Article

Sharply higher rates of iron deficiency in obese Mexican women and children are predicted by obesity-related inflammation rather than by differences in dietary iron intake.

Division of Human Nutrition, Wageningen University, Netherlands.
American Journal of Clinical Nutrition (Impact Factor: 6.5). 03/2011; 93(5):975-83. DOI: 10.3945/ajcn.110.005439
Source: PubMed

ABSTRACT Obese individuals may be at increased risk of iron deficiency (ID), but it is unclear whether this is due to poor dietary iron intakes or to adiposity-related inflammation.
The aim of this study was to examine the relations between body mass index (BMI), dietary iron, and dietary factors affecting iron bioavailability, iron status, and inflammation [C-reactive protein (CRP)] in a transition country where obesity and ID are common.
Data from the 1999 Mexican Nutrition Survey, which included 1174 children (aged 5-12 y) and 621 nonpregnant women (aged 18-50 y), were analyzed.
The prevalence of obesity was 25.3% in women and 3.5% in children. The prevalence of ID was significantly (P < 0.05) higher in obese women and children compared with normal-weight subjects [odds ratios (95% CIs): 1.92 (1.23, 3.01) and 3.96 (1.34, 11.67) for women and children, respectively]. Despite similar dietary iron intakes in the 2 groups, serum iron concentrations were lower in obese women than in normal-weight women (62.6 ± 29.5 compared with 72.4 ± 34.6 μg/dL; P = 0.014), and total-iron-binding capacity was higher in obese children than in normal-weight children (399 ± 51 compared with 360 ± 48 μg/dL; P < 0.001). CRP concentrations in obese women and children were 4 times those of their normal-weight counterparts (P < 0.05). CRP but not iron intake was a strong negative predictor of iron status, independently of BMI (P < 0.05).
The risk of ID in obese Mexican women and children was 2-4 times that of normal-weight individuals at similar dietary iron intakes. This increased risk of ID may be due to the effects of obesity-related inflammation on dietary iron absorption. Thus, ID control efforts in Mexico may be hampered by increasing rates of adiposity in women and children.

0 Bookmarks
 · 
124 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background/Objectives:Earlier we reported an association between iron deficiency and overweight in Brazilian preschoolers. Here, we investigate whether this is the result of adipose-related inflammation.Subjects/Methods:Fasting serum C-reactive protein, α-1-acid glycoprotein (AGP), hepcidin, interleukin-6 (IL-6) and leptin, together with two iron biomarkers (serum ferritin and transferrin receptor (sTfR)), were measured in 364 disadvantaged preschoolers with a mean BMIZ (standardised Z-score for BMI) of 0.015, aged 3-6 years and attending day care in Salvador, Brazil. The role of genetic haemoglobin (Hb) disorders, intestinal parasites and dietary iron supply (calculated from serving sizes of 20 weekday menus) were also examined.Results:Forty-eight children (13%) were overweight (BMIZ >1). Prevalence of tissue iron deficiency (sTfR >113.3 nmol/l; 30.6 vs 12.5%; P=0.002) and chronic inflammation (AGP >25 μmol/l; 19 vs 10%; P=0.025) were higher in overweight than in normal-weight children. From multiple regression, BMIZ was a positive predictor of log serum sTfR, ferritin and leptin, but not of log hepcidin or IL-6. Instead, major positive predictors of log hepcidin were log IL-6, followed by an elevated AGP and sex (male), whereas for log IL-6 elevated AGP was the only significant predictor. Besides BMIZ, sex (female) was also a major positive predictor of leptin. Heterozygous variant of sickle cell Hb (n=20), but not helminths, was also a positive predictor of log sTfR. Median dietary iron supply (mg/day) was above the WHO Recommended Nutrient Intake assuming moderate bioavailability and appeared adequate.Conclusions:The role of adiposity-related inflammation in tissue iron deficiency should be considered even when the prevalence of overweight is relatively low.European Journal of Clinical Nutrition advance online publication, 14 May 2014; doi:10.1038/ejcn.2014.83.
    European journal of clinical nutrition 05/2014; · 3.07 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To investigate the relationship between poor Fe status and overweight or obesity in elderly respondents in South Africa. Cross-sectional, observational baseline survey. Sharpeville, South Africa. A sample size calculation determined a representative sample of 104 randomly selected elderly (≥60 years) respondents. Measurements included weight, height, biochemical and haematological parameters. Measured BMI was used to categorise the respondents into normal weight, overweight and obese groups. The majority of the women were overweight (28·4 %) or obese (54·6 %); 58 % of the respondents had normal Fe status, 15 % were classified as Fe depleted, 9 % as Fe deficient and 13 % as Fe-deficient anaemic. Ten per cent of the respondents had low Hb levels with no other low Fe status parameters, and were thus anaemic due to other causes. A significant correlation (r = 0·318, P < 0·001) existed between BMI and high-sensitivity C-reactive protein (hs-CRP). hs-CRP was negatively correlated to serum Fe levels (r = -0·319, P < 0·001). No significant relationships existed between BMI and Fe status parameters. A coexistence of obesity and poor Fe status were observed in these elderly respondents. The positive relationship between hs-CRP and BMI indicated chronic inflammation in the higher BMI groups. The negative relationship between hs-CRP and serum Fe indicated that lower serum Fe levels were related to the inflammation linked with higher BMI. A relationship between obesity-related chronic, low-grade inflammation and poor Fe status has been found in adults, but the significance of the current study is that this relationship was also confirmed for elderly persons.
    Public Health Nutrition 03/2014; · 2.25 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To examine the association between overweight and obesity and serum ferritin among women of reproductive age (15-49 years) in Nicaragua, considering the effect of α1-acid glycoprotein (AGP), a marker of inflammation.
    Public health nutrition. 05/2014;

Full-text (2 Sources)

View
34 Downloads
Available from
May 27, 2014