Journal Article

Adiposity in women and children from transition countries predicts decreased iron absorption, iron deficiency and a reduced response to iron fortification

Muthayya, S, Aeberli, I, Winichagoon, P, Hurrell, R.F, Zimmermann, M.B, Chaouki, N, Zeder, C

2008

Overview

Background: Overweight is increasing in transition countries, while iron deficiency remains common. In industrialized countries, greater adiposity increases risk of iron deficiency. Higher hepcidin levels in obesity may reduce dietary iron absorption. Therefore, we investigated the association between body mass index (BMI) and iron absorption, iron status and the response to iron fortification in populations from three transition countries (Thailand, Morocco and India). Methods: In Thai women (n=92), we examined the relationship between BMI and iron absorption from a reference meal containing 4 mg of isotopically labeled fortification iron. We analyzed data from baseline (n=1688) and intervention (n=727) studies in children in Morocco and India to look for associations between BMI Z-scores and baseline hemoglobin, serum ferritin and transferrin receptor, whole blood zinc protoporphyrin and body iron stores, and changes in these measures after provision of iron. Results: In the Thai women, 20% were iron deficient and 22% were overweight. Independent of iron status, a higher BMI Z-score was associated with decreased iron absorption (P=0.030). In the Indian and Moroccan children, 42% were iron deficient and 6.3% were overweight. A higher BMI Z-score predicted poorer iron status at baseline (P<0.001) and less improvement in iron status during the interventions (P<0.001). Conclusions: Adiposity in young women predicts lower iron absorption, and pediatric adiposity predicts iron deficiency and a reduced response to iron fortification. These data suggest the current surge in overweight in transition countries may impair efforts to control iron deficiency in these target groups. Interactions of the 'double burden' of malnutrition during the nutrition transition may have adverse consequences.

• Publisher: Nature Publishing Group UK,Nature Publishing,Nature Publishing Group
• Subject: Absorption / Adiposity / administration & dosage / Adolescent / Adult / analysis / Anemia / Anemia, Iron-Deficiency / Anemia, Iron-Deficiency - metabolism / Anemias. Hemoglobinopathies / Biological and medical sciences / Biomarkers / Biomarkers - blood / Blood / blood chemistry / Body Mass Index / Child / children / Complications and side effects / controlled-trial / Developing Countries / Diagnosis / Diseases of red blood cells / double-blind / dual fortification / Epidemiology / Female / ferric pyrophosphate / ferritin / Ferritins / Ferritins - blood / Food, Fortified / fortified foods / Health aspects / Health Promotion and Disease Prevention / Health Surveys / Hematologic and hematopoietic diseases / Hemoglobin / Hemoglobins / Hemoglobins - analysis / hepcidin / Humans / incidence / India / Internal Medicine / Intervention / Intestinal Absorption / Iron / Iron - metabolism / Iron deficiency anemia / Iron Metabolism Disorders / Iron Metabolism Disorders - blood / Iron, Dietary / Iron, Dietary - administration & dosage / Isotope Labeling / Laboratories / Male / Malnutrition / Meals / Medical sciences / Medicine / Medicine & Public Health / Metabolic Diseases / metabolism / Metals (hemochromatosis...) / Middle Aged / Morocco / Multivariate Analysis / normal-weight / nutrient deficiencies / Nutrient deficiency / nutrient reserves / nutrient uptake / Nutrition / nutrition transition / nutritional status / Obesity / original-article / Other metabolic disorders / Overweight / Pediatrics / protoporphyrin / Protoporphyrins / Protoporphyrins - analysis / Public Health / Receptors, Transferrin / Receptors, Transferrin - blood / Risk factors / school-children / serum transferrin receptor / Standard scores / Target groups / Thailand / transferrin / transition countries / united-states / Women / Womens health