Micronutrient status differs among Maasai and Kamba preschoolers in a supplementary feeding programme in Kenya

Matern Child Nutr. 2019 Jul;15(3):e12805. doi: 10.1111/mcn.12805. Epub 2019 Apr 11.

Abstract

Since 2001, ChildFund Kenya has supplied micronutrient fortified school meals to preschoolers from two tribes (Kamba and Maasai) attending early childhood development (ECD) centres in Emali, S.E. Kenya. Lack of information on the micronutrient status of the preschoolers prompted a cross-sectional assessment of micronutrient (iron, zinc, selenium, vitamin A, vitamin D) status and prevalence of deficiencies among the two tribes. Data on sociodemographic, health, anthropometric status, and micronutrient supply from preschool meals were collected from 287 Kamba and 213 Maasai children aged 3 to 5 years attending 23 ECD centres. Nonfasting blood samples were collected for haemoglobin and plasma biomarkers of iron, zinc, selenium, vitamin A, vitamin D, C-reactive protein (CRP), α1 -acid glycoprotein, and immunoglobin G. The prevalence of anaemia was significantly higher in Maasai children than Kamba (38%, 95% CI [31%, 45%], vs. 5%, [3%, 9%]), as well as iron deficiency and its various stages (P < 0.001). No differences were seen in the prevalence of zinc, selenium, vitamin A, or vitamin D deficiencies (all P > 0.05). Body iron, CRP, and age were significant predictors of haemoglobin concentrations for both tribes (all P < 0.006) and plasma 25-OHD for Maasai children only. The higher prevalence of iron deficiency among Maasai than Kamba children was possibly attributed to the high consumption of cow's milk (low in bioavailable iron) in place of micronutrient fortified meals together with a higher prevalence of chronic inflammation and intestinal damage.

Keywords: Kenya preschool children; anaemia; haemoglobin; iron; vitamin D; zinc.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anemia, Iron-Deficiency / ethnology*
  • Anthropometry
  • Biomarkers / blood
  • Child Nutritional Physiological Phenomena*
  • Child, Preschool
  • Female
  • Food, Fortified
  • Hemoglobins / analysis*
  • Humans
  • Inflammation / ethnology
  • Iron / blood
  • Iron Deficiencies
  • Kenya / epidemiology
  • Male
  • Meals
  • Micronutrients / blood*
  • Micronutrients / deficiency*
  • Nutritional Status*
  • Prevalence
  • Selenium / blood
  • Selenium / deficiency
  • Vitamin A / blood
  • Vitamin A Deficiency
  • Vitamin D / blood
  • Vitamin D Deficiency
  • Zinc / blood
  • Zinc / deficiency

Substances

  • Biomarkers
  • Hemoglobins
  • Micronutrients
  • Vitamin A
  • Vitamin D
  • Iron
  • Selenium
  • Zinc