Children with lower iron and haemoglobin levels tend to perform poorly in IQ tests and exams, with some even experiencing stunted growth.
University Malaya Medical Centre (UMMC) Department of Paediatrics, Faculty of Medicine head, consultant paediatrician, endocrinologist and associate professor Dr Muhammad Yazid Jalaludin emphasised the crucial role of iron in early childhood development, particularly during the first two years of life.
Dr Yazid stressed that iron is essential for growth and development, as it helps produce haemoglobin, the red blood cell component that delivers nutrients to growing cells. He added without sufficient haemoglobin, these vital nutrients cannot reach target organs, potentially affecting a child’s growth.
"We need iron because it plays a critical role in the development and production of our immune markers, such as interleukin and TNF alpha, which are vital for immune function.
"If a child doesn't get enough iron or has iron deficiency, it can cause significant and irreversible effects on the brain, impacting learning ability.
"Studies have shown that these children can have lower verbal IQ and experience inattention as they grow up, which is why mental health and brain development are so important to address early on,” he said during a panel session focused on childhood anemia.
Following last year's alarming findings from the Iron Strong Study, which indicated that one in three Malaysian children are at risk of anemia, with iron deficiency being the primary cause, the situation has become even more concerning.
Dr Yazid highlighted that iron plays a key role in growth, particularly in oxygen-carrying capacity and haemoglobin development. Without sufficient haemoglobin, nutrients essential for bone growth and proper development of growth plates can't be delivered, leading to stunted growth over time.
He also pointed out that historically, Malaysians were taller than the Japanese in the 1940s, but now the Japanese are 10 cm taller, largely due to better intake of iron and protein, whereas Malaysians still rely heavily on carbohydrate-rich foods, which lack the necessary iron for growth and immune system protection.
"When you lack sufficient iron, your immune system can be compromised, making you more susceptible to infections. For instance, if a child in a nursery catches a virus, it's easy for others to contract it and suffer recurring illnesses,” he added.
Meanwhile, Universiti Sains Malaysia, School of Health Sciences, Nutrition Programme, Professor Dr Hamid Jan emphasised the significance of iron's physiology on the body.
Dr Hamid added that iron plays a crucial role in oxygen transport, highlighting that every cell requires oxygen for proper function.
"When a child is low in iron, their oxygen levels drop, which directly impacts brain development, as this process begins in the womb and continues after birth.
"Maternal iron is vital for brain development during pregnancy, and after nine months, the child still needs iron from external sources,” he said.
He stated that if iron sources are insufficient, brain development during the critical first 1,000 days will be compromised, a period widely recognised for its importance due to the high plasticity of the brain.
Furthermore, Dr Hamid referenced his master's thesis from 2002, which examined the effects of iron levels on IQ and academic performance among schoolchildren in Ulu Langat, highlighting the cooperative nature of the children involved despite the non-invasive methods used at that time.
"I'm here living evidence, telling you that from my research in Malaysia, which indicates that children with lower iron and haemoglobin levels tend to score poorly on IQ tests and perform inadequately in exams.
"We analysed some of the subjects' exam results, and the evidence consistently points to similar findings across various locations,” he said.
He further pointed out that low oxygen levels can lead to lethargy, making children easily fatigued, even after minimal physical exertion like climbing stairs. Hamid said that a key indicator of potential anemia in children is persistent tiredness, lack of energy, and disinterest in play, signalling that there may be an underlying issue.
"This is a crucial warning sign, as all muscles require adequate oxygen to function properly,” he said.