Anemia and iron status in the free-living and institutionalized elderly in Kentucky

A study of the iron status and anemia in 101 elderly persons, age 60 to 95, included 50 free-living and 51 institutionalized subjects. Daily iron intakes and biochemical parameters including hemoglobin, hematocrit, mean corpuscular hemoglobin concentration (MCHC), plasma iron levels and total iron binding capacity (TIBC) were determined. In the free-living group, only 4% male and 8% female subjects had iron-deficiency anemia. Whereas about 40% of the institutionalized group had iron deficiency anemia with low hemoglobin, hematocrit, MCHC, plasma iron levels, and elevated TIBC. Hemoglobin, hematocrit, MCHC and plasma iron levels were significantly higher, and TIBC was significantly lower in the free-living group than the institutionalized group. The lack of correlation between dietary iron intakes and plasma iron levels suggest that iron deficiency anemia in these elderly subjects was not due to lack of iron intakes. The possible causes might be medications and diseases in these elderly subjects.     

Predictors of iron status in well-nourished 4-y-old children

BACKGROUND: Iron status in childhood is influenced by diet. Other factors affecting iron status at that age are unclear. OBJECTIVES: The objectives of the study were to evaluate iron status in 4-y-old children, to track that status from infancy to childhood, and to examine the associations of iron status with dietary factors, growth, and heredity. DESIGN: This study consisted of a longitudinal follow-up at age 4 y of children (n = 127) from the cohort of a study that began at age 6 mo. Blood samples and anthropometry were assessed in both children and their parents; food records were collected from children only. RESULTS: Dietary intake was not significantly correlated with hemoglobin concentrations, whereas the consumption of meat products had a positive effect on serum ferritin concentrations and mean corpuscular volume in boys (P = 0.015 and 0.04, respectively). The prevalences of anemia and iron deficiency were low, affecting 2 (1.8%) and 3 (2.8%) children, respectively; no child had iron deficiency anemia. There was significant within-subject tracking of hemoglobin and mean corpuscular volume from age 6 mo to 4 y. The mother's but not the father's hemoglobin correlated with the child's hemoglobin over time. CONCLUSIONS: Food choices had little effect on iron status. Hemoglobin concentrations and mean corpuscular volume were tracked from infancy to childhood. In healthy, well-nourished children with a low prevalence of iron deficiency, the mother's hemoglobin was significantly associated with that of her child, but the underlying mechanism is unclear.     

Correct assessment of iron depletion and iron deficiency anemia

OBJECTIVE: Iron deficiency anemia is caused by decreased production of red blood cells (RBCs) and is characterized by a reduction in either the hematocrit (Ht) or the concentration of hemoglobin (Hb). It is detected by blood iron status measures that are below population reference standards and also below the "usual or normal" levels for an individual. In some medicine practices, usually only hemoglobin and hematocrit are routinely measured with a full blood count, without measuring the indicators of iron status. Biochemical measures that are collected on single occasion are difficult to interpret in individuals, and normal ranges of hemoglobin and hematocrit do not necessarily confirm an iron deficiency condition, because they decrease only when severe iron depletion is present and are often unreliable or misleading. Thus, iron-depleted individuals can quickly develop iron deficiency if not detected early. METHODS: Information from hematological laboratory tests records on female patients at reproductive ages were collected and analysed. RESULTS: In this study, measurement of general test for anemia in some individuals revealed normal levels of RBCs count, Hb, Ht, mean corpuscular volume (MCV), mean cell hemoglobin concentration (MCHC), and cell morphology, whereas the levels of parameters of iron depletion and iron deficiency anemia such as serum iron and ferritin showed reduced values. The results indicate that individuals who are ordered cell blood count (CBC) measures alone without examining the indicators of iron status (Group C vs Group D) may not be correctly assessed with a definitive diagnosis and categorized as normal individuals. But in fact, they are susceptible to iron depletion and could develop iron deficiency anemia. CONCLUSIONS: In evaluation of iron deficiency status it is important that total CBC test be accompanied by the other tests of iron status to pinpoint true iron deficiency. Otherwise, many cases may be missed out and misdiagnosed as normal individuals.     

