Corrigenda tipped to title page. / Includes bibliographical references (leaves 313-353). / xxvii, 353 leaves : ill. (some col.) ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Investigates the iron status and dietary intakes in 6-24 month old children in Australia and Ghana and assesses the effects of dietary calcium on intestinal iron absorption. The true prevalence of non-anaemic iron deficiency (NAID) and iron deficiency anaemia (IDA) and dietary intakes in infants and toddlers from a broad socio-economic background were assessed by haematological and biochemical parameters, semi-quantitative diet recall and anthropometric measurements. The high prevalence of iron deficiency and anaemia found in Australian and Ghanaian children can be attributed to the low intake of bioavailable iron in weaning diets which are often ingested with large amounts of calcium. While calcium has been shown to inhibit the absorption of iron, its mechanism of interaction with iron absorption at the intestinal level is not known. The rat was used as an experimental model to investigate the effects of dietary calcium on duodenal iron uptake. The results indicate there is a critical period during weaning when the consumption of high dietary calcium with low iron can retard growth potential. Dietary calcium significantly inhibits non-haem iron absorption at the intracellular level by up-regulating villus enterocyte ferritin concentrations under iron deficiency conditions. / Thesis (Ph.D.)--University of Adelaide, Dept. of Animal Science, 1998

Thesis (Ph.D.)--University of Adelaide, Dept. of Animal Science, 1998? / Corrigenda tipped to title page. Bibliography: leaves 313-353.

Corrigenda tipped to title page. Bibliography: leaves 313-353. This study investigated the iron status and dietary intakes in 6-24 month old children in Australia and Ghana and assessed the effects of dietary calcium on intestinal iron absorption. The true prevalence of non-anaemic iron deficiency (NAID) and iron deficiency anaemia (IDA) and dietary intakes in infants and toddlers from a broad socio-economic background were assessed by haematological and biochemical parameters, semi-quantitative diet recall and anthropometric measurements. The high prevalence of iron deficiency and anaemia found in Australian and Ghanaian children can be attributed to the low intake of bioavailable iron in weaning diets which are often ingested with large amounts of calcium. While calcium has been shown to inhibit the absorption of iron, its mechanism of interaction with iron absorption at the intestinal level is not known. The rat was used as an experimental model to investigate the effects of dietary calcium on duodenal iron uptake. The results indicate there is a critical period during weaning when the consumption of high dietary calcium with low iron can retard growth potential. Dietary calcium significantly inhibits non-haem iron absorption at the intracellular level by up-regulating villus enterocyte ferritin concentrations under iron deficiency conditions.

