Korean Journal of Community Nutrition

[English]
A Screening Tool for Identifying High-Risk Pregnant Women of Fe Deficiency Anemia : Process II: Jung A Park, Jin Sook Yoon; Korean J Community Nutr 2003;8(2):160-170. Published online April 30, 2003

Abstract PDF: Pregnant women in South Korea are a highly risk group for iron deficiency anemia. Previous studies indicated that the 24-hour recall method was insensitive in distinguishing iron deficiency anemic women from normal women. This method is also impractical to when used at community health centers where no public health dietitians are employed. The objective of this study was to develop a convenient tool to evaluate the usual iron (Fe) intake of pregnant women. The study participants were 115 pregnant women (age 23 to 37 years) at gestational stage of 13 to 24 weeks. Anemic subjects were classified on the basis of their serum ferritin < 12.0 microgram/L and hemoglobin < 12.0microgram/dL levels. Food frequency questionnaires with 46, 29, and 15 commonly consumed food items were used to measure the usual intake of iron of the subjects. Hemoglobin and serum ferritin were measured from fasting blood samples. Nutrients intake was assessed on three consecutive days using the 24-hour recall method and the food record method. The iron index score calculated using the food frequency method showed a significantly positive correlation with iron intake for the three days dietary intake. The iron index showed a significantly difference (p < 0.05) between the normal and anemic groups. However, there was no significant difference in the iron intake between the anemic and the normal women as measured by the 24-hour recall and food record method. Our study indicated that the 29-food items questionnaire could be used as a screening tool to identify poor dietary intake of iron.

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[English]
Iron Status and Anemia of Middle School Girls in Ulsan Metropolitan City: Soon Myung Hong, Young Eun Seo, Hye Jin Hwang; Korean J Community Nutr 2003;8(1):26-32. Published online February 28, 2003

Abstract PDF: This study was designed to assess the nutritional iron status and anemia of middle school girls. Three-hundred-fiftythree female subjects in Ulsan metropolitan city were evaluated using a questionnaire, and hematological indices. The average height and weight of the respondents were 157.19 +/- 5.57 cm and 51.06 +/-9.42 kg, respectively. The average Body Mass Index (BMI, Kg/m2) was 20.63 +/-3.23, which was within the normal range. With regard to clinical symptoms, the greatest number of respondents reported that they experienced 'decreased ability to concentrate'. The total caloric intake of each subject was 1743.28 +/- 343.47 kcal (83.01% of the Korean RDA) and the calcium intake was 634.98 +/- 201.43 mg (79.37% of the Korean RDA). The mean daily intake of iron was 14.76 +/- 4.36 mg (92.25% of the Korean RDA) and the heme iron intake was 6.12 +/- 2.30 mg, which was 41.5% of the total iron intake. The average hemoglobin (Hb) concentration of the subjects was 13.24 +/- 1.01 g/dl, and the average hematocrit (Hct) level was 37.79 +/- 4.10%. The transferrin saturation {TS (%)} was 19.41 +/- 9.21%, and the ferritin level was 26.26 +/- 18.60 ng/ml. The iron deficiency anemia among the subjects was estimated at 6.1% by using Hb (< 12 g/dl), 20.5% by using Hct (< 36%), 30.8% by using TS (< 14%), and 23.1% by using ferritin (< 12 ng/ml). The total iron binding capacity (TIBC) showed a negative correlation with the Hb, iron, ferritin and TS. With regard to the correlation between blood biochemistry and clinical symptoms related to anemia, the Hb concentration was negatively correlated with 'pale face' (p < 0.05). In addition, the level of iron was significantly and negatively correlated with 'poor memory' (p < 0.01) and the ferritin concentration was negatively correlated with 'no appetite' (p < 0.05), 'pale face (p < 0.05). These results suggest that the prevalence of iron deficiency among middle school girls is very high; therefore, guidelines on dietary support and nutritional education to improve their dietary iron status should be provided.