Diet-induced iron deficiency anemia and pregnancy outcome in rhesus monkeys

BACKGROUND: Iron deficiency anemia (IDA) is relatively common in the third trimester of pregnancy, but causal associations with low birth weight and compromised neonatal iron status are difficult to establish in human populations. OBJECTIVE: The objective was to determine the effects of diet-induced IDA on intrauterine growth and neonatal iron status in an appropriate animal model for third-trimester IDA in women. DESIGN: Hematologic and iron-status measures, pregnancy outcomes, and fetal and neonatal evaluations were compared between pregnant rhesus monkeys (n = 14) fed a diet containing 10 microg Fe/g diet from the time of pregnancy detection (gestation days 28-30) and controls (n = 24) fed 100 microg Fe/g diet. RESULTS: By the third trimester, 79% of the iron-deprived dams and 29% of the control monkeys had a hemoglobin concentration <11 g/dL. There were also significant group differences in hematocrit, mean corpuscular volume, transferrin saturation, serum ferritin, and serum iron. At birth, the newborns of monkeys iron-deprived during pregnancy had significantly lower hemoglobin, mean corpuscular volume, and mean corpuscular hemoglobin values and a lower ratio of erythroid to total colony-forming units in bone marrow than did the control newborns. Pregnancy weight gain did not differ significantly between the iron-deprived and control dams, and the fetuses and newborns of the iron-deprived dams were not growth retarded relative to the controls. Gestation length, the number of stillbirths, and neonatal neurobehavioral test scores did not differ significantly by diet group. CONCLUSION: These data indicate that an inadequate intake of iron from the diet during pregnancy in rhesus monkeys can lead to compromised hematologic status of the neonate without indications of growth retardation or impaired neurologic function at birth.     

Cross-sectional study of blood lead effects on iron status in Korean lead workers

OBJECTIVE: This study assessed the iron status of Korean male lead workers by measuring the dietary iron intake and biochemical indices, and tested the hypothesis that a high blood lead level is associated with impaired iron function, which results in higher prevalence of iron deficiency when the route of exposure is not the gastrointestinal tract. METHODS: One hundred eighteen lead workers and 42 non-lead workers were recruited from mandatory annual health surveillance sites for industrial workers. Blood lead, hemoglobin, and hematocrit levels were evaluated as hematologic parameters, and serum iron concentrations, total iron-binding capacity, and percentage of transferrin saturation were evaluated as iron-status parameters. Dietary iron intake was assessed by a 24-h recall method. RESULTS: Lead workers had significantly lower hemoglobin, hematocrit, serum iron levels, percentage of transferrin saturation, and dietary iron intake than did non-lead workers, and they had significantly higher (P < 0.01) total iron-binding capacity. The occurrence of iron-deficiency cases, as assessed by hematocrit values, was significantly higher (P < 0.001) in lead workers than in non-lead workers, and the prevalence of iron deficiency was associated with high blood lead levels (P = 0.033). The dietary iron intake was inversely associated with zinc protoporphyrin (P = 0.032). CONCLUSIONS: This study confirmed the adverse effects of high blood lead levels on hematologic pathways and the effectiveness of dietary iron intake as a secondary preventive intervention against lead toxicity. To promote health and to prevent toxic effects of lead exposure in Korean lead workers, an adequate intake of dietary iron is strongly recommended.     

