• Journal of Nutrition and Health
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• v.30 no.8
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• pp.960-975
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• 1997

This study was carried out to evaluate the iron nutrition status of 212 middle school students(106 males and 106 females) residing in Seoul(13-14 years old ) using eating patterns and a measurement of anthropometrical determination and hematological indices. Fasting blood samples were taken from all subjects, serum iron (SI) and total iron binding capacity(TIBC) concentrations were measured, and transferrin saturation(TS) levels were calculated. Iron and other nutrient intakes were estimated by a semi-quantitative frequency questionnaire. The level of TS(%) which was calculated with TIBC and SI in females(20.4$\mu\textrm{g}$/dl) was significantly lower(p<0.050 than that of males (27.4$\mu\textrm{g}$/㎗). The prevalence of iron deficiency was found to be 36.7% when defined by TS(%) (<05%). Mean daily intake of total iron in the study subjects was 14mg and heme iron intake was 5.4mg(38.1%) . There was a significant negative correlation between the level of SI and the income level and a positive correlation with the level of TIBC and the income level. TIBC had a positive correlation with the anthropometric variables(Ht, Wt, BMI, RI and PIBW). SI and TS had a negative correlation with body fat percentage. There was a positive correlation between energy intake and TIBC only among females. The logistic regression analysis revealed that income level, body fat percentage , weight and energy intake were major determinants of low SI levels. Among the determinants of abnormal TIBC levels were weight , height, income level and energy intake. Finally , among those of low TS% were iron and energy intake and income level. These observations suggest that physical status, body fat percentage energy and iron intakes and income level are risk factors for iron-deficiency anemia among the middle school students in Seoul.

• Journal of Nutrition and Health
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• v.33 no.5
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• pp.532-539
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• 2000

The purpose of this research is to assess th iron nutritional status of pregnant women and to evaluate the appropriateness of the present cut off levels of hemoglobin(Hgb), hematocrit(Hct) and total iron binding capacity(TIBC) for assessing iron deficiency status. Pregnant women who were visiting public helath centers in Ulsan were interviewed and agreed to attend the study. Blood sample was taken and biochemical analysis of blood was performed. The collected data were classified into 3 trimesters by gestational age and then statistical analysis was performed. The prevalence of anemia in all subjects was 32.3% by WHO criteria(Hgb < 11.0g/dl) and 17.8% of all subjects was iron deficient anemia by CDC criteria(Hgb < 11.0/dl and serum ferritin < 12.0ug/l). Since the iron deficient anemia generally occures at the last stage of iron deficiency, it is not efficient to diagnose and prevent the iron deficient anemia in pregnant women by using the present cut off level of Hgb. Therefore, the new cut off level of iron status indices is necessary for assessing iron deficiency in early pregnancy before manifestation of anemia and for reducing the prevalence of anemia in later pregnancy. For this reason, the present cut off levels of iron status indices were estimated and compared by assessing the iron deficiency judged by serum ferritin level (<12.0ug/l)as true iron deficiency. It follows from the results of this research that present cut off levels of Hgb, Hct and TIBC were very insensitive in identifying the subjection with iron deficiency. The appropriate cut off levels of Hgb were 11.5g/dl for total period of pregnancy, 12.0g/dl for 1st and 3rd trimester, and 11.5g/dl for 2nd trimester. The cut off level of Hct was 34.0% for total period for pregnancy, 35.0% for 1st trimester, and 34.0% for 2nd and 3rd trimester. The cut off level of TIBC was 400ug/dl for total period, 360ug/dl for 1st 2nd trimester, and 450ug/dl for 3rd trimester.

• Preventive Nutrition and Food Science
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• v.8 no.4
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• pp.406-411
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• 2003

