• Journal of the Korean Home Economics Association
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• v.20 no.3
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• pp.35-43
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• 1982

The purpose of this survey was to investigate the nutrient and food intake and haematology of the latter half of pregnant women in Nam Hae Do. The nutrient intake study was performed by Twenty-four hour dietary recall method. As Haematology, RBC, Hb. and Hct were measured. 1. The results of nutritional survey were, 1) The mean nutrient intakes that were below the RDA were Protein, Calorie, Calcium and Iron. 2) The mean nutrient intakes that were above the RDA were Vitamin A, Thiamin, Riboflavin, Ascorbic acid. 3) Most of calorie and other nutrients were obtained from vegetable food sources. 4) Animal protein intake was 33% of total protein intake and most of this value was obtained from fish and shell fishes. 2. The extent of malnutrition was explained in terms of the amount of calorie, protein, calcium and iron. The results were, The predicted percentage of deficiency, in case of Calorie, 53.3% of total subjects. in case of Protein, 52% of total subjects. in case of Calcium, 78.7% of total subjects. in case of Iron, 54.7% of total subjects. 3. The results of Haematology were, 1) The mean level of RBC, Hb and Hct were 3.76$\times$106cm/㎣, 10.47gm%, and 32.56% 2) There were significant correlation between calorie intake and Hct level, protein intake and RBC level, Iron intake and MCHC level.

• Journal of Nutrition and Health
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• v.27 no.5
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• pp.451-459
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• 1994

This study was performed to investigate the effect of sources of protein on iron bioavailability in 10 healthy young Korean women. The 18-day metabolic study consisted of a 6-day adaptation period, 6-day moderate protein(60g protein/day, 18mg Fe/day) and 6-day high protein period(90g protein/day, 18mg Fe/day). During the moderate and high protein period, 5 subjects were fed the high plant protein meals(80% plant protein). Fecal excretion of dietary iron was significantly higher(p<0.05) in high protein high plant diet group(HPP, 9.48$\pm$1.61mg/day) than in high protein high animal diet group (HPA, 14.40$\pm$0.89mg/day). Apparent absorption and bioavailability of iron was also significantly higher(p<0.10) in HPA(40.7$\pm$5.3%, 6.46$\pm$1.61mg/day) than in HPP(14.4$\pm$5.3%, 2.39$\pm$0.89mg/day). But there was no significant difference between the high animal protein group and high plant protein group in moderate protein period. Serum iron concentration and transferrin saturation increased as animal protein intake increased, from 106.0$\pm$5.1ug/이 and 30.6$\pm$1.5% for MPA to 129.1$\pm$6.7ug/이 and 37.1$\pm$1.3% for HPA. Statistically positive correlations were shown not only between the level of dietary heme iron and apparent absorption(r=0.95, p<0.05), but also between serum iron concentration and apparent absorption(r=0.64, p<0.05). Negative iron balance was shown in two subjects fed the moderate protein meals. These results suggest that recommanded dietary allowances of iron may be under the need to maintain the positive balance, and iron bioavaliability increase by only high level of animal protein intake.

• Journal of Nutrition and Health
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• v.31 no.1
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• pp.96-101
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• 1998

The prevalence of iron deficiency in later infancy and the toddler years(25% to 40% at 1 year of age) has not decreased remarkably , except in Western countries. The purpose of this study was to 1) determine the relationship between current feeding practices and iron status, and 2) assess compliance to infant feeding instructions. Two groupsof infants were examined. The first group of 302 infants aged 6 to 24months was seen at a well baby clinic while the second group of 135 infants of the same age group was assessed by venipuncture. Cutoff values for laboratory tests were as follows ; hemoglobin<11g/dL, mean corpuscular volume (MCV) <72fl ; red cell distribution width(RDW)>15% ; serum ferritin level<10ng/ml ; and transferrin saturation (serum iron(TIBC)<10%. The diagnosis of iron deficiency anemia (IDA) was made when a low hemoglobin level was associated with either low ferritin orlow transferrin saturation . Of the 302 children brought to the well baby clinic , 12.3%(n=37) were found to have anemia (hemoglobin<11.0/dL). In terms of children grouped according to feeding practices, it was found that children with anemial comprised 32.0% (24/75) of the prolonged breast-fed group (Group A), significantly more than the 4.0%(7/176) of the artificial milk feeding group(Group B). and 3.9%(2/51) of the switched from breast milk to iron -fortified weaning foods group(Group C).Among the 107 children with IDA , iron deficiency in 105 children(98.1%) was suggested by their dietary histories ; exclusive or prolonged breast-feeding for more than 6 months without iron fortification in 98 infants ; cow's milk consumption> 500ml/day without iron fortification during infancy(n=12), or >800ml without iron-fortified foods after infancy(n=15) ; and the use of unfortified forumula or unbalanced diets, mainly limited to rice gruel. Despite the relatively high (79.6%) motivation on the part of the infants mothers and supervison by professional personnel, the poor results in the infants receiving iron fortified foods were due to poor compliance(85.75). Among the mothers of 98 IDA patients who were contacted by telephone , it was revealed that 29% did not give the oral iron preparation for more than 2 months. Furthermore, negligence or disregard by the parents occurred in 14% of the case , discontinuance of the oral iron preparation by the parents due to side effects occurred in 6%, and the children's refusal or poor oral intake and no further trial occurred in 6%. The dietary history of a large group of infants was highly predictive of their risk for anemia . Continued consumption of breast milk until the age of 1 year is not warranted unless iron-fortified foods are given concomitantly. Because there is a problem with compliance, more successful and safe strategies for preventing iron deficiency woold included dual coverage in the from of therapeutic iron supplementation as well use of iron-fortified foods for teddlers who are at risk of iron deficiency.

