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Dietary education and iron deficiency anaemia in the inner city

OBJECTIVES To assess if a dietary health education programme could be used within existing health resources to reduce the incidence of iron deficiency anaemia in an inner city population. DESIGN Prospective cohort study. SETTING Inner city areas of west and south Birmingham. SUBJECTS A total of 1000 children recorded on the child health computer register. INTERVENTION Children were recruited at birth and randomised into control and intervention groups. Families in the intervention group received specific health education information at key ages by face to face contact using a range of materials. The control group received standard health education as delivered by the health visitors at the time. MAIN OUTCOME MEASURES Haemoglobin estimation and iron content of the diet at 18 months of age. RESULTS A total of 455 children completed the study. Sixty nine (27%) of the control group and 55 (28%) of the intervention group were anaemic as defined by haemoglobin less than 110 g/l. There was no difference in the iron content of the diets offered to the two groups of children. CONCLUSION In this deprived population we have shown no reduction in anaemia using a targeted nutritional programme and have highlighted the difficulties in conducting health education programmes within the scope of current health resources. Key messages The prevalence of iron deficiency anaemia in young children is high, particularly those disadvantaged by poor socio-economic circumstances and in children of certain ethnic groups Iron deficiency adversely effects children’s cognitive development—this effect may not be fully reversible with treatment Standard nutritional educational packages were ineffective in reducing the level of anaemia in this study Community based approaches to prevention should be combined with secondary prevention by screening and treatment of populations at risk