ALTI AY- BEŞ YAŞ ARASI ÇOCUKLARDA DEMİR EKSİKLİĞİ VE BESLENME İLİŞKİSİ

Amaç: Demir eksikliği (DE) ve demir eksikliği anemisi (DEA) en sık besinsel eksiklik olup, çocuklarda fiziksel ve kognitif gelişim üzerinde olumsuz etkiler doğurabilmektedir. Özellikle yaşamın ilk yıllarındaki beslenme DE/DEA ile doğrudan ilişkilidir. Bu çalışmadaki amacımız, 6 ay-5 yaş arasındaki sağlıklı çocuklarda beslenme ile DE/DEA arasındaki ilişkiyi araştırmaktır. Gereç ve Yöntemler: Çalışmamız, Eylül 2014 - Eylül 2016 tarihlerinde Sivas Cumhuriyet Üniversitesi Tıp Fakültesi Hastanesi, Pediatri Polikliniğine başvuran 6 ay-5 yaştaki çocuklarda gerçekleştirilmiştir. Çocuklar tam kan sayımı, serum demir düzeyi, total demir bağlama kapasitesi, serum ferritin düzeyi ölçülerek iki gruba ayrılmıştır. Grup 1; DE/DEA olanlar, Grup 2; normal çocuklardan oluşmaktadır. Çocukların beslenme özellikleri annelerinden öğrenilmiştir. Bulgular: Çalışmamızda toplam187 çocuk yer almıştır (Grup 1=88, Grup 2=99). Her iki grupta çocukların cinsiyet ve yaş ortalamaları benzerdir (sırasıyla 22,68±14,22 ve 21,77±13,27 ay, p>0,05). Grup 2’deki çocukların doğum ağırlığı daha fazla (sırasıyla 3091,07±487,78 ve 3268,68±509,28 gr, p<0,05) ve doğum haftası daha geçtir (38,46±1,19 ve 38,82±1,24 hafta, p<0,05). Ağırlık ve boy persentili, ≥50 p olan çocuk sayısı Grup 2’de daha fazladır. Toplam anne sütü ile beslenme süresi benzer iken (sırasıyla 12,59±8,50 ve 13,50±7,06 ay, p>0,05), sadece anne sütü ile beslenme süresi Grup 1’de daha uzundur (sırasıyla 5,74±2,89 ve 4,36±2,15 ay, p<0,05). Grup 1’deki çocukların ek besine başlama zamanları daha geçtir. Çocukların demir durumu ile tüketilen beyaz peynir, kaşar, lor ve labne peyniri, yumurta, kırmızı et, tavuk ve balık, ev yoğurdu ve sebze yemekleri arasında pozitif korelasyon, yemek suyu, hazır çorba, hazır meyve suyu ve siyah çay tüketimi ile ise negatif korelasyon saptanmıştır. Sonuç: Çocuklarda DE/DEA ile beslenme arasında yakın bir ilişki vardır. Çocukların DE/DEA nden korunması için annelerin demir deposunun yeterli olması, anne sütüyle beslenme, doğru zamanda demir içeriği zengin ve biyoyararlanımı yüksek besinlerle tamamlayıcı beslenmeye geçiş ve düzenli takip önemlidir.

Anahtar Kelimeler:

Çocukluk çağı, demir eksikliği, beslenme

THE RELATIONSHIP BETWEEN IRON DEFICIENCY AND NUTRITION IN CHILDREN AGED 6 MONTHS-5 YEARS

Objective: Iron deficiency (ID)/iron deficiency anemia (IDA) are the most common nutritional deficiencies and may have negative effects on physical-cognitive development in children. Nutrition, especially in the first years of life, is directly related to ID/IDA. The aim of this study was to investigate the relationship between nutrition and ID/IDA in healthy children aged 6 months-5 years. Material-Methods: Our study was carried out between September 2014-September 2016 in children aged 6 months-5 years who applied Pediatric Outpatient Clinic of Sivas Cumhuriyet University Medical Faculty. Children were divided into two groups by measuring complete blood count, serum iron, ferritin levels and total iron binding capacity. Group1: patients with ID/IDA, Group2: normal children. Nutritional characteristics of children were learned from their mothers. Results: The study included totally 187 children (Group1=88, Group2=99). The sex and mean age of the children were similar (respectively, 22.68±14.22 vs. 21.77±13.27 months, p>0.05). In Group2, mean birth weight was higher (respectively, 3091.07±487.78 vs. 3268.68±509.28 gr, p<0.05) and mean birth weeks were later (38.46±1.19 vs. 38.82±1.24 weeks, p<0.05). In Group2, the number of children with weight-height percentile ≥50 p were higher. While total duration of breastfeeding was similar (12.59±8.50 vs. 13.50±7.06 months, p>0.05), exclusively breastfeeding time was longer in Group1 (5.74±2.89 vs. 4.36±2.15 months, p<0.05). The time of starting complementary feeding was later in Group1. There was a positive correlation between the iron status of children and consumed white/cheddar/curd/labne cheese, eggs, red meat, chicken, fish, home yoghurt, vegetables and negative correlation with consumption of food juice, instant soup, instant fruit juice and black tea. Conclusion: There is a close relationship between ID/IDA and nutrition in children. For the protection of children from ID/IDA, sufficient iron storage of mothers’, breastfeeding, transition to complementary feeding with iron rich content and bioavailability at the right time and regular follow-up are important.

Keywords:

Childhood, iron deficiency, nutrition,

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