대한지역사회영양학회지 (Korean Journal of Community Nutrition)

대한지역사회영양학회 (The Korean Society of Community Nutrition)
권호 표지

임신기간 중 모체의 식사 철 섭취상태와 생체이용률 및 철 영양상태의 변화

A Study on the Changes of Maternal Dietary Iron Intakes, Its Bioavailability, and Iron Status during Pregnancy

  • 이정아 (전남대학교 생활과학대학 식품영양학과) ;
  • 이종임 (전남대학교 생활과학대학 식품영양학과) ;
  • 임현숙 (전남대학교 생활과학대학 식품영양학과)
  • 발행 : 2004.04.01
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

To increase both iron and enhancers for iron absorption through diets should be a basic strategy to sufficiently provide increased iron for pregnancy. Previous studies reported that iron intakes of Korean pregnant women were short and their iron status deteriorated as pregnancy progressed. However, there is little data about the bioavailability of dietary iron during pregnancy. Therefore, this study was conducted to determine the changes of dietary iron intakes, its bioavailability and iron status during pregnancy longitudinally in Korean women. A total of 151 pregnant women in their first trimester of pregnancy voluntarily participated. Among them, 72 women finished the research protocol during the second trimester and 55 did it during the third trimester. Dietary intakes of total iron, both non-heme and heme iron, as well as enhancers, both MPF (meat, poulty, and fish) and vitamin C, increased significantly as pregnancy progressed. As the results, bioavailability of dietary iron and iron absorbed increased significantly as pregnancy progressed. However, the amount of iron absorbed at each trimester did not meet considerably the iron needed during pregnancy. All five indices examined in the study, Hb level, Hct, serum concentrations of ferritin and sTfR (soluble transferrin receptor), and sTfR: ferritin ratio, showed that iron status of the subjects deteriorated as pregnancy progressed. The rate of anemia of the subjects increased as pregnancy progressed although more than 80% of the subjects took iron supplements after the 20th week of pregnancy. These results imply that it is needed to provide more iron especially, heme iron and dietary enhancers to prevent the deterioration of iron status during pregnancy. Future research on bioavailability of supplemental iron should be performed to determine the iron balance precisely.

