A study conducted by Texas' UT Southwestern Medical Center, published in this month's Pediatrics, found overweight toddlers and those not enrolled in day care are at a higher risk for iron deficiency. Researchers drew from a national survey of 1,641 toddlers and deduced that 20 percent of overweight toddlers were iron-deficient, compared with seven percent of normal-weight toddlers. The food industry could in part play a role in bridging this gap, coupled with increased consumer awareness on the significance of this lack of nutrition. Iron-deficiency this early in life can result in delays in behavioral and cognitive development. "Given the detrimental long-term effects and high prevalence of iron deficiency, preventing iron deficiency in early childhood is an important public health issue," said Dr. Jane Brotanek, assistant professor of pediatrics at UT Southwestern and lead author of the study. While several studies have demonstrated a high prevalence of iron deficiency in the US among low-income infants and children, the UT Southwestern study claims to be the first to report an association between iron deficiency and being overweight among children at such an early age. Beyond the US, iron deficiency has become a global health problem with potentially catastrophic consequences. According to the United Nations World Food Programme (WFP), iron deficiency is the most common form of malnutrition, affecting 4.5bn people worldwide. It is estimated to impair the mental development of 40-60 percent children in developing countries. Not only can iron deficiency, a common cause of anemia, affect children's ability to learn and perform in school, but it can also negatively effect their bone marrow and muscle function. In addition, WFP says that, later in life, widespread iron deficiency in turn damages productivity and can cut GDP by as much as two percent in some countries. The UT Southwestern study used data from the National Center for Health Statistics' National Health and Nutrition Examination Survey (NHANES) IV - conducted from 1999 to 2002 - and compiled a nationally representative sample of US children aged one to three years old. The results indicate risk factors that diverge along ethnic lines, giving further clout to the concept of ethnically geared functional foods and nutrition. Of the toddlers, 42 percent were Hispanic, 28 percent were white and 25 percent were black. For the Hispanic toddlers participating, iron deficiency was at 12 percent, while it stood at six percent for both white and black participants. The researchers attributed such iron deficiency to the practice of continuing to exclusively breastfeed beyond six months without also giving infant foods supplemented with iron. The study also identified a discrepancy between iron deficiency rates for stay-at-home and day care-enrolled children. Dr. Brotanek said the reason is unclear and needs to be further studied. "It may be that children enrolled in day care centers have better diets, with higher amounts of iron, than children who do not attend day care," she said. "Little is known about the quantity and types of foods and beverages served in child care settings as well as staff training on nutrition." Hispanic toddlers were also significantly more likely than the white and black toddlers to be overweight and not in day care. Dr. Brotanek suggested prevention programs should consider these differing needs between races and ethnicities as well as the increased risk of iron deficiency among overweight toddlers. Previous research has indicated that malnutrition early in life leads to a higher incidence of obesity later in life - thereby underscoring that the seemingly different health problems are not mutually exclusive. A study released by the UN-backed Food and Agriculture Organization (FAO) in February 2004 concluded that preventing malnutrition and hunger in pregnant women and children could stop the onset of obesity in later life.