Département de médecine sociale et préventive, Université Laval, Quebec City, QC, Canada.
Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec, Université Laval, Quebec City, QC, Canada.
Can J Public Health. 2020 Oct;111(5):682-693. doi: 10.17269/s41997-020-00304-7. Epub 2020 Mar 13.
Anemia and iron deficiency (ID) are frequent among Indigenous children of Canada, but few data are available in Quebec. The present study aimed to characterize anemia and ID prevalence and associated protective and risk factors among First Nations youth in Quebec.
The 2015 First Nations (JES!-YEH!) pilot study was conducted among children and adolescents (3 to 19 years; n = 198) from four First Nations communities in Quebec. Blood and urine samples and anthropometric measurements were collected. Hemoglobin (Hb), serum ferritin (SF), plasma hs-CRP, and urinary cotinine levels were measured. Factors associated with anemia and ID (including traditional and market food consumption) were assessed using an interview-administered food frequency questionnaire, based on which nutritional intakes were calculated. Structural equation models were used to test associations.
The prevalence of anemia and ID was elevated (16.8% and 20.5% respectively). Traditional meat, fruit, and fruit juice (natural and powdered)-via their positive association with vitamin C intake-were the only food variables positively associated with SF (coefficient [95% CI] 0.017 [0.000, 0.114]; 0.090 [0.027, 0.161]; and 0.237 [0.060, 0.411]). Male sex was also associated with higher SF (0.295 [0.093, 0.502]). Inflammation status (hs-CRP > 5 mg/L) was inversely associated with Hb (- 0.015 [- 0.025, - 0.005]), whereas SF was positively associated with Hb (0.066 [0.040, 0.096]). Fruit and juice consumption was also positively associated with Hb, via vitamin C intake and SF (0.004 [0.001, 0.010]; 0.008 [0.003, 0.017]).
Interventions fostering healthier food environments as well as higher consumption of traditional meats and foods naturally rich in vitamin C, which is known to enhance iron absorption, and fighting inflammation could contribute to decrease the high prevalence of anemia and ID in this young Indigenous population.
在加拿大的原住民儿童中，贫血和铁缺乏症（ID）很常见，但魁北克的数据很少。本研究旨在描述魁北克第一民族青年中贫血和 ID 的流行情况以及相关的保护和危险因素。
2015 年，在魁北克的四个第一民族社区中进行了 2015 年第一民族（JES！-YEH！）试点研究，参与者为儿童和青少年（3 至 19 岁；n=198）。采集了血液和尿液样本以及人体测量数据。测量了血红蛋白（Hb）、血清铁蛋白（SF）、血浆 hs-CRP 和尿可替宁水平。使用访谈式食物频率问卷评估与贫血和 ID 相关的因素（包括传统食物和市场食物的消费），并据此计算营养摄入量。使用结构方程模型检验关联。
贫血和 ID 的患病率较高（分别为 16.8%和 20.5%）。传统肉类、水果和水果汁（天然和粉末状）通过与维生素 C 摄入呈正相关，与 SF 呈正相关（系数 [95%CI]：0.017 [0.000，0.114]；0.090 [0.027，0.161]；0.237 [0.060，0.411]）。男性也与更高的 SF 相关（0.295 [0.093，0.502]）。炎症状态（hs-CRP>5mg/L）与 Hb 呈负相关（-0.015 [-0.025，-0.005]），而 SF 与 Hb 呈正相关（0.066 [0.040，0.096]）。水果和果汁的消费也与 Hb 呈正相关，这是通过维生素 C 的摄入和 SF 实现的（0.004 [0.001，0.010]；0.008 [0.003，0.017]）。
促进更健康的食物环境以及更高的传统肉类和天然富含维生素 C 的食物的消费，这可以增强铁的吸收，同时对抗炎症，可能有助于降低这一年轻的原住民人群中贫血和 ID 的高患病率。