Iron status and dietary iron intake of adolescents from a rural community in Sabah, Malaysia

Iron deficiency anaemia (IDA) is the most prevalent micronutrient deficiency in the world affecting the general health and wellbeing of millions. In Malaysia, moderately high prevalences of anaemia have been reported amongst infants, young children and women of childbearing age. Data is scant for the adolescents. This study was undertaken to assess the iron status and dietary intake of 165 adolescents, comprising 74 male and 91 female subjects, aged 12 to 19 years, from the rural communities in Tuaran District of Sabah, Malaysia. Convenience sampling was used for the selection of study subjects. Multiple iron status indicators namely, serum ferritin (SF), transferrin saturation (TS), mean corpuscular volume (MCV) and haemoglobin (Hb) were determined for the study. The mean age of the subjects was 15.2 +/-2.1 years. While the majority of the subjects (77.6%) had normal body mass index (BMI) values, 17.6% were underweight and 4.8% overweight. About 35% to 40% of the subjects showed deficient values for haematocrit, serum ferritin, serum iron, mean corpuscular haemoglobin (MCH), mean corpuscular volume (MCV) and transferrin saturation (TS), and 20% were anaemic (Hb <12 g/L). Using the multiple criteria of iron status indicators, the prevalence of iron depletion, iron deficiency and IDA in the male and female adolescents were 5.4% vs. 6.6%, 18.9% vs. 26.4% and 5.4% vs. 26.4%, respectively. Iron deficiency anaemia (85.0%) contributed largely to the prevalence of anaemia. The dietary iron intake of the adolescents was unsatisfactory, with approximately 98% of subjects failing to meet the Malaysian RDA level. Almost all the female subjects (91%) had dietary iron intake below two-thirds of the RDA level compared with a much smaller proportion for the male adolescents (68%). The prevalence of IDA in the present study population, especially in the female adolescents, appears to be a significant public health problem. Priority should therefore be given to the eradication of iron deficiency in adolescents from low-income areas by dietary modification and micronutrient supplementation amongst female adolescents.     

Food stamps and the iron status of the U.S. elderly poor

With the use of data from NHANES I and II, the iron status of poor elderly persons was examined by comparing it with that of nonpoor elderly persons. Within the poor group, the iron status of Food Stamp Program participants was compared with that of nonparticipants. The poor were those below the poverty line; the nonpoor were those with incomes at least twice the poverty line. The indicators of iron status were: hemoglobin, hematocrit, free erythrocyte protoporphyrin, transferrin saturation, total iron-binding capacity, serum iron, and iron intake. Iron status was examined by analyses of variance. The effects associated with sex, race, age, geographic region, and other potentially confounding factors were included in the model. In both surveys, there were interactions with race. That is, the poor whites had lower transferrin saturation and iron intake means than the nonpoor whites, while the Food Stamp Program participants were no different from the nonparticipants in transferrin saturation. Within the nonwhites, the poor had a lower hemoglobin mean than the nonpoor, and the program participants had a lower hemoglobin mean than the nonparticipants. Therefore, the Food Stamp Program was not consistently associated with better iron nutrition of the elderly poor in NHANES I and II.     

Diet and iron status of nonpregnant women in rural Central Mexico

BACKGROUND: Few studies have examined the relation of iron status to diet in populations from developing countries with high levels of iron deficiency and diets of poor quality. OBJECTIVE: The objective was to identify nutrients, dietary constituents, and foods that are associated with better iron status in a rural Mexican population. DESIGN: A prospective cohort study was conducted in rural central Mexico. The subjects were 125 nonpregnant women aged 16-44 y. During the 12 mo before blood collection, food intakes were assessed repeatedly by a combination of dietary recalls, food weighing, and food diaries [mean (+/-SD) days of food intake data: 18.8 +/- 5.9 d]. Hemoglobin, hematocrit, and plasma ferritin were measured at the end of the study. RESULTS: Higher plasma ferritin concentrations were associated with greater intakes of nonheme iron and ascorbic acid after control for age, BMI, breast-feeding, season, and the time since the birth of the last child. Higher ascorbic acid intakes, but not higher intakes of heme and nonheme iron, predicted a lower risk of low hemoglobin and hematocrit values after control for the background variables. Consumption of the alcoholic beverage pulque predicted a lower risk of low ferritin and low hemoglobin values. Seasonal variation in ferritin, hemoglobin, and hematocrit values was observed. CONCLUSION: Better iron status was associated with greater intakes of foods containing nonheme iron and ascorbic acid. PULQUE:a beverage containing iron, ascorbic acid, and alcohol-may influence the iron status of women in rural central Mexico.     