• Journal of Nutrition and Health
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• v.36 no.7
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• pp.729-735
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• 2003

This study was performed to evaluate the effect of iron supplement for 4 weeks on iron status, immunity, and antioxidant status of national female soccer players (n = 25). This study was performed at summer hard training period right before competition. A single blind design was used to divide the subjects into iron-supplement (IS) or placebo group (P). Iron-supplement group was supplemented with iron (40 mg/d) for 4 weeks. The mean age of the subjects was 23.3 $\pm$ 2.5 years old. Mean height and body weight of the subjects were 164.4 $\pm$ 5.7 em and 57.4 $\pm$ 4.6 kg, respectively. The mean carrier as soccer player was 11.0 $\pm$ 2.6 years and mean training time was 7.0 $\pm$ 1.3 hr/day. The mean hemoglobin, hematocrit, total iron binding capacity and ferritin concentrations before iron supplementation were not different between two groups. After 4 weeks of summer training and iron supplementation, serum ferritin level was significantly increased only in IS group after supplementation. Mean corpuscular volume and total iron binding capacity were significantly decreased in both groups. Meanwhile, hemoglobin and red blood cell count were significantly lowered only in placebo group. The IgM concentration increased significantly in both groups, but IgG concentration had increasing tendency only in IS group (p < 0.064). Therefore, iron supplementation during hard training period may be helpful to improve work capacity of the athletes by improving ferritin status and humoral immune responses.

• Journal of the East Asian Society of Dietary Life
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• v.6 no.2
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• pp.135-142
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• 1996

The purpose of this study was to examine nutritional status of iron in 27 rural elderly subjects. The daily intake, urinary excretion and serum level of iron were determined by 24-hr food collection method, and 24-hr urine and serum collection for 3 days. The results were summarized as follows. 1. The mean age, height, weight, and blood pressure were 67.7 years, 163.2cm, 55.9kg, and 121.1/80. 0mmHg in men and 69.9 years, 146.5cm, 47.6kg, and 108.9/71.1mmHg in women, respectively 2. The daily intake of energy, protein, vitamin A, vitamin B$_1$, vitamin B$_2$, niacin, vitamin C, and iron were lower than Korean recommended dietary allowances. 3. The daily iron intake was 7.82mg. The proportion of heme iron and nonheme iron to the total iron intake were 8.05% and 91.94%, respectively Major iron sources of the rural elderly were cooked rice, Ko Chu Jang, beef blood, anchovy, soybean paste, and leafy radish. 4. The hemoglobin, hematocrit, serum iron, and total iron binding capacity were 14.3g/㎗, 42.9%, 79.4 $\mu\textrm{g}$/㎗, and 268.4 $\mu\textrm{g}$/㎗ in men and 12.9g/㎗, 38.8%,92.4 $\mu\textrm{g}$/㎗, and 277.9$\mu\textrm{g}$/㎗ in women, respectively. 5. There was a significant positive correlation between dietary intake and urinary excretion of iron.

• Korean Journal of Community Nutrition
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• v.9 no.2
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• pp.142-150
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• 2004

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.

