Essential Nutrients-Cognition:  Research Article

Essential Nutrients Menu

Malnourished Children:  Iron Deficiency
This table comes from Janina R. Galler (editor).  Nutrition and Behavior.  1984. Plenum Press New York. 
This book is out of print.
Table V. Summary of Studies of Iron Deficiency
Author Subjects Description Results
Werkman et al. (1964) 28 Iron-deficient and 28 non-iron-' deficient children Administration of semistructured questionnaire to mother of each subject. Iron-deficient children seemed to have more feeding and behavior problems; also, they seemed to have mothers who were inattentive, causing the children to be orally fixated, drinking excessive amounts of milk.
Sulzer et al. (1973) 230 Male and female children (ages 4–5) (anemic and nonanemic) Administration of tests to two subgroups. Tests included global IQ test, vocabulary test, measures of moral development, grouping behavior, reaction time, and attentive recall. Anemics performed more poorly on vocabulary tests, latency, and associate( reaction measures. Younger children showed signs of permanent damage.
Webb and Oski (1973a,b; 1974) 92 Anemic and 101 nonanemic adolescents (ages 12–14) Comparison of test results between two groups (Iowa Test of basic skills, teacher ratings of personality disturbance, visual afterimage task). Anemics had lower composite scores on the Iowa test and significantly longer latency in the visual afterimage task. Anemic males exhibited more conduct problems than nonanemic males. Anemic male test scores showed progressive decline from ages 12 to 14. Anemic female test scores remained consistently poor.
R. J. Cantwell (1974) 61 Children studied from birth to 7 years; 32 developed iron deficiency between 6 months and 18 months of age Neurological exam was given to each subject by age 7 (examiners did not know which subjects were formerly anemic). Formerly anemic subjects had more "soft signs" of permanent minimal brain dysfunction and were inattentive and hyperactive with lower average IQ scores than the nonanemics.
Webb and Oski (1974) 74 Anemic and 36 nonanemic junior high students Administration of behavior problem checklist. Anemics tended to have more conduct disturbances.
Voorhees at al. (1975) 9 Male and 2 female iron-deficient infants and children (ages 10 months to 13 years) Measurement of subjects' urinary excretion of dopamine, norepinephrine, metanephrine-normetanephrine, 3-methoxy-4-hydroxymandelic acid before and after treatment with intramuscular iron. Subjects excreted increased quantities of norepinephrine before treatment, perhaps as a result of MAO deficiency. Urinary excretion of norepinephrine returned to normal levels within 5 days of treatment with intramuscular iron.
Pollitt et at. (1978b) 46 Children (mean age = 31 years) iron-deficient or iron-sufficient Administration of behavioral tests to two subgroups; between-group (double-blind) comparison before and after treatment with iron or placebo. Iron deficiency had adverse effects on attention and memory control processes. Deficits were eliminated after treatment with iron.
Oski and Honig (1978) 24 Infants (ages 9–26 months) with iron-deficiency anemia Random assignment to treatment with intramuscular iron or placebo groups; administration of Bayley Scale of Infant Development before and after treatment or placebo. Test scores improved somewhat for placebo group, but performance improved more with iron treatment, especially on the index of mental development.
Lozoff et al. (1979) 40 Anemic and 43 nonanemic infants (ages 6–24 months) Double-blind randomized block design; treatment with oral iron or placebo; Bayley Scale of Infant Development before and after treatment with iron or placebo. Anemics had significantly lower pretest scores than nonanemics; remained low on physical and mental scales. Short-term oral iron therapy did not correct developmental deficits.
Oski et al. (1981)  33 Nonanemic intants (ages 9–13 months) Divided into four groups: normals, iron-depleted, iron-deficient (with MCV > 70fl), and iron-deficient (with MCV 70fl). Bayley Scale of Infant Development administered before and after treatment with intramuscular iron. Iron-deficient groups exhibited alterations in behavior that were readily reversible with treatment with iron, as shown by greater test sccore improvement than normals.
Deinard et al. (1981) 01 Male and Ill female nonanemic infants (ages 11–13 months) Subjects were divided into three groups: mildly iron-deficient, severely iron-deficient, and iron-replete. Administration of Bayley Scale of Infant Development and index of attending behavior. There were no statistically significant differences in overall performance levels between the iron-depleted and the iron-repleted groups.
Lozoff (1983) 8 Anemic and 40 nonanemic infants (ages 6–24 months) Subjects were assigned to treatment or placebo group; Bayley Scale of Infant Development was administered pre- and posttreatment with intramuscular iron or placebo. Nonanemics had higher mean scores in pretest. Mental score deficits in anemics became more marked with age. Scores of both treatment and placebo groups improved by 6 points in the posttest.
Pollitt and Liebel (1982) 19 Anemic and 20 nonanemic
children (ages 4–5 years)
Subjects assigned to treatment or placebo group. Psychological tests of discriminate learning and oddity learning administered before and after treatment with intramuscular iron or placebo. No differences were evident between groups on the discriminate learning test. Anemics performed less well on the oddity learning test pretreatment, but had identical scores as the control group posttreatment.


Cantwell, R. J., 1974, The long term neurological sequelae of anemia in infancy, Pedintr. Res. 8:342.

Deinard, A., Gilbert, A., Dodds, M., and Egeland, B., 1981, Iron deficiency and behavioral deficits, Pediatrics 68(6):828.

Lozoff, B., Brittenham. G., Viteri, F. E.. Wolf, A. W.. Urritia, J. 1.. 1979. Developmental test deficit in infants with iron deficiency anemia. Pediatr. Res. 13:334.

Oski. F. A., and Honig, A. S., 1978, The effects of therapy on the developmental scores of iron-deficient infants, J. Pediatr. 92:21.

Oski. F. A., Honig. A. S., Helu, B. M.. and Howanitz. P. H.. 1981. Effect of iron deficiency without anemia on infant behavior, Pediatr. Res. 15:583.

Pollitt, E., and Liebel, R. L., eds., 1982, Iron Deficiency, Brain Biochemistry, and Behavior, Raven Press, New York.

Pollitt, E., Greenfield, a, and Leibel, R., 19786, Behavioral effects of iron deficiency among preschool children in Cambridge, Mass., Fed. Proc. Fed. Am. Soc. Exp. Biol. 37:487.

Sulzer, J. L., Wesley, H. H., Leonig, F., 1973, Nutrition and behavior in Head Start children: Results from the Tulane study, in: Nutrition, Development and Social Behavior (D. J. Kallen, ed.), publication 73-242, Department of Health, Education, and Welfare.

Voorhees, M. L., Stuart, M. J., Stockman, J. A., and Oski, J. A., 1975, Iron deficiency anemia and increased urinary norepinephrine excretion, J. Pediatr. 86:542.

Webb, T. E., and Oski, F. A., 1973a, The effect of iron deficiency anemia on scholastic achieve 
ment, behavioral stability and perceptual sensitivity of adolescents, Pediatr. Res. 7:294.

Webb, T. E., and Oski, F. A., 19736, Iron deficiency anemia and scholastic achievement in young
adolescents, J. Pediatr. 82:827.

Webb, T. E., and Oski, F. A., 1974, Behavioral status of young adolescents with iron deficiency anemia, J. Spec. Ed. 8:153.

Werkman, S. L., Shifman, L., and Skelly, T., 1964, Psychosocial correlates of iron deficiency anemia in early childhood, Psychosom. Med. 26(2):125.