Maternal ethnicity and iron status in early childhood in Toronto, Canada: a cross-sectional study

Objectives This study aimed to evaluate the association between maternal ethnicity and iron deficiency (ID) in early childhood, and to evaluate whether infant feeding practices linked to ID differ between maternal ethnic groups.Methods This was a cross-sectional study of healthy children 1–3 years o...

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Main Authors: Michael Peer, Tara Kiran, Noor Ramji, Mary Beth Derocher, Margarita Lam-Antoniades, Peter Szatmari, Gerald Lebovic, Peter Jüni, Colin Macarthur, Christopher Allen, Julia Thompson, Charlie Guiang, Kevin Thorpe, Marty Perlmutar, Douglas Campbell, Andreas Laupacis, Elise Mok, Curtis Handford, Suzanne Turner, Christine Koroshegyi, Catherine S. Birken, Jonathon L. Maguire, Ronald Cohn, Eddy Lau, Patricia C. Parkin, Michael Salter, Shannon Weir, Laura N. Anderson, Cornelia M. Borkhoff, Charles Keown-Stoneman, Christine Kowal, Dalah Mason, Murtala Abdurrahman, Kelly Anderson, Gordon Arbess, Jillian Baker, Tony Barozzino, Sylvie Bergeron, Dimple Bhagat, Gary Bloch, Joey Bonifacio, Ashna Bowry, Caroline Calpin, Sohail Cheema, Elaine Cheng, Brian Chisamore, Evelyn Constantin, Karoon Danayan, Paul Das, Anh Do, Kathleen Doukas, Anne Egger, Allison Farber, Amy Freedman, Sloane Freeman, Sharon Gazeley, Dan Ha, Laura Hanson, Leah Harrington, Sheila Jacobson, Lukasz Jagiello, Gwen Jansz, Paul Kadar, Florence Kim, Holly Knowles, Bruce Kwok, Sheila Lakhoo, Fok-Han Leung, Alan Li, Patricia Li, Jessica Malach, Roy Male, Vashti Mascoll, Aleks Meret, Rosemary Moodie, Maya Nader, Katherine Nash, Sharon Naymark, James Owen, Kifi Pena, Navindra Persaud, Andrew Pinto, Michelle Porepa, Vikky Qi, Nasreen Ramji, Danyaal Raza, Alana Rosenthal, Katherine Rouleau, Caroline Ruderman, Janet Saunderson, Vanna Schiralli, Michael Sgro, Hafiz Shuja, Susan Shepherd, Barbara Smiltnieks, Cinntha Srikanthan, Carolyn Taylor, Stephen Treherne, Fatima Uddin, Meta van den Heuvel, Joanne Vaughan, Thea Weisdorf, Sheila Wijayasinghe, Peter Wong, John Yaremko, Ethel Ying, Elizabeth Young, Michael Zajdman, Farnaz Bazeghi, Vincent Bouchard, Marivic Bustos, Charmaine Camacho, Dharma Dalwadi, Tarandeep Malhi, Sharon Thadani, Laurie Thompson, Mary Aglipay, Imaan Bayoumi, Sarah Carsley, Katherine Cost, Karen Eny, Theresa Kim, Laura Kinlin, Jessica Omand, Shelley Vanderhout, Leigh Vanderloo, Bryan Boodhoo, Olivia Chan, David W.H. Dai, Judith Hall, Karen Pope, Rita Kandel, Michelle Rodrigues, Hilde Vandenberghe, Gita Wahi, Vinusha Gunaseelan, Denis Leuc
Format: Article
Language:English
Published: BMJ Publishing Group 2020-02-01
Series:BMJ Paediatrics Open
Online Access:https://bmjpaedsopen.bmj.com/content/4/1/e000635.full
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author Michael Peer
Tara Kiran
Noor Ramji
Mary Beth Derocher
Margarita Lam-Antoniades
Peter Szatmari
Gerald Lebovic
Peter Jüni
Colin Macarthur
Christopher Allen
Julia Thompson
Charlie Guiang
Kevin Thorpe
Marty Perlmutar
Douglas Campbell
Andreas Laupacis
Elise Mok
Curtis Handford
Suzanne Turner
Christine Koroshegyi
Catherine S. Birken
Jonathon L. Maguire
Ronald Cohn
Eddy Lau
Patricia C. Parkin
Michael Salter
Shannon Weir
Laura N. Anderson
Cornelia M. Borkhoff
Charles Keown-Stoneman
Christine Kowal
Dalah Mason
Murtala Abdurrahman
Kelly Anderson
Gordon Arbess
Jillian Baker
Tony Barozzino
Sylvie Bergeron
Dimple Bhagat
Gary Bloch
Joey Bonifacio
Ashna Bowry
Caroline Calpin
Sohail Cheema
Elaine Cheng
Brian Chisamore
Evelyn Constantin
Karoon Danayan
Paul Das
Anh Do
Kathleen Doukas
Anne Egger
Allison Farber
