Household food insecurity is a risk factor for iron-deficiency anaemia in a multi-ethnic, low-income sample of infants and toddlers

Abstract

Objective: The present study examines the relationships of household food security status with Fe deficiency (ID) and Fe-deficiency anaemia (IDA) among children less than 3 years of age, and associated factors that contribute to ID and IDA.Design Cross-sectional study and chart review. The US Food Security Survey Module was administered to adult caregivers as part of the Childrens Sentinel Nutrition Assessment Project (C-SNAP). Haematological data were obtained from medical records.Setting A large metropolitan medical centre in Minneapolis, Minnesota, USA.Subjects A multi-ethnic sample of 2853 low-income children aged <36 months who received care at the medical centre.Results: Among the caregivers, 23.3% reported low household food security and 11.6% reported very low household food security (VLFS). After controlling for background factors, children from households with VLFS were almost twice as likely to have IDA than were children from households with high or marginal food security (OR = 1.98, 95% CI 1.11, 3.53); the corresponding associations for ID were not statistically significant.Conclusions: The prevalence of IDA in early childhood is significantly larger in low-income infants and toddlers living in VLFS households. Asian, Hispanic and African-American children have elevated prevalences of ID and IDA. Breast-feeding may be associated with elevated ID and IDA, while participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) may be protective for ID.