Abstract
Objectives
To assess the following relations in women of reproductive age: 1) food security (FS) and iron status, 2) iron status and depressive symptoms (DS), 3) FS and DS and if iron status mediates this relation.
Methods
From the NHANES 2005–2010 cycles, we included 2507 non-pregnant women (20–44 yrs) with complete data for iron biomarkers, DS (Patient Health Questionnaire-9), FS (Food Security Survey Module), BMI, and sociodemographic variables. Ferritin (Ft), transferrin receptor (TfR), body iron (BI) and hemoglobin (Hb) were used to classify iron sufficient (IS), ID, and ID anemic (IDA). Logistic regression models were run (entire sample and within poverty income ratio (PIR) categories). A mediation model was also run. Age, race/ethnicity, marital status, total number of people in the household, PIR, education level, health insurance, parity, BMI, welfare status, and antidepressant use were potential covariates.
Results
The prevalence of ID was 43% (Ft), 2% (TfR), 37% (BI) and of anemia, 9% (Hb); IDA ranged from 19–77%. In adjusted models: 1) those with food insecurity (FIS) were 2.58 times (95% CI: 1.53–4.35) more likely to be ID (TfR); those in the lowest PIR and with FIS were 1.46 (95% CI: 1.06–2.01) (Ft), 4.00 (1.80–8.88) (TfR), and 1.43 (1.06–1.93) (BI) times more likely to be ID; 2) ID in the lowest PIR were 2.84 (95% CI:1.24–6.51) times more likely to have higher DS; 3) those with low FS had increased risk for moderate and severe DS (2.17 (95% CI: 1.28–3.68) and 3.44 (95% CI: 1.55–7.63)), and for those with very low FS, the risk for mild, moderate, and severe DS was 2.26 (95% CI: 1.20–4.24), 3.10 (95% CI: 1.67–5.76), and 9.01 (95% CI: 4.87–16.64), respectively. Iron status did not mediate the relation between FS and DS.
Conclusions
Women with FIS are at increased risk of ID and DS compared to FS women, and ID women are at increased risk of DS compared to IS women. However, iron status did not mediate the relation between FS and DS. These risks are higher in those with the lowest PIR.
Funding Sources
Internal Penn State funds.