Dietary intakes,iron status and growth status of southeast Asian refugee children

Seventy two Southeast Asian refugee children, age 2–60 months, were examined using 24-hour dietary recalls, hemoglobin or hematocrit measurements, and height and weight measurements. The mean nutrient intake was considered adequate as compared to the NRC RDA. Several children had consumed a number of servings of highly fortified breakfast cereal thus consuming the highest levels of nutrients. Those with the lowest nutrient intakes were older infants who consumed formula exclusively. The iron status was considered adequate with the mean hemoglobin at 12g and hematocrit at 37.2%. On NCHS references over two-thirds of the children were considered stunted in height. However, by Thailand references less than one-fourth would be considered stunted. Iron status and growth status were considered to be adequate given the ethnic background and early experience. The mothers' beliefs about foods leading to excessive intake of highly fortified foods as well as prolonged infant formula feeding need further investigation.     

Actions of black tea and Rooibos on iron status of primary school children

The aim of this study was to compare the effects of black tea and Rooibos on the iron status of primary school children. This parallel intervention trial included 175 children who were randomly allocated to receive 2 200-mL servings of either black tea or Rooibos daily with milk and sugar. The children received antihelminthic treatment (500 mg mebendazole) at baseline. Hemoglobin, hematocrit, serum iron, ferritin, and transferrin were measured, and total iron binding capacity and transferrin saturation were calculated. Dietary intakes were measured by means of 24-hour dietary recalls, and anthropometric measurements were taken. A malnourished population in anthropometric indices and nutrient intakes was identified. Biochemical markers of iron status also indicated a population at risk for iron depletion. Children in the black tea group had significantly higher hemoglobin concentrations, and children in both groups had significantly higher mean corpuscular volume, transferrin, and total iron binding capacity after the intervention. Changes in biochemical parameters did not differ significantly between the 2 groups. During the intervention period, the changes in dietary intakes were similar in the black tea and the Rooibos groups but with increased heme iron intakes in the black tea group. Iron status markers seemed to improve from baseline to the end of the study in both of the study groups. One possible reason is the antihelminthic treatment the participants received when the study commenced.     

Evaluation of an iron specific checklist for the assessment of dietary iron intake in pregnant and postpartum women

OBJECTIVE: This study developed and validated an iron checklist for assessing dietary iron intake of pregnant and postpartum women. METHODS: The checklist included 65 food and drink items. Iron intake measured by the checklist was compared with a diet history interview by paired t test and by the Bland-Altman method in 54 pregnant women. We then used the checklist to prospectively assess iron intake in a separate group of women in late pregnancy (n = 179) and at 6 mo postpartum (n = 177). The ability of the checklist to predict iron status was evaluated. RESULTS: There was no difference in reported mean iron intakes between the checklist and the diet history and there were good correlations between iron intake estimated from both methods (r = 0.69, P < 0.001 for food alone, r = 0.99, P < 0.001 for food plus supplements). However, the agreement between the two methods at an individual level was low. Pregnant women with low iron intake (lower than the recommended dietary intake) had lower serum ferritin levels (9.7 versus 14.5 microg/L, P < 0.001) and higher risk of iron deficiency (67.5% versus 34.9%, P < 0.0001) compared with women with adequate iron intake (at least the minimum recommended dietary intake), but these differences disappeared when women taking iron supplements were excluded. There was no association between iron intake and serum ferritin at 6 mo postpartum or between iron intake and hemoglobin levels at the end of pregnancy or at 6 mo postpartum. CONCLUSION: This simple iron checklist is a useful tool in describing iron intake of population samples of pregnant women but has limited ability to predict iron status.     

