iron deficiency anemia. Iron deficient erythropoiesis was observed in 7.8% of the children and iron depletion only in 4.4%. The Yaqui diet seems to provide adequate amounts of iron but not of vitamin A or its precursors, which renders a vitamin A status of sub-clinical deficiency that could be considered a public health problem.

Effect of bovine-hemoglobin-fortified cookies on iron status of schoolchildren: a nationwide program in Chile

The Chilean School Lunch program, which serves one million children nationwide, was supplied with three 10-g cookies fortified with 6% bovine hemoglobin concentrate, designed to provide 1 mg bioavailable iron per day. A survey of 1000 children was performed after 3 y. Significant differences in hemoglobin concentrations were found in the children from the fortified vs the nonfortified province (P < 0.01). Low serum ferritin values were also significantly more prevalent in the nonfortified group. The effect was evident despite the very low prevalence of anemia in both the fortified and the unfortified school groups. Heme-iron-fortified cookies are a feasible and effective way to improve the iron status of school-age children. In regions of high prevalence of iron-deficiency anemia, the effect of a heme-fortified cookie program should be even more important.

Nutritional Profile of Saudi Primary Schoolgirls in an Urban Region

Two hundred eighty-five primary schoolgirls from the urban area of Thugba, Al-Khobar, in the Eastern Province of Saudi Arabia were examined anthropometrically. Hemoglobin estimations and laboratory...

Has Routine Screening of Infants for Anemia Become Obsolete in the United States?

Iron deficiency anemia was common and often severe as recently as 15 years ago in the United States.1 During that period, it had become a well-established routine to evaluate all term infants for anemia at about 1 year of age2; screening at the preschool checkup and in adolescence also became widespread. Declining Prevalence of Iron Deficiency Anemia During the past decade, iron deficiency anemia has become less and less common.1,3 The first strong evidence of a relatively low nationwide prevalence of anemia was provided by the second National Health and Nutrition Examination Survey (NHANES II) conducted between 1976 and 1980.4 In that large, representative sampling of the US population, only about 6% of adolescent girls between 15 and 17 years of age were anemic.4

Clinical utility of erythrocyte sedimentation rate and plasma protein analysis in the elderly

The utilization and interpretation of the erythrocyte sedimentation rate in the elderly have been surrounded by controversy and confusion. To improve the understanding of the erythrocyte sedimentation rate and its determinants in the aged, a defined population of 111 ambulatory, retirement-home residents underwent thorough clinical and laboratory evaluation. Westergren erythrocyte sedimentation rate, Wintrobe erythrocyte sedimentation rate, and plasma viscosity measurements were all significantly correlated with one another as well as with plasma proteins, particularly fibrinogen and globulins. Age per se had no influence on the erythrocyte sedimentation rate in the study population. On the basis of standard upper limits of normal for younger populations, the Wintrobe sedimentation rate was most commonly abnormal and plasma viscosity least commonly abnormal. The “normal” upper limit of 20 mm/hour for Westergren sedimentation rate was also the optimal limit of normal by receiver operating characteristic analysis of the study population. Although the sensitivity of the Westergren sedimentation rate for the presence of an inflammatory condition or monoclonal gammopathy was only 0.55, the specificity was 0.96, and the positive predictive value of an elevated erythrocyte sedimentation rate being associated with a clinical disorder was 0.93. The enhanced clinical utility of the erythrocyte sedimentation rate in this population compared with other elderly populations may be due to a low prevalence of anemia and hypoalbuminemia. In such populations, the erythrocyte sedimentation rate may remain a useful clinical test, regardless of patient age.

LOW PREVALENCE OF ANEMIA AMONG NAVAJO CHILDREN

Both historical and recent evidence has suggested that iron deficiency may be common among southwestern American indians. To assess the nutritional status of young Navajo indians, nutritional histories, heights, weights, and fingerstick blood samples were collected from 576 children from 6 months to 10 years of age. Using Harvard standards, 19% of heights and 9% of weights were <3rd percentile for age; only 2% of heights and 4% of weights were >97th percentile. Microhematocrit determinations demonstrated a very low prevalence of anemia: only 2% were >2 S.D. below the mean for age. Plasma iron levels were determined on 440 samples with a new spectrophotometric method using ferrozine and requiring 50μl of plasma. Less than 6% of the children had iron values <12.5μmol/l (70μg/dl). Although almost all hematocrit values were normal, children with lower hematocrits for age tended to have lower plasma irons (p<.001) and to be shorter (p<.001) and lighter (p<.03). A much higher proportion of children with iron deficiency anemia has been reported in other U.S. populations of similar economic level. The high prevalence of breastfeeding (46%), the use of iron fortified infant formulas (by history 75% of formula users), participation in food supplementation programs, and a cultural tradition that includes meat in children's regular diet may be factors in the unusually low prevalence of nutritional anemia among these Navajo children.