Korean Journal of Community Nutrition

[English]
Iron Nutritional Status by ALAD Genotype and Intervention Study for Rural Area Residents: Hee Seon Kim, Min Kyung Kim, Sohee Kim, Sung Soo Lee, Byung Kook Lee; Korean J Community Nutr 2006;11(6):771-778. Published online December 31, 2006

Abstract PDF: Previous studies have suggested that delta-aminolevulinic acid dehydratase (ALAD) phenotype differently affect mineral metabolism. The objective of this study was to determine the effectiveness of 6-month iron supplementation as syrup of NaFeEDTA in improvement of iron status according to ALAD genotype. One hundred thirty adult women living in rural areas of Asan were provided NaFeEDTA syrup once a week for 6 months at the dose of 64mg Fe/week. Three hundred control subjects were observed during the study period. Fasting blood was obtained for analyzing hemoglobin (Hb) and zinc protophorphyrin (ZPP) and serum was analyzed for ferritin, iron and total iron capacity (TIBC) levels before and after iron supplementation. Ninety percent of ALAD 1-1 (ALAD1) and 10% of ALAD 1-2 (ALAD2) genotype were observed in the control group. However, in the intervention group, 98% showed ALAD1 while only 2% was ALAD2, which is significantly lower proportions of ALAD2 compared to the control group (p<0.01). The iron status of intervention group significantly improved except for ferritin and TIBC regardless of ALAD genotype, while the control group did not show any changes in iron status except for ZPP. ZPP concentration of the control group significantly increased in both ALAD1 and 2 while the intervention group showed significantly decreased ZPP after supplementation in ALAD1. Iron supplementation in the form of NaFeEDTA seems to be effective in reduction of ZPP levels although ALAD2 did not show significant changes due to the small number. However, it is difficult to make a conclusion from these results, and more specified further investigation is needed with more participants.

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[English]
A Study on the Changes of Maternal Dietary Iron Intakes, Its Bioavailability, and Iron Status during Pregnancy: Jeong A Lee, Jong Im Lee, Hyeon Sook Lim; Korean J Community Nutr 2004;9(2):142-150. Published online April 30, 2004

Abstract PDF: To increase both iron and enhancers for iron absorption through diets should be a basic strategy to sufficiently provide increased iron for pregnancy. Previous studies reported that iron intakes of Korean pregnant women were short and their iron status deteriorated as pregnancy progressed. However, there is little data about the bioavailability of dietary iron during pregnancy. Therefore, this study was conducted to determine the changes of dietary iron intakes, its bioa-vailability and iron status during pregnancy longitudinally in Korean women. A total of 151 pregnant women in their first trimester of pregnancy voluntarily participated. Among them, 72 women finished the research protocol during the second trimester and 55 did it during the third trimester. Dietary intakes of total iron, both non-heme and heme iron, as well as enhancers, both MPF (meat, poulty, and fish) and vitamin C, increased significantly as pregnancy progressed. As the results, bioavailability of dietary iron and iron absorbed increased significantly as pregnancy progressed. However, the amount of iron absorbed at each trimester did not meet considerably the iron needed during pregnancy. All five indices examined in the study, Hb level, Hct, serum concentrations of ferritin and sTfR (soluble transferrin receptor), and sTfR:ferritin ratio, showed that iron status of the subjects deteriorated as pregnancy progressed. The rate of anemia of the subjects increased as pregnancy progressed although more than 80% of the subjects took iron supplements after the 20th week of pregnancy. These results imply that it is needed to provide more iron especially, heme iron and dietary enhancers to prevent the deterioration of iron status during pregnancy. Future research on bioavaila-blility of supplemental iron should be performed to determine the iron balance precisely.

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[English]
The Iron Status and Diet Quality of Pregnant Women during the First Five Months of Pregnancy: Jin Sook Yoon, Jung A Park, Sook Mee Son; Korean J Community Nutr 2003;8(6):803-813. Published online December 31, 2003