Poor iron status is more prevalent in Hispanic than in non-Hispanic white older adults in Massachusetts

Iron status and dietary correlates of iron status have not been well described in Hispanic older adults of Caribbean origin. The aim of this study was to evaluate iron status and describe dietary components and correlates of iron status in Hispanic older adults and in a neighborhood-based comparison group of non-Hispanic white older adults. Six hundred four Hispanic and non-Hispanic white adults (59-91 y of age) from the Massachusetts Hispanic Elders Study were included in the analysis. We examined physiological markers of iron status as well as dietary factors in relation to iron status. Dietary intake was assessed by FFQ. Our results revealed that Hispanics had significantly lower geometric mean serum ferritin (74.1 microg/L vs. 100 microg/L; P<0.001), lower hemoglobin concentrations (137+/-13 vs. 140+/-12 g/L; P<0.01), higher prevalence of anemia (11.5 vs. 7.3%; P<0.05), and suboptimal hemoglobin concentrations (<125 g/L) for this age group (21.4 vs. 13.3%; P<0.05). Iron deficiency anemia was higher (7.2% vs. 2.3%; P<0.05) in Hispanic women. Hispanics had lower mean intakes of total iron, vitamin C, supplemental vitamin C, and total calcium than did non-Hispanic whites. After adjusting for age, sex, BMI, alcohol use, smoking, total energy intake, inflammation, diabetes, and liver disease, intake of heme iron from red meat was positively associated and dietary calcium was negatively associated with serum ferritin. This population of Hispanic older adults was significantly more likely than their non-Hispanic white neighbors to suffer from anemia and poor iron status, particularly among women. Cultural variation in dietary patterns may influence iron availability and body iron stores and contribute to an increased risk for iron deficiency anemia among some Hispanic older adults.     

Differentiation of iron deficiency and the anemia of chronic disease

The predictive value positive of serum iron studies and erythrocyte indices in differentiating between iron deficiency anemia and the anemia of chronic disease (ACD) were determined in 82 hospitalized patients with an iron-binding saturation of 15 percent or less. Iron deficiency, determined by serum ferritin of 20 ng/mL or less, was present in only 31 percent of patients with a serum iron level of 10 micrograms/dL or less; 39 percent of patients with a transferrin saturation of 5 percent or less, and 54 percent of patients with a total iron-binding capacity (TIBC) of 350 micrograms/dL or greater; conversely, iron deficiency was present in only 3 percent of patients with a TIBC of 250 micrograms/dL or less. Iron deficiency was present in 83 percent of patients with a mean corpuscular volume (MCV) of 75 microns3 or less, but only 2 percent of patients with an MCV of 86 microns3 or greater. It is concluded that the MCV has strong predictive value positive (and negative) when below (or above) the values just cited, but that serum iron studies do not have sufficient predictive value to justify their use in the routine differentiation between iron deficiency anemia and the ACD in hospitalized patients when no other cause for anemia is likely.     

儿童维生素A与铁营养状况的相关性研究

目的了解中国儿童维生素A(VA)的营养状况、VA缺乏率、VA边缘缺乏率,研究血浆VA与铁营养状况的相关性。方法由2002年“中国居民营养与健康状况调查”的大样本中随机抽取380名3~12岁儿童,检测血浆VA含量,同时测定血红蛋白(Hb)、总铁结合力(TIBC)、铁蛋白(SF)及转铁蛋白受体(sTfR)。了解儿童VA营养状况,计算VA缺乏率、VA边缘缺乏率,研究VA与铁营养状况评价指标的相关性。结果受试儿童VA平均含量为(1·03±0·24)μmol/L,其中8·4%儿童VA缺乏,44·7%儿童VA边缘缺乏。血浆VA与Hb呈正相关(r=0·16986,P<0·01),与sTfR呈负相关(r=-0·12863,P<0·05),与TIBC、SF不相关。结论铁缺乏伴随VA边缘缺乏在中国儿童中普遍存在,VA与铁营养状况存在相关性。     

