Skip to main content Accessibility help
×
Home

Sex differences in prevalence of anaemia and iron deficiency in infancy in a large multi-country trial in South-East Asia

  • Frank T. Wieringa (a1), Jacques Berger (a2) (a3), Marjoleine A. Dijkhuizen (a1), Adi Hidayat (a4), Nguyen X. Ninh (a3), Budi Utomo (a5), Emorn Wasantwisut (a6) and Pattanee Winichagoon (a6)...

Abstract

To evaluate effects of Fe supplementation and sex on the prevalence of anaemia and Fe status in infants in South-East Asia, biochemical data from four parallel, randomized, double-blind trials with Fe and/or Zn supplementation in infants (n 2452) in Indonesia, Thailand and Vietnam was pooled. At recruitment (5 months of age), Hb concentrations were slightly but significantly lower in boy infants compared with girl infants (108·7 g/l v. 111.4 g/l, P = 0·04). At 11 months of age, boy infants not receiving Fe had significantly lower Hb (106·2 g/l v. 111.0 g/l, P < 0·001) and lower serum ferritin concentrations (14·3 μg/l v. 21.1 g/l, P < 0·001) than girl infants not receiving Fe. Consequently, boy infants had a relative risk of 1·6 (95 % CI 1·3, 2·1) to be anaemic, and of 3·3 (95 % CI 2·1, 5·0) for having Fe deficiency anaemia compared with girl infants. Fe supplementation significantly increased Hb concentrations in both boys and girls. There was no sex difference in Fe status in infants receiving Fe for 6 months. This study shows that the markedly higher risk for anaemia and Fe deficiency indicates higher Fe requirements in boy than in girl infants. In South-East Asia, standard infant feeding practices do not provide sufficient Fe to meet requirements of infants, especially boys. Current daily recommended intake for Fe in infancy is the same for boy and girl infants however. Our findings suggest that in especially the second half of infancy, Fe requirements for boy infants are approximately 0·9 mg/d higher than for girl infants.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Sex differences in prevalence of anaemia and iron deficiency in infancy in a large multi-country trial in South-East Asia
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Sex differences in prevalence of anaemia and iron deficiency in infancy in a large multi-country trial in South-East Asia
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Sex differences in prevalence of anaemia and iron deficiency in infancy in a large multi-country trial in South-East Asia
      Available formats
      ×

Copyright

Corresponding author

*Corresponding author: Dr. F.T. Wieringa, fax 31 20 6168226, email wieringa@tiscali.nl