Amy Freedman
Sloane Freeman
Sharon Gazeley
Dan Ha
Laura Hanson
Leah Harrington
Sheila Jacobson
Lukasz Jagiello
Gwen Jansz
Paul Kadar
Florence Kim
Holly Knowles
Bruce Kwok
Sheila Lakhoo
Fok-Han Leung
Alan Li
Patricia Li
Jessica Malach
Roy Male
Vashti Mascoll
Aleks Meret
Rosemary Moodie
Maya Nader
Katherine Nash
Sharon Naymark
James Owen
Kifi Pena
Navindra Persaud
Andrew Pinto
Michelle Porepa
Vikky Qi
Nasreen Ramji
Danyaal Raza
Alana Rosenthal
Katherine Rouleau
Caroline Ruderman
Janet Saunderson
Vanna Schiralli
Michael Sgro
Hafiz Shuja
Susan Shepherd
Barbara Smiltnieks
Cinntha Srikanthan
Carolyn Taylor
Stephen Treherne
Fatima Uddin
Meta van den Heuvel
Joanne Vaughan
Thea Weisdorf
Sheila Wijayasinghe
Peter Wong
John Yaremko
Ethel Ying
Elizabeth Young
Michael Zajdman
Farnaz Bazeghi
Vincent Bouchard
Marivic Bustos
Charmaine Camacho
Dharma Dalwadi
Tarandeep Malhi
Sharon Thadani
Laurie Thompson
Mary Aglipay
Imaan Bayoumi
Sarah Carsley
Katherine Cost
Karen Eny
Theresa Kim
Laura Kinlin
Jessica Omand
Shelley Vanderhout
Leigh Vanderloo
Bryan Boodhoo
Olivia Chan
David W.H. Dai
Judith Hall
Karen Pope
Rita Kandel
Michelle Rodrigues
Hilde Vandenberghe
Gita Wahi
Vinusha Gunaseelan
Denis Leuc
author_facet Michael Peer
Tara Kiran
Noor Ramji
Mary Beth Derocher
Margarita Lam-Antoniades
Peter Szatmari
Gerald Lebovic
Peter Jüni
Colin Macarthur
Christopher Allen
Julia Thompson
Charlie Guiang
Kevin Thorpe
Marty Perlmutar
Douglas Campbell
Andreas Laupacis
Elise Mok
Curtis Handford
Suzanne Turner
Christine Koroshegyi
Catherine S. Birken
Jonathon L. Maguire
Ronald Cohn
Eddy Lau
Patricia C. Parkin
Michael Salter
Shannon Weir
Laura N. Anderson
Cornelia M. Borkhoff
Charles Keown-Stoneman
Christine Kowal
Dalah Mason
Murtala Abdurrahman
Kelly Anderson
Gordon Arbess
Jillian Baker
Tony Barozzino
Sylvie Bergeron
Dimple Bhagat
Gary Bloch
Joey Bonifacio
Ashna Bowry
Caroline Calpin
Sohail Cheema
Elaine Cheng
Brian Chisamore
Evelyn Constantin
Karoon Danayan
Paul Das
Anh Do
Kathleen Doukas
Anne Egger
Allison Farber
Amy Freedman
Sloane Freeman
Sharon Gazeley
Dan Ha
Laura Hanson
Leah Harrington
Sheila Jacobson
Lukasz Jagiello
Gwen Jansz
Paul Kadar
Florence Kim
Holly Knowles
Bruce Kwok
Sheila Lakhoo
Fok-Han Leung
Alan Li
Patricia Li
Jessica Malach
Roy Male
Vashti Mascoll
Aleks Meret
Rosemary Moodie
Maya Nader
Katherine Nash
Sharon Naymark
James Owen
Kifi Pena
Navindra Persaud
Andrew Pinto
Michelle Porepa
Vikky Qi
Nasreen Ramji
Danyaal Raza
Alana Rosenthal
Katherine Rouleau
Caroline Ruderman
Janet Saunderson
Vanna Schiralli
Michael Sgro
Hafiz Shuja
Susan Shepherd
Barbara Smiltnieks
Cinntha Srikanthan
Carolyn Taylor
Stephen Treherne
Fatima Uddin
Meta van den Heuvel
Joanne Vaughan
Thea Weisdorf
Sheila Wijayasinghe
Peter Wong
John Yaremko
Ethel Ying
Elizabeth Young
Michael Zajdman
Farnaz Bazeghi
Vincent Bouchard
Marivic Bustos
Charmaine Camacho
Dharma Dalwadi
Tarandeep Malhi
Sharon Thadani
Laurie Thompson
Mary Aglipay
Imaan Bayoumi
Sarah Carsley
Katherine Cost
Karen Eny
Theresa Kim
Laura Kinlin
Jessica Omand
Shelley Vanderhout
Leigh Vanderloo
Bryan Boodhoo
Olivia Chan
David W.H. Dai
Judith Hall
Karen Pope
Rita Kandel
Michelle Rodrigues
Hilde Vandenberghe
Gita Wahi
Vinusha Gunaseelan
Denis Leuc
author_sort Michael Peer
collection DOAJ
