Abstract
BACKGROUND: Prevalence of anemia and iron deficiency (ID) are higher among indigenous children in Canada, although few data are available in Quebec. Iron is metal that interact with the absorption of manganese (Mn) and Lead (Pb) cobalt (Co). ID is known to upregulate these metals, thereby increasing their absorption, concentration inside the body and their toxicity. OBJECTIVES: The objectives of the present study are to: (i) Characterize ID and anemia prevalence and their protective/risk factors; and (ii) Study associations between blood Mn, Pb and iron status biomarkers. DESIGN/METHODS: Data from The 2015 First Nation Youth Health and Environment Pilot Study was conducted among children (3 to 19 y, n = 198) from four First Nations communities in Quebec will be used in these study where, blood samples and anthropometric measures were collected, hemoglobin was measured on site using an Hemocue analyser. Protective/risk factors including education, food security, housing conditions and lifestyle and dietary habits were documented using interview-administered questionnaire to children’ parents. Serum ferritin and blood Pb, Mn, Co, Zn and Ca were measured by Modular P analyser and ICPMS. Descriptive and multiple regression statistical analyses adjusting for relevant co-variables were used. RESULTS: Results showed ID and anemia prevalence of 20.7% and 17.6% respectively, among which 8.8% presented iron deficiency anemia. Moreover, up to 11.9% had elevated blood Mn (median = 15.9 µg/L, range 7.1 to 31.9 µg/L) of which 27.5% presented ID. However, blood Pb was low (median = 5.4 µg/L, range 1.8 to 50.8 µg/L). Multiple logistic regression analysis showed that crystal juice intake was associated with lower ID and anemia (OR (95%): 0.50 (0.30 - 0.82) and 0.47 (0.26 - 0.87) respectively) in girls. Likewise, the presence of hunter in the household was associated with lower anemia in girls (0.09 (0.02 - 0.53)). No factors were associated with ID in boys, and for anemia, lower serum ferritin and older age was associated with higher prevalence of anemia (1.08 (1.01 - 1.14) and 1.23 (1.02 - 1.48) respectively). In adjusted models, blood Mn was negatively associated with serum ferritin concentrations (ß = -0.05; p < 0.02) in girls and positively associated with blood Co (ß = 8.50; p < 0.01) in boys. CONCLUSION: Findings on high prevalence of ID, anemia and elevated blood Mn among children form these First Nation communities support that, community and family activities increasing traditional foods consumption improve nutritional status and suggest that foods and beverages naturally rich in vitamin C - but lower in added sugar than crystal juice - would improve iron intake in girls, which would contribute to improve their iron status, decrease anemia and restore normal Mn blood levels.