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Serum Iron, Zinc, and Vitamin A Levels in 2-to-6-Year-Old Children with Small or No Appetite

Year 2024, Volume: 24 Issue: 1, 5 - 10, 07.05.2024
https://doi.org/10.26650/jchild.2024.1192386

Abstract

Objective: This study aimed to compare height, weight measurements and serum iron, serum zinc, and serum vitamin A levels of children identified as having small/no appetites by their parents, with healthy controls.

Methods: The research has been designed as a prospective study involving children ages 2-6 years who have been identified as having small or no appetite by their parents, as well as healthy controls from the same age group. After obtaining the informed consent forms, the parents filled out the questionnaire that includes questions about their sociodemographic parameters and children’s eating behaviors. The children’s medical and family history were taken and their physical examinations regarding systems, height, and weight were examined. The study also evaluated the children’s hemoglobin, serum iron, serum zinc, and serum vitamin A levels. For both groups, the study excluded children who were born prematurely, who had a family history of chronic drug use or chronic disease, who had abnormal laboratory tests, or who received pathological findings from their physical examination. The study uses the package program SPSS 15.0 package program for statistical comparisons, the chi-squared test for qualitative variations, and the Student’s t test and Mann- Whitney U test for quantitative variations with a value of p<0.05 being considered significant. The study also obtained ethical approval from the regional ethical committee.

Results: The study group includes 54 children (50% female, 50% male), and the control group includes 53 children (59% female, 41% male), each group having similar age and gender distributions. Children with weight and height above the 75th percentile are more common in the control group (28% and 30%, respectively) than among the anorexic children group (2% and 4%, respectively; p=0.002). The study group’s serum iron and serum zinc levels are lower than the control group’s (p=0.026, p=0.002, respectively). The two groups had similar serum vitamin A levels (p>0.05).

Conclusions: Although most children defined as having a small appetite continue to grow normally, evaluating them in terms of iron and zinc deficiencies and supporting them is appropriate in essential cases.

Project Number

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References

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  • Wright CM, Parkinson KN, Shipton D, Drewett RF. How do toddler eating problems relate to their eating behavior, food preferences, and growth? Pediatrics 2007; 120: e1069-75. google scholar
  • Bekem Ö, Öztürk Y, Arslan N. İştahsız çocuklarda beslenme özelliklerinin değerlendirilmesi. DEÜ Tıp Fakültesi Dergisi 2003; 17: 181-9. google scholar
  • Lee K, Song YM. Parent-reported appetite of a child and the child’s weight status over a 2-year period in Korean children. J Am Diet Assoc 2007; 107: 678-80. google scholar
  • Isguven P, Arslanoglu I, Erol M, Yildiz M, Adal E, Erguven M. Serum levels of ghrelin, leptin, IGF-I, IGFBP-3, insulin, thyroid hormones and cortisol in prepubertal children with iron deficiency. Endocr J 2007; 54: 985-90. google scholar
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  • Suzuki H, Asakawa A, Li JB, Tsai M, Amitani H, Ohinata K, et al. Zinc as an appetite stimulator - the possible role of zinc in the progression of diseases such as cachexia and sarcopenia. Recent Pat Food Nutr Agric 2011; 3: 226-31. google scholar
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  • Thomas DM, Mirowski GW. Nutrition and oral mucosal diseases. Clin Dermatol 2010;28:426-31. google scholar
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  • Anzano Ma, Lam AJ, Olson JA. Impaired salivary gland secretory function following the induction of rapid, synchronous vitamin A deficiency in rats. J Nutr 1981; 111: 496-504. google scholar
  • Gökçay G. A vitamin eksikliği. İçinde:Neyzi O, Ertuğul T, Darendeliler T, editörler. Pediatri. İstanbul: Nobel Tıp Kitabevleri; 2021.p. 265-7. google scholar
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  • Tympa-Psirropoulou E, Vagenas C, Psirropoulos D, Dafni O, Matala A, Skopouli F. Nutritional risk factors for iron-deficiency anaemia in children 12-24 months old in the area of Thessalia in Greece. Int J Food Sci Nutr 2005; 56: 1-12. google scholar
  • Liu J, Ai YX, Hanlon A, Shi Z, Shi Z, Dickerman B, et al. Micronutrients deficiency and associated sociodemographic factors in Chinese children. World J Pediatr 2011; 7: 217-23. google scholar
  • Öktem F, Yavrucuoğlu H, Türedi A, Tunç B. Çocuklarda beslenme alışkanlıklarının hematolojik parametreler ve eser elementler üzerine etkisi. SDÜ Tıp Dergisi 2005: 12: 6-10. google scholar
  • Ergul AB, Turanoglu C, Karakukcu C, Karaman S, Torun YA. Increased iron deficiency and iron deficiency anemia in children with zinc deficiency. Eurasian J Med 2018; 50: 34-7. google scholar
  • Kondaiah P, Yaduvanshi PS, Sharp PA, Pullakhandam R. Iron and zinc homeostasis and interactions: Does enteric zinc excretion cross-talk with intestinal iron absorption? Nutrients 2019; 11: 1885. google scholar
  • Taneli B. Anadolu toplumunda çinko. Ege Tıp Dergisi 2005; 44: 1-10. google scholar
  • Schneider JM, Fujii ML, Lamp CL, Lönnerdal B, Zidenberg-Cherr S. The prevalence of low serum zinc and copper levels and dietary habits associated with serum zinc and copper in 12- to 36-month-old children from low-income families at risk for iron deficiency. J Am Diet Assoc 2007; 107: 1924-9. google scholar
  • Levenson CW. Zinc regulation of food intake: new insights on the role of neuropeptide Y. Nutr Rev 2003; 61: 247-9. google scholar
  • Zhang JG, Zhang B, DU WW, Su C, Liu AD, Zhang J, et al. Analysis on the status of vitamin A deficiency among children under 5 years old in poor rural areas of 6 Western Chinese provinces in 2009. Zhonghua Liu Xing Bing Xue Za Zhi 2011; 32: 1224-6. google scholar
  • Garcia MT, Granado FS, Cardoso MA. Complementary feeding and nutritional status of 6-24-month-old children in Acrelândia, Acre State, Western Brazilian Amazon. Cad Saude Publica 2011; 27: 30516. google scholar
  • Global prevalence of vitamin A deficiency in populations at risk 1995-2005 [Internet]. WHO Global Database on Vitamin A Deficiency. Geneva, World Health Organization, 2009 . (cited 2021 September 18). Available from: URL: http://whqlibdoc.who.int/ publications/2009/9789241598019_eng.pdf. google scholar
  • Sheftel J, Tanumihardjo SA. Systematic review and meta-analysis of the relative Dose-response tests to assess vitamin A status. Adv Nutr 2021;12:904-41. google scholar
Year 2024, Volume: 24 Issue: 1, 5 - 10, 07.05.2024
https://doi.org/10.26650/jchild.2024.1192386

