Inadequate Riboflavin Intake and Anemia Risk in a Chinese Population: Five-Year Follow Up of the Jiangsu Nutrition Study

Abstract

ObjectivesRiboflavin (vitamin B2) has been shown in animal studies to affect the absorption and metabolism of iron. Cross-sectional population studies show a relationship between riboflavin intake and anemia but prospective population studies are limited. The aim of the study was to determine the relationship between riboflavin intake and the risk of anemia in a Chinese cohort.MethodThe study used data from 1253 Chinese men and women who participated in two waves of the Jiangsu Nutrition Study (JIN), five years apart, in 2002 and 2007. Riboflavin intake and hemoglobin (Hb) were quantitatively assessed together with dietary patterns, lifestyle, socio-demographic and health-related factors.ResultsAt baseline, 97.2% of participants had inadequate riboflavin intake (below the estimate average requirement). Riboflavin intake was positively associated with anemia at baseline, but low riboflavin intake was associated with an increased risk of anemia at follow-up among those anemic at baseline. In the multivariate model, adjusting for demographic and lifestyle factors and dietary patterns, the relative risk and 95% confidence interval for anemia at follow-up, across quartiles of riboflavin intake were: 1, 0.82(0.54–1.23), 0.56(0.34–0.93), 0.52(0.28–0.98) (p for trend 0.021). There was a significant interaction between riboflavin and iron intake; when riboflavin intake was low, a high iron intake was associated with a lower probability of anemia at follow-up. This association disappeared when riboflavin intake was high.ConclusionInadequate riboflavin intake is common and increases the risk of anemia in Chinese adults. Given the interaction with iron intake correcting inadequate riboflavin intake may be a priority in the prevention of anemia, and population based measurement and intervention trials are required.

The Difference in Nutrient Intakes between Chinese and Mediterranean, Japanese and American Diets

“…Besides, vitamin B 2 intake was inadequate. Its deficiency has been shown to negatively affect iron absorption and utilization, which is associated with increased risk of anemia [ 38 ]. Consequently, a higher intake of fruit, vegetables, cereals, legumes, dairy and certain animal-source foods should be recommended.…”

Lactic acid bacteria as a cell factory for riboflavin production

“…According to Foley and colleagues () riboflavin supplementation can combat the progression of neurodegenerative conditions. Another study by Shi and colleagues () showed that inadequate riboflavin intake was associated with an increased risk of persistent anaemia. Riboflavin can act as a protectant from oxidative injury independently by the conversion of its reduced form to oxidized form, or as a component of glutathione redox cycle (Ashoori and Saedisomeolia, ).…”

“…A high prevalence of poor riboflavin status has been observed among adolescent girls in the United Kingdom and among the Irish population (O'Brien et al, 2001;Powers, 2003). Riboflavin deficiency is associated with impaired vision, reduced growth rate, increased levels of homocysteine with consequent cardiac risk (Moat et al, 2003), pre-eclampsia (Wacker et al, 2000), oxidative stress (Ashoori and Saedisomeolia, 2014) and anaemia (Shi et al, 2014). Riboflavin deficiency can lead to liver and skin damage, and changes in cerebral glucose metabolism (LeBlanc et al, 2011) with symptoms like hyperaemia, sore throat, oedema of oral and mucous membranes, cheilosis and glossitis (Wilson, 1983).…”

Vitamins and Minerals for Energy, Fatigue and Cognition: A Narrative Review of the Biochemical and Clinical Evidence

“…Anemia, a condition related to fatigue, is associated with low riboflavin status. For example, in 1253 adult Chinese individuals followed for 5 years, more than 97% had inadequate riboflavin intake at baseline and this was associated with an increased risk of anemia at follow-up [100]. High rates of marginal and deficient riboflavin status have been found in healthy women from both Canada and Malaysia and were indicative of a higher risk of anemia [101], which enhances the risk of associated fatigue symptoms.…”