Eliana Pereira Vellozo, Josefina Aparecida Pellegrini Braga, Maria Aparecida Zanetti Passos, Peter Richard Hall, Mauro Fisberg


OBJECTIVE: To assess nutritional status and factors associated with iron deficiency in children and adolescents, before and after intervention with iron amino chelate.

METHODS: In this community-based, double-blind, randomized controlled trial, we assessed children aged 3-14 years. Children were cluster randomized to receive either iron supplemented food (intervention), or the same food without supplement (control).

RESULTS: Most participants presented adequate height-for-age and BMI-for-age values. No association between nutritional status and the iron deficiency anemia (IDA), independently of the allocation group, was observed. After intervention, there was a reduction of anemic children in both groups; however there was a more significant reduction in the intervention group when compared to the control group, p<0.0001. There was also a greater reduction in the number anemic individuals with low height-for-age in the intervention group when compared to control, p=0,028. Those who remained anemic during the study were more likely to present short stature at the end, with no association or difference between the two groups.

CONCLUSIONS: It was concluded that in the supplementation group that those who remained anemic during the trial were more likely to continue anemic after intervention, with shorter stature; with no other association or difference between groups.


Iron deficiency anemia; Nutritional status; Obesity; Children; Adolescents.

Full Text:



Cancado RD, Chiattone CS. Iron deficiency anaemia in the adult: causes, diagnosis and treatment. Rev Bras Hematol Hemoter. 2010;32(3):240-6. doi: 10.1590/S1516-84842010005000075.

Instituto Brasileiro de Geografia e Estatística (IBGE). Pesquisa de Orçamentos Familiares 2008-2009: análise do consumo alimentar pessoal no Brasil. Rio de Janeiro: IBGE, 2011.

Bloch KV, Cardoso MA, Sichieri R. Study of Cardiovascular Risk Factors in Adolescents (ERICA): results and potentiality. Rev Saude Publica. 2016;50 Suppl 1:2s. doi: 10.1590/S01518-8787.201605000SUPL1AP.

Leal VS, Lira PI, Menezes RC, Oliveira JS, Sequeira LA, Andrade SL, et al. Factors associated with the decline in stunting among children and adolescents in Pernambuco, Northeastern Brazil. Rev Saude Publica. 2012;46(2):234-41.

Instituto Brasileiro de Geografia e Estatística (IBGE). Pesquisa Nacional por Amostra de Domicílios – 2013. (19 September 2017, date last accessed).

MondiniI L, Rodrigues DA, Gimeno SGA, Baruzzi RG. Nutritional status and hemoglobin values of Aruak and Karibe Indian children – Upper Xingu, Central Brazil, 2001-2002. Rev Bras Epidemiol 2009;12(3):1-8.

World Health Organization, United Nations Children’s Fund, United Nations University. Iron Deficiency Anaemia Assessment, Prevention, and Control: A guide for programme managers. WHO/NHD/01.3. http://www.who. int/nutrition/publications/en/ida_assessment_prevention_control.pdf (19 September 2017, date last accessed).

Jeliffe DB. The assessment of the nutritional status of the community. Geneva: World Health Organization; 1966. Monograph Series No. 53.

WHO Multicentre Growth Reference Study Group. Assessment of differences in linear growth among populations in the WHO Multicentre Growth Reference Study. Acta Paediatr Suppl. 2006;450:56-65.

World Health Organization. Child growth standards: WHO Anthro (version 3.2.2, January 2011) and macros. (19 September 2017, date last accessed).

Batista Filho M, Rissin A. Nutritional transition in Brazil: geographic and temporal trends [Article in Portuguese]. Cad Saude Publica. 2003;19(Suppl 1):S181-91. doi: 10.1590/S0102-311X2003000700019.

Dutra CL, Araújo CL, Bertoldi AD. Prevalence of overweight in adolescents: a population-based study in a southern Brazilian city [Article in Portuguese]. Cad Saude Publica. 2006;22(1):151-62. doi: 10.1590/S0102-311X2006000100016.

Carvalho EAA, Simão MTJ, Fonseca MC, Andrade RG, Ferreira MSG, Silva AF, et al. Obesity: epidemiological aspects and prevention [Article in Portuguese]. Rev Med Minas Gerais. 2013;23(1):74-82. doi: 10.5935/2238-3182.20130012.

Ribeiro CSG, Pilla MCBA. Segurança alimentar e nutricional: interfaces e diminuição de desigualdades sociais [Article in Portuguese]. DEMETRA: Alimentação, Nutrição & Saúde. 2014;9(1);41-52. doi: 10.12957/demetra.2014.6642.

Ramires EK, de Menezes RC, Oliveira JS, Oliveira MA, Temoteo TL, Longo-Silva G, et al. Nutritional status of children and adolescents from a town in the semiarid Northeastern Brazil. Rev Paul Pediatr. 2014;32(3):200-7. doi: 10.1590/0103-0582201432309.

Zimmermann MB, Hurrell RF. Nutritional iron deficiency. Lancet. 2007 11;370(9586):511-20. doi: 10.1016/S0140-6736(07)61235-5.

Schmidt L, Binotto RF. Obesity and its relationship with the iron in the organism homeostasis: importance of hepcidin [Article in Portuguese]. Revista de Enfermagem. 2015;11(11);40-53.

Lecube A, Carrera A, Losada E, Hernández C, Simó R, Mesa J. Iron deficiency in obese postmenopausal women. Obesity (Silver Spring). 2006;14(10):1724-30. Doi: 10.1038/oby.2006.198.

Pinhas-Hamiel O, Singer S, Pilpel N, Fradkin A, Modan D, Reichman B. Health-related quality of life among children and adolescents: associations with obesity. Int J Obes (Lond). 2006;30(2):267-72. doi: 10.1038/sj.ijo.0803107.

Bezerra IN, Cavalcante JB, Moreira TMV, Mota CC, Sicheiri R. Eating away from home and excess weight: an analysis of explanatory mechanisms. Rev Bras Promoç Saúde. 2016;29(3):455-61.

Seltzer CC, Wnzel BJ, Mayer J. Serum iron and iron-binding capacity in adolescents. I. Standard values. Am J Clin Nutr. 1963;13:343-53.

Miraglia F, Assis MCS, Beghetto MG, Almeida CAN, Mello ED. Is serum ferritin a good marker of iron deficiency in obese adolescents? [Article in Portuguese]. International Journal of Nutrology. 2015;8(4):72-6. doi: 10.22565/ijn.v8i3.192.

National Center for Health Statistics. HANES, examination staff procedures manual for the Health and Nutrition Examination Survey, 1971-1973. Rockville, MD: National Center for Health Statistics, 1972.

Micozzi MS, Albanes D, Stevens RG. Relation of body size and composition to clinical biochemical and hematologic indices in US men and women. Am J Clin Nutr. 1989;50(6):1276-81.

Brunken GS, Guimarães LV, Fisberg M. Anemia in children under 3 years of age in public day care centers [Article in Portuguese]. J Pediatr (Rio J) 2002;78(1):50-6. doi: 10.1590/S0021-75572002000100011.

Slap GB, Khalid N, Paikoff RL, Brooks-Gunn J, Warren MP. Evolving self-image, pubertal manifestations, and pubertal hormones: preliminary findings in young adolescent girls. J Adolesc Health. 1994;15(4):327-35.


  • There are currently no refbacks.

Comments on this article

View all comments

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.