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[English]
Effects of Iron Supplementation on Iron Status of Anomic High School Girls: Soon Myung Hong, Hye Jin Hwang; Korean J Community Nutr 2001;6(5):726-733. Published online December 31, 2001

Abstract PDF: This study was designed to investigate the effect of iron supplementation on the iron nutritional status and anemia of high school girls in Korea. One hundred thirty-five female students residing in Ulian metropolitan city in Korea diagnosed as having anemia or iron deficiency participated in this study. One or two tablets of iron medicine(80-160 mg Fe as ferrous sulfate/day) were administered to all participants for 3 months. Subjects were evaluated with a questionaire, measurement of hematological indices before and after iron supplementation. The average height and weight of respondents were 161.62 +/- 4.68 cm and 53.87 +/- 6.10 kg, respectively. Daily intakes of energy were 1597.8 +/- 302.35 kcal(76.0% RDA). Iron intakes were 13.72 +/- 4.17 mg (76.3% of RDA) and calcium intakes were 580.74 +/- 177.21(72.5% of RDA) before iron supp]ementation. At baseline, 63% of all participants had depleted store(serum ferritin 12 ug/ml and/or transferrin saturation(TS)<14%). After iron supplementation, this proportion declined to 19.3%. 55.6% of subjects had 12 ug/m1 of basal ferritin concentration before iron supplementation, and this proportion declined to 16.3% after iron supplementation. The basal hemoglobin(Hb) concentrations were 12.13 +/- 1.01 g/dl and they increased to 12.79 +/- 0.81 g/dl, which showed significant difference artier iron supplementation(p<0.001). The basal ferritin and TS(%) were 13.24 +/- 11.66 ng/ml, 18.42 +/- 10.12% and they significantly increased to 32.95 +/- 21.14 ng/ml, 33.53 +/- 16.64%, respectively(p<0.001). The basal total iron binding protein(TIBC) were 467.81 +/- 97.24 ug/dl and they significantly decreased to 325.05 +/- 48.89 ug/dl(p<0.001) after iron supplementation. The number of tablets administered was positively correlated with serum iron(t = 0.553, p<0.01), serum ferritin(t = 0.557, p<0.01), TS(%)(t = 0.588, p<0.01) and negatively correlated with TIBC(t= -0.409, p<0.01). The anemia symptoms such as 'Shortening of breath when going upstairs(p<0.01)', 'Tired out easily(p<0.01)', 'Feeling blue(p<0.001)', 'Decreased ability to concentrate(p<0.01)', and 'Poor memory(p<0.001)'improved significantly after iron supplementation. In this study, daily iron supplementations were efficacious in improving the iron status and anemic symptoms of female high school students. Regular check-ups and nutrition education for adolescents are necessary because of their vulnerability to iron deficiency. Further studies are needed to determine the minimum effective dose of iron and to examine the adverse effect of long-term iron supplementation.

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[English]
A Study on Iron Nutritional Status of Girls at Puberty in Kangnung Area: Eun Kyung Kim, Ok Nam Ryu, Ky Wol Park; Korean J Community Nutr 1999;4(2):139-148. Published online June 30, 1999

Abstract PDF: This study was designed to assess the iron nutritional status of girls at puberty in Kangnung area. The subjects consisted of 161 adolescents in sixth-grade in primary school and first-grade in middle school girls. Anthropometric measurements were taken for body weight, height, percentage of body fat, and circumferences of waist and hip. Nutrient intakes were assessed by modified 24-hour recall method. Food models and other measuring tools were also used. Fasting blood samples were obtained and analyzed for hemoglobin(Hb) concentration, hematocrit(Hct), serum iron(FE) and total iron binding capacity(TIBC). Mean values for Hb, Hct, Fe, TIBC, TS and serum ferritin were 13.6+/-0.9g/dl, 39.6+/-3.9%, 91.3+/-36.3 microgram/dl, 327.9+/-45.2 microgram/dl, 28.3+/-11.8% and 37.4+/-24.2ng/ml, respectively. Prevalence of iron deficiency greatly varied by indices from 4.8% when judged by Hb to 18.4% by serum Fe concentration. The Hb concentration was positively correlated with Hct(r=0.641), serum iron(r=0.266) and transferrin saturation(r=0.237)(p<0.05). On the other hand, serum ferritin concentration showed significantly negative correlation with TIBC(r=-0.572). Mean daily intake of iron was 14.94mg and heme iron intake was 1.13mg and which was 7.6% of total iron intake. Total absorbable iron calculated by the method of Mosen was 1.38mg and bioavailability of diectary iron was 9.3%. These results suggest that the prevalence of iron deficiency of pubertal girls is very high, therefore the guidelines for diet and social supports, such as, school food service system should be provided to improve their iron status in middle school students.

