*Department of Management, Health Systems Management Program, Bar Ilan University, Ramat Gan †Meuhedet Health Services ‡Hadassah University Mt Scopus, Jerusalem, Israel.
J Pediatr Gastroenterol Nutr. 2013 Dec;57(6):722-7. doi: 10.1097/MPG.0b013e3182a80c42.
The aim of this study was to study the relative contribution of dietary sources of iron in children with high prevalence of anemia and iron deficiency (ID).
A cross-sectional study in 263 healthy, 1.5- to 6-year-old children in the Jewish sector of Jerusalem, Israel. Venous blood samples and a qualitative Food Frequency Questionnaire on iron-rich foods were obtained. Anemia was defined as hemoglobin <11 g/dL for children younger than 4 years and <11.5 g/dL for children older than 4 years; ID was defined as ferritin <12 μg/L.
Anemia was found in 11.2%, ID in 22%, and iron-deficiency anemia in 3.7%. The prevalence of anemia was higher in toddlers ages 1.5 to 3 years compared with children ages 3 to 6 years (17.7% vs 7.3%, P = 0.01). Children with extremely low red meat consumption (seldom) had 4-fold higher rates of ID than those who consumed ≥2 times per week (odds ratio 3.98; 95% confidence interval 1.21-13.03; P = 0.023), whereas poultry consumption was not associated with ID. Soy consumption was inversely associated with ferritin (marginally significant, r = -0.134, P = 0.057).
The high prevalence of anemia and ID found in this study, mainly in children 1.5 to 3 years old, is related to low red meat consumption. The characteristically high poultry consumption in the Israeli population was not protective. The shift toward reduced red meat consumption and higher poultry consumption in developed countries may result in increasing the risk of ID.
本研究旨在研究高贫血和缺铁（ID）患病率儿童膳食铁来源的相对贡献。
这是在以色列耶路撒冷的犹太区进行的一项横断面研究，共纳入 263 名 1.5 至 6 岁健康儿童。采集静脉血样本和一份关于富含铁食物的定性食物频率问卷。贫血定义为血红蛋白<11 g/dL 的 4 岁以下儿童和血红蛋白<11.5 g/dL 的 4 岁以上儿童；ID 定义为铁蛋白<12 μg/L。
发现贫血患病率为 11.2%，ID 患病率为 22%，缺铁性贫血患病率为 3.7%。1.5 至 3 岁幼儿贫血患病率高于 3 至 6 岁儿童（17.7%比 7.3%，P=0.01）。极少食用红肉的儿童 ID 发生率是每周至少食用 2 次红肉的儿童的 4 倍（比值比 3.98；95%置信区间 1.21-13.03；P=0.023），而禽类摄入与 ID 无关。大豆摄入与铁蛋白呈负相关（有边缘统计学意义，r=-0.134，P=0.057）。
本研究发现的高贫血和 ID 患病率，主要发生在 1.5 至 3 岁的儿童，与低红肉摄入有关。以色列人群特有的高禽类摄入并未起到保护作用。在发达国家，人们对红肉的摄入减少、对禽类的摄入增加，可能会导致 ID 风险增加。
