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Risk factors for low iron intake and poor iron status in a national sample of British young people aged 4–18 years

Published online by Cambridge University Press:  22 December 2006

CW Thane*
Affiliation:
MRC Human Nutrition Research, Elsie Widdowson Laboratory, Fulbourn Road, Cambridge CB1 9NL, UK
CJ Bates
Affiliation:
MRC Human Nutrition Research, Elsie Widdowson Laboratory, Fulbourn Road, Cambridge CB1 9NL, UK
A Prentice
Affiliation:
MRC Human Nutrition Research, Elsie Widdowson Laboratory, Fulbourn Road, Cambridge CB1 9NL, UK
*
*Corresponding author: Email [email protected]
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Abstract

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Objective:

To examine the prevalence and dietary, sociodemographic and lifestyle risk factors of low iron intake and poor iron status in British young people.

Design:

National Diet and Nutrition Survey of young people aged 4–18 years.

Setting:

Great Britain, 1997.

Subjects:

In total, 1699 young people provided 7-day weighed dietary records, of which 11% were excluded because the participant reported being unwell with eating habits affected. Blood was obtained from 1193 participants, with iron status indicated by haemoglobin, serum ferritin and transferrin saturation.

Results:

Iron intakes were generally adequate in most young people aged 4–18 years. However, low iron intakes (below the Lower Reference Nutrient Intake) occurred in 44% of adolescent girls (11–18 years), being less prevalent with high consumption of breakfast cereals. Low haemoglobin concentration (<115 gl−1, 4–12 years; <120 or <130 gl−1, 13+ years for girls and boys, respectively) was observed in 9% of children aged 4–6 years, pubertal boys (11–14 years) and older girls (15–18 years). Adolescent girls who were non-Caucasians or vegetarians had significantly poorer iron status than Caucasians or meat eaters, independent of other risk factors. The three iron status indices were correlated significantly with haem, but not non-haem, iron intake.

Conclusions:

Adolescent girls showed the highest prevalence of low iron intake and poor iron status, with the latter independently associated with non-Caucasian ethnicity and vegetarianism. Risk of poor iron status may be reduced by consuming (particularly lean red) meat or enhancers of non-haem iron absorption (e.g. fruit or fruit juice) in vegetarians.

