Is it inadequate diet or unbalanced diet, as an important etiological association of nutritional anaemia in children aged 1 to 5 Years?

Introduction: Nutritional anaemia in under 5 children is not decreasing despite profound efforts, so question arises is it single nutrient deficiency or wrong dietary pattern which is responsible for some manifested and other masked micronutrient deficiencies? Materials and Method: 300 under-5 children who were apparently normal and came to the OPD of a tertiary level care hospital in urban Ghaziabad for routine vaccination or minor ailments of short duration were enrolled. Haemoglobin, S. Iron., Ferritin, MCV, MCHC, MCH were done in all. If these investigations were suggestive of iron deficiency anaemia than only S.B12 and folate levels were estimated. Anthropometric data (weight, height),and 24 hr. dietary recall was analysed to assess nutritional status and nutritional intake according to recommendations of ICMR both in terms of number of serves as well as amount per serve. Results: Nutritional anaemia was found in 78% children of which 88% were having iron deficiency anaemia while 12% had macrocytic anaemia due to Vitamin B12 deficiency. None had folate deficiency.73% children in anaemia group were having moderate (67.8%) and severe (5.5%) underweight. Regarding dietary pattern the daily intake was less than recommended for cereals, pulses, GYOR vegetables and fruits in 45%, 87% and 98% children respectively. While daily intake of milk (although quite diluted) and high trans-fats snacks was much higher and intake was frequent than the recommendations. Calorie gap was found in staggering 97.4% children while protein gap was present in only 4.7% children. Conclusion: To combat the nutritional anaemia the approach should be directed towards overall improvement of dietary habits rather than isolated instructions to consume more of iron rich diet.