Longitudinal study of diet and iron deficiency anaemia in infants during the first two years of life

The objectives of this study were: (i) to investigate the energy, iron, zinc, calcium and vitamin C intakes of a group of healthy term Caucasian infants resident in Dunedin, New Zealand, prospectively from age 9 months to 2 years; and (ii) to determine the prevalence of iron deficiency anaemia among these infants. A self-selected sample of 74 Caucasian mothers and their infants born in Dunedin, New Zealand, between October 1995 and May 1996 were recruited. Dietary intake was determined using estimated diet records at 9, 12, 18 and 24 months of age. Haemoglobin concentration, mean corpuscular volume andzinc protoporphyrin concentration were determined at the same ages. The infants' zinc, calcium and vitamin C intakes appeared adequate. Their median iron intakes ranged from 4.3 mg (at 12 months) to 7.0 mg (at 9 months) per day and were below estimated requirements at all ages. At 9, 12 and 18 months of age, 7% (n = 4) of the infants had iron deficiency anaemia. None of the infants had iron deficiency anaemia at 24 months. The iron intakes of this group of Caucasian infants and young children appeared inadequate. However, their rate of iron deficiency anaemia was lower than has been reported in previous New Zealand studies.     

Determinants of iron status in Malaysian adolescents from a rural community

Iron deficiency anaemia is the most common micronutrient deficiency worldwide. The prevalence of anaemia in the developing countries is three to four times higher than that in the developed countries. The iron status was assessed in 199 apparently healthy male and female adolescents aged 12-19 years living in a fishing community in Sabah, Malaysia. Data on socio-economic characteristics, lifestyles, anthropometry measurements, iron status, and dietary intake were gathered. Dietary intake of energy, iron, and most nutrients (with the exception of protein and vitamin C) were below the recommended levels for Malaysian adolescents. Three-quarters of the iron was derived from plant foods. The mean haemoglobin value for the male was 13.9 +/- 1.3 g/dl with 9.5% having less than 12 g/dl, while the respective figures for the female were 12.4 +/- 1.6 g/dl and 28.6%. The mean serum ferritin concentrations for male and female adolescents were 21.5 and 15.4 microg/l, respectively; with 25.7% of the males and 49.5% of the females having deficient levels of ferritin. Dietary intake of total energy and iron, and gender were found to be independent determinants of serum ferritin and haemoglobin levels, accounting for over 40% of the variations for each of these iron indicators. In males, but not in females, the intake of dietary protein and iron, and physical activity were also found to be significant determinants of serum ferritin. The age of subjects and household size were significant determinants of haemoglobin levels for male subjects, but not for female subjects. The findings indicate the importance of adequate intake of energy and dietary iron for improving the iron status of adolescents.     

Nutritional status of Head Start and nursery school children. II. Biochemical measurements.

At the beginning of a Head Start and nursery school program in the fall, nursery school children had significantly higher hemoglobin and hematocrit levels and mean corpuscular volume than Head Start children. The latter had a higher mean corpuscular hemoglobin concentration and alpha 1 globulin level. In the spring, at the close of both preschool programs, nursery school children still had higher hemoglobin and hematocrit levels and mean corpuscular volume, and also a higher mean corpuscular hemoglobin and total iron binding capacity. Head Start children exhibiting signs of anemia in the fall were improving in iron status in the spring. Normal blood protein levels for both groups of children indicated adequate protein status. This condition was confirmed by urinary analysis of urea, creatinine, and inorganic sulfate sulfur.     