Adequate nutrition is fundamental to optimal physical and cognitive growth in the second year of life. Toddlers, however, are particularly vulnerable to poor nutrition due to their high nutrient needs in relation to their body size and energy intakes. Nutrient-dense diets are therefore essential during this period. However, no practical quantitative food-based dietary guidelines directed at this age group are available to help caregivers choose nutrient-rich foods for their toddler. Such guidelines are needed not only to ensure adequate intakes of all nutrients during the period of dietary transition from infant to family foods, but also to emphasise intakes of nutrients for which toddlers are at particular risk of deficiency. Biochemical evidence suggests that iron nutrition requires special attention in New Zealand toddlers. The overall aim of this thesis was to design and assess the efficacy of practical food-based strategies for toddlers to ensure optimal nutritional status of 12-24 month old New Zealand children, with a specific focus on iron nutrition. To achieve these overall aims, the research was carried out in three stages. In the first stage, secondary data analysis of food intake data for New Zealand toddlers identified the foods commonly consumed by New Zealand toddlers, the serving sizes and frequency of consumption of these foods, and the nutrients that New Zealand toddlers are at risk of consuming in suboptimal amounts. The food intake data were obtained from 3-day weighed food intakes that had been collected on non-consecutive days in an earlier community-based cross-sectional survey of 188 randomly selected non-breastfeeding 12-24 month old urban South Island New Zealand children. In addition to describing the food consumption patterns of New Zealand toddlers, the secondary data analysis also identified that nearly 40% of New Zealand toddlers were at risk of suboptimal iron intakes. The results of these analyses were used in the second stage of the thesis to develop three food-based strategies. To do this a 4-phase approach based on linear and goal programming was used to design and hypothetically evaluate three sets of food-based strategies for 12-24 month old non-breastfeeding New Zealand children, and to identify the key problem nutrients for each set of strategies. The three sets of strategies were based on: (1) all foods consumed by toddlers including iron-fortified infant and toddler foods, (2) family foods only, or (3) family foods that are not fortified with iron. The mathematical modelling confirmed that iron was the key problem nutrient in the diets of New Zealand toddlers. The analysis showed that only food-based strategies that included a recommendation for the replacement of non-fortified cow�s milk with an iron-fortified toddler milk (500 mL), i.e. strategy set 1, achieved the Australian-New Zealand Recommended Dietary Intakes for all nutrients, including iron. In fact, inclusion of a recommendation for a substantially increased consumption of flesh foods was identified as the only possible alternative to the iron-fortified toddler milk recommendation for improving iron nutrition in New Zealand toddlers. Although the set of strategies including this flesh food recommendation did not provide as much total iron as those including the iron-fortified toddler milk recommendation, the bioavailability of the iron is likely to be greater because flesh foods provide highly bioavailable haem iron (red meat being a particularly rich source) and have an enhancing effect on the absorption of non-haem iron. The two key recommendations for achieving New Zealand toddlers� iron needs were, therefore, a recommendation to consume an iron-fortified toddler milk and a recommendation to consume substantial amounts of red meat. In the third stage, the efficacy of an increased intake of red meat or the use of an iron-fortified milk for improving biochemical iron status in healthy non-anaemic 12-20 month old New Zealand children was investigated in a 20-week partial double-blind randomised placebo-controlled intervention trial. The study also examined the effect of these two interventions on dietary iron intakes and growth, and investigated the association between the amount of meat consumed and biochemical iron parameters. Participants (n=225) were assigned to one of three groups: Meat Group (n=90), Fortified Milk Group (n=45), or Placebo Group (n=90). Children in the Meat Group were encouraged to consume two red meat dishes per day (~ 2.6 mg of iron). In the Fortified Milk Group and Placebo Group, the children�s regular milk was replaced with iron-fortified cow�s milk (1.5 mg of iron per 100 g of prepared milk), or non-fortified cow�s milk (< 0.1 mg of iron per 100 g of prepared milk), respectively. Geometric mean dietary iron intakes (95% CI) increased from 4.7 (4.1, 5.3) to 5.3 (4.7, 6.0) mg per day in the Meat Group (P=0.007), and from 4.3 (3.7, 5.0) to 10.4 (9.0, 12.2) mg per day in the Fortified Milk Group (P<0.001). These increased iron intakes differed significantly from the Placebo Group (both P<0.001), which declined from 5.1 (4.5, 5.7) to 4.6 (4.1, 5.2) mg per day during the intervention (P=0.047). Over 20 weeks, adjusted geometric mean serum ferritin concentration increased by 44% (95% CI: 14%, 82%) in the Fortified Milk Group (P=0.002), tended to decrease in the Placebo Group (14% decrease (95% CI: -27%, 1%; P=0.063)), and did not significantly change in the Meat Group (10% increase (95% CI: -7%, 30%; P=0.241)). However, because iron status declined in the Placebo Group, both groups fared significantly better than the Placebo Group: serum ferritin concentration at 20 weeks was 68% (95% CI: 27%, 124%; P<0.001) greater in the Fortified Milk Group than in the Placebo Group, and 29% (95% CI: 2%, 63%; P=0.033) greater in the Meat Group than in the Placebo Group. There were no intervention effects on haemoglobin or serum transferrin receptor concentration. The cross-sectional analysis showed that a daily intake of 1 g of red meat was associated with 0.65% (95% CI: 0.18%, 1.11%; P=0.007) higher serum ferritin concentration. No adverse effects of the interventions on the toddlers� growth were detected. In conclusion, this thesis shows that food-based strategies can be designed that, if adhered to, should ensure adequate iron status in New Zealand toddlers. Although both the iron-fortified milk recommendation and the increased red meat recommendation are likely to prevent the decline in body iron stores that can occur during the second year of life, only consumption of iron-fortified milk can successfully increase iron stores. Therefore, food-based strategies for New Zealand toddlers will need to include a recommendation that encourages the consumption of foods developed specifically for toddlers that are fortified with iron.

