Iron-fortified milk and noodle consumption is associated with lower risk of anemia among children aged 6-59 mo in Indonesia.
BACKGROUND
Anemia is common among children in developing countries and is associated with decreased cognitive and physical development. Iron-fortified foods may decrease child anemia.


OBJECTIVE
The objective was to describe the association between iron-fortified milk and iron-fortified noodle consumption and anemia in children aged 6-59 mo.


METHODS
Consumption of fortified milk and fortified noodles and child anemia were assessed in 81,885 families from rural and 26,653 families from urban slum areas in Indonesia.


RESULTS
The proportions of children who received fortified milk and noodles were 30.1% and 22.6%, respectively, in rural families and 40.1% and 48.9%, respectively, in urban families. The prevalence of anemia among children from rural families was 55.9% and from urban families was 60.8%. Children from rural and urban families were less likely to be anemic if they received fortified milk [odds ratio (OR): 0.76; 95% CI: 0.72, 0.80 (P < 0.0001) and OR: 0.79; 95% CI: 0.74, 0.86 (P < 0.0001), respectively] but not fortified noodles [OR: 0.98; 95% CI: 0.93, 1.09 (P = 0.56) and OR: 0.95; 95% CI: 0.88, 1.02 (P = 0.16), respectively] in multiple logistic regression models with adjustment for potential confounders. In rural families, the odds of anemia were lower when the child who consumed fortified milk also consumed fortified noodles or when the child who consumed fortified noodles also consumed fortified milk.


CONCLUSIONS
In Indonesia, consumption of fortified milk and noodles was associated with decreased odds of child anemia. Iron-fortified milk and noodles may be a strategy that could be applied more widely as an intervention to decrease child anemia.
Semba
Richard D
RD
Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. rdsemba@jhmi.edu
Moench-Pfanner
Regina
R
Sun
Kai
K
de Pee
Saskia
S
Akhter
Nasima
N
Rah
Jee Hyun
JH
Campbell
Ashley A
AA
Badham
Jane
J
Bloem
Martin W
MW
Kraemer
Klaus
K
D018798:Anemia, Iron-Deficiency / Q000453:epidemiology* / Q000517:prevention & control*; D000818:Animals; D001942:Breast Feeding; D002648:Child; D002675:Child, Preschool; D003296:Cooking; D004522:Educational Status; D005220:Fathers; D005260:Female; D005527:Food, Fortified; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007501:Iron / Q000008:administration & dosage / Q000627:therapeutic use*; D044342:Malnutrition / Q000517:prevention & control; D008892:Milk; D009035:Mothers; D016017:Odds Ratio; D018579:Patient Selection; D011203:Poverty; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data
D007501:Iron