Korean Journal of Community Nutrition

Original Articles

[English]
The Use of Iron Supplements of Pregnant Women and Pregnancy Outcome: Ji Hyun Cho, Hong Seok Ahn, Hyun Sook Bae; Korean J Community Nutr 2009;14(3):327-339. Published online June 30, 2009

Abstract PDF: It is known that Korean pregnant women take iron supplements at a higher than the recommended level. This study was designed to provide data on current iron intake levels both from food sources and supplement to better guide iron supplement use during pregnancy. We also explored associations of iron supplement intake levels with varioussociocultural factors and pregnancy outcomes. Dietary intakes of 510 pregnant women were assessed by a validated 102- item food frequency questionnaire, and information on types and amounts of nutritional supplement intakes were also attained. While dietary intake levels of most nutrients exceeded the KDRIs (Korea Dietary Reference Intakes: EAR: Estimated Average Requirements), folate fell short of the KDRIs. A total of 428 women (83.9%) reported to take iron supplement. The pregnant women were divided into the three groups (group I: Fe supplement intake < or = EAR, group II: EAR< Fe supplement intake < or = 3 times of EAR, group III: 3 times of EAR< Fe supplement intake). The mean dietary intake of iron was 24% of the total iron intake for pregnant women. Iron intake from food was not significantly different among I, II, and III. In case of iron intake from supplements, the most frequent dose (34.1%) was 90-100 mg/day, and the mean iron supplement intake was 362% of the EAR. The study findings showed that those with higher levels of iron supplements had better meal quality measured by NAR (Nutrient Adequacy Ratio) and INQ (Index of Nutrient Quality). In addition iron supplement intake levels were significantly related to age (20s: 66.5 +/- 38.6 mg/day, 30s: 77.3 +/- 47.8 mg/ day, p< 0.0116) and experience of childbirth (1st pregnancy: 70.9 +/- 41.2 mg/day, 2nd pregnancy: 64.5 +/- 39.5 mg/day, > or = 3rd pregnancy: 94.4 +/- 63.8 mg/day, p< 0.005). However, no significant difference was found between iron supplement intake levels and various pregnancy outcomes including birth weight, birth height, gestational age, weight gain during pregnancy, and jaundice. It is worrisome that iron intake by supplement use greatly exceeded the EAR, suggesting the need of appropriate guidelines for iron supplement intake during pregnancy. Thus iron overdose from supplements in pregnancy should be considered as a serious condition.

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[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]
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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