The threat of COVID-19 on iron deficiency anaemia rates

The COVID-19 pandemic is undermining nutrition across the world, particularly in low-income and middle income countries (LMICs).Even prior to COVID-19 there are millions of families worldwide living on poor diets; either through poverty or from a lack of understanding of the principles of optimal nutrition. The COVID-19 pandemic has turned a worrying situation into a critical one. Tens of millions of families dependent on casual labor and daily wages have been made destitute.1,2 Oxfam predicts an additional 500 million people will be driven into poverty.3 The effects will be felt worst by young children.1, 4-6

Early childhood is a period of rapid growth and organ development.7 This requires foods with very high nutrient densities; much higher than in later life. Nutrients that need to be laid down in the growing tissues are especially critical; protein, calcium, zinc, iron and polyunsaturated fatty acids. 8 An absence of some of these nutrients (protein, energy, zinc and riboflavin) limit a child’s growth and lead to stunting and wasting.8

Iron is one of the most common nutritional deficiencies worldwide. It is estimated that about 1.6 billion people worldwide suffer from iron deficiency anemia with Africa, Asia and South America identified as most affected continents.3 Iron deficiency anaemia can have an effect on immune function9 and may have an impact on the cognitive and physical development of children10-12 making iron deficiency anaemia a public health issue.3

Learn more in infographic below, including alleviating the impact of COVID-19 – now and post-pandemic - on child nutrition and iron deficiency anaemia rates, which can be achieved through a combination of practical strategies which support the mother and child. 

  1. United Nations. The impact of COVID-19 on food security and nutrition. 2020. resources-details/es/c/1287907/ (accessed July 21, 2020).
  2. Akseer N et al. COVID-19 pandemic and mitigation strategies: implications for maternal and child health and nutrition. Am J Clin Nutr 2020;00:1–6.
  3. Oxfam
  4. Henrietta H Fore, Qu Dongyu, David M Beasley, Tedros A Ghebreyesus. Child malnutrition the time to act is now. 2020 Lancet. 2020; (published online July 27.)
  6. WHO 2008, Global anaemia prevalence
  7. UNICEF, 1000 DAYS
  8. Golden H et al. Food and Nutrition Bulletin, vol. 30, no. 3 © 2009 (supplement), The United Nations University
  9. Hassan et al. Impact of iron deficiency anemia on the function of the immune system in children Medicine (2016) 95:47
  10. De-Regil LM, Jefferds ME, Sylvetsky AC, Dowswell T. Intermittent iron supplementation for improving nutrition and development in children under 12 years of age. Cochrane Database of Systematic Reviews 2011, Issue 12.
  11. Stevens GA, Finucane MM, De-Regil LM, Paciorek CJ, Flaxman SR, Branca F, Peña-Rosas JP, Bhutta ZA, Ezzati M; Nutrition Impact Model Study Group (Anaemia). Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995-2011: a systematic analysis of population-representative data. Lancet Glob Health. 2013; 1:e16-25.
  12.  Lozoff B, Jimenez E, Smith JB. Double burden of iron deficiency in infancy and low socioeco- nomic status: a longitudinal analysis of cogni- tive test scores to age 19 years. Arch Pediatr Adolesc Med. 2006;160(11):1108 –1113
  13.  WHO, anaemia definition 
  14.  WHO, Worldwide prevalence of anaemia 1993-2005
  15.  WHO, Worldwide prevalence of anaemia 1993-2005
  16.  GBD-2016-Disease-and-Injury-Incidence-and-Prevalence-Collaborators Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390:1211–1259. doi: 10.1016/S0140-6736(17)32154-2
  17.  Source of data (% of anemia) for all countries: World Bank (2016)
  18.  UNICEF / WHO / World Bank Group, 2017 
  19.  Ministry of Health, National Nutrition and Health Survey, 2007, Argentina
  20.  Carvalho, A. G. C., et al. (2010). Diagnosis of iron deficiency anemia in children of Northeast Brazil. Revista de Saúde Pública, 44(3), 513–519. doi:10.1590/s0034-89102010000300015
  21.  WHO, global targets 2025
  22.  Infant & young feeding, COVID-19, UNICEF
  23.  EFSA. Dietary Reference Values for nutrients. EFSASupporting publication 2017:e15121 Chamley CA. Developmental Anatomy and Physiology of Children: A Practical Approach. London: Elsevier, 2005
  24.  Iron-Deficiency Anemia 
  25.  Hassan et al. Impact of iron deficiency anemia on the function of the immune system in children Medicine (2016) 95:47
  26.  WHO, 2016 
  27.  Verger et al. Evaluation of a Nutrient-Based Diet Quality Index in UK Young Children and Investigation Into the Diet Quality of Consumers of Formula and Infant Foods Public Health Nutr. 2016 Jul;19(10):1785-94
  28.  Lovell, A.L., et al. 2018. Compared with Cow Milk, a Growing-Up Milk Increases Vitamin D and Iron Status in Healthy Children at 2 Years of Age: The Growing-Up Milk–Lite (GUMLi) Randomized Controlled Trial. The Journal of Nutrition 148, 1570–1579 17. Akkermans et al., 2017. A micronutrient-fortified young-child formula improves the iron and vitamin D status of healthy young European children: a randomized, double-blind controlled trial. The American Journal of Clinical Nutrition 105, 391–399 18. Gera et al. Effect of iron-fortified foods on hematologic and biological outcomes: systematic review of randomized controlled trials. Am J Clin Nutr 2012;96:309–24


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The impact of COVID-19 on food security and nutrition

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