Nutritional Status, Anemia and Eating Behavior among Children with Elevated Blood Lead Levels in a Primary Health Care of Peru

Juan Morales1, *
, Elizabeth María Yovera-Sandoval2
, Marlene Raquel Basilio-Rojas3

1 University of Sciences and Humanities, Faculty of Health Sciences, E-Health Research Center. Lima, Peru
2 University of Sciences and Humanities, Faculty of Education, Lima, Peru
3 DIRESA Callao, Lima, Peru

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Creative Commons License
© 2023 Morales et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the University of Sciences and Humanities, Faculty of Health Sciences, E-Health Research Center, Address: Av. Universitaria 5175, Los Olivos (P.O. box 15304), Lima, Peru;
Tel: (+511) 989521832; E-mail:



Malnutrition, anemia, and lead exposure are important public health problems.


To assess nutritional status, anemia, and eating habits and their relationship to elevated blood lead levels in children.

Materials and Methods:

Descriptive study conducted with data from children evaluated in a district of Callao, Peru. The variables studied were: nutritional status, based on anthropometric measurements; anemia, determined by blood hemoglobin concentration; dietary habits, evaluated by the 24-hour dietary recall method and food consumption frequency; and blood lead, determined by LeadCare II analyzer.

Results and Discussion:

A total of 425 children participated, with a median age of 6 years (IQR=5; Q3=9, Q1=4), 52.2% (n=222) were female and 71.3% (n=303) had blood lead level (BLL) ≥5μg/dL. Among children with BLL ≥5 μg/dL, 11.6% (n=35) presented poor nutritional status, 9.9% (n=30) had anemia, and 63% (n=191) had inadequate eating habits. Of the children with inadequate eating habits, 17.4% (n=47) had poor nutritional status and 15.9% (n=43) had anemia, compared to children with adequate eating habits (p<0.001). In children with BLL ≥5 μg/dL, the children's median hemoglobin, body weight, and height were 12.2 g/dL, 21.6 Kg, and 114.8 cm, respectively; while in those with Pb levels <5 μg/dL it was 12.5 g/dL, 29 Kg and 126.55 cm, respectively (p<0.05).


Nutritional status, anemia, and eating habits did not differ according to BLL; however, lower median hemoglobin, weight, and height were found in children with elevated lead levels. Children with subnormal nutritional status and children with anemia presented a shorter time to reach elevated blood lead levels.

Keywords: Lead poisoning, Nutritional status, Anemia, Feeding behavior, Child, Eating levels.