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[English]
Effects of Maternal Anemia on the Iron Status of the Cord Blood and Pregnancy Outcomes: Hyeon Sook Lim, Hee Ah Kim; Korean J Community Nutr 1998;3(4):565-573. Published online October 31, 1998

Abstract PDF: Iron deficiency anemia in pregnant women has been of great concern because of its negative effects on the outcomes of pregnancy. Much of evidence has shown that there are associations between pregnancy outcomes and maternal iron status. Maternal iron status might affect pregnancy outcomes through the iron status of the cord blood. In this study, we divided 91 subjects into two groups : the anemic and the normal groups. The groups were classified according to their hemoglobin(Hb) and hematocrit(Hct) values of the maternal blood in the third trimester of the pregnancies. We determined the parameters for the iron status of the cord blood and then analyzed the correlations between these parameters and the pregnancy outcomes. Mothers in the anemic group had a significantly higher parity number and a lower dietary score as well as a shorter duration of iron supplements consumed compared to those in the normal group. Maternal Hb values in the third trimester had positive correlations with the infant's head and chest circumferences, and the Hct values related positively to the infant's chest circumferences. On the other hand, Hb concentrations of the cord blood had positive correlations with the infant's height and head and chest circumferences. The Hct values of the cord blood had positive correlations with gestational periods and the cord lengths. These results suggest that the maternal iron status might influence fetal development through the iron status of the cord blood.

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[English]
Nutritional Status of 5th Grade School Children Residing in Low-Income Area of Pucheon City: Sook Mee Son, Chung Sook Yang; Korean J Community Nutr 1997;2(3):267-274. Published online August 31, 1997

Abstract PDF: The purpose of this study was to determine the proportion of 5th grade school children with iron depletion or iron depleted anemia with simultaneously assessing their general nutritional status. The anthropometric measurements, nutrient intake, and biochemical status of iron were measured for 261 school children from 5th grade residing in low income area of Pucheon. The mean height and weight of male were 138.7 cm and 33.6 kg respectively and were significantly lower than those of female. Mean fat percent, triceps skinfolds thickness and arm circumference were 21.4%, 13.7 mm and 22.2 cm for female and were significantly higher than 19.1%, 11.4 mm, 21.4 cm of male respectively. The intake on vitamin A and calcium were 46.4% and 47.7% of RDA for male and 36.6% and 44.9% for male respectively. The energy intake, carbohydrate, thiamin, niacin, ascorbic acid of male were significantly higher than those of female respectively. The mean daily intake of iron were 7.5 mg for male and 7.3 mg for female and were not significantly different. The mean biochemical indices of iron nutritional status were not significantly different between male and female expect free erythrocyte protoporphyrin(FEP) and FEP : hemoglobin ratio. The proportion of male assessed by serum iron(<70 microgram/dl), Hb(<12g/dl), Hct(<36%), FEP(<70 microgram/dlRBC) were 25.4%, 8.4%, 0.8%, 1.8% respectively and 23.2%, 8.4%, 3.4%, 1.0% for female respectively.

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[English]
Iron Nutritional Status of Female Students in Kangnung National University: Kyukee Lee, Eunkyung Kim, Mikyung Kim; Korean J Community Nutr 1997;2(1):23-32. Published online February 28, 1997

Abstract PDF: To evaluate iron nutritional status of female college students, fasting blood samples were taken from 76 female students of Kangnung National University. Hemoglobin(Hb), hematocrit(Hct), serum iron(Fe), total iron binding capacity(TIBC) and serum ferritin concentrations were measured and transferrin saturation was calculated. Mean values for Hb, Hct, Fe, TIBC, TS and serum freeitin were 13.64+/-1.42g/dl, 40.99+/-4.31%, 103.0+/-33.3 microgram/dl, 395.3+/-9.07 microgram/dl, 26.58+/-9.07%and 26.76+/-17.5ng/ml, respectively. Prevalence of iron deficiency greatly varied by indices from 6.8% when judged by Hct to 26.0% by serum ferritin concentration. The Hb concentration was positively correlated with hematocrit (r=0.5402), serum iron(r=0.2819) and transferrin saturation(r=0.2777)(p<0.05). on the other hand, serum ferritin concentration showed significantly negative correlation with TIBC(r=-0.3196). Two-day dietary intake records were collected from subjects to estimate mean daily iron intake and bioavailability of dietary iron. Mean daily intake of iron was 13.15 mg and heme iron intake was 0.83 mg which was 6.4% of total iron intake. Total absorbable iron calculated by the method of Monsen was 1.27 mg and bioavailability of dietary iron was 9.6%. In the light of high prevalence of iron deficiency based of serum ferritin concentration and low bioavailability of iron in the diet, guidelines about diet should be made to increase the content and bioavailability of iron in the diet if female college students.

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