medigraphic.com
Instituto Nacional de Salud Pública

2025, Number 6

<< Back Next >>

salud publica mex 2025; 67 (6)

Epidemiological profile of anemia and micronutrient deficiencies in children

De la Cruz-Góngora V, García-Guerra A, Mejía-Rodríguez F, Valdez-Echeverría R, Shamah-Levy Z

Language: Spanish
References: 40
Page: 676-689
PDF size: 360.29 Kb.


ABSTRACT

Objective. To update the current status of anemia and micronutrient deficiencies (MD) in Mexican children. Materials and methods. The 2022-2024 Encuesta Nacional de Salud y Nutrición is a nationally representative probabilistic survey. Venous blood samples were collected from a sub-sample of 3 230 children (48%). Hemoglobin (Hb) was analyzed in situ using Hemocue. Ferritin, transferrin receptor, vitamin B12, folate, and 25[OH]D were analyzed in serum. Deficiency of these micronutrients was defined according to WHO criteria. Descriptive analyses were performed in preschoolers (1 to 4 years) and school-aged children (5 to 11 years) using a complex design. Logistic regression models were used to identify characteristics associated with anemia and MD. Results. The prevalence of anemia, iron deficiency (ID), and low levels of vitamin B12, and vitamin D were: 8.6, 26.8, 20.2 and 9.6% in children aged 1 to 4; and 4, 19.5, 20.5 and 22.7%, respectively, in children aged 5 to 11. Living in the Southern region and in rural areas were commonly associated with a higher odds of anemia or MD. Conclusions. A high proportion of children (›40%) have at least one MD. Targeted interventions for micronutrient supplementation are urgently needed, with a focus on infants, children from indigenous communities, and those in lower socioeconomic conditions. These findings provide critical, updated evidence to inform nutrition and public health policies in Mexico.


REFERENCES

  1. Kassebaum NJ. The global burden of anemia. Hematol Oncol Clin NorthAm. 2016;30(2):247-308. https://doi.org/10.1016/j.hoc.2015.11.002

  2. Safiri S, Kolahi AA, Noori M, Nejadghaderi SA, Karamzad N, Bragazzi NL,et al. Burden of anemia and its underlying causes in 204 countries and territories,1990-2019: results from the Global Burden of Disease Study 2019. JHematol Oncol. 2021;14:185. https://doi.org/10.1186/s13045-021-01202-2

  3. Lozoff B, Beard J, Connor J, Barbara F, Georgieff M, Schallert T. Longlastingneural and behavioral effects of iron deficiency in infancy. Nutr Rev.2006;64(5 Pt 2):S34-43. https://doi.org/10.1301/nr.2006.may.s34-s43

  4. Bailey RL, West KP, Black RE. The epidemiology of global micronutrientdeficiencies. Ann Nutr Metab. 2015;66(supl 2):22-33. https://doi.org/10.1159/000371618

  5. Hernández-Licona G, De la Garza T, Zamudio J, Yaschine I (coords.) ElProgresa-Oportunidades-Prospera, a 20 años de su creación. Ciudad deMéxico: CONEVAL, 2019 [citado marzo 2025]. Disponible en: https://www.coneval.org.mx/EvaluacionDS/PP/CEIPP/IEPSM/Documents/Libro_POP_20.pdf

  6. Mejía-Rodríguez F, De la Cruz-Góngora V, García-Guerra A, Mundo-Rosas V, Villalpando S, Méndez-Gómez-Humarán I, et al. Anemia enpoblación infantil y en mujeres en edad reproductiva. Salud Publica Mex.2024;66(4):459-66. https://doi.org/10.21149/15830

  7. De la Cruz-Góngora V, García-Guerra A, Shamah-Levy T, VillalpandoS, Valdez-Echeverría R, Mejía-Rodríguez F. Estado de micronutrimentosen niños, niñas y mujeres mexicanas: análisis de la EnsanutContinua 2022. Salud Publica Mex. 2023;65(supl 1):s231-7. https://doi.org/10.21149/14781

  8. Kolenikov S, Angeles G. The use of discrete data in PCA: theory, simulations,and applications to socioeconomic indices. Chapel Hill: CarolinaPopulation Center, University of North Carolina, 2004.

  9. WHO Multicentre Growth Reference Study Group. WHO child growthstandards: length/height-for-age, weight-for-age, weight-for-length, weightforheightand body mass index-for-age: methods and development. Ginebra:WHO Child Growth Standards, 2006 [citado marzo 2025]. Disponibleen: http://hpps.kbsplit.hr/hpps-2008/pdf/dok03.pdf

  10. World Health Organization. Guideline on haemoglobin cutoffs todefine anaemia in individuals and populations. Ginebra: WHO, 2024[citado marzo 2025]. Disponible en: https://www.who.int/publications/i/item/9789240088542

  11. Thurnham DI, Mccabe LD, Haldar S, Wieringa FT, Northrop-ClewesCA, McCabe GP. Adjusting plasma ferritin concentrations to remove theeffects of subclinical inflammation in the assessment of iron deficiency: ameta-analysis. Am J Clin Nutr. 2010;92(9):546-55. https://doi.org/10.3945/ajcn.2010.29284

  12. World Health Organization. Iron Deficiency Anaemia: Assessment,Prevention, and Control. A guide for programme managers. Ginebra:WHO, 2001:114.

