Impact of menstrual blood loss and diet on iron deficiency among women in the UK

Women of childbearing age are at risk of Fe deficiency if insufficient dietary Fe is available to replace menstrual and other Fe losses. Haem Fe represents 10–15 % of dietary Fe intake in meat-rich diets but may contribute 40 % of the total absorbed Fe. The aim of the present study was to determine the relative effects of type of diet and menstrual Fe loss on Fe status in women. Ninety healthy premenopausal women were recruited according to their habitual diet: red meat, poultry/fish or lacto-ovo-vegetarian. Intake of Fe was determined by analysing 7 d duplicate diets, and menstrual Fe loss was measured using the alkaline haematin method. A substantial proportion of women (60 % red meat, 40 % lacto-ovo-vegetarian, 20 % poultry/fish) had low Fe stores (serum ferritin <10 μg/l), but the median serum ferritin concentration was significantly lower in the red meat group (6·8 μg/l (interquartile range 3·3, 16·25)) than in the poultry/fish group (17·5 μg/l (interquartile range 11·3, 22·4) (P<0·01). The mean and standard deviation of dietary Fe intake were significantly different between the groups (P=0·025); the red meat group had a significantly lower intake (10·9 (sd 4·3) mg/d) than the lacto-ovo-vegetarians (14·5 (sd 5·5) mg/d), whereas that of the poultry/fish group (12·8 (sd 5·1) mg/d) was not significantly different from the other groups. There was no relationship between total Fe intake and Fe status, but menstrual Fe loss (P=0·001) and dietary group (P=0·040) were significant predictors of Fe status: poultry/fish diets were associated with higher Fe stores than lacto-ovo-vegetarian diets. Identifying individuals with high menstrual losses should be a key component of strategies to prevent Fe deficiency.

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Iron nutrition in the UK: getting the balance right

Proceedings of The Nutrition Society ◽

10.1079/pns2004394 ◽

2004 ◽

Vol 63 (4) ◽

pp. 519-528 ◽

Cited By ~ 38

Author(s):

Susan J. Fairweather-Tait

Keyword(s):

Negative Impact ◽

Iron Nutrition ◽

Fe Deficiency ◽

Adaptive Responses ◽

Childbearing Age ◽

Related Factors ◽

High Fibre ◽

Single Meal ◽

Fe Homeostasis ◽

The Uk

Fe homeostasis is considered in the context of the UK diet, using information on Fe intake and status from the National Diet and Nutrition Surveys. The importance of assessing Fe availability rather than total Fe intake is discussed. Dietary and host-related factors that determine Fe bioavailability (Fe utilised for Hb production) are reviewed using information from single-meal studies. When adaptive responses are taken into consideration, foods associated with higher Fe status include meat (haem-Fe and the ‘meat factor’) and fruits and fruit juice (vitamin C). Foods that may have a negative impact include dairy products (Ca), high-fibre foods (phytate) and tea and coffee (polyphenols), but the effects are more apparent in groups with marginal Fe deficiency, such as women of childbearing age. Analysis of dietary intake data on a meal-by-meal basis is needed to predict the influence of changing dietary patterns on Fe nutrition in the UK. Current information suggests that in the UK Fe deficiency is a greater problem than Fe overload.

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The responses of serum transferrin receptors to iron supplements in subjects with iron-deficiency erythropoiesis and iron-deficiency anaemia

British Journal Of Nutrition ◽

10.1017/s0007114507797040 ◽

2008 ◽

Vol 99 (2) ◽

pp. 416-420 ◽

Cited By ~ 5

Author(s):

Xiao-Ming Lin ◽

Wei Tian ◽

Le Ma ◽

Zhu Long ◽

Juan Zhang ◽

...

Keyword(s):

Iron Deficiency ◽

Serum Ferritin ◽

Fe Deficiency ◽

Serum Transferrin ◽

Transferrin Receptors ◽

Women Of Childbearing Age ◽

Childbearing Age ◽

Iron Supplements ◽

Deficiency Anaemia ◽

Biochemical Indices

We aimed to study the response of serum transferrin receptors (sTfR) to Fe supplementation in women of childbearing age with Fe-deficiency erythropoiesis (IDE) and Fe-deficiency anaemia (IDA). Primary screening was performed in 942 women ranging in age from 18 to 45 years. After Fe-related biochemical indices such as serum ferritin, Zn protoporphyrin and Hb were determined, the subjects were divided into four groups: normal, Fe store depletion, IDE and IDA. A total of 131 women were randomly selected from the normal, IDE and IDA groups. Subsequently, seventy-six women with IDE and IDA were given various doses of Fe (14 mg/d for IDE; 28 mg/d for IDA) with ferrousl-threonate capsules for twelve consecutive weeks. After receiving Fe supplements, the levels of Fe and sTfR were determined at weeks 0, 3, 6, 9 and 12.The levels of sTfR in women of childbearing age with IDE and IDA were significantly higher than those in the normal group. After receiving Fe supplements, the levels of sTfR were significantly decreased in women of childbearing age with IDE and IDA, while the levels of serum ferritin were significantly increased. In conclusion, STfR can be used as a reliable indicator for assessing the efficacy of Fe supplements.

