Examining the Double Burden of Underweight, Overweight/Obesity and Iron Deficiency among Young Children in a Canadian Primary Care Setting

Author:

Borkhoff Sean A.1,Parkin Patricia C.1234,Birken Catherine S.1234,Maguire Jonathon L.245,Macarthur Colin1234ORCID,Borkhoff Cornelia M.123ORCID

Affiliation:

1. Division of Pediatric Medicine and the Pediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, ON M5G 1E8, Canada

2. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada

3. Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON M5G 1X8, Canada

4. Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada

5. Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON M5B 1A6, Canada

Abstract

There is little evidence on the prevalence of the double burden and association between body mass index (BMI) and iron deficiency among young children living in high-income countries. We conducted a cross-sectional study of healthy children, 12–29 months of age, recruited during health supervision visits in Toronto, Canada, and concurrently measured BMI and serum ferritin. The prevalence of a double burden of underweight (zBMI < −2) and iron deficiency or overweight/obesity (zBMI > 2) and iron deficiency was calculated. Regression models examined BMI and serum ferritin as continuous and categorical variables, adjusted for covariates. We found the following in terms of prevalence among 1953 children (mean age 18.3 months): underweight 2.6%, overweight/obesity 4.9%, iron deficiency 13.8%, iron-deficiency anemia 5.4%, underweight and iron deficiency 0.4%, overweight/obesity and iron deficiency 1.0%. The change in median serum ferritin for each unit of zBMI was −1.31 µg/L (95% CI −1.93, −0.68, p < 0.001). Compared with normal weight, we found no association between underweight and iron deficiency; meanwhile, overweight/obesity was associated with a higher odds of iron deficiency (OR 2.15, 95% CI 1.22, 3.78, p = 0.008). A double burden of overweight/obesity and iron deficiency occurs in about 1.0% of young children in this high-income setting. For risk stratification and targeted screening in young children, overweight/obesity should be added to the list of important risk factors.

Funder

Canadian Institutes of Health Research

SickKids Foundation

Publisher

MDPI AG

Subject

Food Science,Nutrition and Dietetics

Reference36 articles.

1. WHO (2023, July 22). The Double burden of Malnutrition. Policy Brief. World Health Organization: Geneva, Switzerland, 2017. Available online: https://www.who.int/publications/i/item/WHO-NMH-NHD-17.3.

2. Dynamics of the double burden of malnutrition and the changing nutrition reality;Popkin;Lancet,2020

3. The Double Burden of Malnutrition: A Systematic Review of Operational Definitions;Davis;Curr. Dev. Nutr.,2020

4. (2023, July 22). The Bright Futures/American Academy of Pediatrics (AAP) Recommendations for Preventive Pediatric Health Care, Periodicity Schedule. Updated April 2023. Available online: https://www.aap.org/periodicityschedule.

5. Diagnosis and Prevention of Iron Deficiency and Iron-Deficiency Anemia in Infants and Young Children (0–3 Years of Age);Baker;Pediatrics,2010

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