Analysis of Environmental Determinants of Heme and Nonheme Iron Intake in a National Sample of Polish Adolescents.

Dominika Skolmowska,Dominika Głąbska

doi:10.3390/ijerph18105252

Abstract

Intake of sufficient amounts of iron by adolescents is a matter of great concern. Therefore, it is crucial to determine the factors that may influence iron intake in this specific population. The present study aimed to analyze the environmental determinants of the intake of heme and nonheme iron in a national homogenous sample of Polish adolescents. Adolescents (aged 15–20 years) were randomly chosen from all the regions of Poland by performing a sampling of secondary schools (random quota sampling). The total iron intake, as well as the intake of heme iron, nonheme iron, animal iron, plant iron, and iron from various food products, was assessed among 1385 female respondents and 1025 male respondents using the validated IRON Intake Calculation—Food Frequency Questionnaire (IRONIC-FFQ). The intake was compared between the subgroups stratified by meat intake in the region, gross domestic product (GDP) in the region, and size of the city (rural vs. urban environment). It was observed that meat intake in the region did not influence the intake of total iron, as well as the intake of heme iron, nonheme iron, animal iron, plant iron, and iron from various food products (p > 0.05). However, GDP and the size of the city were determined as the most influencing factors, as they were associated with iron intake in both female and male adolescents, with the most prominent differences between the subgroups found in the case of females. Female adolescents from high-GDP regions had significantly higher intake of heme iron (p = 0.0047) and animal iron (p = 0.0029), and lower intake of nonheme iron compared to those from low-GDP regions (p = 0.0342). The total iron intake was higher among female adolescents who were from medium cities than those from big cities (p = 0.0350), but significantly higher animal iron intake (p = 0.0404) and plant iron intake (p = 0.0385) were observed among females from villages and small towns compared to females from other groups. Based on the results, it may be concluded that size of the city and the economic status of the region are the most important environmental determinants of iron intake in adolescents and, hence, they should be taken into account while developing educational programs, especially for the female adolescent population.

Highlights

It may be concluded that size of the city and the economic status of the region are the most important environmental determinants of iron intake in adolescents and, they should be taken into account while developing educational programs, especially for the female adolescent population
There was no difference of intake of iron forms in the subgroups of female adolescents from the regions with low and high meat intake
Female adolescents from the regions with high meat intake were characterized by higher iron intake from fat, comparing to female adolescents from the regions with low meat intake (p = 0.0087), but not by higher iron intake from meat products (p = 0.8849)

Summary

Introduction

Adolescence is a unique stage of life marked by biological, cognitive, and social changes [1]. During this period, health behaviors, including dietary choices, are most vulnerable [2] and may be influenced by both individual and environmental factors [3]. Environmental factors, in particular, may be decisive of food choices, as these factors affect the availability and choices of food products and the development of specific preferences [4]. Environment can be distinguished into four different types as follows: physical, political, sociocultural, and economic [5].

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Discussion

Conclusion