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Overweight children and adolescents: a risk group for iron deficiency.
Pediatrics 2004; 114(1):104-8Ped

Abstract

BACKGROUND

The prevalence of obesity has increased at an epidemic rate, and obesity has become one of the most common health concerns in the United States. A few small studies have noted a possible association between iron deficiency and obesity.

OBJECTIVE

To investigate the association between weight status, as measured by body mass index (BMI), and iron deficiency in a nationally representative sample of children and adolescents.

DESIGN

National Health and Nutrition Examination Survey III (1988-1994) provides cross-sectional data on children 2 to 16 years of age. Recorded measures of iron status included transferrin saturation, free erythrocyte protoporphyrin levels, and serum ferritin levels. Children were considered iron-deficient if any 2 of these values were abnormal for age and gender. With the use of age- and gender-specific BMI percentiles, at risk for overweight was defined as a BMI of > or =85th percentile and <95th percentile, and overweight was defined as a BMI of > or =95th percentile. The prevalence of iron deficiency was compared across weight groups. Logistic regression was used to estimate the association between iron status and overweight, controlling for age, gender, ethnicity, poverty status, and parental education level.

RESULTS

In this sample of 9698 children, 13.7% were at risk for overweight and 10.2% were overweight. Iron deficiency was most prevalent among 12- to 16-year-old subjects (4.7%), followed by 2- to 5-year-old subjects (2.3%) and then 6- to 11-year-old subjects (1.8%). Overweight 2- to 5-year-old subjects (6.2%) and overweight 12- to 16-year-old subjects (9.1%) demonstrated the highest prevalences of iron deficiency. Overall, the prevalence of iron deficiency increased as BMI increased from normal weight to at risk for overweight to overweight (2.1%, 5.3%, and 5.5%, respectively), and iron deficiency was particularly common among adolescents (3.5%, 7.2%, and 9.1%, respectively). In a multivariate regression analysis, children who were at risk for overweight and children who were overweight were approximately twice as likely to be iron-deficient (odds ratio: 2.0; 95% confidence interval: 1.2-3.5; and odds ratio: 2.3; 95% confidence interval: 1.4-3.9; respectively) as were those who were not overweight.

CONCLUSIONS

In this national sample, overweight children demonstrated an increased prevalence of iron deficiency. Given the increasing numbers of overweight children and the known morbidities of iron deficiency, these findings suggest that guidelines for screening for iron deficiency may need to be modified to include children with elevated BMI.

Authors+Show Affiliations

Section of General Pediatrics, Department of Pediatrics, Yale University, New Haven, Connecticut 06520-8064, USA. kgnead@alumni.middlebury.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15231915

Citation

Nead, Karen G., et al. "Overweight Children and Adolescents: a Risk Group for Iron Deficiency." Pediatrics, vol. 114, no. 1, 2004, pp. 104-8.
Nead KG, Halterman JS, Kaczorowski JM, et al. Overweight children and adolescents: a risk group for iron deficiency. Pediatrics. 2004;114(1):104-8.
Nead, K. G., Halterman, J. S., Kaczorowski, J. M., Auinger, P., & Weitzman, M. (2004). Overweight children and adolescents: a risk group for iron deficiency. Pediatrics, 114(1), pp. 104-8.
Nead KG, et al. Overweight Children and Adolescents: a Risk Group for Iron Deficiency. Pediatrics. 2004;114(1):104-8. PubMed PMID: 15231915.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Overweight children and adolescents: a risk group for iron deficiency. AU - Nead,Karen G, AU - Halterman,Jill S, AU - Kaczorowski,Jeffrey M, AU - Auinger,Peggy, AU - Weitzman,Michael, PY - 2004/7/3/pubmed PY - 2004/10/1/medline PY - 2004/7/3/entrez SP - 104 EP - 8 JF - Pediatrics JO - Pediatrics VL - 114 IS - 1 N2 - BACKGROUND: The prevalence of obesity has increased at an epidemic rate, and obesity has become one of the most common health concerns in the United States. A few small studies have noted a possible association between iron deficiency and obesity. OBJECTIVE: To investigate the association between weight status, as measured by body mass index (BMI), and iron deficiency in a nationally representative sample of children and adolescents. DESIGN: National Health and Nutrition Examination Survey III (1988-1994) provides cross-sectional data on children 2 to 16 years of age. Recorded measures of iron status included transferrin saturation, free erythrocyte protoporphyrin levels, and serum ferritin levels. Children were considered iron-deficient if any 2 of these values were abnormal for age and gender. With the use of age- and gender-specific BMI percentiles, at risk for overweight was defined as a BMI of > or =85th percentile and <95th percentile, and overweight was defined as a BMI of > or =95th percentile. The prevalence of iron deficiency was compared across weight groups. Logistic regression was used to estimate the association between iron status and overweight, controlling for age, gender, ethnicity, poverty status, and parental education level. RESULTS: In this sample of 9698 children, 13.7% were at risk for overweight and 10.2% were overweight. Iron deficiency was most prevalent among 12- to 16-year-old subjects (4.7%), followed by 2- to 5-year-old subjects (2.3%) and then 6- to 11-year-old subjects (1.8%). Overweight 2- to 5-year-old subjects (6.2%) and overweight 12- to 16-year-old subjects (9.1%) demonstrated the highest prevalences of iron deficiency. Overall, the prevalence of iron deficiency increased as BMI increased from normal weight to at risk for overweight to overweight (2.1%, 5.3%, and 5.5%, respectively), and iron deficiency was particularly common among adolescents (3.5%, 7.2%, and 9.1%, respectively). In a multivariate regression analysis, children who were at risk for overweight and children who were overweight were approximately twice as likely to be iron-deficient (odds ratio: 2.0; 95% confidence interval: 1.2-3.5; and odds ratio: 2.3; 95% confidence interval: 1.4-3.9; respectively) as were those who were not overweight. CONCLUSIONS: In this national sample, overweight children demonstrated an increased prevalence of iron deficiency. Given the increasing numbers of overweight children and the known morbidities of iron deficiency, these findings suggest that guidelines for screening for iron deficiency may need to be modified to include children with elevated BMI. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/15231915/Overweight_children_and_adolescents:_a_risk_group_for_iron_deficiency_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&amp;pmid=15231915 DB - PRIME DP - Unbound Medicine ER -