  13. Carmel R. Biomarkers of cobalamin (vitamin B-12) status in theepidemiologic setting: A critical overview of context, applications, andperformance characteristics of cobalamin, methylmalonic acid, andholotranscobalamin II. Am J Clin Nutr. 2011;94(1):348S-358S. https://doi.org/10.3945/ajcn.111.013441

  14. Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357(3):266-81.https://doi.org/10.1056/NEJMra070553

  15. Green R. Indicators for assessing folate and vitamin B-12 status andfor monitoring the efficacy of intervention strategies. Am J Clin Nutr.2011;94(2):666S-672S. https://doi.org/10.3945/ajcn.110.009613

  16. Fernández-Gaxiola AC, Neufeld LM, García-Guerra A.Considerations for correction of micronutrient deficiencies throughsupplementation in pregnant women and children under-5 in LatinAmerica. Food Nutr Bull. 2024;45(supl 2):S47-S54. https://doi.org/10.1177/03795721231219824

  17. Gosdin L, Addo OY, Palmieri M, Mesarina K, Mazariegos DI, MartínezC, et al. Trends in micronutrient interventions, anemia, and iron deficiencyamong women and children in Guatemala, 2009-2019. Curr Dev Nutr.2023;7(8):101970. https://doi.org/10.1016/j.cdnut.2023.101970

  18. Mujica-Coopman MF, Brito A, López-de-Romaña D, Ríos-CastilloI, Coris H, Olivares M. Prevalence of anemia in Latin America andthe Caribbean. Food Nutr Bull. 2015;36(2):S109-S128. https://doi.org/10.1177/0379572115585775

  19. De la Cruz-Góngora V, Martínez-Tapia B, Shamah-Levy T, VillalpandoS. Nutritional status of iron, vitamin B12, vitamin A and anemia inMexican children: results from the Ensanut 2018-19. Salud Publica Mex.

  20. 2021;63(3):359-70. https://doi.org/10.21149/1215820. Flores ME, Rivera-Pasquel M, Valdez-Sánchez A, de la Cruz-GóngoraV, Contreras-Manzano A, Shamah-Levy T, Villalpando S. Vitamin Dstatus in Mexican children 1 to 11 years of age: an update from theEnsanut 2018-19. Salud Publica Mex. 2021;63(3):382-93. https://doi.org/10.21149/12156

  21. Villalpando S, de la Cruz V, Shamah-Levy T, Rebollar R, Contreras-ManzanoAC. Nutritional status of iron, vitamin B12, folate, retinol and anemiain children to 11 years old. Results of the Ensanut 2012. Salud PublicaMex. 2015;57(5):372-84. https://doi.org/10.21149/spm.v57i5.7616

  22. Orjuela MA, Mejía-Rodríguez F, Quezada AD, Sánchez-Pimienta TG,Shamah-Levy T, Romero-Rendón J, et al. Fortification of bakery and cornmasa-based foods in Mexico and dietary intake of folic acid and folatein Mexican national survey data. Am J Clin Nutr. 2019;110(6):1434-48.https://doi.org/10.1093/ajcn/nqz224

  23. De la Cruz-Góngora V, Villalpando S, Shamah-Levy T. Overviewof trends in anemia and iron deficiency in the Mexican populationfrom 1999 to 2018-19. Food Nutr Bull. 2024;45(1):57-64. https://doi.org/10.1177/03795721241240014

  24. Shekar M, Condo J, Pate MA, Nishar S. Maternal and child undernutrition:progress hinges on supporting women and more implementationresearch. Lancet. 2021;397(10282):1329-1331. https://doi.org/10.1016/S0140-6736(21)00577-8

  25. Organización de las Naciones Unidas para la Alimentación y laAgricultura. Prevención de mala nutrición en niñas y niños en México antela pandemia de COVID-19. Recomendaciones dirigidas a tomadores dedecisiones. Roma: FAO, 2020 [citado abril 2025]. Disponible en: https://www.insp.mx/resources/images/stories/2020/docs/200721_posicionamiento_conjunto_nutricion_covid19_1.pdf

  26. Bonvecchio-Arenas A, González W, Théodore FL, Lozada-TequeanesAL, García-Guerra A, Alvarado R, et al. Translating evidence-based programrecommendations into action: the design, testing, and scaling up of the behaviorchange strategy EsIAN in Mexico. J Nutr. 2019;149(supl 1):2310S-22S. https://doi.org/10.1093/jn/nxz229

