OBJECTIVEIn order to better understand the iron status in pregnant and premenopausal nonpregnant women in China.

METHODSA nationwide epidemiological survey was undertaken in the year 2000 to investigate the prevalence rates (PR) of iron depletion (ID), iron deficiency anemia (IDA) and iron deficiency (ID + IDA). 3591 pregnant women and 3721 premenopausal women were selected by multi-stratification and random sampling from 26 cities and counties of 15 provinces. Hb was measured by cyanmethemoglobin assay, zinc protoporphyrin by hemo-fluorescein assay and serum ferritin by radioimmunoassay.

RESULTSThe PR of ID and IDA were 42.6% and 19.1% in pregnant women, while 34.4% and 15.1% in premenopausal nonpregnant women respectively. There were statistical differences in the PR of IDA and ID + IDA in pregnant women between different trimesters (P < 0.01), with the highest in the third trimester (33.8%, 85.4%), followed by the second and the first trimesters. The prevalence rate of ID was also the highest during late pregnancy (51.6%), which was statistically different from that of early and mid-pregnancies (39.9% and 38.8% respectively), whereas there was no significant difference between the PR in early and mid-pregnancies. The PR of ID, IDA and ID + IDA in pregnant women were all significantly higher than that in premenopausal non-pregnant women (P < 0.01). The PR of ID in urban first-trimester pregnant women (41.9%) and premenopausal non-pregnant women (35.6%) were significantly higher than that in their rural counterparts (36.1% and 32.4% respectively P < 0.05). On the other hand, the PR of IDA in rural pregnant women in first-trimester (12.2%) and premenopausal non-pregnant women (17.4%) were significantly higher than that in their urban counterparts (8.2% and 13.8% respectively, P < 0.05). However, there was no significant difference between the PR of ID + IDA in urban pregnant women (62.0%), premenopausal nonpregnant women (49.4%) and then rural counterparts (61.1% and 49.7%).

CONCLUSIONSIDA and latent iron deficiency are still quite common in Chinese pregnant and premenopausal nonpregnant women. Pregnant women in mid and late pregnancies are at risk for iron deficiency. Latent iron deficiency is more prevalent in urban pregnant and nonpregnant premenopausal women, but their rural counterparts were prone to the development of IDA.

Adult ; Anemia, Iron-Deficiency ; epidemiology ; China ; epidemiology ; Female ; Humans ; Iron ; deficiency ; Middle Aged ; Pregnancy ; Pregnancy Complications ; epidemiology ; Premenopause ; Prevalence ; Young Adult

BACKGROUNDS: Previous surveys have found that children with iron deficiency (ID) were likely to suffer from early childhood caries (ECC). We aimed to assess the scientific evidence about whether ID is intrinsically related to ECC. METHODS: The medical subject headings (MeSH) terms and free words were searched on PubMed, Web of Science, Cochrane, China National Knowledge Infrastructure, Wanfang, and the Database for Chinese Technical Periodicals from March 2020 to September 2020. Two researchers independently screened the articles. Data extraction and cross-checking were performed for the studies that met the inclusion criteria. Meta-analysis was performed using the Cochrane Collaboration's Review Manager 5.3 software. RESULTS: After excluding duplication and irrelevant literature, 12 case-control studies were included in the study. The meta-analysis demonstrated that children with ECC were more likely to have ID (odds ratio [OR] = 2.63, 95% confidence interval [CI]: [1.85, 3.73], P < 0.001). There was no statistically significant association found between the level of serum ferritin and ECC (weighted mean difference (WMD) = -5.80, 95% CI: [-11.97, 0.37], P = 0.07). Children with ECC were more likely to have iron-deficiency anemia (OR = 2.74, 95% CI: [2.41,3.11], P < 0.001). The hemoglobin (HGB) levels in the ECC group were significantly lower compared with that in the ECC-free group (WMD = -9.96, 95% CI: [-15.45, -4.46], P = 0.0004). The mean corpuscular volume (MCV) levels in the ECC group were significantly lower compared with that in the ECC-free group (WMD = -3.72, 95% CI: [-6.65, -0.79], P = 0.01). CONCLUSIONS ID was more prevalent in children with ECC, and the markers of iron status in the ECC group, such as serum ferritin, HGB, and MCV, were relatively lower than the ECC-free group.
Anemia, Iron-Deficiency/epidemiology* ; Case-Control Studies ; Child ; Child, Preschool ; Dental Caries Susceptibility ; Erythrocyte Indices ; Humans ; Iron Deficiencies