Abstract

Supporting Institution

-

Project Number

-

Thanks

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References

  • Saltık-Temizel. İştahsız çocuk. Çocuk Sağlığı ve Hastalıkları Dergisi 2008; 51: 176-81. google scholar
  • Carter RG, Susan Feigelman S. The preschool years. In: Kliegman RM, St Geme J, Blum NJ, Shah SS, Tasker RC, Wilson KM, editors. Nelson Textbook of Pediatrics. 21th edition, Philadelphia: Elsevier; 2020.p.143-6. google scholar
  • Phalen JA. Managing feeding problems and feeding disorders. Pediatr Rev 2013; 34: 549-57. google scholar
  • Kerzner B, Milano K, MacLean WC, Berall G, Stuart S, Chatoor I. A Practical approach to classifying and managing feeding difficulties. Pediatrics 2015; 135: 345-53. google scholar
  • Wright CM, Parkinson KN, Shipton D, Drewett RF. How do toddler eating problems relate to their eating behavior, food preferences, and growth? Pediatrics 2007; 120: e1069-75. google scholar
  • Bekem Ö, Öztürk Y, Arslan N. İştahsız çocuklarda beslenme özelliklerinin değerlendirilmesi. DEÜ Tıp Fakültesi Dergisi 2003; 17: 181-9. google scholar
  • Lee K, Song YM. Parent-reported appetite of a child and the child’s weight status over a 2-year period in Korean children. J Am Diet Assoc 2007; 107: 678-80. google scholar
  • Isguven P, Arslanoglu I, Erol M, Yildiz M, Adal E, Erguven M. Serum levels of ghrelin, leptin, IGF-I, IGFBP-3, insulin, thyroid hormones and cortisol in prepubertal children with iron deficiency. Endocr J 2007; 54: 985-90. google scholar
  • Ghrayeb H, Elias M, Nashashibi J, Youssef A, Manal M, Mahagna L, et al. Appetite and ghrelin levels in iron deficiency anemia and the effect of parenteral iron therapy: A longitudinal study. PLoS One 2020 ;15:e0234209. google scholar
  • Suzuki H, Asakawa A, Li JB, Tsai M, Amitani H, Ohinata K, et al. Zinc as an appetite stimulator - the possible role of zinc in the progression of diseases such as cachexia and sarcopenia. Recent Pat Food Nutr Agric 2011; 3: 226-31. google scholar
  • Kurtoğlu S, Köklü E, Hatipoğlu N, Atabek ME. The relationship between serum ghrelin levels and hair zinc concentrations in children. J Clin Res Pediatr Endocrinol 2008; 1: 1-7. google scholar
  • Thomas DM, Mirowski GW. Nutrition and oral mucosal diseases. Clin Dermatol 2010;28:426-31. google scholar
  • Anzano Ma, Lam AJ, Olson JA. Growth, appetite, sequence of pathological signs and survival following the induction of rapid, synchronous vitamin A deficiency in the rat. J Nutr 1979; 109: 1419-31. google scholar
  • Anzano Ma, Lam AJ, Olson JA. Impaired salivary gland secretory function following the induction of rapid, synchronous vitamin A deficiency in rats. J Nutr 1981; 111: 496-504. google scholar
  • Gökçay G. A vitamin eksikliği. İçinde:Neyzi O, Ertuğul T, Darendeliler T, editörler. Pediatri. İstanbul: Nobel Tıp Kitabevleri; 2021.p. 265-7. google scholar
  • Türkiye İşçi Sendikaları Konfederasyonu [Internet]. (Erişim Tarihi: 06 Ağustos 2021). Erişim: http://www.turkis.org.tr. google scholar
  • Bundak R. Büyüme. İçinde: Neyzi O, Ertuğul T, Darendeliler T, editörler.. Pediatri. İstanbul: Nobel Tıp Kitabevleri; 2021.p.83-104. google scholar
  • Stanley FL. Reference intervals for laboratory tests and procedures. In: Kliegman RM, St Geme J, Blum NJ, Shah SS, Tasker RC, Wilson KM, editors. Nelson Textbook of Pediatrics. 21th edition, Philadelphia: Elsevier; 2020.p. e5-e14. google scholar
  • Saner G, Durmaz Ö, Özden TA. Eser elementlerle ilgili bozukluklar. İçinde: Neyzi O, Ertuğul T, Darendeliler T, editörler. Pediatri. İstanbul: Nobel Tıp Kitabevleri; 2021.p. 255-64 google scholar
