[Cow's milk consumption and childhood anemia in the city of São Paulo, southern Brazil]

Rev Saude Publica. 2004 Dec;38(6):797-803. doi: 10.1590/s0034-89102004000600007. Epub 2004 Dec 10.
[Article in Portuguese]


Objective: To evaluate the influence of the consumption of cow's milk on the risk of anemia during childhood in the city of São Paulo.

Methods: We have studied a probabilistic sample (n=584) of underfive children living in the city of São Paulo, southeastern Brazil, between 1995 and 1996. Anemia (hemoglobin <11 g/dl) was diagnosed using capillary blood obtained by fingertip puncture. The cow's milk content and the density of heme and nonheme iron in the child's diet were obtained using 24-hour recall questionnaires. Multiple linear and logistic regression models were used to study the association between cow's milk content in the diet and hemoglobin concentration or risk of anemia, and included statistical control for potential confounders (age, sex, birthweight, presence of intestinal parasites, family income, and mother's schooling).

Results: The prevalence of anemia was 45.2% and the mean contribution of milk to the total caloric content of the children's diets was 22.0%. The association between milk consumption and risk of anemia remained significant, even after considering the dilutive effect of milk consumption on the density of iron in the diet, thus indicating a possible inhibitor effect of milk on the absorption of the iron present in the other foods ingested by the child.

Conclusions: The relative participation of cow's milk in the child's diet showed a significant positive association with risk of anemia in children between ages six and 60 months, regardless of the density of iron in the diet.

Publication types

  • English Abstract

MeSH terms

  • Age Factors
  • Anemia / diagnosis
  • Anemia / epidemiology*
  • Anemia / etiology
  • Animals
  • Brazil / epidemiology
  • Child, Preschool
  • Diet / statistics & numerical data*
  • Epidemiologic Methods
  • Female
  • Hemoglobins / analysis
  • Humans
  • Infant
  • Infant Nutritional Physiological Phenomena*
  • Iron, Dietary / blood
  • Male
  • Milk / adverse effects*
  • Nutrition Surveys
  • Socioeconomic Factors


  • Hemoglobins
  • Iron, Dietary