Abstract PDF: Literature suggests that iron deficiency anemia is prevalent among pregnant women all over the world. This study was designed to evaluate the iron status of pregnant women during the fist five months, with the intention of determining ways to reduce the prevalence of iron deficiency anemia among pregnant women in Korea. We collected dietary information and measured the biochemical status of iron in 171 pregnant women over 16 weeks of gestation (= 16.7 +/- 2.34 week). Dietary intakes for 3 days were collected using the 24 hour recall and food record methods. The daily Fe intake was measured using the food frequency method. The Body Mass Index (BMI), calculated by using the pre-pregnancy weight and height, indicated that 31.3% of subjects were under-weight. We divided the subjects into normal and anemic group by using the serum ferritin levels. It appeared that the mean dietary intake of iron was 52.3% of the recommended level for pregnant women. The dietary quality evaluation showed that pregnant women ate only 58% of the recommended amount in the food groups of meat, fish, eggs, beans and milk and dairy products. The hematological indices showed that the mean Hemoglobin (Hb) was 11.9 g/dl, Hematocrit (Hct) was 35.1%, ferritin was 23.9 ng/ml, and transferrin was 297.3 microgram/dl. The dietary intake of iron was significantly lower and the vitamin C intake was significantly higher in the anemic group. The pre-pregnancy BMI was significantly lower in the anemic group. Variables affecting iron intake were the Fe intake frequency index and the food group score. The Fe index showed significantly positive correlation with the pre-pregnancy food intake and the food group score. Hb showed a significantly positive correlation with the prepregnancy food intake. We concluded that strategies to improve iron status be implemented in the pre-pregnant stage so as to reduce the prevalence of iron deficiency and that we should stress on the importance of an adequate diet as well as the maintenance of a heathy weight.

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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]
Iron Status Indices of Maternal, Umbilical Cord, Placenta and Birth Weight: Hyun Sook Bai, Geum Ju Lee, Min Sook Lee, Ju Ye Lee, Yong Mi Shin, Hong Seok Ahn; Korean J Community Nutr 2002;7(5):686-695. Published online October 31, 2002

Abstract PDF: The purpose of this study is to assess the maternal iron status during pregnancy and to evaluate the relationships between the iron indices of maternal, umbilical cord serum, placenta and pregnancy outcomes. Venous bloods samples were drawn from 54 pregnant women just before delivery and cord bloods of their newborn babies were collected immediately after birth. And also, placental tissues were extracted. We investigated the difference of the iron status indices of maternal, umbilical cord serum and placental tissue between two gestational age group (PT group, NT group : preterm delivery and normal term delivery at 34.9wk and 39.0wk of mean gestational length, respectively) and also assessed correlations of iron status indices of maternal, umbilical cord serum and placenta tissue. And lastly, we related between birth weight and iron status indices of maternal, umbilical cord serum and placental tissue. The concentrations of maternal serum ferritin and of placental iron were significantly higher in PT group (32.1 +/- 21.1 ng/ml, 68.5 +/- 16.7microgram / g), than those of NT group (20.8 +/- 11.6 ng / ml, 53.2 +/- 17.4 microgram / g) respectively (p < 0.001). However the serum ferritin of umbilical cord were significantly higher in NT group (PT : 109.4 +/- 65.7 ng/ml, NT : 147.0 +/- 56.8 ng / ml) than those of PT group (p < 0.05). Our results showed that a negative association between birth weight (r=-0.361) and maternal serum ferritin and that a positive association between birth weight and umbilical cord serum ferritin (r=0.261). Despite not a significant difference, there was tendency that highest concentration of maternal serum ferritin was associated with the lowest birth weight. These findings indicate that birth weight of newborn is dependent of multiple factors such as maternal iron status during pre-pregnancy, body size, general nutritional status. Although for women who enter pregnancy with low iron stores, enough intakes of iron during pregnancy could produce undesirable pregnancy outcome. Therefore we suggest for successful pregnancy outcome and delivery differential iron supplementation program will be carried out individual pregnant women on the basis of pre-pregnancy nutritional status.

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[English]
A Longitudinal Study on Maternal Iron and Folate Status During and After Pregnancy in Korean Women: Jong Im Lee, Hyeon Sook Lim; Korean J Community Nutr 2001;6(2):182-191. Published online May 31, 2001

Abstract PDF: Anemia in women during pregnancy and after delivery has been known to affect the mother, the fetus, and the infant's growth and health status. Studies examining, changes in iron and folate status associated with anemia during pregnancy and during pregnancy, and those supplements are stopped after postpartum. However, the effects of those have not been clearly determined in pregnant and lactating Korea women. Therefore, this study was performed to determine the changes in maternal iron and folate status during pregnancy and six months after delivery longitudinally in six pregnant women who consumed supplements from 20 wk to delivery. We concluded that the iron status deteriorated during pregnancy and especially was weak in the third trimester, but had a tendency to recovery after delivery. On the other hand, the folate status deteriorated in the first and second trimester and was good in the third trimester, but had a tendency to decrease after delivery. These results suggested that the iron status was not improved despite consuming total iron supplements of 50 mg/day through diets and supplements during the second half of the pregnancy. On the other hand, the folate status improved at the end of pregnancy by consuming folate supplements of a total of 800 mg/day through diets and supplements. However, folate status was poor in the first half of the pregnancy, and the tendency of folate status to decrease during postpartum was advanced. At the point in which iron and therefore supplementation is essential. However, the effects of supplement intake time and intake dosage need to be verified and the nutritional status changes of postpartum women should be carefully monitored.