The aims of the present studies were to determine the magnitude of iron deficiency anemia among preschool children in Northern Ethiopia and to evaluate different control strategies. The cross-sectional study showed that anemia was highly prevalent (42%) and that iron deficiency was the commonest cause of anemia. However, the iron deficiency was not due to lack of iron in the diet but to its poor availability and to other non-dietary risk factors. Unsafe water, mother's illness, older child (24--60 months), family not having food reserves and family income below poverty-line were predictors of anemia. Hookworm and malaria were rare and did not account for the anemia. In the iron pot study three types of Ethiopian foods were cooked in three types of pots (iron, aluminum and clay) and assessed for their total and available iron. After adjusting for cooking time and moisture, there were significantly higher total and available iron in all the three types of foods when cooked in iron pots compared to the aluminum or clay pots. The study also showed that the hemoglobin status and length of children improved significantly when they consumed food cooked in iron pots. In the third study, a randomized, placebo-controlled, and double-blind trial, both iron and vitamin A supplemented children showed increased hemoglobin levels. Combined iron and vitamin A supplementation showed the highest rise. Iron-supplemented children showed increase in length, but no increase in weight. They also showed lower rates of c-reactive protein positivity and decreases in the prevalence and frequency of diarrhea. A single dose of vitamin A did not result in any increase in length or weight but a decrease in the prevalence and frequency of diarrhea was observed. Children supplemented with iron only or vitamin A only showed higher ARI rates, but those children who received combined iron and vitamin A showed significantly lower ARI rates. Iron supplementation did not have any effect on either zinc

