Micronutrients Associated With Anemia in School-age Children and Adolescents 2005–2018: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) Project
Background: School-age children and adolescents may be at risk of anemia through demands on micronutrients required for growth and maturation. Objectives: This multicountry analysis examined the burden of anemia in children aged 5–19 y by sex and age category and associations with micronutrient defi...
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Elsevier
2025-08-01
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| Series: | Current Developments in Nutrition |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2475299125029634 |
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| author | Rochelle Werner Hanqi Luo Lei Liu Yuqing Wang Jiaxi Geng Yi-An Ko Parminder S Suchdev Yaw Addo Zulfiqar Ahmed Bhutta Victor Temple Frank Wieringa Fabian Rohner Maria J Ramirez-Luzuriaga Reina Engle-Stone Anne Williams Melissa F Young |
| author_facet | Rochelle Werner Hanqi Luo Lei Liu Yuqing Wang Jiaxi Geng Yi-An Ko Parminder S Suchdev Yaw Addo Zulfiqar Ahmed Bhutta Victor Temple Frank Wieringa Fabian Rohner Maria J Ramirez-Luzuriaga Reina Engle-Stone Anne Williams Melissa F Young |
| author_sort | Rochelle Werner |
| collection | DOAJ |
| description | Background: School-age children and adolescents may be at risk of anemia through demands on micronutrients required for growth and maturation. Objectives: This multicountry analysis examined the burden of anemia in children aged 5–19 y by sex and age category and associations with micronutrient deficiencies, inflammation, and BMI. Methods: Children aged 5–19 y from surveys in the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) Project were included with hemoglobin, ≥1 micronutrient (iron, vitamin A, folate, vitamin B12, or zinc) and inflammation biomarker, and n > 100 per survey. Factors with bivariate relationships with anemia (P < 0.1) were included in multivariable modified Poisson regression models to examine the attributable burden of anemia. Results: This analysis included 54,534 children from 17 surveys in 16 countries (16 surveys for 15–19 y; 9 surveys for 10–14 y; 8 surveys for 5–9 y). Median overall anemia prevalence was 16% (range: 5% in Ecuador, United Kingdom, and United States to 59% in Côte d’Ivoire) with the highest burden in 15–19-y-old females (24%). In most surveys, anemia prevalence did not differ by sex for children aged 5–14 y, and median anemia prevalence was lower in children aged 10–14 y (7%) than in those aged 5–9 y (9%) or 15–19 y (22%). In most surveys, higher anemia prevalence was associated (P < 0.05) with iron deficiency (15%) [prevalence ratio (PR): 1.6–14.2; 5–9 y, 4/7 surveys; 10–14 y, 6/6 surveys; 15–19 y, 13/14 surveys), vitamin A deficiency (2%) (PR: 1.8–3.0; 5–9 y, 2/2 surveys; 10–14 y, 2/3 surveys; 15–19 y, 2/3 surveys), and inflammation (13%) (PR: 1.4–2.4: 5–9 y, 4/4 surveys; 10–14 y, 2/4 surveys; 15–19 y, 6/8 surveys). Folate, vitamin B12, zinc, and BMI had weak, variable associations with anemia. Conclusions: Iron deficiency and vitamin A deficiency are consistently associated with anemia in school-age children and adolescents, whereas inflammation and other micronutrients had context-dependent associations. This research underscores the importance of examining multiple micronutrients associated with anemia in the context of factors such as country, age, and sex. |
| format | Article |
| id | doaj-art-d1c15ee9c6324edeb9d47532f7b5bd78 |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-08-01 |
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| spelling | doaj-art-d1c15ee9c6324edeb9d47532f7b5bd782025-08-24T05:13:56ZengElsevierCurrent Developments in Nutrition2475-29912025-08-019810750210.1016/j.cdnut.2025.107502Micronutrients Associated With Anemia in School-age Children and Adolescents 2005–2018: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) ProjectRochelle Werner0Hanqi Luo1Lei Liu2Yuqing Wang3Jiaxi Geng4Yi-An Ko5Parminder S Suchdev6Yaw Addo7Zulfiqar Ahmed Bhutta8Victor Temple9Frank Wieringa10Fabian Rohner11Maria J Ramirez-Luzuriaga12Reina Engle-Stone13Anne Williams14Melissa F Young15Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States; Corresponding author.Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United StatesHubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United StatesHubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United StatesDepartment of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, United StatesDepartment of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, United StatesHubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States; Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia, United States; Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia, United StatesDivision of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia, United StatesInstitute for Global Health & Development, Aga Khan University, Karachi, Pakistan; Centre for Global Child Health, The Hospital for Sick Children, Toronto, CanadaDivision of Basic Medical Sciences, School of Medicine and Health Sciences, University of Papua New Guinea, Port Moresby, Papua New GuineaFrench National Research Institute for Sustainable Development, Montpellier, FranceGroundWork, Fläsch, SwitzerlandPhoenix Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, United StatesDepartment of Nutrition, Institute for Global Nutrition, UC Davis, Davis, California, United StatesHubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United StatesHubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States; Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia, United StatesBackground: School-age children and adolescents may be at risk of anemia through demands on micronutrients required for growth and maturation. Objectives: This multicountry analysis examined the burden of anemia in children aged 5–19 y by sex and age category and associations with micronutrient deficiencies, inflammation, and BMI. Methods: Children aged 5–19 y from surveys in the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) Project were included with hemoglobin, ≥1 micronutrient (iron, vitamin A, folate, vitamin B12, or zinc) and inflammation biomarker, and n > 100 per survey. Factors with bivariate relationships with anemia (P < 0.1) were included in multivariable modified Poisson regression models to examine the attributable burden of anemia. Results: This analysis included 54,534 children from 17 surveys in 16 countries (16 surveys for 15–19 y; 9 surveys for 10–14 y; 8 surveys for 5–9 y). Median overall anemia prevalence was 16% (range: 5% in Ecuador, United Kingdom, and United States to 59% in Côte d’Ivoire) with the highest burden in 15–19-y-old females (24%). In most surveys, anemia prevalence did not differ by sex for children aged 5–14 y, and median anemia prevalence was lower in children aged 10–14 y (7%) than in those aged 5–9 y (9%) or 15–19 y (22%). In most surveys, higher anemia prevalence was associated (P < 0.05) with iron deficiency (15%) [prevalence ratio (PR): 1.6–14.2; 5–9 y, 4/7 surveys; 10–14 y, 6/6 surveys; 15–19 y, 13/14 surveys), vitamin A deficiency (2%) (PR: 1.8–3.0; 5–9 y, 2/2 surveys; 10–14 y, 2/3 surveys; 15–19 y, 2/3 surveys), and inflammation (13%) (PR: 1.4–2.4: 5–9 y, 4/4 surveys; 10–14 y, 2/4 surveys; 15–19 y, 6/8 surveys). Folate, vitamin B12, zinc, and BMI had weak, variable associations with anemia. Conclusions: Iron deficiency and vitamin A deficiency are consistently associated with anemia in school-age children and adolescents, whereas inflammation and other micronutrients had context-dependent associations. This research underscores the importance of examining multiple micronutrients associated with anemia in the context of factors such as country, age, and sex.http://www.sciencedirect.com/science/article/pii/S2475299125029634anemiairon deficiency (ID)micronutrientsbody mass index (BMI)Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA)school-age children |
| spellingShingle | Rochelle Werner Hanqi Luo Lei Liu Yuqing Wang Jiaxi Geng Yi-An Ko Parminder S Suchdev Yaw Addo Zulfiqar Ahmed Bhutta Victor Temple Frank Wieringa Fabian Rohner Maria J Ramirez-Luzuriaga Reina Engle-Stone Anne Williams Melissa F Young Micronutrients Associated With Anemia in School-age Children and Adolescents 2005–2018: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) Project Current Developments in Nutrition anemia iron deficiency (ID) micronutrients body mass index (BMI) Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) school-age children |
| title | Micronutrients Associated With Anemia in School-age Children and Adolescents 2005–2018: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) Project |
| title_full | Micronutrients Associated With Anemia in School-age Children and Adolescents 2005–2018: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) Project |
| title_fullStr | Micronutrients Associated With Anemia in School-age Children and Adolescents 2005–2018: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) Project |
| title_full_unstemmed | Micronutrients Associated With Anemia in School-age Children and Adolescents 2005–2018: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) Project |
| title_short | Micronutrients Associated With Anemia in School-age Children and Adolescents 2005–2018: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) Project |
| title_sort | micronutrients associated with anemia in school age children and adolescents 2005 2018 biomarkers reflecting inflammation and nutritional determinants of anemia brinda project |
| topic | anemia iron deficiency (ID) micronutrients body mass index (BMI) Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) school-age children |
| url | http://www.sciencedirect.com/science/article/pii/S2475299125029634 |
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