  • Ross AC, Tan L. Vitamin A deficiencies and excess. In: Kliegman RM, St Geme J, Blum NJ, Shah SS, Tasker RC, Wilson KM, editors. Nelson Textbook of Pediatrics. 21th edition, Philadelphia: Elsevier; 2020.p. 360-5. google scholar
  • Investing in the future: A united call to action on vitamin and mineral deficiency [Internet]. Global Report 2009. (cited 2021 September 13). Available from: URL: https://www.who.int/vmnis/ publications/investing_in_the_future.pdf . google scholar
  • World Health Organization [2020 [Internet]. WHO guideline on use of ferritin concentrations to assess iron status in individuals and populations. (cited 2021 September 13). Available from: URL: https://apps.who.int/iris/handle/10665/331505 License: CC BY-NC-SA 3.0 IGO. google scholar
  • World Health Organization 2015 [Internet]. The global prevalence of anaemia in 2011. . (cited 2021 September 14). Available from: URL: https://apps.who.int/iris/bitstream/ handle/10665/177094/9789241564960_eng.pdf. google scholar
  • Tympa-Psirropoulou E, Vagenas C, Psirropoulos D, Dafni O, Matala A, Skopouli F. Nutritional risk factors for iron-deficiency anaemia in children 12-24 months old in the area of Thessalia in Greece. Int J Food Sci Nutr 2005; 56: 1-12. google scholar
  • Liu J, Ai YX, Hanlon A, Shi Z, Shi Z, Dickerman B, et al. Micronutrients deficiency and associated sociodemographic factors in Chinese children. World J Pediatr 2011; 7: 217-23. google scholar
  • Öktem F, Yavrucuoğlu H, Türedi A, Tunç B. Çocuklarda beslenme alışkanlıklarının hematolojik parametreler ve eser elementler üzerine etkisi. SDÜ Tıp Dergisi 2005: 12: 6-10. google scholar
  • Ergul AB, Turanoglu C, Karakukcu C, Karaman S, Torun YA. Increased iron deficiency and iron deficiency anemia in children with zinc deficiency. Eurasian J Med 2018; 50: 34-7. google scholar
  • Kondaiah P, Yaduvanshi PS, Sharp PA, Pullakhandam R. Iron and zinc homeostasis and interactions: Does enteric zinc excretion cross-talk with intestinal iron absorption? Nutrients 2019; 11: 1885. google scholar
  • Taneli B. Anadolu toplumunda çinko. Ege Tıp Dergisi 2005; 44: 1-10. google scholar
  • Schneider JM, Fujii ML, Lamp CL, Lönnerdal B, Zidenberg-Cherr S. The prevalence of low serum zinc and copper levels and dietary habits associated with serum zinc and copper in 12- to 36-month-old children from low-income families at risk for iron deficiency. J Am Diet Assoc 2007; 107: 1924-9. google scholar
  • Levenson CW. Zinc regulation of food intake: new insights on the role of neuropeptide Y. Nutr Rev 2003; 61: 247-9. google scholar
  • Zhang JG, Zhang B, DU WW, Su C, Liu AD, Zhang J, et al. Analysis on the status of vitamin A deficiency among children under 5 years old in poor rural areas of 6 Western Chinese provinces in 2009. Zhonghua Liu Xing Bing Xue Za Zhi 2011; 32: 1224-6. google scholar
  • Garcia MT, Granado FS, Cardoso MA. Complementary feeding and nutritional status of 6-24-month-old children in Acrelândia, Acre State, Western Brazilian Amazon. Cad Saude Publica 2011; 27: 30516. google scholar
  • Global prevalence of vitamin A deficiency in populations at risk 1995-2005 [Internet]. WHO Global Database on Vitamin A Deficiency. Geneva, World Health Organization, 2009 . (cited 2021 September 18). Available from: URL: http://whqlibdoc.who.int/ publications/2009/9789241598019_eng.pdf. google scholar
  • Sheftel J, Tanumihardjo SA. Systematic review and meta-analysis of the relative Dose-response tests to assess vitamin A status. Adv Nutr 2021;12:904-41. google scholar
There are 35 citations in total.

