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BMC Fam Pract. 2018 Sep 24;19(1):161. doi: 10.1186/s12875-018-0848-9.

Iron deficiency among low income Canadian toddlers: a cross-sectional feasibility study in a Community Health Centre and non-Community Health Centre sites.

Bayoumi I1, Parkin PC2,3,4,5, Lebovic G4,6,7, Patel R8,9, Link K9, Birken CS2,3,4,5, Maguire JL5,7,10,11, Borkhoff CM2,3,4.

Author information

Department of Family Medicine, Queen's University, 220 Bagot St., P.O. Bag 8888, Kingston, ON, K7L5E9, Canada.
Division of Paediatric Medicine and the Paediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, ON, Canada.
Sick Kids Research Institute, Toronto, ON, Canada.
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Division of Paediatric Medicine, Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Applied Health Research Centre (AHRC), Toronto, Canada.
Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
Department of Family Medicine, Queen's University, 220 Bagot St., P.O. Bag 8888, Kingston, ON, K7L5E9, Canada.
Kingston Community Health Centres, Kingston, Canada.
Department of Paediatrics, St. Michael's Hospital, Toronto, ON, Canada.
Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.



Iron deficiency in early childhood has been associated with poor developmental outcomes. Little is known about the nutritional health of young children receiving care at Canadian Community Health Centres (CHCs). Our objectives were to describe iron deficiency among toddlers at an Ontario CHC, to compare young children attending CHCs and non-CHCs, and assess the feasibility of conducting research on children in CHC settings.


One CHC, Kingston Community Health Centres (CHC) with two clinical sites and one community programming site was added to the nine non-CHC pediatric and primary care clinics in the existing TARGet Kids! research network. A cross-sectional feasibilitystudy was conducted.and. Healthy children, ages 12-36 months were Enrolled. iron deficiency without inflammation (ferritin< 14 μg/L and CRP < 10 mg/L) and serum ferritin were assessed. Adjusted multivariable regression analyses were used to evaluate an association between CHC enrolment and iron status.


The CHC cohort (n = 31) was older, had lower household income, lower maternal education, higher nutrition risk scores, higher cow's milk intake, shorter breastfeeding duration and higher prevalence of unhealthy weights compared with the non-CHC cohort (n = 875). There was no association between CHC status and serum ferritin (difference in median serum ferritin 4.78 μg/L, 95% confidence interval [CI] -2.5, 14.3, p = 0.22) or iron deficiency (OR 0.55, 95% CI 0.11, - 2.73, p = 0.46) using multivariable linear and logistic regression, respectively.


Despite differences in sociodemographic variables, we did not detect a difference in iron status between toddlers enrolled at CHCs compared to non-CHC settings. Further research is needed to understand the health effects of poverty generally, and iron deficiency specifically among children receiving care at CHCs.


Early childhood; Iron deficiency; Social determinants of health

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