• Korean Journal of Community Nutrition
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• v.6 no.1
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• pp.28-35
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• 2001

This study was designed to assess the iron nutritional status and anemia of high school students. 383 female subjects in Ulsan Metropolitan city were evaluated using a questionnaire, and a measurement of hematological indices. The average height and weight of the respondents were 161.24$\pm$4.90 cm and 53.12$\pm$6.37kg, repectively. The average BMI(body mass index) was 20.43$\pm$2.26 which was in the normal ramge. The average hemoglobin(Hb) concentration of the subjects was 13.14$\pm$0.97g/dl, and the average hematocrit(Hct) level was 40.84$\pm$17.40%. Transferrin saturation{TS(%)} was 20.86$\pm$10.32%, and the ferritin by Hct(＜36%), 27.2%by TS(＜14%),26.6% by ferritin(＜12 ng/ml). As for clinical symptoms, the greatest number of respondents reported that they experienced ‘decreased ability to concectrate’. Mean daily intakes of iron were 14.89$\pm$4.48 mg and heme iron intakes were 5.04$\pm$2.13 mg, which was 29.6% of total iron intake. The total iron binding capacity(TIBC) was negatively correlated with Hb concentration(r= -0.222, p＜0.01). Serum ferritin was positively correlated with Hb concentration(r= - 0.323, p＜0.05) and negatively correlated with TIBC(r= -0.367, p＜0.01). TS(%) was positively correlated with Hb concentration(r= 0.402, p＜0.01) and positively correlated with serum ferritin(r=0.413, p＜0.01). As for the correlation between blood biochemistry and clinical symptoms related to anemia, the Hb concentration was negatively correlated with ‘shortening of breath when going upstairs(p＞0.05)’ and ‘cold hands and feet’ significantly(r= -0.109, p＜0.05). The level of Mean corpuscular volume(MCV) was negatively correlated with ‘feel dizzy when standing up’,‘tired out easily’, and ‘decrease ability to concentrate’ significantly(p＜0.05). In particular, the level of Fe was negatively correlated with ‘shortening of breath when going upstairs’ and ‘feeling blue’ significantly(p＜0.01). These results suggest That the prevalence of iron deficiency of female high school students is very high, therefore guidelines for diet supports and nutrition education to improve their iron status should be provided.

• Clinical and Experimental Pediatrics
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• v.51 no.8
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• pp.827-833
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• 2008

Purpose : Early identification of iron deficiency in young children is essential to prevent damaging long-term consequences. It is often difficult for the pediatrician to know which indices should be used when diagnosing these conditions especially in hospitalized young children. This study investigated the clinical significances of reticulocyte hemoglobin content in young children with acute infection. Methods : We studied 69 young children aged from 6 to 24 months admitted with acute infection in a single center. Venous blood was drawn to determine hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), hemoglobin content (CH), reticulocyte hemoglobin content (CHr), and red blood cell distribution width (RDW) using ADVIA 120 (Bayer Diagnostics, NY, USA). For evaluating iron status, iron, total iron binding capacity, ferritin and transferrin saturation (Tfsat) were determined. Iron deficiency was defined as Tfsat less than 20%, and iron deficiency anemia as Tfsat less than 20% and Hb level less than 11 g/dL. Results : In all, 47 were iron deficient; 17 of these had iron deficiency anemia. CHr was the only significant predictor of iron deficiency (likelihood ratio test=71.25; odds ratio=0.67; P<0.05). Plasma ferritin level had no predictive value (P=0.519). Subjects with CHr less than 27.4 pg had lower Hb level, MCH, CH, Tfsat, and iron levels than those with CHr 27.4 pg or more (P<0.05 for all). Conclusion : CHr level was a sensitive screening tool and the strongest predictor of iron deficiency in hospitalized infants with acute infection; it was cost saving and avoiding additional sampling. However its reference range should be established.

• Journal of Nutrition and Health
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• v.7 no.3
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• pp.1-13
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• 1974