Type
Research Article
Copyright
Copyright © The Authors 2003

References

1Gregory, JR, Collins, DL, Davies, PSW, Hughes, JM, Clarke, PC. National Diet and Nutrition Survey: children aged 1.5 to 4.5 years. Vol. 1. Report of the Diet and Nutrition Survey. London: HMSO, 1995.Google Scholar
2Nelson, M. Anaemia in adolescent girls: effects on cognitive function and activity. Proceedings of the Nutrition Society 1996; 55: 359–67.CrossRefGoogle Scholar
3Looker, AC, Dallman, PR, Carroll, MD, Gunter, EW, Johnson, CL. Prevalence of iron deficiency in the United States. Journal of the American Medical Association 1997; 277: 973–6.CrossRefGoogle ScholarPubMed
4Walter, T. Impact of iron deficiency on cognition in infancy and childhood. European Journal of Clinical Nutrition 1993; 47: 307–16.Google ScholarPubMed
5Brock, JH. Iron and immunity. Journal of Nutritional Immunology 1993; 2: 47106.CrossRefGoogle Scholar
6Nelson, M, Bakaliou, F, Trivedi, A. Iron-deficiency anaemia and physical performance in adolescent girls from different ethnic backgrounds. British Journal of Nutrition 1994; 72: 427–33.CrossRefGoogle ScholarPubMed
7Youdim, MB, Ben-Shachar, D, Yehuda, S. Putative biological mechanisms of the effect of iron deficiency on brain biochemistry and behavior. American Journal of Clinical Nutrition 1989; 50(Suppl. 3): 607–15.CrossRefGoogle ScholarPubMed
8Ballin, A, Berar, M, Rubinstein, U, Kleter, Y, Hershkovitz, A, Meytes, D. Iron state in female adolescents. American Journal of Diseases in Childhood 1992; 146: 803–5.Google Scholar
9Bruner, AB, Joffe, A, Duggan, AK, Casella, JF, Brandt, J. Randomised study of cognitive effects of iron supplementation in non-anaemic iron-deficient adolescent girls. Lancet 1996; 348: 992–6.CrossRefGoogle ScholarPubMed
10Walker, SP, Grantham-McGregor, S, Himes, JH, Williams, S. Adolescent Kingston girls' school achievement: nutrition, health and social factors. Proceedings of the Nutrition Society 1996; 55: 333–43.CrossRefGoogle ScholarPubMed
11Godfrey, KM, Redman, CWG, Barker, DJP, Osmond, C. The effect of maternal anaemia and iron deficiency on the ratio of fetal weight to placental weight. British Journal of Obstetrics and Gynaecology 1991; 98: 886–91.CrossRefGoogle ScholarPubMed
12Barker, DJ. Maternal nutrition, fetal nutrition, and disease in later life. Nutrition 1997; 13: 807–13.CrossRefGoogle ScholarPubMed
13Crawley, HF, Summerbell, CD. The nutrient and food intakes of British male dieters aged 16–17 years. Journal of Human Nutrition and Dietetics 1998; 11: 3340.CrossRefGoogle Scholar
14Crawley, H, Shergill-Bonner, R. The nutrient and food intakes of 16–17 year old female dieters in the UK. Journal of Human Nutrition and Dietetics 1995; 8: 2534.CrossRefGoogle Scholar
15Nelson, M, White, J, Rhodes, C. Haemoglobin, ferritin, and iron intakes in British children aged 12–14 years: a preliminary investigation. British Journal of Nutrition 1993; 70: 147–55.CrossRefGoogle Scholar
16Williamson, CS, Al-Hamad, H, Nelson, M. Iron status, diet and cognitive ability in schoolboys aged 11–14 years. Proceedings of the Nutrition Society 2002; 61: 56A.Google Scholar
17Hallberg, L, Hultén, L, Lindstedt, G, Lundberg, P-A, Mark, A, Purens, J, et al. Prevalence of iron deficiency in Swedish adolescents. Pediatric Research 1993; 34: 680–7.CrossRefGoogle ScholarPubMed
18Bergström, E, Hernell, O, Lönnerdal, B, Persson, . Sex differences in iron stores of adolescents: what is normal? Journal of Pediatric Gastroenterology and Nutrition 1995; 20: 215–24.CrossRefGoogle Scholar
19Gregory, J, Lowe, S, Bates, CJ, Prentice, A, Jackson, LV, Smithers, G, et al. National Diet and Nutrition Survey: young people aged 4 to 18 years. Vol. 1. Report of the Diet and Nutrition Survey. London: The Stationery Office, 2000.Google Scholar
20Department of Health. Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. Report on Health and Social Subjects No. 41. London: HMSO, 1991.Google Scholar
21Monsen, ER. Iron nutrition and absorption: dietary factors which impact iron bioavailability. Journal of the American Dietetic Association 1988; 88: 786–90.CrossRefGoogle ScholarPubMed
22Cook, JD, Monsen, ER. Vitamin C, the common cold, and iron absorption. American Journal of Clinical Nutrition 1977; 30: 235–41.CrossRefGoogle ScholarPubMed
23Lynch, SR. Interaction of iron with other nutrients. Nutrition Reviews 1997; 55: 102–10.CrossRefGoogle ScholarPubMed
24Garcia-Casal, MN, Layrisse, M, Solano, L, Baron, MA, Arguello, F, Llovera, D, et al. Vitamin A and beta-carotene can improve nonheme iron absorption from rice, wheat, and corn by humans. Journal of Nutrition 1998; 128: 646–50.CrossRefGoogle ScholarPubMed
25Hallberg, L, Brune, M, Erlandsson, M, Sandberg, A-S, Rossander-Hulthen, L. Calcium: effect of different amounts on nonheme- and heme-iron absorption in humans. American Journal of Clinical Nutrition 1991; 53: 112–9.CrossRefGoogle ScholarPubMed
26Gleerup, A, Rossander-Hulthen, L, Gramatokovski, E, Hallberg, L. Iron absorption from the whole diet: comparison of the effect of two different distributions of daily calcium intake. American Journal of Clinical Nutrition 1995; 61: 97104.CrossRefGoogle ScholarPubMed
27Schofield, WN, Schofield, C, James, WPT. Basal metabolic rate. Human Nutrition: Clinical Nutrition 1985; 39C:(Suppl. 1.): 196.Google Scholar
28Torun, B, Davies, PSW, Livingstone, MBE, Paolisso, M, Sackett, R, Spurr, GB. Energy requirements and dietary energy recommendations for children and adolescents 1 to 18 years old. European Journal of Clinical Nutrition 1996; 50(Suppl. 1): S3781.Google ScholarPubMed