The objective of this study was to investigate the effects of iron supplementation and nutrition education on the iron status and anemia of middle school girls in Ulsan city in Korea. The subjects were already diagnosed as having anemia (hemoglobin < 12 g/dL) or iron deficiency (ferritin < 12 ng/mL and/or transferrin sataturation < 14 %). Over a period of three months, one iron tablet (80 mg Fe as ferrous sulfate/day) was administered to the iron deficient subjects and two tablets (160 mg Fe as ferrous sulfate/day) were administered to the anemia subjects. Total calorie intake of subjects was 82.1 % of RDA. The iron intake of subjects was 91.3 % of RDA and the Ca intake was 78.8 % of RDA. The basal hemoglobin concentration of subjects averaged 12.8 1.2 g/dL, and this increased significantly (p < 0.001) to 13.2 0.9 g/dL after iron supplementation. The basal ferritin concentrations were 14.9 14.2 ng/mL and these significantly increased to 26.6 19.8 ng/mL (p < 0.001). The level of total iron binding protein (TIBC) significantly decreased from the initial 523.1 108.7 $\mu\textrm{g}$/dL to 462.2 90.2 $\mu\textrm{g}$/dL (p < 0.001) after iron supplementation. Anemia symptoms such as‘Being bruised easily’, ‘Inflamed inner mouth’, and ‘Pale face’ improved significantly after iron supplementation in the subjects. There was a negative correlation between their class & year ranking and serum iron level, transferrin saturation after nutritional education and iron supplementation. It was shown, therefore, that the higher the improvement of their anemia level after iron supplementation, the higher their academic performance. It was shown that there was some improvement of their dietary attitudes after nutritional education, and that their serum level related to anemia symptoms and iron nutrition was improved after iron supplementation.

• Journal of Physiology & Pathology in Korean Medicine
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• v.20 no.3
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• pp.638-641
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• 2006

Iron is the required microelement supporting life and is the main component of hemoglobin. Thus iron has affinity with exercise capacity. Iron metabolism turbulence induced by exercise is one of causes of hematopoietic hypofunction. Results of the experiment showed that long-term treadmill exercise of progressive loading significantly decreased levels of erythrocyte indexes, serum iron, serum ferritin and significantly increased serum transferrin level. Nutrition supplement could significantly retard the variations, and Exercise +Nutrition group have higher levels of erythrocyte indexes, serum iron, serum ferritin and lower level of serum transferrin than Exercise group. The results indicated that nutrition supplement have function of prevent and cure on iron metabolism turbulence induced by exercise, furthermore significantly enhance hemoglobin level in rats.

• Journal of Nutrition and Health
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• v.35 no.9
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• pp.919-925
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• 2002

Iron deficiency is a severe nutritional problem in the world. Coffee intake of the people is increasing every year and it can increase the loss of several essential body minerals including iron. Either iron deficiency or coffee intake may increase the oxidative stress of the body. However, the effect of iron deficiency and/or coffee intake on peroxidation have not been studied much. Therefore, the aim of this study was to investigate the effect of coffee intake on oxidative stress and antioxidative enzyme activities of iron-deficient rats. Forty-eight male rats of Sprague-Dawley strain were divided into two groups by dietary iron levels. Iron deficient group were fed 5 ppm iron diet and iron-sufficient group were fed 50 ppm iron diet. Each iron group were divided into three sub-groups by coffee levels (0%, 1%, 4%) included in the experimental diet. The experimental diets were fed for 4 weeks. The hemoglobin level was significantly low in iron deficient group and the level was exacerbated by high coffee intake. The malondialdehyde concentration of the plasma and liver were not affected by iron or coffee level in this study. However, plasma aspartate aminotransferase and alanine aminotransferase, the indicator of the liver damage, were increased by high coffee intake. The erythrocyte and liver superoxide dismutase (SOD) activities were elevated in iron deficient groups. Coffee intake increased erythrocyte SOD activity in iron sufficient groups. Glutathione peroxidase and catalase activities were not influenced much by either iron or coffee intake. In conclusion, high coffee intake in iron deficiency may not only increase the anemia symptoms, but also may increase the oxidative stress of the body.(Korean J Nutrition 35(9) : 919~925, 2002)

• Journal of Nutrition and Health
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• v.32 no.7
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• pp.787-792
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• 1999

The purpose of this study was to estimate the iron availability and to analyze dietary factors which influence hematological indices of 130 female adolescents with iron deficiency anemia. Intakes of iron and other nutrients were estimated using a self-administrated questionnaire combined with the 24-hour recall mehtod and iron availability was calculated by Monsen's method. Mean daily intakes of calorie, protein and vitamin C were 1631.0kcal(77.7% of RDA), 54.7g(84.2% of RDA) and 45.7mg(83.0% of RDA), respectively. In terms of iron, mean daily intake was 8.7mg(48.3% of RDA) and heme iron intake was 3.0mg which correspond to 34% of total iron intake. The amount of total absorbable iron was 1.5mg and the estimated bioavailability of dietary iron was 17.2%. In summary, intake of several nutrients for most of the subjects were under RDA. Dietary factors affecting hematological indices were analyzed by stepwise multiple regression. Intake of vitamin C was a major determinant of Hb level, while both intake of enhancing factor and iron availability were major determinants of serum ferritin level. In conclusion proper nutritional education and guidance for iron deficiency anemic female adoalescent needs to be developed and to improve their iron storage should be increased intakes of enhancing factors, female adoalescents.

