유아의 철분 영양 상태 및 철분결핍과 관련된 식이요법 분석 = Analysis of Dietary Factors Associated with lron Deficiency in Preschool Children

다국어 초록 (Multilingual Abstract)

Background Iron deficiency remains the most prevalent nutritional deficiency in the world. Especially, iron is very important inpreschool children who need it for their growth. This study was performed to investigate the iron status and the dietaryfactors for iron deficiency in preschool children.Methods One hundred twenty eight preschool children residing in In-chon were selected with age range of 3-6 years. Thehematological indices, daily nutrient intakes and food frequency were measured.Results Three poirot one%, 0.8%, 28.9%, 10.9% and 9.4% of the children were less than 11 g/in Hb, 33% in Hct, 60 ㎍/dl inserum iron, 12% for 3-4 years old children or 14% for 5-6 year old children in transferrin saturation and 10 ng/ml inserum ferritin, respectively. Twenty-three of the children (18.0%) showed iron deficiency which was defined by serumferritin (〈10 ng/ml) or transferrin saturation (〈12% for 3-4 year old children, 〈14% for 5-6 year old children). Inunivariate analysis, iron deficiency was associated with low intake of vitamin B6 or C and low intake frequency of fruitsor vegetables. In multivariate analysis, which was adjusted for age, sex and type of feeding method, the odds ratio ofcomparison of vegetables consumption more than 4 times a week with that less than 4 times a week was 0.267(95%confidence interval 0.077-0.928).

국문 초록 (Abstract)

-연구배경 유아기의 철 결핍성 빈혈은 가장 흔한 영양결핍이지만 유아기 섭식패턴과 관련된 연구는 부족한 실정으로 본 연구에서는 학령전 아동을 대상으로 철분 영양상태를 조사하고 철분 결핍과 관련된 식이요인을 분석하여 향후 유아들의 영양상태 개선 및 영양교육의 기초자료를 마련하고자 하였다 .방 법 인천 일부지역 유치원에 다니는 만 3~6세의 유아 128명을 대상으로 신체계측과 24시간 회상법으로 식이섭취를 조사하였고 , 정맥혈을 채취하여 헤모글로빈 , 헤마토크리트치, 혈청 페리틴과 철 및 트랜스페린 포화도를 측정하여 철분 영양상태를 평가하였다 . 또한 철분 결핍과 관련된 식이요인을 다중 로지스틱 회귀분석을 이용하여 교차비 (odds ratio)와 95% 신뢰구간으로 분석하였다.결 과 대상자의 철분 영양지표는 평균적으로는 철분 결핍 기준보다 높았으나 혈청 페리틴 (10 ng/㎖미만)과 트랜스페린 포화도 (12%미만)를 기준으로 보았을 때 , 대상자 중 18% 에 해당하는 23명의 유아는 철분 결핍이었다 . 단변량 분석시 철분결핍은 비타민 B6 혹은 비타민 C의 섭취량이 낮을수록 , 과일류와 채소류의 섭취빈도가 낮을수록 발생률이 높았으며 연령 , 설병, 수유방법을 보정하여 다변량 분석을 했을 경우 채소류의 주 4회 미만 섭취에 대한 주 4회 이상 섭취시 교차비가 0.267이었다.

참고문헌 (Reference)

1 "hematocrit and serum ferritin as markers of iron status" 450-457, koreanjnutrition1991

2 "Valyasevi A" 50 : 687-697, 1989

3 "The effect of variety in food choices on dietary quality" 87 : 897-903, 1987

4 "Report on 2001national health and nutrition survey - Nutrition survey" 2002

5 "Principles of nutritional assessment" 1990

6 "Preventing specific micronutrient deficiencies. In:" Foodand Agriculture Organization of the United Nations 399-418, 1997

7 "Prevalence of iron deficiency in the United Status" 227 : 973-976, 1997

8 "Nutritionalstatus of preschool children" 20-26, jamdietassoc1977

9 "Nutritional status of preschool children inlow income urban area - Ⅰ. Anthropometry and dietary intake" 4 (4): 123-131, 1999

10 "Nutritional status of iron zinc and copper ofpreschool children residing in low-income area of Seoul" 1 (1): 3-9, 1999

11 "Nutrition survey ofchildren in a Kindergarden of a private elementary school inPusan A study on nutrient intake and nutritional status" 587-1 593, jkoreansocfoodnutr1994

12 "Nutrition survey of children of a day care center in thelow income area of Pusan - Ⅰ A study on nutrient intake andnutritional status" 27-33, jkoreansocfoodnutr1993

13 "Nutrition intakes and relations to theobesity and the prevalance of anemia in preschool childrenliving in metropolitan area of Korea" 16 (16): 451-462, 2001

14 "Nutrition in infancy and childhood" Mosby 30-58, 1993pp

15 "Nonheme iron absorption and dietary factors" 22 (22): 349-358, 1993

16 "Ironstatus of active premenopausal women" 9 (9): -52, Assoc1993

17 "Iron deficiency in infancy the influence of mild antecedent infection" 874-879, jpediatr1984

18 "Influence ofascorbic acid in iron absorption from an iron-fortified chocolate-flavored milk drink in Jamaican children" 67 : 873-877, 1998

19 "Indicators of nutritional status onthe basis of preschool children's anthropometry" 31 (31): 1283-1294, 1998

20 "Improving iron absorption from a Peruvuan school breakfast meal byadding ascorbic acid or Na2 EDTA" 73 : 283-287, 2001

21 "Importance of ascorbic acid inthe absorption of iron from infant foods" 25 (25): 193-201, 1980

22 "Effects of iron supplementation on serum ferritin andother hematological indices of iron status in menstruatingwomen" 2 : 232-238, 1985

23 "Effect of iron therapy onbehavior performance in nonanaemic" 877-880, pediatrics1983

24 "Effect of ascorbic acid oniron absorption from different types of meals Studies withascorbic-acid-rich foods and synthetic ascorbic acid given indifferent amounts with different meals" 97-113,

25 "Decliningprevalence of anemia in childhood in a middle-class setting" 330-334,

26 "Changing characteristics of childhoodanemia" 114 : 161-164, 1989

27 "Biochemical basis for the manifestations of irondeficiency" 6 : 13-40, 1986

28 "Behavioral alterations in iron deficiency" 35 : 331-359, Pediar1988

29 "Assessment of dietary ironavailability and analysis of dietary factors affecting hematologicalindices in iron deficiency anemic female high school students" 32 (32): 787-792, 1999

30 "Are they equally sensitive in detecting anemia? AmJ Clin Nutr 1980" 61-64,

31 "An effect of children's food altitude onnutritional status and personality" 20 (20): 258-271, 1987

32 "A survey on nutritional status andanthropometry of preschool children in orphanage" 22 (22): 552-558, 1993

33 "A study on the food habit anddietary intake of preschool children" 32 (32): 419-429, 1999