[2001] [2668] Is Food Insecurity Associated with Iron Deficiency?
Anne M. Skalicky, Deborah A. Frank, Alan F. Meyers, William G. Adams, John T. Cook Pediatrics, Boston Medical Center, Boston, MA
BACKGROUND: According to 1999 USDA data, 14% of U.S. households with children are food insecure, having limited or uncertain access to adequate food for a healthy life due to inadequate resources. Food insecurity is highly associated with poverty, but has not been linked to objective adverse nutrition or health outcomes in children. Iron deficiency is the most prevalent nutritional deficiency in the US, affecting nearly one quarter of low-income children <3 years of age.
OBJECTIVE: This analysis examines the association between iron deficiency and household food insecurity in a convenience sample of high-risk children <3 years.
DESIGN/METHODS: Between 6/96 and 8/00, Spanish and English speaking caregivers of children <3 years of age seen in the Pediatric Emergency Department at Boston Medical Center (BMC)were interviewed (n=1096). Interviews included the USDA Food Security Instrument, demographic, and program participation questions. Hematological laboratory data from the BMC primary care clinic were linked by medical record number to caregiver interviews. Children with anemia, but no other indication of iron deficiency (n=82), as well as children with gestational age <37 weeks (n=150) or households receiving SSI (n=122), were excluded. After restricting sample, 768 (70%) interviews were matched to hematological laboratory indices or parent report of iron medicine (n=113).
RESULTS: Iron nurtriture was classified in three categories: Iron Deficiency with Anemia [IDA]: Hemoglobin [Hb] <11 for age <2 yr, Hb <11.1 for age 2-3 yr and erythrocyte protoporphyrin [EP] >35 or mean cell volume [MCV] <77 for age <2 yr, <79 for age 2-3 yr; or parent report of iron medicine. Iron Deficient without Anemia [ID]: normal Hb with abnormal EP or MCV. Normal: normal Hb, EP, and MCV.
| | Food Secure | Food Insecure | | | | | Normal (n=418) | 353 (84%) | 65 (16%) | vs. normal | | | | ID (n=209) | 166 (79%) | 43 (21%) | OR=1.41 | CI(0.9-2.20) | P<.12 | | IDA (n=141) | 108 (77%) | 33 (23%) | OR=1.66 | CI(1.01-2.73) | P<.03 |
CONCLUSIONS: Household food insecurity is associated with iron deficiency anemia in children. These results support the use of the Food Security Measurement to assess household conditions associated with adverse health outcomes.
|