• Journal of Nutrition and Health
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• v.32 no.8
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• pp.946-956
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• 1999

The iron nutritional status of 328(20-70 years old) women in Seoul and Puyo areas was evaluated using a dietary information and a measurement of hematological indices. The serum iron was measured by Red Blood Cell(RBC), Hemoglobin(Hb), Hematocrit(Hct), Serum Iron(S-Fe), Total Iron Binding Capacity (TIBC), Transferrin Saturation(TS) and Serum Ferritin(SF) and was analyzed with the information obtained by interviews which included socio-demographic variables and the dietary pattern of the subjects. The mean Hb was 12.6 $\pm$ 1.21g/dl(Seoul : 12.4 $\pm$ 1.14g/dl, Puyo : 13.2 $\pm$ 1.28g/dl), Hct was 38.7 $\pm$ 3.84%(Seoul: 37.5 $\pm$ 3.28%, Puyo: 4.19 $\pm$ 3.48%), S-Fe was 76.8 $\pm$ 31.49ug/dl(Seoul: 68.8 $\pm$ 27.3ug/dl, Puyo: 78.8 $\pm$ 32.3ug/dl) and TIBC was 277.7 $\pm$ 86.15ug/dl(Seoul: 354.1 $\pm$ 129.8ug/dl, Puyo: 259.0 $\pm$ 59.55ug/dl). The mean Ts(%) was 30.9 $\pm$ 17.9% (Seoul: 21.7 $\pm$ 10.52%, Puyo: 33.2 $\pm$ 18.68%) and the level was significantly higher in Puyo women(p<0.05). The mean SF was 45.4 $\pm$ 46.21ng/ml(Seoul: 53.6 $\pm$ 50.21ng/ml, Puyo: 36.1 $\pm$ 39.83ng/ml). The Red Blood Cell(RBC) showed a negative correlation with age and Hb, Hct showed a negative correlation with education and income level. However TIBC showed a and total energy expenditure per day. Energy, protein, carbohydrate, iron and vit.C intake showed a positive correlation with Hb and Hct. In particular, heme iron showed a positive correlation with RBC and nonheme iron of Hb, income level and iron intake affected on the level of Hct. In Seoul women, the age of menarche affected on the level of TIBC, total energy expenditure affected on the level of Hct. In Seoul women, the age of menarche affected on the level of TIBC, total energy expenditure affected on the level of S-Fe.

• The Korean Journal of Nuclear Medicine
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• v.5 no.2
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• pp.19-40
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• 1971

Since the iron balance is maintained by regulated intestinal absorption rather than regulated excretion, there have been many reports concerning the factors which may influence the intestinal iron absorption. As the liver is the largest iron storage organ of the body, any hepatocellular damage may result in disturbances in iron metabolism, e,g., frequent co-existence of hemochromatosis and liver cirrhosis, or elevated serum iron level and increased iron absorption rate in patients with infectious hepatitis or cirrhosis. In one effort to demonstrate the influence of hepatocellular damage on intestinal iron absortion, the iron absorption rate was measured in the rabbits whose livers were injured by a single subcutaneous injection of carbon tetrachloride (doses ranging from 0.15 to 0.5cc per kg of body weight) or by a single irradiation of 2,000 to 16,000 rads with $^{60}Co$ on the liver locally. A single oral dose of $1{\mu}Ci\;of\;^{59}Fe$-citrate with 0.5mg of ferrous citrate was fed in the fasting state, 24 hours after hepatic damage had been induced, without any reducing or chelating agents, and stool was collected for one week thereafter. Serum iron levels, together with conventional liver function tests, were measured at 24, 48, 72, 120 and 168 hours after liver damage had been induced. All animals were sacrificed upon the completing of the one week's test period and tissue specimens were prepared for H-E and Gomori's iron stain. Following are the results. 1. Normal iron absorption rate of the rabbit was $41.72{\pm}3.61%$ when 0.5mg of iron was given in the fasting state, as measured by subtracting the amount recovered in stool collected for 7 days from the amount given. The test period of 7 days is adequate, for only 1% of the iron given was excreted thereafter. 2. The intestinal iron absorption rate and serum iron level were significantly increased when the animal was poisoned by a single subcutaneous injection of 0.15cc. per kg. of body weight of carbon tetrachloride or more, or the liver was irradiated with a single dose of 12,000 rads or more. The results of liver function tests which were done simultaneously remained within normal limit except SGOT and SGPT which were somewhat increased. 3. In each case, there has been good correlation between the extent of liver cell damage and degree of increased iron absorption rate or serum iron level. 4. The method of liver damage appeared to make no obvious difference in the pattern of iron deposit in liver. This may be partly due to the fact that tissue specimens were obtained too late, for by this time the elevated serum iron level had returned within normal range and the pathological changes were almost healed. 5. The possible factors and relationship between intestinal iron absorption and hepatic parenchymal cell damage has been discussed.