29Olivares, M, Walter, T, Osorio, M, Chadud, P, Schlesinger, L. Anemia of a mild viral infection: the measles vaccine as a model. Pediatrics 1989; 84: 851–5.CrossRefGoogle ScholarPubMed
30Hulthén, L, Lindstedt, G, Lundberg, P-A, Hallberg, L. Effect of a mild infection on serum ferritin concentration – clinical and epidemiological implications. European Journal of Clinical Nutrition 1998; 52: 376–9.CrossRefGoogle ScholarPubMed
31Department of Health. The Diets of British Schoolchildren. Report on Health and Social Subjects No. 36. London: HMSO, 1989.Google Scholar
32Adamson, A, Rugg-Gunn, A, Butler, T, Appleton, D, Hackett, A. Nutritional intake, height and weight of 11–12-year-old Northumbrian children in 1990 compared with information obtained in 1980. British Journal of Nutrition 1992; 68: 543–63.CrossRefGoogle ScholarPubMed
33McNulty, H, Eaton-Evans, J, Cran, G, Woulahan, G, Boreham, C, Savage, JM, et al. Nutrient intakes and impact of fortified breakfast cereals in schoolchildren. Archives of Disease in Childhood 1996; 75: 474–81.CrossRefGoogle ScholarPubMed
34Hurson, M, Corish, C. Evaluation of lifestyle, food consumption and nutrient intake patterns among Irish teenagers. Irish Journal of Medical Science 1997; 166: 225–30.CrossRefGoogle ScholarPubMed
35Löwik, MRH, Hulshof, KFAM, van der Heijden, LJM, Brussaard, JH, Burema, J, Kistemaker, C. et al. Changes in the diet in The Netherlands: 1987–88 to 1992. International Journal of Food Sciences and Nutrition 1998; 49: S164.Google Scholar
36Antal, M, Regöly-Mérei, A, Biró, L, Greiner, E, Sági, K, Agfalvy, R, et al. Iron status in a healthy population of Hungarian secondary school boys and girls. Annals of Nutrition & Metabolism 1998; 42: 33–9.CrossRefGoogle Scholar
37Bergström, E, Hernell, O, Persson, . Dietary changes in Swedish adolescents. Acta Paediatrica 1993; 82: 472–80.CrossRefGoogle ScholarPubMed
38Samuelson, G, Bratteby, L-E, Enghardt, H, Hedgren, M. Food habits and energy and nutrient intake in Swedish adolescents approaching the year 2000. Acta Paediatrica Scandinavica 1996; 415: 120.CrossRefGoogle ScholarPubMed
39Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2001.Google Scholar
40Prescott-Clarke, P, Primatesta, P, eds. Health Survey for England '96. Vol. 1. Findings. London: The Stationery Office, 1998.Google Scholar
41English, RM, Bennett, SA. Iron status of Australian children. Medical Journal of Australia 1990; 152: 582–6.CrossRefGoogle ScholarPubMed
42Kim, SK, Hong, YJ, Choi, JW, Pai, SH, Son, BK. The prevalence of iron deficiency and iron deficiency anemia in Korean adolescents. International Journal of Pediatric Hematology/Oncology 1998; 5: 455–61.Google Scholar
43Palazzari, GL, Matyniak, K, Schulz, LO. Iron status independent of socioeconomic variables in school-age children. Nutrition Research 1986; 6: 1131–7.CrossRefGoogle Scholar
44Schaaf, D, Scragg, R, Metcalf, P, Grant, C, Buchanan, J. Prevalence of iron deficiency in Auckland high school students. New Zealand Medical Journal 2000; 113: 347–50.Google ScholarPubMed
45Frith-Terhune, A, Cogswell, ME, Khan, LK, Will, JC, Ramakrishnan, U. Iron deficiency anemia: higher prevalence in Mexican American than in non-Hispanic white females in the third National Health and Nutrition Examination Survey, 1988–1994. American Journal of Clinical Nutrition 2000; 72: 963–8.CrossRefGoogle ScholarPubMed
46Ramakrishnan, U, Frith-Terhune, A, Cogswell, M, Khan, LK. Dietary intake does not account for differences in low iron stores among Mexican American and non-Hispanic white women: third National and Nutrition Examination Survey, 1988–1994. Journal of Nutrition 2002; 132: 9961001.CrossRefGoogle Scholar
47Harlow, SD, Campbell, B. Ethnic differences in the duration and amount of menstrual bleeding during the postmenarcheal period. American Journal of Epidemiology 1996; 144: 980–8.CrossRefGoogle ScholarPubMed
48Nathan, I, Hackett, AF, Kirby, S. The dietary intake of a group of vegetarian children aged 7–11 years compared with matched omnivores. British Journal of Nutrition 1996; 75: 533–44.CrossRefGoogle ScholarPubMed
49Krajcovicová-Kudlácková, M, Simoncic, R, Béderová, A, Grancicová, E, Magálová, T. Influence of vegetarian and mixed nutrition on selected haematological and biochemical parameters in children. Nahrung 1997; 5: 311–4.CrossRefGoogle Scholar
50Fairweather-Tait, S, Hurrell, RF. Bioavailability of minerals and trace elements. Nutrition Research Reviews 1996; 9: 295324.CrossRefGoogle ScholarPubMed
51Kenney, MA. Factors related to iron nutrition of adolescent females. Nutrition Research 1985; 5: 157–66.CrossRefGoogle Scholar
52Samuelson, G, Bratteby, L-E, Berggren, K, Elverby, J-E, Kempe, B. Dietary iron intake and iron status in adolescents. Acta Paediatrica 1996; 85: 1033–8.CrossRefGoogle ScholarPubMed
53Spodaryk, K. Disparity between dietary iron intake and iron status of children aged 10–12 years. Archives of Physiology and Biochemistry 1999; 107: 361–6.CrossRefGoogle ScholarPubMed
54Rangan, AM, Aitkin, I, Blight, GD, Binns, CW. Factors affecting iron status in 15–30 year old female students. Asia Pacific Journal of Clinical Nutrition 1997; 6: 291–5.Google ScholarPubMed
55Sharma, DC, Mathur, R. Correction of anemia and iron deficiency in vegetarians by administration of ascorbic acid. Indian Journal of Physiology and Pharmacology 1995; 39: 403–6.Google ScholarPubMed