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

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Objective
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.

Methods
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.

Results
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).

Conclusion
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
JournalNutrition
Volume62
DOIs
Publication statusPublished - 1 Jun 2019

Fingerprint

South Africa
Anemia
Iron
Food
Vitamin A
Vitamin B 12
Ascorbic Acid
Vitamin B Complex
Plant Proteins
Iron-Deficiency Anemias
Ferritins
Folic Acid
Statistical Factor Analysis
Zinc
Hemoglobins
Logistic Models
Fats
Odds Ratio
Regression Analysis
Carbohydrates

Keywords

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

Cite this

Visser, M., van Zyl, T., Hanekom, S. M., Baumgartner, J., van der Hoeven, M., Taljaard-Krugell, C., ... Faber, M. (2019). Nutrient patterns and their relation to anemia and iron status in 5- to 12-y-old children in South Africa. Nutrition, 62, 194-200. https://doi.org/10.1016/j.nut.2019.01.016
Visser, Marina ; van Zyl, Tertia ; Hanekom, Susanna M. ; Baumgartner, Jeannine ; van der Hoeven, M. ; Taljaard-Krugell, Christine ; Smuts, C.M. ; Faber, Mieke. / Nutrient patterns and their relation to anemia and iron status in 5- to 12-y-old children in South Africa. In: Nutrition. 2019 ; Vol. 62. pp. 194-200.
@article{48f7c12f7aba4c55bc324bded1b10a8e,
title = "Nutrient patterns and their relation to anemia and iron status in 5- to 12-y-old children in South Africa",
abstract = "ObjectiveThe 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.MethodsData 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.ResultsIn 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).ConclusionThe 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.",
keywords = "Anemia, Iron deficiency, Nutrient patterns, primary school children, South Africa",
author = "Marina Visser and {van Zyl}, Tertia and Hanekom, {Susanna M.} and Jeannine Baumgartner and {van der Hoeven}, M. and Christine Taljaard-Krugell and C.M. Smuts and Mieke Faber",
year = "2019",
month = "6",
day = "1",
doi = "10.1016/j.nut.2019.01.016",
language = "English",
volume = "62",
pages = "194--200",
journal = "Nutrition",
issn = "0899-9007",
publisher = "Elsevier Inc.",

}

Visser, M, van Zyl, T, Hanekom, SM, Baumgartner, J, van der Hoeven, M, Taljaard-Krugell, C, Smuts, CM & Faber, M 2019, 'Nutrient patterns and their relation to anemia and iron status in 5- to 12-y-old children in South Africa' Nutrition, vol. 62, pp. 194-200. https://doi.org/10.1016/j.nut.2019.01.016

Nutrient patterns and their relation to anemia and iron status in 5- to 12-y-old children in South Africa. / Visser, Marina; van Zyl, Tertia; Hanekom, Susanna M.; Baumgartner, Jeannine; van der Hoeven, M.; Taljaard-Krugell, Christine; Smuts, C.M.; Faber, Mieke.

In: Nutrition, Vol. 62, 01.06.2019, p. 194-200.

Research output: Contribution to JournalArticleAcademicpeer-review

TY - JOUR

T1 - Nutrient patterns and their relation to anemia and iron status in 5- to 12-y-old children in South Africa

AU - Visser, Marina

AU - van Zyl, Tertia

AU - Hanekom, Susanna M.

AU - Baumgartner, Jeannine

AU - van der Hoeven, M.

AU - Taljaard-Krugell, Christine

AU - Smuts, C.M.

AU - Faber, Mieke

PY - 2019/6/1

Y1 - 2019/6/1

N2 - ObjectiveThe 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.MethodsData 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.ResultsIn 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).ConclusionThe 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.

AB - ObjectiveThe 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.MethodsData 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.ResultsIn 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).ConclusionThe 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.

KW - Anemia

KW - Iron deficiency

KW - Nutrient patterns

KW - primary school children

KW - South Africa

UR - http://www.scopus.com/inward/record.url?scp=85063348629&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85063348629&partnerID=8YFLogxK

U2 - 10.1016/j.nut.2019.01.016

DO - 10.1016/j.nut.2019.01.016

M3 - Article

VL - 62

SP - 194

EP - 200

JO - Nutrition

JF - Nutrition

SN - 0899-9007

ER -