PREVALENCE OF IRON DEFICIENCY

IN OVERWEIGHT CHILDREN

An Undergraduate Thesis Presented To the

Faculty of the

College of Nursing

World Citi Colleges-Antipolo City

In Partial Fulfillment

Of the Requirements

For the Degree in

Bachelor of Science in Nursing

MARY MILLARDACE V. RAMAYLA

CHRISGIE E. INOCENCIO
 CHAPTER I

THE PROBLEM AND ITS BACKGROUND

INTRODUCTION

Obesity can start in infancy, but it may take years for the most

serious health consequences to develop. Now, new research has found that

some overweight babies may also face a much more immediate health risk.

Nutrition in childhood has a significant impact on lifelong health. Obesity

and iron deficiency (ID) are two of the most common nutritional disorders

worldwide. ID has been associated with decreased exercise capacity,

impaired cognitive function, developmental delays, and behavioral

disturbances.

Obese children are at risk of increased morbidity starting already in

childhood or adolescence. Interestingly, despite their excessive dietary and

caloric intake, obese children and adolescents may be at risk of ID because

they tend to consume unbalanced meals, particularly rich in

carbohydrates and fat. Both obesity and ID are also more prevalent in

lower socioeconomic groups, who consume low-cost fast foods that are low

in essential nutrients and rich in fats, sugars and preservatives.

Screening for iron-deficiency anemia (IDA) by a blood count with

indices, is recommended only in infants, because of the critical role of iron

in brain development, and in menstruating adolescents. However, we were

impressed by the number of children and adolescents, referred to our

obesity clinics, who had evidence of microcytic anemia on complete blood

count screen. To determine the prevalence of ID in this patient population,

we measured serum iron levels as an early sensitive screen. Low serum

iron together with low percent iron saturation precede microcytosis and

hypochromia, which in turn leads to IDA. Our findings suggest that obese

children and adolescents are commonly iron deficient.

ID is common in overweight and obese children. A significantly

greater proportion of obese than normal-weight children have IDA.

Insufficient dietary intake of iron, whether absolute or relative to body

mass, and increased iron needs may be a result of unbalanced nutrition or

repeated short-term restrictive diets. Because of potentially harmful effects

of ID, obese children should be routinely screened and treated as

necessary.

The researcher has pursued this study in order to find out the

prevalence of iron deficiency among overweight children. Studies show that

obesity was always linked to iron deficiency. This is done n order to assess

whether overweight children who often have poor dietary habits, are at

increased risk of iron deficiency.

THEORETICAL FRAMEWORK

Betty Neuman’s Health Care System Model

Neuman's systems model is based on the individual's relationship

to stress, the reaction to it, and reconstitution factors that are dynamic in

nature. Betty Neuman is a community health nurse and a

clinical psychologist who have developed this theory. Her model's basic

central core consists of energy resources (normal temperature range,

genetic structure, response pattern, organ strength or weakness, ego

structure, and knowns or commonalities) that are surrounded by several

lines of resistance, the normal line of defense, and the flexible line of

defense. The lines of resistance represent the internal factors that help the

patient defend against a stressor, the normal line of defense represents the

person's state of equilibrium, and the flexible line of defense depicts the

dynamic nature that can rapidly alter over a short period of time.

The purpose of the nurse is to retain this system's stability through the

three levels of prevention:

1. Primary prevention to protect the normal line and strengthen the

flexible line of defense.

 2. Secondary prevention to strengthen internal lines of resistance,

reducing the reaction, and increasing resistance factors.

3. Tertiary prevention to readapt and stabilize and protect

reconstitution or return to wellness following treatment.

The Neuman (1994, 1980) Health Care Systems Model is derived

theoretically from Gestalt theory, general systems theory, Hans

Selye's theory of stress, the holistic systems concept of Bernard Marx,

Pierre Teilhard deChardin's philosophy of the wholeness of life, and Gerald

Caplan's conceptual models of levels of prevention (Harris, Hermiz,

Meininger, & Steinkeler, 1994).

There are 21 major concepts in the Neuman (1994, 1980) Health Care

Systems Model. These concepts are (1) a holistic approach to the client, (2)

a holistic view of the client, (3) an open systems approach, (4) environment

both internal and external, (5) interaction of human and environment, (6) a

survival structure, (7) a process of interaction of matter, energy, and

information, (8) system input and output, (9) system feedback, (10)

negentropy energy absorption, (11) entropy energy depletion, (12) stability,

(13) reaction to stress, (14) wellness, (15) illness, (16) the system's normal

line of defense, (17) the system's flexible lines of defense, (18) the system's

lines of resistance, (19) the systems degree of reaction, (20) the concept of

prevention as intervention, and (21) reconstitution.