Determinants of iron status in Malaysian adolescents from a rural community

Iron deficiency anaemia is the most common micronutrient deficiency worldwide. The prevalence of anaemia in the developing countries is three to four times higher than that in the developed countries. The iron status was assessed in 199 apparently healthy male and female adolescents aged 12–19 years living in a fishing community in Sabah, Malaysia. Data on socio-economic characteristics, lifestyles, anthropometry measurements, iron status, and dietary intake were gathered. Dietary intake of energy, iron, and most nutrients (with the exception of protein and vitamin C) were below the recommended levels for Malaysian adolescents. Three-quarters of the iron was derived from plant foods. The mean haemoglobin value for the male was 13.9±1.3 g/dl with 9.5% having less than 12 g/dl, while the respective figures for the female were 12.4±1.6 g/dl and 28.6%. The mean serum ferritin concentrations for male and female adolescents were 21.5 and 15.4 μg/l, respectively; with 25.7% of the males and 49.5% of the females having deficient levels of ferritin. Dietary intake of total energy and iron, and gender were found to be independent determinants of serum ferritin and haemoglobin levels, accounting for over 40% of the variations for each of these iron indicators. In males, but not in females, the intake of dietary protein and iron, and physical activity were also found to be significant determinants of serum ferritin. The age of subjects and household size were significant determinants of haemoglobin levels for male subjects, but not for female subjects. The findings indicate the importance of adequate intake of energy and dietary iron for improving the iron status of adolescents.     

Iron status in Swedish teenage girls: impact of low dietary iron bioavailability

OBJECTIVE: Although it is well known that bioavailability of iron in the diet is important, it has not been fully elucidated in practice. We investigated iron intake and iron absorption in the ordinary diet of free-living individuals in relation to iron status and assessed iron requirements. METHODS: From a total of 1245 adolescent boys and girls included in the G?teborg Adolescence Study of food habits, 28 adolescent girls registered their food intake during 7 d. Iron intake was assessed on the basis of these 7-d dietary records. Iron absorption was calculated using an algorithm including enhancing and inhibiting dietary factors on iron absorption in relation to individual iron status. RESULTS: Available iron intake was 11.5 +/- 2.8 mg/d (mean +/- SD). The proportion of girls with an iron intake below the Nordic nutrition recommendations was 85% (n = 24). Calculated iron absorption was 1.09 +/- 0.59 mg/d (mean +/- SD). Only four girls satisfied their estimated individual iron requirement concerning the absorbed amount of iron. Iron depletion (serum ferritin concentration < or = 15 microg/L) was present in 10 girls (36%), 2 of whom were also anemic (hemoglobin concentration < or = 120 g/L). CONCLUSION: Swedish adolescent girls seemed to have difficulties satisfying their iron requirement in terms of absorbed amount. The data support the view that iron intake and bioavailability of dietary iron is important when evaluating whether iron requirements have been met.     

Influence of dietary and socio-demographic factors on the iron status of married adolescent girls from Indian urban slums

To explore the influence of dietary factors of iron bioavailability and socio-demographic conditions on blood iron status of married adolescent girls (MAG), a cross-sectional study was conducted in 173 MAG (15–19 years old) from urban slums near Pune city, India. Diet was assessed by two random 24-h recalls. The age, weight, height, education, family size, income, physical work, and number of days of menstrual loss were recorded. Fasting blood was analyzed for hemoglobin and serum ferritin. Mean intakes of micronutrients were 40–75% less than the recommended dietary intakes for Indian adolescent girls. High intake of phytates (171±6 mg/day) and low intakes of vitamin C (25±1 mg/day) resulted in low bioavailable iron intakes. The mean bioavailable iron intake was 0.76±0.3 mg/day, which is one-half of the basal iron requirement of adolescent girls. The prevalence of iron deficiency (serum ferritin<12 µg/l) was 25.1%, and anemia (hemoglobin <12 g/l) was seen in 46.4% of MAG. A multiple regression model adjusted for energy intake indicated that intakes of β-carotene and riboflavin were associated with hemoglobin (P<0.001) and those of zinc, riboflavin and thiamin associated with serum ferritin (P<0.01). Multiple regressions including socio-demographic factors revealed that the family size, number of menstrual days lost and total bioavailable iron intake were the influencing factors for low iron status. In conclusion, there is a need to increase intakes of vitamin C and other micronutrients of the MAGs and to improve iron bioavailability through diet modifications.