(P18-023-23) High Prevalence of Iron Deficiency in Canadian Toddlers With Adequate Dietary Iron Intakes and Weak Association With Maternal Dietary Iron Intake at 18 Months Postpartum

Objectives: Iron adequacy is critical in early childhood given increased iron needs during this period of rapid growth and neurodevelopment. Little is known about iron status and dietary iron intake throughout toddlerhood, an understudied stage of development. Maternal iron intake may be a predictor of toddler intake given the transition to solid family foods at this life stage. This work assessed the iron status and intake of Canadian toddlers, differences in iron intake between toddlers' iron status, and associations between maternal and toddler iron intake.

Methods: This is a secondary analysis of baseline data from the Growing Up Milk Intake and Nutrient Status Study (NCT03038854). Eligible toddlers, aged 18mo ± 2wks, completed serum biomarker analysis and dietary assessment using a Food Frequency Questionnaire (FFQ) and 5-Day Food Records (FR). Usual nutrient intake of their mothers over the last 12mo was assessed using the Canadian Diet History Questionnaire II.

Results: Of 322 toddlers, 107 (33%) had serum ferritin < 12 ng/mL, indicative of iron deficiency (ID), and 14 (4%) showed ID anemia (IDA; ferritin < 12 ng/mL & hemoglobin < 110 g/L). Toddlers' median (25th, 75th percentile) iron intake was 6.6 (4.9, 8.9) mg/d from foods and supplements as assessed by 5-Day FR. Toddler energy-adjusted iron intakes did not differ between assessment methods (5-day FR vs FFQ). Toddlers with adequate iron status had the highest energy-adjusted iron intake, followed by toddlers with ID and IDA (p < 0.01). Maternal dietary iron intake (n=217) was 12.4 (9.1, 16.5) mg. Maternal energy-adjusted iron intake was associated with that of their toddlers after adjusting for maternal age, household income, toddler sex and ethnicity (β: 0.51, SE: 0.13, p< 0.001).

Conclusions: We observed a high prevalence of iron deficiency in this sample of apparently healthy toddlers despite a probability of adequate intake of 82% and 66% of those with ID and IDA, respectively. Future work will include dietary pattern analysis for mother-child pairs to assess food-derived iron intake given differences in iron bioavailability, and the shift in recommendations in Canada towards plant-based foods.

Funding Sources: This study is supported by The University of British Columbia and the British Columbia Children’s Hospital Research Institute, Canada, and funded by an unrestricted grant from Société des Produits Nestlé S.A.