Lacerda E, Cunha A J
Instituto de Nutrição, Universidade Federal do Rio de Janeiro (UFRJ), e Centro de Referência César Pernetta, Rio de Janeiro (RJ), Brasil.
Rev Panam Salud Publica. 2001 May;9(5):294-301. doi: 10.1590/s1020-49892001000500002.
To assess the influence of feeding practices on the prevalence of anemia among breast-fed children, based on the nutritional profile of children receiving care at an outpatient pediatric clinic in the city of Rio de Janeiro, Brazil.
This was a cross-sectional study with 288 children between 12 and 18 months of age who were seen at the outpatient clinic between January and June 1993. The children were assessed in terms of the presence of iron-deficiency anemia. In addition, two questionnaires were done with the child's mother or the other person who had brought the child to the clinic: a 24-hour dietary recall and a record of the frequency of the consumption of iron-rich foods.
Of the 288 children, 144 of them had signs of anemia (hemoglobin < 11 g/dL); of these 144, 38 of them had severe anemia (hemoglobin < 9.5 g/dL). We found low levels of bioavailable iron in the foods consumed, limited consumption of meat, and vitamin C consumption separate from meals. We found a significant association between the prevalence of severe anemia and inadequate iron intake (relative risk = 2.28; 95% confidence interval = 1.12 to 4.66; P = 0.02). The intake of bioavailable iron was higher in the group without anemia (P = 0.04).
Individuals caring for breast-fed children should be educated concerning the nutritional contents of complementary foods so as to increase the bioavailability of iron in the children's diets. One way to achieve this objective might be through "Integrated Management of Childhood Illnesses," a strategy endorsed by a number of international organizations as a way to reduce child mortality and morbidity in developing countries.
基于巴西里约热内卢市一家儿科门诊所接诊儿童的营养状况，评估喂养方式对母乳喂养儿童贫血患病率的影响。
这是一项横断面研究，研究对象为1993年1月至6月期间在该门诊所就诊的288名12至18个月大的儿童。对这些儿童进行缺铁性贫血情况评估。此外，还对孩子的母亲或带孩子来诊所的其他人进行了两份问卷调查：一份24小时饮食回顾调查，以及一份富含铁食物摄入频率记录。
在288名儿童中，144名有贫血迹象（血红蛋白<11 g/dL）；在这144名儿童中，38名患有重度贫血（血红蛋白<9.5 g/dL）。我们发现所摄入食物中的生物可利用铁水平较低，肉类摄入量有限，且维生素C与餐食分开摄入。我们发现重度贫血患病率与铁摄入不足之间存在显著关联（相对风险=2.28；95%置信区间=1.12至4.66；P=0.02）。无贫血组的生物可利用铁摄入量更高（P=0.04）。
应对照顾母乳喂养儿童的人员进行辅食营养成分方面的教育，以提高儿童饮食中铁的生物利用率。实现这一目标的一种方法可能是通过“儿童疾病综合管理”，这是许多国际组织认可的一种降低发展中国家儿童死亡率和发病率的策略。
