Food insecurity is associated with iron deficiency anemia in US adolescents

Background: Food insecurity, a condition of low or very low food security, is associated with decreased nutrient intake and poor health, which can lead to nutrient deficiency in children, including iron deficiency and iron deficiency anemia. Objective: The purpose of this study was to formally investigate the current relation of iron status and food security status among children aged 3-19 y (n = 11,247). Design: Participants of the National Health and Nutrition Examination Survey 1999-2004 were classified for food security status by using the US Children's Food Security Scale and the US Household Food Security Scale. Iron deficiency was defined as > 2 abnormal values for transferrin saturation, serum ferritin, and erythrocyte protoporphyrin, with the addition of abnormal hemoglobin to classify iron deficiency anemia. Results: The odds of iron deficiency anemia among children aged 12-15 y were 2.95 times (95% CI: 1.18, 7.37; P = 0.02) those for children in households with food insecurity among children compared with children in households with food security among children. Conclusions: The results of this study indicate a continuing need for successful interventions to reduce iron deficiency anemia among food-insecure children and to improve food security among children. Am J Clin Nutr 2009; 90: 1358-71.