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[English]
Nutritional Status of Iron of Elderly in Jeon-Ju Area: Eun Jung Joo, In Sook Kim, Eun A Seo; Korean J Community Nutr 2000;5(3):493-501. Published online September 30, 2000

Abstract PDF: The purpose of this study was to assess the nutritional status of iron of the elderly residing in the Jeonju area. The anthropometric parameters, nutrient intake and biochemical status of iron, were measured for 60 Korean elderly(23 elderly men and 37 elderly women aged 60 - 79 years old). The level of hemoglobin(Hb), hematocrint(Hct), serum iron(Fe), total iron binding capacity(TIBC) and serum ferritin(Ferritin) were measured and transferrin saturation(TFsaturation) was calculated. Mean values of Hb, Hct, Fe, TIBC, TFsaturation and Ferritin were 14.49+/-0.93g/dl, 42.47+/-2.59%, 125.48+/-52,.46 microgram/dl, 338.13+/-45.92 microgram/dl, 193.00+/-125.03 microgram/l in elderly men and 12.82+/-0.99 microgram/dl, 37.66+/-2.90%, 100.08+/-42.82 microgram/dl, 356.41+/-54.65 microgram/dl, and 99.35+/-117.22 microgram/l in elderly women, respectively. Prevalence of iron deficiency varied greatly with biochemical indices of iron. It was 13.0% when judged by Fe(60 microgram/dl) and TFsaturation(15%) whereas 34.78% by Hct(41%) in elderly men. However 13.5% of the elderly women showed iron depletion(Ferritin<20 microgram/l) and 43.2% showed suppressed erythropoiesis with iron deficiency(TIBC>360 microgram/dl). The anemic subjects assessed with TFsaturation(<15%) represented 13.5% of the elderly women, whereas 18.9% of the subjects possessed less than 12g/dl of Hb. The Hb concentration was positively correlated with Hct(r=0.980, p<0.001), Fe(r=0.384, p<0.01) and TFsaturation(r=0.349, p<0.01). On the other hand, Ferritin concentration showed a significantly negative correlation with TIBC(r=0.349, p<0.05) and a positive correlation with TFsaturation(r=0.362, p<0.01). Major food groups of iron intake in the elderly were vegetables, cereals, and fish. The mean daily intake of iron was not significantly different between elderly men and women(12.82mg vs 10.35mg). Intake of heme iron however, was significantly higher(p<0.01) in elderly men(1.03mg) than women(0.42mg). Total absorbable iron caculated by the method of Monsen was 0.55mg, 0.40mg in elderly men and women, respectively and bioavailability of dietary iron 4.29% and 3.87%.

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[English]
The Effect of Milk Supplementation on Bone Density and Iron Status of Elderly: Sook mee Son, Yeh Na Chon; Korean J Community Nutr 1998;3(5):715-721. Published online November 30, 1998

Abstract PDF: This study was performed to investigate how milk supplementation can benefit the elderly by increasing bone density but possibly harming the iron status concomitantly. Forty one elderly subjects over 65 years of age(male : 9, female : 32) participated. All subjects were apparently healthy, home staying and attending meal service for lunch at the welfare center. They were from low income area of Puchon city. One cup of milk per day was served for 10 months. The mean intake of calcium was significantly increased for females after milk supplementation. Males showed significantly increased means of triceps skinfold thickness, suprailiac skinfold thickness and waist circumference. Females showed significantly increased measurements fo three kinds of skinfold thickness, waist circumference, and hip circumference. There were no significant change in the mean bone density of lumbar spine(L2~L4), femoral neck, ward's triangle and torchanter, but the proportion of osteopenia estimated by the T score of lumbar spine bone density was lowered from 50.0% to 34.6% for females. The mean Hb level was significantly for males. The proportion of anemia estimated by Hb(<12g/dl), Hct(<36%) and serum ferritin(<15mg/ml) were increased from 17.2% to 51.7%, from 20.7% to 44.8% and from 10.3% to 17.2%, respectively for females. It looks like milk supplementation can effect the intakes of several nutrients considered to be commonly deficient in the Korean diet fo elderly people, increase some anthropometric measurements, and decrease the proportion of osteopenia. However it can have adverse effects on iron status of females.

