Anemia in rural Kenyan children: role of malaria infection and poor diet quality and meat intake.

Anemia defined as blood hemoglobin (Hb) level below 110 g/L affects roughly half of Kenyan children. Anemia in children is associated with reduced physical activity apathy impaired cognitive function and increased infection. The causes of anemia can be multi-factorial. These include single or multiple nutritional deficiencies malaria intestinal parasites systemic infections and genetic abnormalities. The nutrients of concern are found in abundance in meat fish or fowl. The impact of meat intake on anemia was studied in a randomized feeding intervention study of Kenyan primary school children and toddlers aged 8-42 months. School children were fed on all school days with an isocaloric maize-based dish (githeri) supplemented with meat milk or additional oil for two years. Toddlers received isocaloric millet porridge with added meat milk or oil for six to eight months. At baseline anemia was found in 72% of toddlers and 49% of schoolers. Malaria was present in 13% of the toddlers and 32% of the schoolers and was negatively correlated with Hb. In schoolers Hb was significantly and positively associated with biochemical blood concentrations of iron zinc folate vitamins B12 and A. As for nutrient intakes in the schoolers Hb showed weak but significant positive correlations with protein folate animal source vitamin A and negatively with phytate and fiber. In toddlers intakes of meat and heme iron were positively related to Hb. Although malaria is one of the main causes of anemia little or no meat in the diet with its contribution of heme iron high quality protein and vitamin B/12 plays an important role. Both infection and poor diet quality must be addressed to conquer anemia. (authors)