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Epidemiology and Population Health

Changes in obesity and iron deficiency between 4 and 9 years of age. Longitudinal study of childhood obesity (ELOIN)

International Journal of Obesity volume 46, pages 1992–1999 (2022)Cite this article

Subjects

Abstract

Background

Recent studies revealed that children who are overweight have a higher risk of iron deficiency, although the etiology of this relationship remains unclear. The aim of the study was to evaluate the association between changes in obesity status between 4 and 9 years of age and iron deficiency.

Subjects

This population-based cohort study included 1347 children from the ELOIN study, conducted in Madrid, Spain. Follow-up with physical examinations and a computer-assisted telephone interview were carried out at 4, 6 and 9 years of age, and a blood test was performed at 9 years.

Methods

Changes in obesity were estimated based on body mass index and waist circumference, according to the persistence or variation in obesity rates at 4, 6 and 9 years and were classified as follows: (1) Stable without obesity; (2) Remitting obesity at 9 years; (3) Incident obesity or relapse at 9 years; and (4) Stable with obesity. Iron deficiency was defined as transferrin saturation value below 16%. Odds ratios (ORs) for iron deficiency were estimated according to obesity status using logistic regression and adjusted for confounding variables, including C-reactive protein (CRP).

Results

The prevalence of iron deficiency in the stable general obesity (GO) and abdominal obesity (AO) groups was 38.2% and 41.2%, versus 23.6% and 23.4% in the stable without obesity groups, respectively. The ORs for iron deficiency were 1.85 (95% CI: 1.03–3.32) in the stable GO group and 2.34 (95% CI: 1.29–4.24) in the stable AO group. This association disappeared when CRP was included in the analysis.

Conclusions

An extended state of obesity during the first stages of life is associated with iron deficiency, and this association may be mediated by CRP. Prevention and early detection of obesity in children should be a priority to avoid a double burden of malnutrition.

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Acknowledgements

We thank all of the health care professionals for their assistance with the study and all of the families who were willing to collaborate and participate in the cohort. We thank the Fundación para la Investigación e Innovación Biosanitaria de Atención Primaria (FIIBAP) for funding.

Funding

This work was supported by the General Directorate of Public Health of Ministry of Health (Community of Madrid).

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Authors and Affiliations

  1. Department of Epidemiology, General Directorate of Public Health, Ministry of Health, Community of Madrid (Spain), Madrid, Spain

    Gloria Cabañas Pujadas, Honorato Ortiz-Marrón, Maira Alejandra Ortiz-Pinto & María Ordobás Gavín

  2. Pediatrician at Reyes Católicos Health Center, Northern Area of Primary Care of Madrid, Community of Madrid (Spain), Madrid, Spain

    Adelaida García Gscheidle

  3. Pediatrician at Torres de la Alameda Health Center, Eastern Area of Primary Care of Madrid, Community of Madrid (Spain), Madrid, Spain

    Paloma de la Calle Tejerina

  4. Clinical Analysis and Biochemistry Service, Puerta de Hierro University Hospital, Majadahonda, Community of Madrid (Spain), Madrid, Spain

    Encarnación Donoso-Navarro

  5. National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain

    Iñaki Galán

  6. Department of Preventive Medicine and Public Health, Autonomous University of Madrid/IdiPAZ, Madrid, Spain

    Iñaki Galán

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  1. Gloria Cabañas Pujadas
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Contributions

GC, IG and HOM conceptualized and designed the study, developed the initial manuscript with tables and figures, and checked and revised the final manuscript. GC, IG, HOM and MAOP designed the instruments for data collection, data collection, and initial analysis. AGG, PCT, EDN and MOG participated in the data collection and critically reviewed the manuscript by making important contributions to its content. All authors gave their approval to the final manuscript and agreed and assume responsibility for all aspects of the work.

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Correspondence to Honorato Ortiz-Marrón.

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Cabañas Pujadas, G., Ortiz-Marrón, H., Ortiz-Pinto, M.A. et al. Changes in obesity and iron deficiency between 4 and 9 years of age. Longitudinal study of childhood obesity (ELOIN). Int J Obes 46, 1992–1999 (2022). https://doi.org/10.1038/s41366-022-01196-y

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