OBJECTIVES: To study the efficacy of intermittent iron supplementation in children with mild iron-deficiency anemia. METHODS: A total of 147 children with mild iron-deficiency anemia were enrolled in this prospective study. They were divided into an intermittent iron supplementation group (n=83) and a conventional iron supplementation group (n=64). The levels of hemoglobin were measured before treatment and after 1 and 3 months of treatment. The treat response rate and the incidence rate of adverse drug reactions were compared between the two groups. RESULTS: Both groups had a significant increase in the level of hemoglobin after iron supplementation (P<0.05). After 1 month of treatment, the conventional iron supplementation group had a significantly higher treatment response rate than the intermittent iron supplementation group (61% vs 42%, P<0.05). After 3 months of treatment, there was no significant difference in the treatment response between the two groups (86% vs 78%, P>0.05). The incidence rate of adverse drug reactions in the conventional iron supplementation group was significantly higher than that in the intermittent iron supplementation group (25% vs 8%, P<0.05). CONCLUSIONS For children with mild iron-deficiency anemia, although intermittent iron supplementation is inferior to conventional iron supplementation in the short-term efficacy, there is no significant difference in the long-term efficacy between the two methods, and compared with conventional iron supplementation, intermittent iron supplementation can reduce the incidence of adverse drug reactions, alleviate family financial burdens, and improve treatment compliance of children, thus holding promise for clinical application.
Anemia, Iron-Deficiency/epidemiology* ; Child ; Dietary Supplements/adverse effects* ; Hemoglobins/analysis* ; Humans ; Iron, Dietary/adverse effects* ; Prospective Studies

OBJECTIVETo analyze the detecting rate of iron-deficient anemia and the compose ratio of different degree of anemia in Chinese students.

METHODBy using the WHO screening standard, and using the row data of 1995 and 2000 National Survey sample, to screen the prevalence of anemia in the primary and secondary school students, and compare the detecting rates among different populations.

RESULTSThe detecting rates of iron-deficient anemia have been decreased in a large scale in the Chinese students. Situations are better in the young ages than in the relative old ages. The detecting rates has decreased 7.6% and 5.7% in the urban boys aged 7 and 9 years old, respectively, in recent 5 years, which are more evident than the urban girls. In rural boys and girls, the detecting rates of iron-deficiency anemia of all the age groups have decreasing 3%-7%, which are more significant than in the urban ones. The composing ratio of the middle- and serious-degree anemia has already lower than 2%-3%, whereas the ratios of the marginal anemia have risen significantly in the recent 5 years. In totally, the ratios have risen 7.2%, 1.3%, 7.0% and 6.0% in the urban boys, urban girls, rural boys and rural girls, respectively. This phenomenon shows that the problem of the iron-deficiency anemia of the Chinese students will be easily to be overcome in the future.

CONCLUSIONSAccording to the situation, three measures are suggested by the authors: Focus on increasing the iron storage of the students by scientific arrangement of food intake. Put the students who are during the peak adolescent growth as the key population. Put the widespread of knowledge of anemia-prevention as the contents in the school nutrition education.

Adolescent ; Anemia, Iron-Deficiency ; diagnosis ; epidemiology ; Child ; China ; epidemiology ; Female ; Health Education ; Health Surveys ; Humans ; Male ; Students

OBJECTIVETo collect epidemiological data of iron deficiency in Chinese children 7 months to 7 years of age, so more rational strategies of prevention and treatment against iron deficiency can be made.

METHODSAll the 31 provinces, municipalities and autonomous regions in China were first divided into 3 major regions based on geographic location socioeconomic developmental status. Among them, 15 provinces, municipalities and autonomous regions were randomly selected: 6 from the coastal regions, 5 from inland regions and 4 from remote regions. Then, 26 cities/counties were further selected from the 15 provinces, municipalities and autonomous regions. Ultimately, 9118 children aged 7 months to 7 years were selected as study subjects. Hemoglobin (Hb) was measured by cyanmethemoglobin assay, zinc protoporphorin by hemofluorescence assay and serum ferritin by radioimmunoassay.

