Iron status of inner-city elementary school children: lack of correlation between anemia and iron deficiency

Article Abstract:

In the past, anemia caused by iron deficiency was one of the most common forms of malnutrition in the United States. However, recent reports have indicated that the prevalence of anemia among preschool children has been declining. Although many studies have been performed to evaluate iron status in school children, few studies have focused on minority groups. Many of the studies that have been performed have evaluated iron status based on the amount of hemoglobin (Hb, a red blood cell protein that contains iron and transports oxygen) in the blood. However, this is not the most reliable indicator of iron status and it may underestimate the true prevalence of iron deficiency. The best single indicator of iron status is the amount of ferritin (the storage form of iron) in the blood (SF, serum ferritin). The accepted procedure for diagnosing iron deficiency is to measure SF, Hb and the amount of protoporphyrin (a pigment that binds iron) in red blood cells (EP, erythrocyte protoporphyrin). When two or more of these test results are abnormal, a diagnosis of iron deficiency is made. To accurately estimate the prevalence of anemia among inner-city elementary school children, SF, Hb and EP were measured in blood samples from 103 third and fourth graders attending public school in Philadelphia. Most of the children were black and were from low-income families. Only four of the children tested had two or more abnormal test results and were diagnosed as having anemia. Three of these children had normal Hb levels, indicating that Hb status is not an accurate indicator of iron status. The average level of SF was higher than previously reported, indicating that iron status in school children may be improving. The results of this study indicate that anemia is not prevalent among black inner-city school children. (Consumer Summary produced by Reliance Medical Information, Inc.)

Demographic aspects, Elementary school students

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Conceptual and methodological issues regarding the epidemiology of iron deficiency and their implications for studies of the functional consequences of iron deficiency

Article Abstract:

Iron deficiency (ID) is a condition in which the body does not have enough iron to maintain adequate levels in the blood and in storage sites. Severe ID is referred to as iron-deficiency anemia, but milder forms are not considered anemia. In anemia, the red blood cells (RBCs) are not able to transport adequate amounts of oxygen to body tissues. Of all nutrient deficiencies, ID is one of the most common, both in developing and developed countries. The causes of ID include consuming a diet low in iron-containing foods, blood loss due to injury or illness, and increased requirements during pregnancy and lactation. Frequently, a combination of factors gradually lowers iron stores until deficiency develops. The authors review the various blood tests that can be used to evaluate iron status, including hemoglobin, hematocrit, transferrin and ferritin. Hemoglobin is the protein in RBCs that carries oxygen and gives the RBCs their color. The hematocrit test measures the volume of RBCs as a proportion of the volume of whole blood; a low hematocrit indicates either too few RBCs or RBCs that are too small. Transferrin is a protein that transports iron in the bloodstream, and ferritin is another protein that stores iron in the body. The authors discuss the advantages and disadvantages of each blood test for gauging iron status. Some tests are more sensitive for showing the exact degree of iron depletion while other tests are more specific because they measure iron status alone and are not influenced by other factors. The authors advise other researchers on how to design studies of iron deficiency in population groups. No single test of iron status is ideal in all circumstances, but for each study some tests are preferred over others.

Testing, Pediatric diseases, Iron in the body, Iron (Nutrient), Iron, Iron (Metal), Blood proteins, Iron deficiency anemia in children

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Menstrual-cycle patterns in energy and macronutrient intake

Article Abstract:

There is increasing interest in changes in dietary intake associated with menstrual cycles. Shifts in energy intake according to different cycle phases have been described, but this variability may be related to random error or bias in dietary records. As part of a year-long continuous study of diet, the patterns of energy (calorie) and nutrient intake of 14 women, aged 20 to 47 years, were evaluated during one to four menstrual periods. Energy and fat intake were significantly higher in the 10 days preceding menses, compared to the 10 days following menses. There was also a trend for protein intake to be higher in the premenstrual period. Maximal fat intake, calculated as a proportion of total caloric intake, occurred in the luteal period, between 5 and 10 days preceding menses, while maximum protein intake per calorie coincided with onset of menses. These cyclical variations are consistent with those reported in other studies. The study suggests that total energy intake in menstruating women is responsive to physiological or behavioral regulation, and changes in fat intake represent much of this change. Similarly, protein intake also varies cyclically, but it appears to be subject to different regulatory factors. (Consumer Summary produced by Reliance Medical Information, Inc.)

Women, Physiological aspects, Food and nutrition, Diet, Menstrual cycle

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