Associação entre anemia ferropriva e alimentação complementar em criança de 6 a 24 meses beneficiárias do Programa Bolsa Família

Abstract

Children from poor families suffer a greater risk of food insecurity, which can lead to a lack of micronutrients and malnutrition. Knowing that iron deficiency anemia remains the most prevalent nutritional deficiency in the world and that adequate nutrition is essential for full growth and child development, this thesis was carried out in order to assess the association between iron deficiency anemia and complementary feeding indicators in children aged 6 to 24 months assisted by the Bolsa Família Program (PBF). Thereunto, the thesis is structured in two parts, the first, a literature review chapter and the second, an original article. To elaborate the original article, a cross-sectional study was carried out with children aged 6 to 24 months from six municipalities in the state of Alagoas, assisted by the PBF. The sociodemographic data were obtained through a standardized form and the Brazilian Household Food Insecurity Measurement Scale was used to assess food insecurity. A structured 24-hour recall was applied to assess the consumption of complementary feeding according to the World Health Organization Indicators for assessing infant and young child feeding practices and the diagnosis of anemia was obtained using HemoCue®. To identify the crude and adjusted associations between the independent variables and anemia (hemoglobin <11 mg/dL), the prevalence ratio (PR) and respective confidence intervals (95% CI) were calculated using Poisson regression with robust adjustment of variance, being adjusted at the last level by socioeconomic, demographic and environmental variables of higher hierarchical levels that presented in the crude analysis p <0.20. A total of 1,604 children were evaluated, of which 58.1% had anemia. In the multivariable analysis, the higher number of food groups consumed (PR = 0.97; 95% CI 0.95–0.99), the consumption of dairy (PR = 0.86; 95% CI 0.79–0.84), meat (PR = 0.90; 95% CI 0.83–0.98), in addition to bottle feeding (PR = 0.88; 95% CI 0.81-0.96) were associated with less prevalence of iron deficiency anemia. Having food insecurity increased the prevalence of anemia by 21% (95% CI 1.22–1.32). Iron deficiency anemia is still a serious public health problem in children aged 6 to 24 months assisted by PBF in Alagoas. We highlight the importance of promoting complementary feeding based on diversified dietary intake, as well as ensuring food security together with the implementation of food and nutrition education, to help reduce the risk of this disease.