Abstract
Whether being overweight or obese is associated with increased risk of iron deficiency anemia (IDA) remains controversial. We evaluated the dietary intakes and risk for IDA in relation to body mass index (BMI). One thousand two hundred and seventy-four females aged ≥19 years, enrolled in the third Nutrition and Health Survey in Taiwan (NAHSIT) 2005–2008, were selected. Half of the women were either overweight (24.0%) or obese (25.3%). The overall prevalence of anemia, iron deficiency and IDA among adult women was 19.5%, 8.6% and 6.2%. BMI showed a protective effect on IDA: overweight (odds ratio, OR: 0.365 (0.181–0.736)) and obese (OR: 0.480 (0.259–0.891)) when compared with normal weight. Univariate analysis identified increased IDA risk for overweight/obese women who consumed higher dietary fat but lower carbohydrate (CHO) (OR: 10.119 (1.267–80.79)). No such relationship was found in IDA women with normal weight (OR: 0.375 (0.036–4.022)). Analysis of interaction(s) showed individuals within the highest BMI tertile (T3) had the lowest risk for IDA and the risk increased with increasing tertile groups of fat/CHO ratio; OR 0.381 (0.144–1.008; p = 0.051), 0.370 (0.133–1.026; p = 0.056) and 0.748 (0.314–1.783; p = 0.513); for T1, T2 and T3, respectively. In conclusion, a protective effect of BMI on IDA may be attenuated in women who had increased fat/CHO ratio.
Highlights
A possible relationship between obesity and hypoferremia has recently been described in children [1,2,3]and women [4,5,6,7,8,9,10]
Women with MetS had higher mean serum ferritin levels compared with healthy individuals; 172 (4.2) ng/mL and 120 (2.6) ng/mL, respectively
This suggests that reproductive-aged women who were underweight or normal weight were more likely to develop iron deficiency anemia (IDA) than post-menopausal overweight/obese women
Summary
A possible relationship between obesity and hypoferremia has recently been described in children [1,2,3]and women [4,5,6,7,8,9,10]. This study supports the view that hypoferremia is associated with obesity, but the higher Hb levels observed in overweigh/obese indicates that sufficient iron is available for erythropoiesis [15]. Hypoferremia is defined as low serum iron concentrations and is a common response to systemic infection or chronic inflammation [16]. Obesity-related hypoferremia, on the other hand, is in part due to low-grade inflammation. Inflammatory mediators such as interleukin-6 (IL-6) and interleukin-10 (IL-10) play a key role in iron homeostasis. IL-6 promotes the development of obesity-related hypoferremia by targeting the hepcidin-ferroportin-1 axis [17]. The consensus is that elevated hepcidin levels promote the development of obesity-related hypoferremia.
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