Iron intake and iron status of preschool children: associations with breakfast cereals, vitamin C and meat

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Abstract
Objective:To examine associations between breakfast cereal consumption and iron status and identify dietary patterns that might improve iron status in this vulnerable group.Design:Analysis of data from the UK National Diet and Nutrition Survey (NDNS) of children aged 1.5–4.5 years, including dietary intakes calculated from 4-day weighed records.Subjects:Data were used from 904 children with haematological measurements, excluding those taking iron supplements; 20% had low iron stores (ferritin < 10 μg l−1) while 8% were anaemic (Hb < 11 g dl−1).Results:High cereal consumers had significantly higher iron intakes than low cereal consumers (classified by tertiles) but the 10% difference in mean ferritin levels was not significant (P = 0.067). Lower intakes of vitamin C and meat among high consumers of cereal may have diluted the impact of cereal iron on iron status. When children were reclassified according to their intakes of vitamin C and iron from meat and breakfast cereals, the group with high (above median) intakes of two or more factors had a higher mean haemoglobin (Hb) level and a lower prevalence of anaemia compared with the group with low (below median) intakes of all three dietary constituents.Conclusions:Nutritional advice that aims to improve iron status should emphasize not only rich sources of iron but also factors that may enhance or inhibit absorption. Strategies to optimize iron status in this vulnerable age group include consuming an iron-fortified breakfast cereal, vitamin C-rich fruit or drink at breakfast, and avoiding tea with (or after) meals.