description Objectives This study aimed to evaluate the association between maternal ethnicity and iron deficiency (ID) in early childhood, and to evaluate whether infant feeding practices linked to ID differ between maternal ethnic groups.Methods This was a cross-sectional study of healthy children 1–3 years of age. Adjusted multivariable logistic regression analyses were used to evaluate the association between maternal ethnicity and ID (serum ferritin <12 µg/L) and the association between maternal ethnicity and five infant feeding practices (breastfeeding duration; bottle use beyond 15 months; current formula use; daily cow’s milk intake >2 cups; meat consumption).Results Of 1851 children included, 12.2% had ID. Compared with the European referent group, we found higher odds of ID among children of South Asian and West Asian/North African maternal ethnicities, and lower odds of ID among children of East Asian maternal ethnicity. Statistically significant covariates associated with higher odds of ID included longer breastfeeding duration and daily cow’s milk intake >2 cups. Current infant formula use was associated with lower odds of ID. Children of South Asian maternal ethnicity had higher odds of bottle use beyond 15 months of age and lower odds of meat consumption.Conclusions We found increased odds of ID among children of South Asian and West Asian/Northern African maternal ethnicities. We found a higher odds of feeding practices linked to ID in children of South Asian maternal ethnicity, but not in children of West Asian/North African maternal ethnicity. Culturally tailored approaches to providing guidance to parents on healthy infant feeding practices may be important to prevent ID in early childhood.Trial registration number NCT01869530.
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spelling doaj-art-efb980281ac04b70be4ba3c56eb9d4602025-08-20T02:49:08ZengBMJ Publishing GroupBMJ Paediatrics Open2399-97722020-02-014110.1136/bmjpo-2020-000635Maternal ethnicity and iron status in early childhood in Toronto, Canada: a cross-sectional studyMichael PeerTara KiranNoor RamjiMary Beth DerocherMargarita Lam-AntoniadesPeter Szatmari0Gerald LebovicPeter Jüni1Colin Macarthur2Christopher Allen3Julia Thompson4Charlie GuiangKevin Thorpe5Marty PerlmutarDouglas Campbell6Andreas Laupacis7Elise Mok8Curtis HandfordSuzanne TurnerChristine KoroshegyiCatherine S. Birken9Jonathon L. Maguire10Ronald Cohn11Eddy LauPatricia C. Parkin12Michael SalterShannon WeirLaura N. AndersonCornelia M. Borkhoff13Charles Keown-Stoneman14Christine Kowal15Dalah Mason16Murtala AbdurrahmanKelly AndersonGordon ArbessJillian Baker17Tony BarozzinoSylvie BergeronDimple BhagatGary BlochJoey BonifacioAshna BowryCaroline CalpinSohail CheemaElaine ChengBrian ChisamoreEvelyn ConstantinKaroon DanayanPaul DasAnh DoKathleen DoukasAnne EggerAllison FarberAmy FreedmanSloane FreemanSharon GazeleyDan HaLaura HansonLeah HarringtonSheila JacobsonLukasz JagielloGwen JanszPaul KadarFlorence KimHolly KnowlesBruce KwokSheila LakhooFok-Han LeungAlan LiPatricia Li18Jessica MalachRoy MaleVashti MascollAleks MeretRosemary MoodieMaya NaderKatherine NashSharon NaymarkJames OwenKifi PenaNavindra Persaud19Andrew PintoMichelle PorepaVikky QiNasreen RamjiDanyaal RazaAlana RosenthalKatherine RouleauCaroline RudermanJanet SaundersonVanna SchiralliMichael SgroHafiz ShujaSusan Shepherd20Barbara SmiltnieksCinntha SrikanthanCarolyn Taylor21Stephen TreherneFatima UddinMeta van den HeuvelJoanne VaughanThea WeisdorfSheila WijayasinghePeter WongJohn YaremkoEthel YingElizabeth YoungMichael ZajdmanFarnaz Bazeghi22Vincent BouchardMarivic BustosCharmaine CamachoDharma DalwadiTarandeep MalhiSharon ThadaniLaurie ThompsonMary AglipayImaan Bayoumi23Sarah Carsley24Katherine CostKaren EnyTheresa KimLaura KinlinJessica OmandShelley VanderhoutLeigh VanderlooBryan BoodhooOlivia ChanDavid W.H. DaiJudith HallKaren PopeRita KandelMichelle RodriguesHilde VandenbergheGita Wahi25Vinusha Gunaseelan26Denis Leuc1 Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Ontario, CanadaprofessorDivision of Paediatric Medicine and the Paediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, Ontario, Canada6 The Applied Health Research Centre of the Li Ka Shing Knowledge Institute, St Michael`s Hospital, Toronto, Ontario, Canada5 Children and Young People’s Public Health Team, Sheffield City Council, Sheffield, UKDalla Lana School of Public Health, University of Toronto, Toronto, Ontario, CanadaSt. Michael`s Hospital/Unity Health Toronto, Toronto, Ontario, CanadaprofessorResearch Institute of the McGill University Health Centre, Montreal, QC, Canada4 Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada1 Li Ka Shing Knowledge Institute, St. Michael`s Hospital, Unity Health Toronto, Toronto, Ontario, CanadaDivision of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, Ontario, CanadaDivision of Paediatric Medicine and the Paediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, Ontario, CanadaDivision of Paediatric Medicine and the Paediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, Ontario, Canada3 Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, Ontario, Canada8 SickKids Research Institute, Toronto, Ontario, Canada8 SickKids Research Institute, Toronto, Ontario, CanadaPediatrics, St. Michael`s Hospital, Toronto, Ontario, CanadaPediatrics, McGill University, Montreal, Quebec, Canada1 Department of Family and Community Medicine, St Michael`s Hospital, Toronto, Ontario, CanadaLeeds NIHR Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UKLa Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia1 Institute for Health Systems Solutions and Virtual Care, Women`s College Hospital, Toronto, Ontario, CanadaDepartment of Family Medicine, Queen`s University, Kingston, New York, Canada1 Health Promotion, Chronic, Disease and Injury Prevention, Public Health Ontario, Toronto, Ontario, CanadaDepartment of Pediatrics, McMaster University, Hamilton, Ontario, CanadaDivision of Paediatric Medicine and the Paediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, Ontario, CanadaObjectives This study aimed to evaluate the association between maternal ethnicity and iron deficiency (ID) in early childhood, and to evaluate whether infant feeding practices linked to ID differ between maternal ethnic groups.Methods This was a cross-sectional study of healthy children 1–3 years of age. Adjusted multivariable logistic regression analyses were used to evaluate the association between maternal ethnicity and ID (serum ferritin <12 µg/L) and the association between maternal ethnicity and five infant feeding practices (breastfeeding duration; bottle use beyond 15 months; current formula use; daily cow’s milk intake >2 cups; meat consumption).Results Of 1851 children included, 12.2% had ID. Compared with the European referent group, we found higher odds of ID among children of South Asian and West Asian/North African maternal ethnicities, and lower odds of ID among children of East Asian maternal ethnicity. Statistically significant covariates associated with higher odds of ID included longer breastfeeding duration and daily cow’s milk intake >2 cups. Current infant formula use was associated with lower odds of ID. Children of South Asian maternal ethnicity had higher odds of bottle use beyond 15 months of age and lower odds of meat consumption.Conclusions We found increased odds of ID among children of South Asian and West Asian/Northern African maternal ethnicities. We found a higher odds of feeding practices linked to ID in children of South Asian maternal ethnicity, but not in children of West Asian/North African maternal ethnicity. Culturally tailored approaches to providing guidance to parents on healthy infant feeding practices may be important to prevent ID in early childhood.Trial registration number NCT01869530.https://bmjpaedsopen.bmj.com/content/4/1/e000635.full
