Greater prevalence of iron deficiency in overweight and obese children and adolescents

Abstract

OBJECTIVE: To assess whether overweight children and adolescents, who often have poor dietary habits, are at increased risk of iron deficiency (ID). METHODS:The study sample included 321 children and adolescents followed in two endocrine centers in Israel between 1999 and 2001. The subjects were divided into three groups on the basis of body mass index (BMI) for age and gender as follows: group 1FBMI below 85th percentile (normal weight); group 2FBMI above 85th, but below 97th percentile (overweight); and group 3FBMI above 97th percentile (obese). ID was defined as iron levels o8 mmol/l (45 mcg/dl), and iron-deficiency anemia (IDA) was defined as ID and hemoglobin level below 2 standard deviation score (SDS) for the mean for age and gender. RESULTS: Iron levels below 8 mmol/l (45 mcg/dl) were noted in 38.8% of the obese children and 12.1% of the overweight children, compared with 4.4% of the normal-weight group (Po0.001). There was a significant negative correlation of low iron levels with BMI SDS (r ¼ À0.44, Po0.001), but not with age or gender. Among the children with ID, 26.6% also had IDA. Groups 1, 2, and 3 accounted for 6.7%, 35%, and 58.3% of the children with IDA, respectively. CONCLUSIONS: ID is common in overweight and obese children. A significantly greater proportion of obese than normalweight children have IDA. Insufficient dietary intake of iron, whether absolute or relative to body mass, and increased iron needs may be a result of unbalanced nutrition or repeated short-term restrictive diets. Because of potentially harmful effects of ID, obese children should be routinely screened and treated as necessary.

Adiposity in women and children from transition countries predicts decreased iron absorption, iron deficiency and a reduced response to iron fortification

“…This is consistent with previous studies in children in industrialized countries [13][14][15][16][17][18] reporting an inverse relationship between iron status and adiposity, For example, in the NHANES III sample of 9698 older US children, where 14% were at risk for overweight, 10% were overweight and 3% were iron deficient, those at risk for overweight and who were overweight were twice as likely to be iron deficient compared to those not overweight. 17 Our data demonstrate this same relationship exists in children in transition countries with higher rates of iron deficiency and lower rates of adiposity.…”

“…11 In many lower income countries, the prevalence of overweight is increasing at 2-4 times the rate of the industrialized world. 12 Studies in industrialized countries have consistently found higher rates of iron deficiency in overweight children [13][14][15][16][17][18] and adults. [19][20][21][22][23] Although the mechanism is unclear, this may be due to lower iron intakes and/or increased iron requirements in overweight individuals.…”

Inflammation and iron deficiency in the hypoferremia of obesity

“…Among the proposed causes are deficient iron intake from an iron poor diet, 2 and deficient iron stores owing to greater iron requirements in obese adults because of their larger blood volume. 3,9,10 The relationship between serum iron and dietary iron intake among obese adults has not been previously examined in large studies. Also, since obesity is considered a chronic inflammatory state, 11 inflammatory-mediated sequestration of iron in the reticuloendothelial system, with resultant hypoferremia despite adequate or even increased iron stores could play a role in the hypoferremia of obesity.…”

Effects of trace elements and calcium on diabetes and obesity, and their complications: Protective effect of dairy products – A mini-review

“…First studies on Fe status in obese subjects showed a high prevalence of deficiency [14,19]; however, Fe status assessment only relied on plasma Fe. The measurement of tissue storage parameters of Fe gives far lower values [24].…”