Nutrient patterns and their relation to anemia and iron status in 5- to 12-y-old children in South Africa

Marina Visser*, Tertia van Zyl, Susanna M. Hanekom, Jeannine Baumgartner, M. van der Hoeven, Christine Taljaard-Krugell, C.M. Smuts, Mieke Faber

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

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The aim of this study was to assess nutrient patterns and their relation to anemia and iron status of school children using pooled data from three study populations in South Africa.

Data from 5- to 12-y-old children (N = 578) from three independent studies conducted in two provinces in South Africa were pooled. Data used in the analysis were dietary intake, hemoglobin, and plasma ferritin concentrations. Nutrient patterns were determined using factor analysis. Logistic regression analysis was performed to determine relationships of nutrient patterns with anemia and iron deficiency.

In the pooled group, 13.8% of the children were anemic and 27.7% were iron deficient (ID). More than half of children did not meet the Estimated Average Requirement for various nutrients, including vitamins A, C, B12, folate, and zinc, although only 17.7% of children had an iron intake below the requirements. Median intakes for vitamins A and C were lower for anemic than non-anemic children (P = 0.03 and 0.02, respectively) and for ID versus non-ID children (P = 0.03 and 0.046, respectively). Four nutrient patterns were identified: plant protein, carbohydrate, iron, and B vitamins; animal protein and saturated fat; vitamins A and B12; and calcium and fiber. The vitamin A and B12 nutrient pattern was associated with lower odds of being anemic (odds ratio, 0.63; 95% confidence interval, 0.49–0.91; P = 0.035).

The present results highlighted the potential role of the combination of dietary vitamin A and B12 in the etiology of nutritional anemia in school-age children in South Africa. Nutrient pattern analysis may improve the understanding of the synergistic role of nutrients related to anemia and may assist in planning intervention strategies.
Original languageEnglish
Pages (from-to)194-200
Number of pages7
Early online date26 Jan 2019
Publication statusPublished - Jun 2019


  • Anemia
  • Iron deficiency
  • Nutrient patterns
  • primary school children
  • South Africa


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