RESULTSThe prevalence rates of iron depletion (ID) and iron deficiency anemia (IDA) were 32.5% and 7.8% respectively in children 7 months to 7 years in China. The prevalence rates were highest in infants (ID 44.7%, IDA 20.8%), followed by toddlers aged 1 - 3 years (ID 35.9%, IDA 7.8%) and preschoolers aged 4 to 7 years (ID 26.5%, IDA 3.5%), with statistically significant differences (P < 0.01). In countryside, the prevalence rates of ID were 35.8%, 31.0% and 27.6%, and the prevalence rates of IDA were 30.1%, 15.5% and 6.3% for children 7 to 12 months, 1 to 3 years and 4 to 7 years of age, respectively. While Hb measurements averaged (98.8 +/- 9.1) g/L, (98.2 +/- 10.5) g/L and (101.2 +/- 8.6) g/L respectively for the same age groups with IDA. In cities, the corresponding figures were 48.1%, 38.0% and 26.0% for ID, 16.8%, 4.4% and 1.9% for IDA, (101.0 +/- 6.8) g/L, (102.8 +/- 6.9) g/L and (104.2 +/- 4.4) g/L for average Hb measurements. There were statistically significant difference between the overall prevalence rate of iron deficiency in children living in rural areas and that of children in cities (42.0% versus 39.5%, P < 0.01). Obviously, there were significantly more urban children aged 6 months to 3 years suffering from latent iron deficiency than their rural counterparts, while there were more rural children with iron deficiency anemia. The average Hb measurements from each rural children age group with IDA were lower than that of their urban peers (P < 0.01).

CONCLUSIONSID was more prevalent than IDA in each age group in children, suggesting that latent iron deficiency was currently one of the major nutritional problems for Chinese children. The present study also showed that infants were still at higher risk for iron deficiency in spite of rapid socioeconomic development in the last two decades. Urban children were more likely to be inflicted by latent iron deficiency, while rural children were more prone to development of iron deficiency anemia. The susceptibility of rural children to development of iron deficiency anemia may be related to lower socioeconomic status of their families, poor hygienic conditions etc.

Anemia, Iron-Deficiency ; epidemiology ; Child ; Child, Preschool ; China ; epidemiology ; Deficiency Diseases ; epidemiology ; Ferritins ; blood ; Hemoglobins ; analysis ; Humans ; Infant ; Iron ; deficiency ; Prevalence ; Protoporphyrins ; blood ; Rural Population ; Socioeconomic Factors ; Urban Population

OBJECTIVETo evaluate the effects of Wenchuan Earthquake on the nutritional status, growth, and the prevalence nutritional anemia, vitamin A deficiency (VAD) and vitamin D deficiency among children under 60 months old living in the disaster areas.

METHODSA nutritional survey was conducted in April 2009. The survey recruited 466 under 60 months old children, including 162 children aged 0 months old and 304 children aged 24 - 59 months old. The children's growth status, prevalence of anemia, and the iron deficiency prevalence, vitamin A, D, B(12), folic acid status were measured. The study findings were compared to the results from 2002 Chinese Nutritional and Health Survey.

RESULTSThe exclusive breast milk feeding rate among infants under 6-months was 58.8% (30/51). Among the 0 - 23 months old children, only 10.7% (16/150) got breast feeding within one hour after delivery. Ninety-two per cent (149/162) 0 - 23 months old children never received any nutrient supplements. The average cereals and roots intakes of the 24 - 59 months old children living in the disaster area were (267.2 ± 154.3) g/d, higher than the result of rural children average (178.75 g/d) of 2002 National Nutrition and Health Survey (u = 9.995, P < 0.01). The average intakes of vegetables, aquatic products, meat and poultries were (63.6 ± 56.7), (2.6 ± 7.9), (19.4 ± 24.0) g/d, respectively, significantly lower than 2002 results 135.05, 8.82 and 32.23 g/d (u = 21.971, 13.728 and 9.321, P < 0.01). Fruits, dairy products and legumes intakes were (102.2 ± 110.8), (65.2 ± 123.8) and (20.5 ± 29.0) g/d, respectively, higher than 2002 results (32.81, 2.87 and 6.50 g/d; u = 10.919, 8.778 and 8.417, P < 0.01). The prevalence of vitamin A deficiency and marginal deficiency was 15.4% (29/188) and 30.3% (57/188), respectively. The sum of vitamin D deficiency and insufficiency was 92.0% (183/199). The prevalence of anemia of the 0-months old children and 24 - 59 months old children was 47.5% (77/162) and 21.5% (60/279), respectively. The prevalence of iron and zinc deficiencies was 45.7% (86/188) and 65.5% (127/197). The prevalence of stunt was 13.6% (38/279) among the 24 - 59 months old children.