키워드

참고문헌

  1. Ahn HS, Park YS, Park SH (1996): Ecological studies of maternal-infant nutrition and feeding in urban low income areas -Anthropo-metric measurements, dietary intakes, and serum lipids content/fatty acids composition of the pregnants- Korean J Community Nutr 1(2): 201-214
  2. Barrett JF, Whittaker PG, Williams JG, Lind T (1994): Absorption of non-haem iron from food during normal pregnancy. Br Medical J 309(6947): 79-82 https://doi.org/10.1136/bmj.309.6947.79
  3. Bjorn-Rasmussen E (1974): Iron absorption from wheat bread-influence of various amounts of bran. Nutr Metabol 19: 101-108
  4. CDC (Centers for Disease Control) (1989): CDC criteria for anemia in children and childbearing-aged women. Morbid Mortal Week Rep 38: 400-404
  5. Cook JD, Monsen ER (1976): Food iron absorption in human subjects. III. Comparison of the effects of animal protein on nonheme iron absorption. Am J Clin Nutr 29: 859-867
  6. Cook JD, Skikne BS (1989): Iron deficiency: definition and diagnosis. J Int Med 226: 349-355 https://doi.org/10.1111/j.1365-2796.1989.tb01408.x
  7. Disler PB, Lynch SR, Charlton RW, Torrance JD, Bothwel TH, Walker RB, Mayet F (1975): The effect of tea on iron absorption. Gut 16: 193-199 https://doi.org/10.1136/gut.16.3.193
  8. ESWG (Expert Scientific Working Group) (1980): Summary of a report on assessment of the iron nutritional status of the United States population. Am J Clin Nutr 42: 1318-1330
  9. Hallberg L, Rossander-Hulten L (1991): Iron requirements in mens-truating women. Am J Clin Nutr 54: 1047-1058 https://doi.org/10.1093/ajcn/54.6.1047
  10. Hyun WJ, Lee JY, Kwak CS (1997): Dietary intakes and psychological stress of pregnant women in Taejon in relation to neonatal birth weight. Korean J Community Nutr 2(2): 169-178
  11. Jacob RA, Sanstead HH, Klevay LM, Johnson LK (1980): Utility of serum ferritin as a measure of iron deficiency in normal males undergoing repetitive phlebotomy. Blood 56: 786-791
  12. Kaneshige E (1981): Serum ferritin as an assessment of iron stores and other hematologic parameters during pregnancy. Obst Gyne 57: 238-242
  13. Kim EK, Lee KH (1998): Assessment of the intake and availability of dietary iron and nutrition knowledge in pregnant women. Korean J Community Nutr 3(1): 53-61
  14. Kim EK, Lee KH (1999): Iron status in pregnant women and their new-born infants. Korean J Nutr 32(7): 793-801
  15. Knight EM, Spurlock BG, Edwards CH, Johnson AA, Oyemade UJ(1994): Biochemical profile of African American women during three trimesters of pregnancy and at delivery. J Nutr 124: 943S-953S
  16. Korean Nutrition Society (2000): Recommended Dietary Allowances for Koreans, 7th ed. Jungang Press, Seoul
  17. Kye SH, Paik HY (1993): Iron nutriture and related dietary factors in apparently healthy young Korean women (2): Analysis of iron in major food items and assessment of intake and availability of dietary iron. Korean J Nutr 26(6): 703-714
  18. Layrisse M, Martinez-Torres C, Roche M (1968): Effect of interaction of various foods on iron absorption. Am J Clin Nutr 21: 1175-1182 https://doi.org/10.1093/ajcn/21.10.1175
  19. Lee KH, Kim EK, Kim MK (1997): Iron nutritional status of female students in Kangnung National University. Kor J Community Nutr 2(1): 23-32
  20. Lee J-I, Lim H-S (2001a): A longitudinal study on maternal iron and folate status during and after pregnancy in Korean women. Kor J Community Nutr 6(2): 182-191
  21. Lee J-I, Lim H-S (2001b): Iron status of pregnant women and evalua-ion of cut-off levels of Hb, Hct, TIBC, sTfR, sTfR: ferritin ratio for assessment of iron deficiency. Korean J Human Ecology 4(1) : 36-45
  22. Lee J-I, Lee J-A, Lim H-S. Morning sickness reduces dietary diversity, nutrient intakes, and infant outcome of pregnant women. Unpubli-shed
  23. Martinez-Torres C, Layriss M (1973): Nutritional factors in iron defi-ciency - food iron absorption. Clin Heamatol 2: 339
  24. Monsen E.R, Hallberg L, Layrisse M, Hegsted M, Cook JD, Mertz W, Finch CA (1978): Estimation of available dietary iron. Am J Clin Nutr 31: 134-141 https://doi.org/10.1093/ajcn/31.1.134
  25. Moore CV, DubachR (1951): Observationson the absorption of iron from foods tagged with radio-iron. Trans Assoc Am Phys 64: 245-252
  26. Nam HS, Ly SY (1992): A survey on iron intake and nutritional status of female college students of Chungnam National University. Korean J Nutr 25(5): 404-412
  27. Park J-A, Yoon J-S (2001): A screening tool for identifying high risk pregnant women of Fe deficiency anemia. Korean J Community Nutr 6(5): 734-743
  28. Raper NR, Rosernthal JC, Woteki CE (1984): Estimates of available iron in diets of individuals 1 year old and older in the Nationwide Food Consumption Survey. J Am Diet Assoc 84(7): 783-787
  29. Scholl TO, Hediger ML (1994): Anemia and iron-deficiency anemia: a complication of data on pregnancy outcome. Am J Clin Nutr 59: 492S-501S https://doi.org/10.1093/ajcn/59.2.492S
  30. Song MS, Lee YJ, Cho SS, Kim BC (1993): Statistical analysis using SAS, Seoul, Jayu Academy
  31. Song YS, Kim SH (1989): Nutritional status of rural women in relation to physical condition of offspring at birth. Korean J Nutr 22(6): 547-556
  32. Skikne BS, Ferguson BJ, Simpson K, Baynes RD, Cook JD (1990): Serum transferrin receptor distinguishes anemia of chronic disease from iron deficiency. Blood 76: 49-54
  33. Taylor DJ, Mallen C, McDougall N, Lind T (1982): Effect of iron sup-plementation on serum ferritin levels during and after pregnancy. Br J Obstet Gynecol 89: 1011-1017 https://doi.org/10.1111/j.1471-0528.1982.tb04656.x
  34. Tseng M, Chakraborty H, Robinson DT, Mendez M, Kohlmeier L (1997): Adjustment of iron intake for dietary enhancers and inhi-bitors in population studies: Bioavailable iron in rural and urban residing Russian women and children. J Nutr 127: 1456-1468 https://doi.org/10.1093/jn/127.8.1456
  35. USDA (United States Department of Agriculture), Human Nutrition Information Service (1992): Food Guide Pyramid, A Guide to Daily Food Choices, Home And Garden Bulletin No.252
  36. Worthington-Roberts B (1997): The role of maternal nutrition in the prevention of birth defects. J Am Diet Assoc 97: S184-S185
  37. Yip R, Johnson C, Dallman P (1984): Age-related changes in laboratory values used in the diagnosis of anemia and iron deficiency. Am J Clin Nutr 39: 427-436 https://doi.org/10.1093/ajcn/39.3.427
  38. Yu KH, Yoon JS (1999): A cross-sectional study of nutrient intakes by gestational age and pregnancy outcome (I). Korean J Nutr 32(8): 877-886
  39. Yu KH, Yoon JS (2000): Comparison and evaluation of hematological indices for assessment of iron nutritional status in Korean pregnant women (III). Korean J Nutr 33(5): 532-539
  40. Yu KH, Yoon JS, Hahn YS (1999): A cross-sectional study of bioche-mical analysis and assessment of iron deficiency by gestational age (II). Korean J Nutr 32 (8) : 887-896