spellingShingle Michael Peer
Tara Kiran
Noor Ramji
Mary Beth Derocher
Margarita Lam-Antoniades
Peter Szatmari
Gerald Lebovic
Peter Jüni
Colin Macarthur
Christopher Allen
Julia Thompson
Charlie Guiang
Kevin Thorpe
Marty Perlmutar
Douglas Campbell
Andreas Laupacis
Elise Mok
Curtis Handford
Suzanne Turner
Christine Koroshegyi
Catherine S. Birken
Jonathon L. Maguire
Ronald Cohn
Eddy Lau
Patricia C. Parkin
Michael Salter
Shannon Weir
Laura N. Anderson
Cornelia M. Borkhoff
Charles Keown-Stoneman
Christine Kowal
Dalah Mason
Murtala Abdurrahman
Kelly Anderson
Gordon Arbess
Jillian Baker
Tony Barozzino
Sylvie Bergeron
Dimple Bhagat
Gary Bloch
Joey Bonifacio
Ashna Bowry
Caroline Calpin
Sohail Cheema
Elaine Cheng
Brian Chisamore
Evelyn Constantin
Karoon Danayan
Paul Das
Anh Do
Kathleen Doukas
Anne Egger
Allison Farber
Amy Freedman
Sloane Freeman
Sharon Gazeley
Dan Ha
Laura Hanson
Leah Harrington
Sheila Jacobson
Lukasz Jagiello
Gwen Jansz
Paul Kadar
Florence Kim
Holly Knowles
Bruce Kwok
Sheila Lakhoo
Fok-Han Leung
Alan Li
Patricia Li
Jessica Malach
Roy Male
Vashti Mascoll
Aleks Meret
Rosemary Moodie
Maya Nader
Katherine Nash
Sharon Naymark
James Owen
Kifi Pena
Navindra Persaud
Andrew Pinto
Michelle Porepa
Vikky Qi
Nasreen Ramji
Danyaal Raza
Alana Rosenthal
Katherine Rouleau
Caroline Ruderman
Janet Saunderson
Vanna Schiralli
Michael Sgro
Hafiz Shuja
Susan Shepherd
Barbara Smiltnieks
Cinntha Srikanthan
Carolyn Taylor
Stephen Treherne
Fatima Uddin
Meta van den Heuvel
Joanne Vaughan
Thea Weisdorf
Sheila Wijayasinghe
Peter Wong
John Yaremko
Ethel Ying
Elizabeth Young
Michael Zajdman
Farnaz Bazeghi
Vincent Bouchard
Marivic Bustos
Charmaine Camacho
Dharma Dalwadi
Tarandeep Malhi
Sharon Thadani
Laurie Thompson
Mary Aglipay
Imaan Bayoumi
Sarah Carsley
Katherine Cost
Karen Eny
Theresa Kim
Laura Kinlin
Jessica Omand
Shelley Vanderhout
Leigh Vanderloo
Bryan Boodhoo
Olivia Chan
David W.H. Dai
Judith Hall
Karen Pope
Rita Kandel
Michelle Rodrigues
Hilde Vandenberghe
Gita Wahi
Vinusha Gunaseelan
Denis Leuc
Maternal ethnicity and iron status in early childhood in Toronto, Canada: a cross-sectional study
BMJ Paediatrics Open
title Maternal ethnicity and iron status in early childhood in Toronto, Canada: a cross-sectional study
title_full Maternal ethnicity and iron status in early childhood in Toronto, Canada: a cross-sectional study
title_fullStr Maternal ethnicity and iron status in early childhood in Toronto, Canada: a cross-sectional study
title_full_unstemmed Maternal ethnicity and iron status in early childhood in Toronto, Canada: a cross-sectional study
title_short Maternal ethnicity and iron status in early childhood in Toronto, Canada: a cross-sectional study
title_sort maternal ethnicity and iron status in early childhood in toronto canada a cross sectional study
url https://bmjpaedsopen.bmj.com/content/4/1/e000635.full
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AT leighvanderloo maternalethnicityandironstatusinearlychildhoodintorontocanadaacrosssectionalstudy
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AT judithhall maternalethnicityandironstatusinearlychildhoodintorontocanadaacrosssectionalstudy
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AT hildevandenberghe maternalethnicityandironstatusinearlychildhoodintorontocanadaacrosssectionalstudy
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