  27. Instituto Nacional de Estadística y Geografía. Encuesta Nacional sobreIngreso y Gasto en los Hogares. México: Inegi, 2018 [citado marzo 2025].Disponible en: https://www.inegi.org.mx/programas/enigh/nc/2018/

  28. Holick MF. Biological effects of sunlight, ultraviolet radiation,visible light, infrared radiation and Vitamin D for health. AnticancerRes. 2016;36(3):1345-1356 [citado abril 2025]. Disponible en: https://ar.iiarjournals.org/content/anticanres/36/3/1345.full.pdf

  29. Rivera-Paredez B, Macías N, Martínez-Aguilar MM, Hidalgo-Bravo A, FloresM, Quezada-Sánchez AD, et al. Association between vitamin D deficiencyand single nucleotide polymorphisms in the vitamin D receptor and GCgenes and analysis of their distribution in Mexican postmenopausal women.Nutrients. 2018;10(9):1175. https://doi.org/10.3390/nu10091175

  30. Heaney RP, Holick MF. Why the IOM recommendations for vitamin Dare deficient. J Bone Miner Res. 2011;26(3):455-7. https://doi.org/10.1002/jbmr.328

  31. Hossain SJ, Tofail F, Mehrin SF, Hamadani JD. Six-year follow-up ofchildhood stimulation on development of children with and withoutanemia. Pediatrics. 2023;151(supl 2):e2023060221E. https://doi.org/10.1542/peds.2023-060221E

  32. De la Cruz-Góngora V, Martínez-Tapia B, Cuevas-Nasu L, Rangel-Baltazar E, Medina-Zacarías MC, García-Guerra A, et al. Anemia,deficiencias de zinc y hierro, consumo de suplementos y morbilidad enniños mexicanos de 1 a 4 años: resultados de la Ensanut 100k. SaludPublica Mex. 2019;61(6):821-832. https://doi.org/10.21149/10557

  33. Alruwaili M, Basri R, AlRuwaili R, Albarrak AM, Ali NH. Neurologicalimplications of vitamin B12 deficiency in diet: a systematic review andmeta-analysis. Healthcare. 2023;11(7):958. https://doi.org/10.3390/healthcare11070958

  34. Brito A, Hertrampf E, Olivares M, Gaitán D, Sánchez H, Allen LH, Uauy R.Folatos y vitamina B12 en la salud humana. Rev Med Chil. 2012;140(11):1464-1475. https://doi.org/10.4067/S0034-98872012001100014

  35. Sîrbe C, Rednic S, Grama A, Pop TL. An update on the effects ofvitamin D on the immune system and autoimmune diseases. Int J Mol Sci.2022;23(17):9784. https://doi.org/10.3390/ijms23179784

  36. De la Cruz-Góngora V, Méndez-Gómez-Humarán I, Gaona-Pineda EB,Shamah-Levy T, Dary O. Drops of capillary blood are not appropriate forhemoglobin measurement with point-of-care devices: a comparative studyusing drop capillary, pooled capillary, and venous blood samples. Nutrients.2022;14(24):5346. https://doi.org/10.3390/nu14245346

  37. De la Cruz-Góngora V, Méndez-Gómez-Humarán I, Jaimes-TeránS, Gaytán M, Gómez-Acosta LM, Vizuet-Vega NI, et al. Validation ofhemoglobin measurement in venous blood using HemoCue forthe Ensanut 2022. Salud Publica Mex. 2023;65(6):612-9. https://doi.org/10.21149/15063

  38. Organización Mundial de la Salud. Concentraciones de folato ensuero y eritrocitos para evaluar el estado de nutrición en folato enlas poblaciones. Sistema de Información Nutricional sobre Vitaminas yMinerales. Ginebra: OMS, 2012 [citado marzo 2025]. Disponible en: http://www.who.int/iris/bitstream/10665/77740/1/WH

  39. Diario Oficial de la Federación. Acuerdo por el que se dan a conocerlas Reglas de Operación del Programa de Abasto Social de Leche, a cargode Liconsa, S.A. de C.V. (Liconsa), para el ejercicio fiscal 2025. México:DOF, 2025 [citado marzo 2025]. Disponible en: https://www.dof.gob.mx/nota_detalle.php?codigo=5747593&fecha=23/01/2025#gsc.tab=0

  40. Bonvecchio-Arenas A, Lozada-Tequeanes AL, Kim-Herrera E, Pacheco-Miranda S, Unar-Munguía M, Rivera-Dommarco J, et al. Strategy for healthcare and nutrition during the first thousand days. Salud Publica Mex.2024;66(4):359-67. https://doi.org/10.21149/15854s




2020     |     www.medigraphic.com