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Intravenous iron for the treatment of fatigue in nonanemic, premenopausal women with low serum ferritin concentration

Yearbook of Pediatrics ◽

10.1016/j.yped.2011.11.015 ◽

2013 ◽

Vol 2013 ◽

pp. 53-54

Author(s):

J.A. Stockman

Keyword(s):

Serum Ferritin ◽

Premenopausal Women ◽

Intravenous Iron ◽

Ferritin Concentration ◽

Serum Ferritin Concentration ◽

Low Serum

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Serum Ferritin Is Associated with Metabolic Syndrome and Red Meat Consumption

Oxidative Medicine and Cellular Longevity ◽

10.1155/2015/769739 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 12

Author(s):

Avila Felipe ◽

Echeverría Guadalupe ◽

Pérez Druso ◽

Martinez Carlos ◽

Strobel Pablo ◽

...

Keyword(s):

Metabolic Syndrome ◽

Serum Ferritin ◽

Wide Spectrum ◽

Hdl Cholesterol ◽

Meat Consumption ◽

Mean Value ◽

Red Meat ◽

Ferritin Concentration ◽

Stress Markers ◽

Serum Ferritin Concentration

Background and Aims. Hyperferritinemia has been related with a wide spectrum of pathologies, including diabetes, cardiovascular disease, neurodegenerative disorders, and metabolic syndrome. The aim of this study was to investigate the association between hyperferritinemia and iron consumption.Methods and Results. Serum ferritin concentration was evaluated in 66 presumed healthy men, along with other clinical and biochemical markers of chronic diseases. A three-day food questionnaire was applied for nutrition information. Hyperferritinemia was a condition found in 13.4% of the volunteers analyzed. Significant correlations were found between serum ferritin concentration and metabolic syndrome parameters (HDL cholesterol, triglycerides, and fasting glucose) as well as an increase of the serum ferritin mean value with the number of risk factors of metabolic syndrome. Also, oxidative stress markers (carbonyl groups, AOPP, and glycated hemoglobin), hepatic damage markers (GGT, SGOT), and parameters related to insulin resistance (HOMA, blood insulin, and blood glucose) correlate significantly with serum ferritin. Volunteers had an excessive iron intake, principally by bread consumption. Analyses of food intake showed that red meat consumption correlates significantly with serum ferritin.Conclusion. Red meat consumption, metabolic syndrome, and chronic disease markers are associated with hyperferritinemia in a population of Chilean men.

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Intravenous iron for the treatment of fatigue in nonanemic, premenopausal women with low serum ferritin concentration

Blood ◽

10.1182/blood-2011-04-346304 ◽

2011 ◽

Vol 118 (12) ◽

pp. 3222-3227 ◽

Cited By ~ 150

Author(s):

Pierre-Alexandre Krayenbuehl ◽

Edouard Battegay ◽

Christian Breymann ◽

Joerg Furrer ◽

Georg Schulthess

Keyword(s):

Placebo Group ◽

Serum Ferritin ◽

Premenopausal Women ◽

Intravenous Iron ◽

Controlled Study ◽

Iron Group ◽

Baseline Serum ◽

Ferritin Concentration ◽

Serum Ferritin Concentration ◽

Low Serum

Abstract This is the first study to investigate the efficacy of intravenous iron in treating fatigue in nonanemic patients with low serum ferritin concentration. In a randomized, double-blinded, placebo-controlled study, 90 premenopausal women presenting with fatigue, serum ferritin ≤ 50 ng/mL, and hemoglobin ≥ 120 g/L were randomized to receive either 800 mg of intravenous iron (III)–hydroxide sucrose or intravenous placebo. Fatigue and serum iron status were assessed at baseline and after 6 and 12 weeks. Median fatigue at baseline was 4.5 (on a 0-10 scale). Fatigue decreased during the initial 6 weeks by 1.1 in the iron group compared with 0.7 in the placebo group (P = .07). Efficacy of iron was bound to depleted iron stores: In patients with baseline serum ferritin ≤ 15 ng/mL, fatigue decreased by 1.8 in the iron group compared with 0.4 in the placebo group (P = .005), and 82% of iron-treated compared with 47% of placebo-treated patients reported improved fatigue (P = .03). Drug-associated adverse events were observed in 21% of iron-treated patients and in 7% of placebo-treated patients (P = .05); none of these events was serious. Intravenous administration of iron improved fatigue in iron-deficient, nonanemic women with a good safety and tolerability profile. The efficacy of intravenous iron was bound to a serum ferritin concentration ≤ 15 ng/mL. This study was registered at the International Standard Randomized Controlled Trial Number Register (www.isrctn.org) as ISRCTN78430425.