 These concepts are an holistic approach to the client, a holistic view of

the client, an open systems approach, environment both internal and

external, interaction of human and environment, a survival structure, a

process of interaction of matter, energy, and information system. The

interaction of the human system and her or his environment is affected by

five sets of variables. These variables are associated with physiological

characteristics of the person, psychological characteristics of the person,

sociocultural characteristics of the person's environment, the

developmental characteristics of the person, and the spiritual

characteristics of the person (Harris, Hermiz, Meininger, & Steinkeler,

1994). In the Neuman (1994, 1980) Health Care Systems Model, the

survival structure is the combination of all of the variables applicable to

the survival of any human plus the survival variables that are unique to

each individual person. In the Neuman (1994, 1980) Health Care System

Model, the process of interaction of matter, energy, and information,

system input and output, system feedback, negentropy energy absorption,

entropy energy depletion, and stability function as a single process.

Matter, energy, and information are exchanged by a system and its

environment through a process of inputs, outputs, and feedback. In the

functioning of this process, energy is both absorbed and depleted.

STATEMENT OF THE PROBLEM:

This study is conducted in order to know the prevalence of childhood

obesity on iron deficiency among children who were overweight and obese

in Antipolo City as of 2010-2011.

Specifically, it sought to answer the following questions:

1. What is the demographic profile of the respondents in terms of

1.1 Gender,

1.2 Age, and

1.3 Weight?

2. What is the prevalence of childhood obesity on iron deficiency?

3. What are the risk factors of iron deficiency among overweight and

obese children?

4. Is there a significant relationship between childhood obesity on iron

deficiency among children who were overweight and obese in

Antipolo City as of 2010-2011?

SIGNIFICANCE OF THE STUDY

This study will benefit the following:

 Obese and anemic children. So that as they grow old, they would be

aware of their condition including its risk to their health.

 Parents of children who were overweight or obese. Through this study,

promising problems that may arise will be prevented as early as

possible. This will help them handle the situation and deepen their

knowledge regarding their condition.

 Students who were on their 4th year in nursing. This would let them

know the prevalence of childhood obesity on iron deficiency. This will

also enhance their knowledge regarding the disease. This may also help

them in their future parenting careers.

 Further Researchers who can use the result as a basis for further

study regarding the relationship between the results of aptitude test

and performance on their previous subjects.

SCOPE AND DELIMITATION OF THE STUDY

The scope of the study is all about the prevalence of childhood

obesity on iron deficiency. The researcher chooses children who were

overweight and obese in Antipolo City as their respondents.

Their primary reason is to learn and identify the prevalence of

childhood obesity on iron deficiency. The study looked into the possible

complications that may occur on being overweight specifically, iron

deficiency anemia.

RESEARCH HYPOTHESIS

There is a significant relationship between the prevalence of

childhood obesity on iron deficiency among the children in Antipolo City.

DEFINITION OF TERMS

1. Obesity – is a medical condition in which excess body fat has

accumulated to the extent that it may have an adverse effect on

health, leading to reduced life expectancy and/or increased health

problems. (http://www.wikipedia.org)
2. Iron Deficiency – is one of the most commonly known forms

ofnutritional deficiencies. In the human body, iron is present in

all cells and has several vital functions—as a carrier of oxygen to the

tissues from the lungs in the form of hemoglobin, as a transport

medium for electrons within the cells in the form of cytochromes,

and as an integral part of enzyme reactions in various tissues.

(http://www.wikipedia.org)

3. Holistic – Emphasizing the importance of the whole and the

interdependence of its parts. (http://www.thefreedictionary.com)

4. Morbidity – refers to a diseased state, disability, or poor health due

to any cause. (http://www.wikipedia.org)

5. Restrictive – Tending or serving to restrict; limiting.

(http://www.thefreedictionary.com)

6. Prevalence – is defined as the total number of cases of the disease in

the population at a given time, or the total number of cases in the

population, divided by the number of individuals in the population.

(http://www.wikipedia.org)

7. Socioeconomic – Of or involving both social and economic factors.

(http://www.thefreedictionary.com)