title: Predictors of improvement in hemoglobin concentration among toddlers enrolled in the Massachusetts WIC Program.
abstract: OBJECTIVE
  Nutrition supplementation programs are generally targeted to those members of the population who are thought to be at risk of an undesirable outcome, but not all who participate in such programs respond to them. We sought to identify determinants of improvement in hemoglobin concentration among young children in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
  
  
  METHODS
  We conducted an observational study using data from 9,930 children who were enrolled in the Massachusetts WIC program and had data available on their hemoglobin values at both 1 and 2 years of age. Predictors of change in hemoglobin concentration between these ages were studied using multivariate statistical modeling.
  
  
  RESULTS
  Overall, hemoglobin concentrations increased from age 1 to 2 years in those who had been breastfed 25 or more weeks (P < .0001) and were female (P < .01), and decreased with increasing weight at 1 year of age (P < .001). The determinants of change in hemoglobin concentration differed from the determinants of hemoglobin concentration at age 1 year.
  
  
  CONCLUSIONS
  The analytical approach used here could be extended to identify subgroups of WIC participants likely to improve in other outcomes. If current efforts to increase the duration of breastfeeding among WIC participants are successful, the importance of WIC in improving hemoglobin concentration among young children also will increase.
authors.affiliation: Tompkins Cortland Community College, Dryden, NY, USA.
authors.forename: Kristine
authors.initials: K
authors.lastname: Altucher
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Rasmussen
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Barden
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Habicht
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000453:epidemiology* / Q000517:prevention & control; D001835:Body Weight; D001942:Breast Feeding / Q000009:adverse effects; D002662:Child Health Services; D019587:Dietary Supplements; D004522:Educational Status; D005191:Family Characteristics; D005260:Female; D005522:Food Services; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D008297:Male; D008404:Massachusetts; D015999:Multivariate Analysis; D009749:Nutrition Surveys; D009752:Nutritional Status; D011203:Poverty; D011237:Predictive Value of Tests; D011632:Public Assistance; D012737:Sex Factors
chemical_list: D006454:Hemoglobins