Iron deficiency in early childhood in the United States: Risk factors and racial/ethnic disparities

Jane M. Brotanek, Jacqueline Gosz, Michael Weitzman, Glenn Flores

Research output: Contribution to journalArticle

Abstract

BACKGROUND. Iron deficiency affects 2.4 million US children, and childhood iron-deficiency anemia is associated with behavioral and cognitive delays. Given the detrimental long-term effects and high prevalence of iron deficiency, its prevention in early childhood is an important public health issue. OBJECTIVES. The study objectives were to (1) identify risk factors for iron deficiency in US children 1 to 3 years old, using data from the most recent waves of the National Health and Nutrition Examination Survey IV (1999-2002) and (2) examine risk factors for iron deficiency among Hispanic toddlers, the largest minority group of US children. PATIENTS AND METHODS. Analyses of the National Health and Nutrition Examination Survey IV were performed for a nationally representative sample of US children 1 to 3 years old. Iron-status measures were transferrin saturation, free erythrocyte protoporphyrin, and serum ferritin. Bivariate and multivariable analyses were performed to identify factors associated with iron deficiency. RESULTS. Among 1641 toddlers, 42% were Hispanic, 28% were white, and 25% were black. The iron deficiency prevalence was 12% among Hispanics versus 6% in whites and 6% in blacks. Iron deficiency prevalence was 20% among those with overweight, 8% for those at risk for overweight, and 7% for normal-weight toddlers. Fourteen percent of toddlers with parents interviewed in a non-English language had iron deficiency versus 7% of toddlers with parents interviewed in English. Five percent of toddlers in day care and 10% of the toddlers not in day care had iron deficiency. Hispanic toddlers were significantly more likely than white and black toddlers to be overweight (16% vs 5% vs 4%) and not in day care (70% vs 50% vs 43%). In multivariable analyses, overweight toddlers and those not in day care had higher odds of iron deficiency. CONCLUSIONS. Toddlers who are overweight and not in day care are at high risk for iron deficiency. Hispanic toddlers are more likely than white and black toddlers to be overweight and not in day care. The higher prevalence of these risk factors among Hispanic toddlers may account for their increased prevalence of iron deficiency.

Original languageEnglish (US)
Pages (from-to)568-575
Number of pages8
JournalPediatrics
Volume120
Issue number3
DOIs
StatePublished - Sep 1 2007

Fingerprint

Iron
Hispanic Americans
Nutrition Surveys
Parents
Minority Groups
Iron-Deficiency Anemias
Transferrin
Ferritins
Language
Public Health
Erythrocytes
Weights and Measures

Keywords

  • Day care
  • Disparities
  • Early childhood
  • Iron deficiency
  • Obesity
  • Racial/ethnic minorities

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Iron deficiency in early childhood in the United States : Risk factors and racial/ethnic disparities. / Brotanek, Jane M.; Gosz, Jacqueline; Weitzman, Michael; Flores, Glenn.

In: Pediatrics, Vol. 120, No. 3, 01.09.2007, p. 568-575.

Research output: Contribution to journalArticle

Brotanek, Jane M. ; Gosz, Jacqueline ; Weitzman, Michael ; Flores, Glenn. / Iron deficiency in early childhood in the United States : Risk factors and racial/ethnic disparities. In: Pediatrics. 2007 ; Vol. 120, No. 3. pp. 568-575.
@article{fb546dd17caa4f39839b08ccc2e00436,
title = "Iron deficiency in early childhood in the United States: Risk factors and racial/ethnic disparities",
abstract = "BACKGROUND. Iron deficiency affects 2.4 million US children, and childhood iron-deficiency anemia is associated with behavioral and cognitive delays. Given the detrimental long-term effects and high prevalence of iron deficiency, its prevention in early childhood is an important public health issue. OBJECTIVES. The study objectives were to (1) identify risk factors for iron deficiency in US children 1 to 3 years old, using data from the most recent waves of the National Health and Nutrition Examination Survey IV (1999-2002) and (2) examine risk factors for iron deficiency among Hispanic toddlers, the largest minority group of US children. PATIENTS AND METHODS. Analyses of the National Health and Nutrition Examination Survey IV were performed for a nationally representative sample of US children 1 to 3 years old. Iron-status measures were transferrin saturation, free erythrocyte protoporphyrin, and serum ferritin. Bivariate and multivariable analyses were performed to identify factors associated with iron deficiency. RESULTS. Among 1641 toddlers, 42{\%} were Hispanic, 28{\%} were white, and 25{\%} were black. The iron deficiency prevalence was 12{\%} among Hispanics versus 6{\%} in whites and 6{\%} in blacks. Iron deficiency prevalence was 20{\%} among those with overweight, 8{\%} for those at risk for overweight, and 7{\%} for normal-weight toddlers. Fourteen percent of toddlers with parents interviewed in a non-English language had iron deficiency versus 7{\%} of toddlers with parents interviewed in English. Five percent of toddlers in day care and 10{\%} of the toddlers not in day care had iron deficiency. Hispanic toddlers were significantly more likely than white and black toddlers to be overweight (16{\%} vs 5{\%} vs 4{\%}) and not in day care (70{\%} vs 50{\%} vs 43{\%}). In multivariable analyses, overweight toddlers and those not in day care had higher odds of iron deficiency. CONCLUSIONS. Toddlers who are overweight and not in day care are at high risk for iron deficiency. Hispanic toddlers are more likely than white and black toddlers to be overweight and not in day care. The higher prevalence of these risk factors among Hispanic toddlers may account for their increased prevalence of iron deficiency.",
keywords = "Day care, Disparities, Early childhood, Iron deficiency, Obesity, Racial/ethnic minorities",
author = "Brotanek, {Jane M.} and Jacqueline Gosz and Michael Weitzman and Glenn Flores",
year = "2007",
month = "9",
day = "1",
doi = "10.1542/peds.2007-0572",
language = "English (US)",
volume = "120",
pages = "568--575",
journal = "Pediatrics",
issn = "0031-4005",
publisher = "American Academy of Pediatrics",
number = "3",

}

TY - JOUR

T1 - Iron deficiency in early childhood in the United States

T2 - Risk factors and racial/ethnic disparities

AU - Brotanek, Jane M.