Adequate nutrition is fundamental to optimal physical and cognitive growth in the second year of life. Toddlers, however, are particularly vulnerable to poor nutrition due to their high nutrient needs in relation to their body size and energy intakes. Nutrient-dense diets are therefore essential during this period. However, no practical quantitative food-based dietary guidelines directed at this age group are available to help caregivers choose nutrient-rich foods for their toddler. Such guidelines are needed not only to ensure adequate intakes of all nutrients during the period of dietary transition from infant to family foods, but also to emphasise intakes of nutrients for which toddlers are at particular risk of deficiency. Biochemical evidence suggests that iron nutrition requires special attention in New Zealand toddlers. The overall aim of this thesis was to design and assess the efficacy of practical food-based strategies for toddlers to ensure optimal nutritional status of 12-24 month old New Zealand children, with a specific focus on iron nutrition. To achieve these overall aims, the research was carried out in three stages. In the first stage, secondary data analysis of food intake data for New Zealand toddlers identified the foods commonly consumed by New Zealand toddlers, the serving sizes and frequency of consumption of these foods, and the nutrients that New Zealand toddlers are at risk of consuming in suboptimal amounts. The food intake data were obtained from 3-day weighed food intakes that had been collected on non-consecutive days in an earlier community-based cross-sectional survey of 188 randomly selected non-breastfeeding 12-24 month old urban South Island New Zealand children. In addition to describing the food consumption patterns of New Zealand toddlers, the secondary data analysis also identified that nearly 40% of New Zealand toddlers were at risk of suboptimal iron intakes. The results of these analyses were used in the second stage of the thesis to develop three food-based strategies. To do this a 4-phase approach based on linear and goal programming was used to design and hypothetically evaluate three sets of food-based strategies for 12-24 month old non-breastfeeding New Zealand children, and to identify the key problem nutrients for each set of strategies. The three sets of strategies were based on: (1) all foods consumed by toddlers including iron-fortified infant and toddler foods, (2) family foods only, or (3) family foods that are not fortified with iron. The mathematical modelling confirmed that iron was the key problem nutrient in the diets of New Zealand toddlers. The analysis showed that only food-based strategies that included a recommendation for the replacement of non-fortified cow�s milk with an iron-fortified toddler milk (500 mL), i.e. strategy set 1, achieved the Australian-New Zealand Recommended Dietary Intakes for all nutrients, including iron. In fact, inclusion of a recommendation for a substantially increased consumption of flesh foods was identified as the only possible alternative to the iron-fortified toddler milk recommendation for improving iron nutrition in New Zealand toddlers. Although the set of strategies including this flesh food recommendation did not provide as much total iron as those including the iron-fortified toddler milk recommendation, the bioavailability of the iron is likely to be greater because flesh foods provide highly bioavailable haem iron (red meat being a particularly rich source) and have an enhancing effect on the absorption of non-haem iron. The two key recommendations for achieving New Zealand toddlers� iron needs were, therefore, a recommendation to consume an iron-fortified toddler milk and a recommendation to consume substantial amounts of red meat. In the third stage, the efficacy of an increased intake of red meat or the use of an iron-fortified milk for improving biochemical iron status in healthy non-anaemic 12-20 month old New Zealand children was investigated in a 20-week partial double-blind randomised placebo-controlled intervention trial. The study also examined the effect of these two interventions on dietary iron intakes and growth, and investigated the association between the amount of meat consumed and biochemical iron parameters. Participants (n=225) were assigned to one of three groups: Meat Group (n=90), Fortified Milk Group (n=45), or Placebo Group (n=90). Children in the Meat Group were encouraged to consume two red meat dishes per day (~ 2.6 mg of iron). In the Fortified Milk Group and Placebo Group, the children�s regular milk was replaced with iron-fortified cow�s milk (1.5 mg of iron per 100 g of prepared milk), or non-fortified cow�s milk (< 0.1 mg of iron per 100 g of prepared milk), respectively. Geometric mean dietary iron intakes (95% CI) increased from 4.7 (4.1, 5.3) to 5.3 (4.7, 6.0) mg per day in the Meat Group (P=0.007), and from 4.3 (3.7, 5.0) to 10.4 (9.0, 12.2) mg per day in the Fortified Milk Group (P<0.001). These increased iron intakes differed significantly from the Placebo Group (both P<0.001), which declined from 5.1 (4.5, 5.7) to 4.6 (4.1, 5.2) mg per day during the intervention (P=0.047). Over 20 weeks, adjusted geometric mean serum ferritin concentration increased by 44% (95% CI: 14%, 82%) in the Fortified Milk Group (P=0.002), tended to decrease in the Placebo Group (14% decrease (95% CI: -27%, 1%; P=0.063)), and did not significantly change in the Meat Group (10% increase (95% CI: -7%, 30%; P=0.241)). However, because iron status declined in the Placebo Group, both groups fared significantly better than the Placebo Group: serum ferritin concentration at 20 weeks was 68% (95% CI: 27%, 124%; P<0.001) greater in the Fortified Milk Group than in the Placebo Group, and 29% (95% CI: 2%, 63%; P=0.033) greater in the Meat Group than in the Placebo Group. There were no intervention effects on haemoglobin or serum transferrin receptor concentration. The cross-sectional analysis showed that a daily intake of 1 g of red meat was associated with 0.65% (95% CI: 0.18%, 1.11%; P=0.007) higher serum ferritin concentration. No adverse effects of the interventions on the toddlers� growth were detected. In conclusion, this thesis shows that food-based strategies can be designed that, if adhered to, should ensure adequate iron status in New Zealand toddlers. Although both the iron-fortified milk recommendation and the increased red meat recommendation are likely to prevent the decline in body iron stores that can occur during the second year of life, only consumption of iron-fortified milk can successfully increase iron stores. Therefore, food-based strategies for New Zealand toddlers will need to include a recommendation that encourages the consumption of foods developed specifically for toddlers that are fortified with iron.

Thesis (Ph.D.)--University of California, San Francisco, 2004. / Includes bibliographical references. Also available online.

No description available.

The aim of this study was to assess the performance of the children in the study on some psychometric tests and to find out whether iron deficiency had any effect on cognitive skills as measured by the selected psychometric tests. The study also wanted to find out if there would be any gender differences on the psychometric tests. A sample of 810 children was selected from eleven schools from the rural Southern part of KwaZulu-Natal. The children were of ages eight to ten years old, were all Zulu speaking and in standard one. Blood samples were taken from all the children to determine iron levels. Psychometric tests viz., the Symbol Digit Modalities Test, Raven's Coloured Progressive Matrices, Rey's Auditory Verbal Learning Test and Young's Group Mathematics Test, were all administered to measure cognitive performance. The results showed no significant iron level effects on most of the measured cognitive skills. There were some significant gender effects on all the psychometric tests except for the Maths test. There was general low performance on all the psychometric tests. Therefore, the results highlighted the importance of designing more tests that can be standardized and thus be applicable to Zulu speaking children and other children with similar backgrounds. The tests should also be able to tap into the cognitive skills that may be affected by iron levels. There is also a great need for studies looking at the lower end of iron deficiency. / Thesis (M.Sc.)-University of Natal, Pietermaritzburg, 1998.