CONCLUSIONThe results indicated that the dietary structure of the children living in the disaster area was not ideal. Although, the intakes of energy and protein supporting foods could meet the requirements, but the dietary lacks of meats, poultries, dairy products, legume products, aquatic products and vegetables. The vitamin A, vitamin D deficiency, iron and zinc deficiencies are of a high prevalence in the disaster area.

Anemia, Iron-Deficiency ; epidemiology ; Child Nutritional Physiological Phenomena ; Child, Preschool ; China ; epidemiology ; Disasters ; Earthquakes ; Humans ; Infant ; Nutrition Surveys ; Nutritional Status ; Prevalence ; Rural Population ; Vitamin A Deficiency ; epidemiology ; Vitamin D Deficiency ; epidemiology ; Zinc ; deficiency

OBJECTIVETo evaluate the effects of Wenchuan Earthquake on the nutritional status and the prevalence of nutritional anemia, vitamin A deficiency (VAD) and vitamin D deficiency among reproductive women (15 - 44 years old) in the disaster areas one year after the Earthquake.

METHODSA nutritional survey was conducted in 3 counties in April 2009, one year after the Earthquake. Two towns from each county were selected as study sites, and this survey recruited 58 pregnant, 66 lactating and 242 non-pregnant-non-lactating women. A comparison was made to the results of 2002 Chinese Nutrition and Health Survey.

RESULTSThe cereals and roots intakes of the pregnant, lactating and non-pregnant-non-lactating women living in the disaster area were (426.8 ± 271.8), (568.0 ± 306.1), and (483.0 ± 277.7) g/d respectively, which were almost the same results (486.8, 509.3 and 495.1 g/d, respectively) from 2002 National Nutrition and Health Survey. The fat and oil intakes were (41.9 ± 51.6), (55.5 ± 69.2), and (66.9 ± 125.7) g/d, respectively, which were also the same ad the results (45.2, 43.9 and 41.4 g/d, respectively) from 2002 National Nutrition and Health Survey. The intakes of meats and poultries were only (58.1 ± 67.7), (76.3 ± 218.7), and (23.9 ± 29.6) g/d respectively, which were much lower than the recommended food intakes from the Branch of Maternal and Child Nutrition of Chinese Nutrition Society. The vitamin A deficiency and marginal deficiency prevalence were 6.9% (24/347) and 18.2% (63/347), respectively. The deficiency and insufficiency of vitamin D was sum to 93.9% (323/344). The prevalence of anemia was 32.6% (112/344). 51.0% (171/335) reproductive women were iron deficient, and 61.6% (210/347) women were suffering zinc deficiency.

CONCLUSIONThe study findings indicated that the dietary structure was seriously effected by the Earthquake. The sources from animal and legume products were relatively low. The micronutrients nutritional status was poor. The vitamin A, vitamin D, and iron, zinc deficiencies were highly prevalent in the disaster area.

Adolescent ; Adult ; Anemia, Iron-Deficiency ; epidemiology ; China ; epidemiology ; Disasters ; Earthquakes ; Eating ; Female ; Humans ; Nutrition Surveys ; Nutritional Status ; Pregnancy ; Surveys and Questionnaires ; Vitamin A Deficiency ; epidemiology ; Vitamin D Deficiency ; epidemiology ; Young Adult ; Zinc ; deficiency

Children have been identified as the most nutritionally vulnerable group when disaster happens. The most common nutritional risks include protein-energy malnutrition, iron-deficiency anemia, and trace element deficiency in children after earthquake. During the disaster relief, effective nutritional interventions should be performed according to the nutritional conditions of children in the affected area, so as to prevent the common nutritional risks. Timely diagnosis and treatment should be provided for children at a high risk of malnutrition.
Anemia, Iron-Deficiency ; epidemiology ; prevention & control ; Child ; Earthquakes ; Humans ; Malnutrition ; epidemiology ; prevention & control ; Prevalence ; Protein-Energy Malnutrition ; epidemiology ; prevention & control ; Risk Factors ; Vitamin A Deficiency ; epidemiology ; prevention & control ; Zinc ; deficiency

OBJECTIVETo explore the effect of vitamin A (VA) combined iron supplements on iron metabolic homeostasis for preschoolers.