AU - Gosz, Jacqueline

AU - Weitzman, Michael

AU - Flores, Glenn

PY - 2007/9/1

Y1 - 2007/9/1

N2 - BACKGROUND. Iron deficiency affects 2.4 million US children, and childhood iron-deficiency anemia is associated with behavioral and cognitive delays. Given the detrimental long-term effects and high prevalence of iron deficiency, its prevention in early childhood is an important public health issue. OBJECTIVES. The study objectives were to (1) identify risk factors for iron deficiency in US children 1 to 3 years old, using data from the most recent waves of the National Health and Nutrition Examination Survey IV (1999-2002) and (2) examine risk factors for iron deficiency among Hispanic toddlers, the largest minority group of US children. PATIENTS AND METHODS. Analyses of the National Health and Nutrition Examination Survey IV were performed for a nationally representative sample of US children 1 to 3 years old. Iron-status measures were transferrin saturation, free erythrocyte protoporphyrin, and serum ferritin. Bivariate and multivariable analyses were performed to identify factors associated with iron deficiency. RESULTS. Among 1641 toddlers, 42% were Hispanic, 28% were white, and 25% were black. The iron deficiency prevalence was 12% among Hispanics versus 6% in whites and 6% in blacks. Iron deficiency prevalence was 20% among those with overweight, 8% for those at risk for overweight, and 7% for normal-weight toddlers. Fourteen percent of toddlers with parents interviewed in a non-English language had iron deficiency versus 7% of toddlers with parents interviewed in English. Five percent of toddlers in day care and 10% of the toddlers not in day care had iron deficiency. Hispanic toddlers were significantly more likely than white and black toddlers to be overweight (16% vs 5% vs 4%) and not in day care (70% vs 50% vs 43%). In multivariable analyses, overweight toddlers and those not in day care had higher odds of iron deficiency. CONCLUSIONS. Toddlers who are overweight and not in day care are at high risk for iron deficiency. Hispanic toddlers are more likely than white and black toddlers to be overweight and not in day care. The higher prevalence of these risk factors among Hispanic toddlers may account for their increased prevalence of iron deficiency.

AB - BACKGROUND. Iron deficiency affects 2.4 million US children, and childhood iron-deficiency anemia is associated with behavioral and cognitive delays. Given the detrimental long-term effects and high prevalence of iron deficiency, its prevention in early childhood is an important public health issue. OBJECTIVES. The study objectives were to (1) identify risk factors for iron deficiency in US children 1 to 3 years old, using data from the most recent waves of the National Health and Nutrition Examination Survey IV (1999-2002) and (2) examine risk factors for iron deficiency among Hispanic toddlers, the largest minority group of US children. PATIENTS AND METHODS. Analyses of the National Health and Nutrition Examination Survey IV were performed for a nationally representative sample of US children 1 to 3 years old. Iron-status measures were transferrin saturation, free erythrocyte protoporphyrin, and serum ferritin. Bivariate and multivariable analyses were performed to identify factors associated with iron deficiency. RESULTS. Among 1641 toddlers, 42% were Hispanic, 28% were white, and 25% were black. The iron deficiency prevalence was 12% among Hispanics versus 6% in whites and 6% in blacks. Iron deficiency prevalence was 20% among those with overweight, 8% for those at risk for overweight, and 7% for normal-weight toddlers. Fourteen percent of toddlers with parents interviewed in a non-English language had iron deficiency versus 7% of toddlers with parents interviewed in English. Five percent of toddlers in day care and 10% of the toddlers not in day care had iron deficiency. Hispanic toddlers were significantly more likely than white and black toddlers to be overweight (16% vs 5% vs 4%) and not in day care (70% vs 50% vs 43%). In multivariable analyses, overweight toddlers and those not in day care had higher odds of iron deficiency. CONCLUSIONS. Toddlers who are overweight and not in day care are at high risk for iron deficiency. Hispanic toddlers are more likely than white and black toddlers to be overweight and not in day care. The higher prevalence of these risk factors among Hispanic toddlers may account for their increased prevalence of iron deficiency.

KW - Day care

KW - Disparities

KW - Early childhood

KW - Iron deficiency

KW - Obesity

KW - Racial/ethnic minorities

UR - http://www.scopus.com/inward/record.url?scp=34548399062&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34548399062&partnerID=8YFLogxK

U2 - 10.1542/peds.2007-0572

DO - 10.1542/peds.2007-0572

M3 - Article

C2 - 17766530

AN - SCOPUS:34548399062

VL - 120

SP - 568

EP - 575

JO - Pediatrics

JF - Pediatrics

SN - 0031-4005

IS - 3

ER -