Iron status in 2-year-old Icelandic children and associations with dietary intake and growth

Objective: To investigate the effects of food and nutrient intake at 2 y and growth from birth on iron status at 2 y in a population with high birth weight. Design: In a cross-sectional study, children's food consumption and body size measurements were recorded and blood samples taken. Weighed 3-day food records were used to analyse food and nutrient intake. Setting: Children were recruited from across Iceland from the Icelandic National Registry by the University of Iceland, Computing Services. The children in the sample were born over a 1-y period. Subjects: Parents of randomly selected 2-year-old children (n = 130) were contacted, and 72% ( n 94) participated. Blood samples were analysed in 76% ( n 71) of participating children. Results: In total, 9% of the children were iron-deficient ( serum ferritin ( SF) <12 mu g/l and mean corpuscular volume (MCV) <74 fl) and 1.4% were also anaemic (Hb<105 g/l), while 27% of children were iron-depleted ( SF<12 mug/l). Iron status indices were negatively associated with cow's milk consumption. Half of children consuming >500 g cow's milk/day ( n 10) were iron-deficient, while one child in 58 consuming <500 g cow's milk/day had iron deficiency ( P<0.001). In multiple regression analyses, also biscuits and crackers consumption was positively associated with MCV. Weight gain from birth to 2 y was negatively associated with SF (adjusted R-2 0.15; P=0.002; n = 58). Iron-depleted children were heavier than children not iron-depleted (14.7 +/- 1.3 vs 13.8 +/- 1.7 kg; P = 0.043), had higher BMI (17.7 +/- 1.5 vs 16.7 +/- 1.4 kg/m(2); P = 0.028) and gained more weight from birth (11.2 +/- 1.3 vs. 10.0 +/- 1.6 kg; P = 0.011). Conclusions: The results suggest that cow's milk consumption above 500 g/day should be avoided at the age of 2 y for better iron status. Iron depletion at 2 y is associated with faster growth from birth. Sponsorship: Research Fund of the University of Iceland.