References

Hide All
UNICEF/UNU/WHO/MI (1999) Preventing iron deficiency in women and children. Technical consensus on key issues. Boston, MA: International Nutrition Foundation.
Allen, LH (1994) Nutritional influences on linear growth: a general review. Eur J Clin Nutr 48, Suppl. 1, S75S89.
Pollitt, E (1999) Early iron deficiency anemia and later mental retardation. Am J Clin Nutr 69, 45.
Pollitt, E, Watkins, WE & Husaini, MA (1997) Three-month nutritional supplementation in Indonesian infants and toddlers benefits memory function 8 y later. Am J Clin Nutr 66, 13571363.
Grantham-McGregor, SM & Ani, C (2001) A review of studies on the effect of iron deficiency on cognitive development in children. J Nutr 131, 649S668S.
Sherriff, A, Emond, A, Bell, JCGolding, J (2001) Should infants be screened for anaemia? A prospective study investigating the relation between haemoglobin at 8, 12, and 18 months and development at 18 months. Arch Dis Child 84, 480485.
Dijkhuizen, MA, Wieringa, FT, West, CE, Muherdiyantiningsih, Muhilal, (2001) Concurrent micronutrient deficiencies in lactating mothers and their infants in Indonesia. Am J Clin Nutr 73, 786791.
Whittaker, P (1998) Iron and zinc interactions in humans. Am J Clin Nutr 68, 442S446S.
Dewey, KG, Domellof, M, Cohen, RJ, Landa Rivera, L, Hernell, O & Lonnerdal, B (2002) Iron supplementation affects growth and morbidity of breast-fed infants: results of a randomized trial in Sweden and Honduras. J Nutr 132, 32493255.
Oppenheimer, SJ (2001) Iron and its relation to immunity and infectious disease. J Nutr 131, 616S635S.
Sazawal, S, Black, RE, Ramsan, M, et al. (2006) Effects of routine prophylactic supplementation with iron and folic acid on admission to hospital and mortality in preschool children in a high malaria transmission setting: community-based, randomised, placebo-controlled trial. Lancet 367, 133143.
Domellof, M, Lonnerdal, B, Dewey, KG, Cohen, RJ, Rivera, LL & Hernell, O (2002) Sex differences in iron status during infancy. Pediatrics 110, 545552.
Sherriff, A, Emond, A, Hawkins, N & Golding, J (1999) Haemoglobin and ferritin concentrations in children aged 12 and 18 months. ALSPAC Children in Focus Study Team. Arch Dis Child 80, 153157.
Wasantwisut, E, Winichagoon, P, Chitchumroonchokchai, C, Yamborisut, U, Boonpraderm, A, Pongcharoen, T, Sranacharoenpong, K & Russameesopaphorn, W (2006) Iron and zinc supplementation improved iron and zinc status, but not physical growth, of apparently healthy, breast-fed infants in rural communities of northeast Thailand. J Nutr 136, 24052411.
Berger, J, Ninh, NX, Khan, NC, Nhien, NV, Lien, DK, Trung, NQ & Khoi, HH (2006) Efficacy of combined iron and zinc supplementation on micronutrient status and growth in Vietnamese infants. Eur J Clin 60, 443454.
Nguyen, XN, Berger, J, Dao, TQ, Nguyen, CK, Traissac, PHa, HK (2002) Efficacy of daily and weekly iron supplementation for the control of iron deficiency anaemia in infants in rural Vietnam. Sante 12, 3137.
Dijkhuizen, MA, Wieringa, FT, West, CE, Martuti, S & Muhilal, (2001) Effects of iron and zinc supplementation in Indonesian infants on micronutrient status and growth. J Nutr 131, 28602865.
Gibson, RS (1990) Principles of nutritional assessment. Oxford: Oxford University Press.
Wieringa, FT, Berger, J, Dijkhuizen, MA, Hidayat, A, Ninh, NX, Utomo, B, Wasantwisut, E & Winichagoon, P (2007) Combined iron and zinc supplementation in infants improved iron and zinc status, but interactions reduced efficacy in a multicountry trial in southeast Asia. J Nutr 137, 466471.
UNICEF (2005) The State of the World's Children 2006. New York: UNICEF.
Institute of Medicine (2000) Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, D.C.: National Academy Press.
Joint FAO/WHO Expert Consultation (2002) Vitamin and mineral requirements in human nutrition. Geneva, Switzerland: World Health Organization.
Lutter, CK & Dewey, KG (2003) Proposed nutrient composition for fortified complementary foods. J Nutr 133, 3011S3020S.
Sharieff, W, Zlotkin, S, Tondeur, M, Feldman, B & Tomlinson, G (2006) Physiologic mechanisms can predict hematologic responses to iron supplements in growing children: a computer simulation model. Am J Clin Nutr 83, 681687.
Tondeur, MC, Schauer, CS, Christofides, AL, Asante, KP, Newton, S, Serfass, RE & Zlotkin, SH (2004) Determination of iron absorption from intrinsically labeled microencapsulated ferrous fumarate (sprinkles) in infants with different iron and hematologic status by using a dual-stable-isotope method. Am J Clin Nutr 80, 14361444.
Thurlow, RA, Winichagoon, P, Green, T, Wasantwisut, E, Pongcharoen, T, Bailey, KB & Gibson, RS (2005) Only a small proportion of anemia in northeast Thai schoolchildren is associated with iron deficiency. Am J Clin Nutr 82, 380387.
Weatherall, DJ & Clegg, JB (2001) Inherited haemoglobin disorders: an increasing global health problem. Bull WHO 79, 704712.
Suharno, D, West, CE, Muhilal, , Karyadi, D & Hautvast, JG (1993) Supplementation with vitamin A and iron for nutritional anaemia in pregnant women in West Java, Indonesia. Lancet 342, 13251328.
Wieringa, FT, Dijkhuizen, MA, West, CE, Northrop-Clewes, CA & Muhilal, (2002) Estimation of the effect of the acute phase response on indicators of micronutrient status in Indonesian infants. Journal of Nutrition 132, 30613066.

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed