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Potential for misclassification of micronutrient status in children participating in a Head Start program
Elizabeth A Droke1, Tay Seacord Kennedy, Laura Hubbs-Tait
1Department of Nutrition, Food Science, and Hospitality, South Dakota State University, Brookings 57007, USA. elizabeth.droke@sdstate.edu
Insights
Infection indicators like C-reactive protein (CRP) and leukocytes affect iron and zinc status in low-income children. Standard iron deficiency criteria may misidentify children with low iron stores when infection is present.
Area of Science:
- Pediatric Nutrition
- Micronutrient Status
- Infectious Disease Markers
Background:
- Low-income preschool children are at risk for micronutrient deficiencies.
- Iron and zinc are crucial for child development.
- Infection can influence micronutrient status measurements.
Purpose of the Study:
- To examine the relationship between iron and zinc status, C-reactive protein (CRP), and leukocyte counts.
- To assess how infection markers impact micronutrient status in Head Start children.
- To determine appropriate methods for evaluating micronutrient status in the presence of infection.
Main Methods:
- A cross-sectional correlational study was conducted with 47 preschool children in rural Head Start centers.
- Blood samples were analyzed for zinc, ferritin, CRP, and complete blood count.
- Statistical analyses included correlations and univariate analysis of variance.
Main Results:
- 72% of children had elevated CRP levels, indicating infection.
- Using a standard criterion, 11% had low iron stores, but 77% had low iron stores when infection was considered.
- 21% had low plasma zinc levels, and children with infection markers had higher ferritin and lower zinc levels.
Conclusions:
- The standard ferritin criterion (
- Zinc deficiency may be overestimated in this population due to infection.
- Assessing infection status (CRP and leukocytes) is essential for accurate micronutrient status evaluation in low-income children.
Objective:
To evaluate relations among measures of iron and zinc status, C-reactive protein (CRP), and leukocytes in low-income children participating in the Head Start program.
Design:
Cross-sectional correlational study with samples collected at Head Start centers in May 2003.
Subjects/Setting:
Forty-seven children (aged 3 to 5 years) attending Head Start centers in three rural communities.
Measures:
Zinc, ferritin, CRP, and complete blood count were analyzed in nonfasting blood samples.
Statistical Analyses:
Correlations were computed among leukocyte levels, CRP levels, and measures of micronutrient status. Children having two abnormal measures (ie, leukocytes and CRP) were compared by univariate analysis of variance with children having zero or one abnormal measure.
Results:
Most (72%) of the children had elevated CRP levels. Four percent were anemic (hemoglobin<11.0 g/dL [<110 g/L]); 11% had low iron stores (serum ferritin
Conclusions:
The link between measures of infection and serum ferritin levels suggests low-income preschool children with low iron stores are not identified by the
