Caregiver-initiated food avoidance and risk of iron deficiency anemia in early childhood: Evidence from the Japan environment and children's study

Background There is limited evidence regarding the association between dietary restrictions and iron deficiency anemia in children. Aim This study aimed to evaluate the association of iron deficiency anemia with avoidance of specific foods without medical advice due to concerns about the onset of food allergies in young children. Methods A longitudinal study (N = 60,751) was conducted using the data from the Japan Environment and Children's Study. Information regarding dietary restriction and diagnosis of iron deficiency anemia was assessed using a self-administered questionnaire completed by the caregivers. Logistic regression analysis was conducted to evaluate the likelihood of developing iron deficiency anemia up to 3 years of age following age 2 among children under avoidance of specific food without a medical advice. Results Children with the dietary restriction were more likely to be diagnosed with iron deficiency anemia for 3 years or less after age 2 (dietary restriction at 2 years of age: OR 1.74, 95% CI 1.04–2.91, P = 0.034; at 1.5 years of age: OR 1.88, 95% CI 1.17–2.99, P = 0.008; 1.5, 2, and 3 years of age: OR 2.18, 95% CI 1.32–3.59, P = 0.002). Conclusion Avoidance of specific foods without medical advice due to concerns about food allergies in young children may be associated with an increased risk of iron deficiency anemia.