Several children seen at a local pediatric clinic are found to have a hemoglobin level of 10-11 g/dL (100-110 g/L). Which dietary modification would most likely help increase hemoglobin levels in these clients?

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Iron deficiency is the leading cause of anemia worldwide. Most cases of iron deficiency anemia (IDA) result from inadequate intake of foods high in iron. In IDA, red blood cells are small (microcytic) with reduced hemoglobin content, appearing paler (hypochromic) under a microscope. The richest dietary sources of iron include meat, fish, and poultry, which provide a form of iron that is easily absorbed by the body (Option A). Plant-based foods (eg, dried fruits, nuts, legumes, green leafy vegetables, whole grains) are not as iron rich and contain a less bioavailable form of iron than animal-based foods. However, foods high in vitamin C (eg, tomatoes, potatoes, strawberries) may boost iron absorption when consumed with iron-rich foods. (Option B) Fruits and vegetables are not the best sources of dietary iron. (Option C) Milk and milk products are poor sources of dietary iron, and excessive calcium intake interferes with iron absorption. Overconsumption of milk, along with little or no consumption of other foods, is a leading cause of iron deficiency in young children. (Option D) Although sources of vitamin C (eg, orange juice) may enhance iron absorption, increased intake of iron-rich foods is priority in treatment of IDA. Vitamin D has no direct effect on anemia. Educational objective: Most cases of iron deficiency anemia result from inadequate intake of iron-rich foods. The richest dietary sources of iron include meat, fish, and poultry. Consuming fruits or juices high in vitamin C may enhance the absorption of iron.

Several Children Seen at a Local Pediatric Clinic Are Found