METHODSAbout 445 preschoolers with aged 3-6 years old from eight kindergartens in Pixian county, Chengdu were recruited into this trial from March to September, 2011. All subjects met the inclusion criteria were randomly divided into four groups using random number table: sole VA supplementation group (VA group, a single oral dose of VA at about 200 000 units), sole iron supplementation group (FE group, daily oral supplementation with the element iron 1-2 mg·kg(-1)·d(-1) for five days a week, lasting for 6 months), the combined supplementation of VA and iron group (VF group) and control group (CO group, no VA and iron supplementation). The concentration of serum VA, serum ferritin (SF), serum transferring receptor (sTfR), C-reactive protein (CRP) and hemoglobin (Hb) were measured from 3 ml vein blood. The sTfR-SF index (TFR-F index) and total body iron content (TBIC) before and after intervention were calculated. The differences of these indexes between groups before and after intervention were analyzed.

RESULTSThe level of sTfR before intervention in VA group ((1.78 ± 0.17) mg/L) was significantly higher than that of after intervention ((1.18 ± 0.11)mg/L) (t = 28.88, P < 0.01). The levels of TFR-F index and TBIC in FE and VF groups before intervention ( (1.59 ± 0.37), (1.63 ± 0.40) and (9.04 ± 2.71), (9.26 ± 2.33) mg/kg, respectively) were all lower than those of after intervention (TFR-F index:(1.84 ± 0.51), (1.87 ± 0.45) and TBIC:(12.42 ± 3.49), (13.01 ± 2.98)mg/kg) (t values were 3.93, 3.78, 7.57 and 9.41, respectively, all P values were <0.01). The incidence of iron deficiency in VA, FE, and VF groups before intervention were 26% (25/95), 31% (30/98) and 31% (28/90) and were 41% (39/95), 10% (10/98) and 18% (16/90) for after intervention, respectively. The difference of this index in VA, FE and VF groups were significant (χ(2) values were 4.59, 12.50 and 4.31, respectively, all the P values were <0.05).

CONCLUSIONCombined VA and iron was as effective as VA alone or iron alone in decreasing the iron deficiency, the impact of VA intervention on iron metabolic homeostasis was mainly manifested in iron usage and mobilization, but showed no effect on total body iron content.

Anemia, Iron-Deficiency ; epidemiology ; Child ; Child, Preschool ; Dietary Supplements ; Female ; Homeostasis ; Humans ; Iron ; administration & dosage ; metabolism ; Male ; Nutritional Status ; Vitamin A ; administration & dosage ; pharmacology

BACKGROUNDGrowth and development of infants has been an important topic in pediatrics for a long time. Infants must be provided with food containing all necessary nutrients. Breast milk is believed to be the most desirable natural and cheapest food for well-balanced nutrition. But with the progress in the development of substitute food in developed countries, it is thought that formula milk can meet the requirement for infant growth. During early infancy, growth, as the most sensitive index of health, is therefore a critical component in evaluating the adequacy of breast-feeding, mixed-feeding and formula feeding. Iron status is another important index of infant health. Iron deficiency anemia remains the most prevalent nutritional deficiency index in infants worldwide. This study is to compare infants in Beijing at 4 months who are on three different feeding modes (breast feeding, mixed feeding and formula feeding) in physical changes and iron status. The results may provide new mothers with support in feeding mode selection, which will also be helpful to the China Nutrition Association in feeding mode education.

METHODSThis is a cohort study. One thousand and one normal Beijing infants were followed regularly for 12 months. Body weight and horizontal length were measured. Hemoglobin, red blood cell counts, mean corpuscular volume, mean corpuscular hemoglobin and serum iron were analyzed at 4 months.

RESULTSThe breast feeding percentage in the first 4 months was 47.9%. The feeding mode was not significantly related to maternal delivery age, education, labor pathway nor infant sex (P>0.05). Infant boys and girls exclusively breast-fed from 0 to 4 months had the highest weight at 0-6 months. The anemia rate of breast-fed infant boys at 4 months was the highest.

CONCLUSIONSBreast feeding should be given more emphasis. It is compulsory for new mothers to breast-feed their infants if possible. Social environment should also guarantee the requirement for breast feeding. Furthermore the normal values of hemoglobin, mean corpuscular volume and serum iron, which were originally used to judge children's iron deficiency anemia, might not be optimal for evaluating infants. There might be a need to develop sex-specific cutoff levels of hemoglobin, mean corpuscular volume and serum iron for infants.

Anemia, Iron-Deficiency ; epidemiology ; Breast Feeding ; Child Development ; Erythrocyte Indices ; Hemoglobins ; analysis ; Humans ; Infant ; Infant Formula ; Infant, Newborn ; Iron ; blood ; Prevalence