Major Study Finds 1 in 7 Babies is Iron Deficient
New
Zealand’s infants and toddlers have high levels of iron
deficiency, with one in seven missing out on this vital
micronutrient, a major new study has found. Researchers
examined 405 children aged between six and 23 months from
New Zealand’s three largest ethnic groups and across all
socioeconomic levels.
The
dietary habits of these children were examined in detail by
Deborah Brunt, a medical student at the University of
Auckland. Her detailed work was performed under the guidance
of Dr Clare Wall, Paediatric Nutritionist, and Associate
Professor and Starship paediatrician Dr Cameron Grant. The
study discovered that New Zealand’s young children have a
rate of iron deficiency twice that of American, Australian
and European youngsters.
Dr Grant
said the study identified four key dietary risk factors for
iron deficiency:
1.
Drinking cow’s milk daily and not breast-feeding or
using infant formula in children less than 12 months old;
2.
No infant formula;
3.
Having home-made rather than commercial solids as the
first solid food;
4.
Having fruit as a snack rather than with a meal.
“Any one
of these factors, as part of a baby’s feeding habits,
increases the risk of iron deficiency at least three times,”
Dr Grant said. “Once you have two or more factors present,
the risk increases dramatically. For example, if a child
aged six to 23 months is drinking cow’s milk every day, and
the first solid food is home-made, the likelihood of iron
deficiency increases by a factor of eight.”
“Very
young children have high iron needs. In New Zealand, as in
many developed countries, there is a nutritional paradox –
we eat many foods that are high in energy but don’t contain
enough micronutrients.”
Dr Grant
said one of his team’s main discoveries was that the feeding
habits of many youngsters were not consistent with current
recommendations. Less than one third of infants and toddlers
consumed the currently recommended four servings of fruit
and vegetables per day.
“We
discovered that the timing of fruit consumption was
important. Having fruit or fruit juice with meals protects
against iron deficiency whereas having it as a snack does
not. This helps to explain why iron deficiency is more
frequent in Maori and Pacific children. Maori and Pacific
children were more likely to be given fruit as a snack,
while European babies tend to have it with meals.”
“The
research results stress the need to breast-feed infants, to
give infants and toddlers fruit with meals and feed them
infant formula instead of cow’s milk. It also showed that
home-made foods need to be iron-rich, and that commercial
baby foods are useful for baby’s first solids,“ Dr Grant
said.
The
study also found that for 39% of children, the introduction
of meat into the diet was delayed beyond the recommended age
of six to seven months. Meat is an excellent source of iron.
The
study was funded through a grant from the Health Research
Council of New Zealand. Mrs Brunt’s work was made possible
by a research scholarship created by the Starship Foundation
and endowed by the baby-food producer Only Organic. Muir
McCallum, director of Only Organic, said his company wanted
to work with Starship to find out how they could meet
parents’ needs. “One of the biggest things we find when
talking to parents is that they’re often confused about the
best ways to feed their kids, with all the conflicting
messages about health and nutrition. The findings of this
research make it very clear to parents that there are some
key things they can do to keep their babies and toddlers
healthy.”
Mr
McCallum believed many parents would be reassured by the
study’s evidence that giving children commercial baby food
may assist in preventing iron deficiency. “The difficulty is
even for the best home cooks, it can be tough to master the
techniques for getting baby food to the right consistency
without losing some of the micronutrients. On top of
everything else you have to do to care for a baby, preparing
the right food for them is a lot of work.”
Iron
deficiency is the world’s most common micronutrient
deficiency, with an estimated 3.5 billion people affected
worldwide. Iron is essential for brain development, and many
studies have linked a deficiency in iron to lower mental and
motor function and altered social and emotional behaviour in
infants. Behavioural effects can include clinginess,
weariness and irritability, and the results of deficiency
can last into childhood and adolescence.
The
research team conducted interviews with 405 families about
their toddlers’ diets and eating habits, and compared this
information with an analysis of their iron status,
determined from a blood sample. The results showed the
prevalence of iron deficiency varied across ethnic groups;
overall, 13% were found to be iron deficient, compared with
20% of Maori children,16% of Pacific children and 7% of
European children in the same age group. In a fourth,
smaller category – defined as Other and including mostly
south-east Asian, Chinese and Indian children – 27% of
toddlers were iron deficient.
Starship
Foundation Chief Executive Andrew Young was pleased parents
could take away some helpful messages from the study. “It’s
reinforced the nutritional importance of fruits and
vegetables, as we expected. However, we were surprised at
how some simple dietary changes, like using formula instead
of cow’s milk, and the use of baby food from the
supermarket, can prevent iron deficiency.”
The
study has been published in the July-August 2007 issue of
the Journal of
Paediatrics and Child Health.