Details

Primary Language English
Subjects Paediatrics
Journal Section Research Articles
Authors

Medine Taşar 0000-0003-4367-725X

Nevin Özdemiroğlu 0000-0003-3327-9274

Abdurrezak Kaya 0000-0002-2199-0504

Rukiye Ünsal Saç 0000-0002-5077-4843

Project Number -
Publication Date May 7, 2024
Published in Issue Year 2024 Volume: 24 Issue: 1

Cite

APA Taşar, M., Özdemiroğlu, N., Kaya, A., Ünsal Saç, R. (2024). Serum Iron, Zinc, and Vitamin A Levels in 2-to-6-Year-Old Children with Small or No Appetite. Çocuk Dergisi, 24(1), 5-10. https://doi.org/10.26650/jchild.2024.1192386
AMA Taşar M, Özdemiroğlu N, Kaya A, Ünsal Saç R. Serum Iron, Zinc, and Vitamin A Levels in 2-to-6-Year-Old Children with Small or No Appetite. Çocuk Dergisi. May 2024;24(1):5-10. doi:10.26650/jchild.2024.1192386
Chicago Taşar, Medine, Nevin Özdemiroğlu, Abdurrezak Kaya, and Rukiye Ünsal Saç. “Serum Iron, Zinc, and Vitamin A Levels in 2-to-6-Year-Old Children With Small or No Appetite”. Çocuk Dergisi 24, no. 1 (May 2024): 5-10. https://doi.org/10.26650/jchild.2024.1192386.
EndNote Taşar M, Özdemiroğlu N, Kaya A, Ünsal Saç R (May 1, 2024) Serum Iron, Zinc, and Vitamin A Levels in 2-to-6-Year-Old Children with Small or No Appetite. Çocuk Dergisi 24 1 5–10.
IEEE M. Taşar, N. Özdemiroğlu, A. Kaya, and R. Ünsal Saç, “Serum Iron, Zinc, and Vitamin A Levels in 2-to-6-Year-Old Children with Small or No Appetite”, Çocuk Dergisi, vol. 24, no. 1, pp. 5–10, 2024, doi: 10.26650/jchild.2024.1192386.
ISNAD Taşar, Medine et al. “Serum Iron, Zinc, and Vitamin A Levels in 2-to-6-Year-Old Children With Small or No Appetite”. Çocuk Dergisi 24/1 (May 2024), 5-10. https://doi.org/10.26650/jchild.2024.1192386.
JAMA Taşar M, Özdemiroğlu N, Kaya A, Ünsal Saç R. Serum Iron, Zinc, and Vitamin A Levels in 2-to-6-Year-Old Children with Small or No Appetite. Çocuk Dergisi. 2024;24:5–10.
MLA Taşar, Medine et al. “Serum Iron, Zinc, and Vitamin A Levels in 2-to-6-Year-Old Children With Small or No Appetite”. Çocuk Dergisi, vol. 24, no. 1, 2024, pp. 5-10, doi:10.26650/jchild.2024.1192386.
Vancouver Taşar M, Özdemiroğlu N, Kaya A, Ünsal Saç R. Serum Iron, Zinc, and Vitamin A Levels in 2-to-6-Year-Old Children with Small or No Appetite. Çocuk Dergisi. 2024;24(1):5-10.