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[English]
Iron Nutritional Status of Female college Students Residing in the Kyungin Area: Sook Mee Son, Su Im Sung; Korean J Community Nutr 1998;3(4):556-564. Published online October 31, 1998

Abstract PDF: The purpose of this study was to assess the iron nutritional status of college women residing in the Kyungin area. The anthropometric parameters, nutrient intake, and biochemical status of iron were measured for 102 college women. The mean height and weight were 160.3 cm and 52.4 kg, respectively. The proportion of subjects whose BMI was less than 20 was 41.3%. The proportion of subjects assessed as overweight(25 or =25%) assessed by the fat percent(FP) was 53.9%. The mean daily intake of iron was 13.90mg(77.1% of RDA), composed of 0.97mg of heme iron and 12.93mg of nonheme iron. the iron intake computed with the chemical analysis of food was 12.44mg(69.0% of RDA). When the sources of iron were grouped as rice(including bread), noodle, soup, side dish, and snack, noodle provided, 3.95mg of iron regarded as the highest amount. Subjects were taking 6.72mg(51.4% of RDA) of iron per day from main dishes(rice, bread and noddle). The fifty percent of the subjects showed iron depletion(serum ferritin<20ng/ml) and 33.4% showed suppressed erythropoiesis with iron deficiency(serum ferritin<10ng/ml). The anemic subjects assessed with transferrin saturation(<155) represented 33.3% of the test population, whereas 11.8% of the subjects possessed less than 12g/dl of hemoglobin. Subjects not satisfed with their body shape were having significantly lower amount of energy intake(p<0.05) than the subjects satisfied with their body shape. College women having mothers who graduated from university had a significantly decreased amount of energy, carbohydrates, fat and vitamin C(p<0.05). The mean RBC and serum iron of the subjects who were on a diet more than one mouth were lower than those of the subjects who were not on a diet(p<0.05).

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[English]
A Comparative Study on nutrient Intake, Anthropometric Data and Food Behavior in Children with Suboptimal Iron status and Normal children: Sook Mee Son, Jung Sook Yang; Korean J Community Nutr 1998;3(3):341-348. Published online August 31, 1998

Abstract PDF: This study was performed to investigated the difference in the nutritional status of normal children and children with suboptimal iron status. Two hundred and sixty children from 5th grade were divided into 2 groups(normal group and suboptimal group) according to the hematologic parameters of iron(RBC count, hemoglobin, serum ferritin). Normal group was composed of 71 male and 81 female and suboptimal group was consisted of 65 male and 43 female. Fat percentage of children from suboptimal group was 18.9%, which was significantly lower than 22.1% of normal group(p<0.05). TST and MAC of suboptimal group were also lower than those of normal group(p<0.05). Mean intakes of energy, protein, thiamin, riboflavin, iron were lower than those in normal group(p<0.05). suboptimal female students showed 1197.6 kcal of energy intake(63.0% of RDA) and 0.56 mg of thiamin intake(56% of RDA). Mean RBC count, hematocrit, hemoglobin, ferritin(p<0.01) and FEP(p<0.05) of suboptimal group were lower than those of normal group. Thirty-nine point seven percent of children from suboptimal group was observed with having gastrointestinal disease which was significantly higher than 22.1% of normal group.

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[English]
The Difference of Lead and Cadmium Concentration of Blood, Urine and Hair between Children with Suboptimal Iron Status and Normal Children: Sook Mee Son, Jung Sook Yang; Korean J Community Nutr 1998;3(2):167-173. Published online May 31, 1998

Abstract PDF: This study was performed to assess the lead and cadmium status of children residing in urbanfactory area and to see if there is a difference of lead and cadmium status between the group with normal iron status. The mean lead concentration of male hair was 9.55ppm which is significantly higher than 6.61 ppm that of female. The mean lead concentration of male urine sample was 0.04ppm, 10.3ppm and 48.14 microgram/L, which is higher than 0.08ppm, 6.08ppm and 20.69 microgram/L of normal group, respectively. In a suboptimal group the proportion of children whose urinary lead is higher than normal(35 microgram/L)was 87.3%, whereas 2.5% for a normal group. The mean cadmium concentration of male hair was 2.58ppm, which is higher than 2.48ppm that of a female. The mean cadmium concentration of erythrocyte, hair and urine was 0.25ppm, 2.65ppm and 38.83 microgram/L, which is higher than 0.20ppm, 2.40ppm and 19.78 microgram/L of the normal group, respectively. The proportion of children whose urinary cadmium level is higher than the low limit of risk of cadmium intoxication(40 microgram/L) was 21.4%, whereas 0% for a mormal group. Urinary lead and cadmium level showed significantly negative correlation with the RBC count, hematocrit, hemoglobin and serum ferritin, whereas they had significantly positive correlation with FEP/Hb(p<0.01). There was no correlation between the IQ and the level of lead and cadmium.

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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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