• Journal of Nutrition and Health
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• v.35 no.2
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• pp.223-228
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• 2002

The purpose of this study was to investigate the relationship between iron deficiency without anemia and physical performance in healthy women aged 20-21 yrs. Ten subjects with normal iron stores (serum ferritin $\geq$ 12$\mu\textrm{g}$/L: iron-sufficient group) and 11 subjects with iron depletion without anemia (serum ferritin < 12 $\mu\textrm{g}$/L and serum hemoglobin > 120 g/L: iron-depleted group) were chosen from a group of 50 women and were given physical-performance tests, including determinations of maximum oxygen consumption (VO$_2$ max) and ventilatory threshold. Iron status assessment included determination of hemoglobin, hematocrit, seam ferritin, total iron-binding rapacity, serum iron and transferrin saturation values. Dietary iron intake was assessed based on seven-day food intake records written by the subjects. Physical activity level was estimated by frequency questionnaires and two-week physical activity records were compiled daily by the subjects. Blood ferritin concentration was significantly lower in the iron-depleted group than in the iron-sufficient group (p < 0.05). However, other variables showing iron status was not different between the groups. There were no significant differences in body size, body composition and physical activity levels between the groups. Daily dietary iron, total protein and animal protein intakes of the iron-sufficient group were significantly higher than those of the iron depleted group. However, no differences were found in the amount of dietary vitamin C and fiber between the groups. The values for VO$_2$max and VO$_2$max corrected with weight or fat-free mass were not different between the groups. However, the ventilatory threshold was significantly higher in the iron sufficient group than in the iron-depleted group. The lower ventilatory threshold in the iron-depleted group suggests that iron depletion without anemia could diminish aerobic physical performance in young women. In addition, a significant correlation of physical performance to serum fferritin level was shown only in the iron depleted group.

• Journal of Community Nutrition
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• v.6 no.2
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• pp.86-90
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• 2004

This study was designed to assess the iron nutritional status and anemia of middle school girls in Ulsan City, who were evaluated with a questionnaire, measurement of hematological indices. The average height and weight of respondents were 154.81$\pm$6.28cm and 48.51$\pm$8.80kg, respectively. Mean daily energy intake was 1815.72$\pm$328.04kcal and iron intake was 15.13$\pm$4.50mg. The average hemoglobin concentration of subjects was 11.98$\pm$0.78g/dl, and the average hematocrit level was 36.62$\pm$2.21%. Transferrin saturationTS (%) was 25.58$\pm$9.82%, and the ferritin level was 40.45$\pm$23.03ng/ml. Iron deficiency anemia among the subjects was estimated as 54.2% by using hemoglobin(<12g/이), 33.9% by hematocrit (<36%). The clinical symptoms relating anemia were measured with 4 Likert scale (1 : never, 4 : often), 'tired out easily (2.34$\pm$0.92)' was the highest, followed by 'feel dizzy always (2.26$\pm$0.85)', 'decreasing ability to concentrate (2.23$\pm$0.77)', 'get a cold easily (2.19$\pm$0.82)', 'have a headache (2.10$\pm$0.79)', 'poor memory (2.09$\pm$0.83)', 'no appetite (1.99$\pm$0.85)', As for the correlation between iron parameter and clinical symptoms related to anemia, the hematocrit rate was negatively correlated with 'get a cold easily', 'pale face', 'feeling blue', 'difficult digestion' (p<0.05). The level of iron was negatively correlated with 'tired out easily', 'get a cold easily' (p<0.05) and TS (%) were negatively correlated with 'tired out easily (p<0.05)', 'get a cold easily (p<0.01). Our study resulted that the prevalence of a iron deficiency of a middle school girl is very high, therefore the guidelines for iron supplementation and nutritional education to improve their iron status should be provided.