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Nutritional anaemia in pregnant Beninese women: consequences on the haematological profile of the newborn

British Journal Of Nutrition ◽

10.1079/bjn19870024 ◽

1987 ◽

Vol 57 (2) ◽

pp. 185-193 ◽

Cited By ~ 19

Author(s):

Serge Hercberg ◽

Pilar GalÁn ◽

Michel Chauliac ◽

Anne-Marie Masse-Raimbault ◽

Michel Devanlay ◽

...

Keyword(s):

Pregnant Women ◽

Serum Ferritin ◽

Transferrin Saturation ◽

Newborn Infants ◽

Folate Deficiency ◽

Fe Deficiency ◽

Ferritin Concentration ◽

Serum Ferritin Concentration ◽

Menstruating Women ◽

Hb Concentration

1. An assessment of iron and folic acid status, blood thick film and haemoglobin (Hb) electrophoresis was performed on 126 pregnant women (and their newborn infants) and in ninety-five menstruating women in Cotonou (Benin).2. Anaemia (according to the World Health Organization (1972)) was observed in 55% of pregnant women and in 39% of menstruating women.3. Fe-deficiency was defined as a low serum ferritin concentration (12μg/l or less), combined with a low transferrin saturation (less than 16%) or a high erythrocyte protoporphyrin level (more than 3 μg/g Hb), or both. A moderate elevation in the serum ferritin concentration (between 13 and 50 μg/l), associated with a low transferrin saturation or a high erythrocyte protoporphyrin level, or both, indicated Fe-deficiency in an inflammatory context. Fe-deficiency was present in 73% of pregnant women and in 41% of menstruating women.4. Folate deficiency (defined as erythrocyte folate below 160 μg/l) was observed in 45% of pregnant women.5. In pregnant women, anaemia was associated with Fe-deficiency in 83% of cases and with folate deficiency in 48% of cases.6. Haemoglobinopathies were mainly heterozygous and did not seem to contribute significantly to anaemia. Intensity of malaria was not related to Hb level, butPlasmodium falcipurumwas found in 99% of subjects.7. Hb concentration and mean corpuscular volume were significantly lower in babies born of Fe-deficient mothers than in babies born of Fe-sufficient mothers. Hb concentration in newborn infants was positively correlated with maternal serum ferritin.

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The role of red meat in the diet: nutrition and health benefits

Proceedings of The Nutrition Society ◽

10.1017/s0029665115004267 ◽

2015 ◽

Vol 75 (3) ◽

pp. 227-232 ◽

Cited By ~ 34

Author(s):

Laura Wyness

Keyword(s):

Weight Control ◽

Red Meat ◽

Food Sources ◽

Childbearing Age ◽

Short Supply ◽

Young Infants ◽

Varied Diet ◽

Alternative Food Sources ◽

The Uk

Red meat has been an important part of the human diet throughout human evolution. When included as part of a healthy, varied diet, red meat provides a rich source of high biological value protein and essential nutrients, some of which are more bioavailable than in alternative food sources. Particular nutrients in red meat have been identified as being in short supply in the diets of some groups of the population. The present paper discusses the role of red meat in the diets of young infants, adolescents, women of childbearing age and older adults and highlights key nutrients red meat can provide for these groups. The role of red meat in relation to satiety and weight control is discussed as the inclusion of lean red meat in a healthy, varied diet may help weight loss as part of an energy-reduced diet. A summary of the UK advice on the amount of red meat that can be consumed as part of a healthy, varied diet is also provided.

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Iron status in a general practice and its relationship to morbidity

British Journal Of Nutrition ◽

10.1079/bjn19790038 ◽

1979 ◽

Vol 41 (2) ◽

pp. 291-295 ◽

Cited By ~ 5

Author(s):

M. J. Leyland ◽

H. Harris ◽

P. J. Brown

Keyword(s):

General Practice ◽

Clinical Features ◽

Serum Ferritin ◽

Iron Status ◽

Geometric Mean ◽

Fe Deficiency ◽

Full Blood Count ◽

Control Group ◽

Ferritin Concentration ◽

Serum Ferritin Concentration

1. An epidemiological study of iron status in general practice has been undertaken. An age-sex register was established and a 10% stratified random sample (194 males and 220 females) of the patients above the age of 15 years was studied. A full blood count, serum Fe concentration, transferrin saturation and serum ferritin concentration were measured and correlated with clinical features associated with Fe deficiency.2. The geometric mean for serum ferritin for males was 77 μg/1 (20–196 μg/1) and for females 37 μg/1 (8–177 μg/1). A low serum ferritin (male < 30 μg/1, female < 20 μg/1) in the absence of anaemia was found in fifteen males and thirty-five females. In this group forty patients had clinical features which are aetiologically associated with Fe deficiency. The incidence of similar features in a control group of thirty-three patients was seven.3. It is suggested that this is indirect evidence that serum ferritin concentration is the most sensitive monitor of Fe status enabling the detection of pre-anaemic Fe deficiency.

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