The relative state of human iron storage may be ascertained more reliably through determination of the serum iron, iron binding capacity, transferrin saturation and absorption of radioactive iron in conjunction with studies of red cell morphology than from the study of red cell morphology alone. Recent investigations have shown that there is an increase in red cell protoporphyrin concentration in iron deficiency anemia. The significance of the red cell protoporphyrin has been discussed greatly during the years since its discovery. Two of the main factors which appear to influence the amaunt of protoporphyrin are increased erythropoiesis and factors interfering with the utilization of iron in the synthesis of hemoglobin, and iron deficiency. Recently Heller et al. have described a simplified method for blood protoporphyrin assay and this technique could be used assess nutritional iron status, wherein even minor insufficiencies are detectable as increased protoporphyrin concentrations. Based on the evaluation of the relationship between nutritional iron status and red cell protoporphyrin as an index suitable for the detection of the iron deficiency is described in this paper. RESULTS 1. Hemoglobin Concentrations and Anthropometric Measurements. The mean and standard deviations of the various anthropometric measurements of different age and sex groups are shown in table 1. There measurements have been compared with the Korean Standard. In the absence of local standards for arm circumference and skin-fold thickness over triceps, they have been compared with the standard from Jelliffe. Table 2,3, and 4 give anthropometric measurements and frequency (%) of anemia in children surveyed. The mean height of the children studid was 10 to 20 percent; below the Korean Standard. The distribution of height below 80 percent of the Standard was 21.2 percent, however, among anemic group this percentage was 27.7 percent. In general, the mean weight of the children was 10 to 15 percent below the Korean Standard. The percentage of children with weight less than 80 percent of the Standard was about 35 percent. But in the anemic group of the children, this percentage was 44 percent. The mean arm circumference was about 15 percent lower than the Jelliffe's standard. 61.2 percent of the children had values of arm circumference below 80 percent of the standard. Children with low hemoglobin levels, this percentage was 80 percent. The mean skinfold thickness over the triceps of the children studied was about 25 Percent lower than the Jelliffe's standard and 61.2 percent of the children had the value less than 80 percent of the standard. Among anemic children, this percentage was 70.8%. As may be seen from table 5, the mean hemoglobin concentration of the total group was 11.3g/100ml. Hemoglobin concentration was less than 11.0g/100ml. in 65(36.5%) of the 178 children. The degree of anemia in most of these children was mild with a hemoglobin level of less than 8.0g/100ml. found in only one child. In general, the prevalence of anemia was high in female children than male and decreased its frequency with increasing age. Relatively close relationship was observed between hemoglobin level and anthrophometric measurements especially high between arm circumference and skinfold thickness and hemoglobin but very low in height and low in weight and hemoglobin level, estimated by chi-square value. II. Serum iron, Transferrin saturation (1) Serum iron, and transferrin saturation Serum iron, transferrin saturation and red cell protoporphyrin concentrations were estimated in sub-sample of 84 children from 1 to 6 years and 24 older children between 7 and 13 years of age. The findings are presented in table 6. The mean serum iron concentration of the total group was 59ug/100ml. However, the level incrased with age from 36.6ug/100ml. (1-3years) to 80.8ug/100ml. (7-13 years). 60 percent of these children had a serum iron level less than 50ug/10ml. in the 1-3 years age group and 31.4 percent for 4-6 years group. These contrast with the finding of 12.5 percent anemic children in the 7-13 years age group. The mean transferrin saturation for the total group was 18.1 percent and frequency of anemia by transferrin saturation was observed same pattern as serum iron concentration. (2) Red cell protoporphyrin concentrations. (a) Red cell protoporphrin levels of children: Red cell protoporphyrin and other biochemical data are shown in table 4. The mean concentration in red cell of all children was fround 46.3ug/100ml. RBC. and differences with age groups were observed; in the age group 1-3 years, the mean concentration was $59.5{\pm}32.14$ ug/100ml. RBC; 4-6 years $44.1{\pm}22.57$ ug/100ml. RBC. and 7-13 years, $39.0{\pm}13.56$ ug/100ml. RBC. (b) Normal protoporphyrin values in adults: It was observed that in 10 normal adult males studied here the level of protoporphyrin in red cell ranged from 18 to 54 ug/100ml. RBC. and the mean concentration was $47.5{\sim}14.47$ ug/100ml. RBC. Other biochemical determination made on the same subjects are presented in table 8. (c) Red tell protoporphyrin concentration of occupational blood donors: The results of analyses for red cell protoporphyrin as well as serum iron, transferrin saturation and hemoglobin in the 76 blood donors are presented in table 7 and 8. In this experiment, donors were selected at random, however, most of them bled repeatedly because of poor economic situation, I doubt. Table 9 shows the distribution of red cell protoporphyrin concentration and hemoglobin concentration of occupational donors. The mean hemoglobin value for the total was 11.9 g/100 ml. When iron deficiency anemia is defined as a transferrin saturation below 15%, prevalence of anemia was 47.4 percent and the mean serum iron was 27.1ug/100ml. and red cell protoporphyrin, 168.3ug/100ml. RBC. However, mean serum iron and protoporphyrin concentration of above 15% transferrin saturation were 11.6 ug/100 ml. and 58.8 ug/100 ml. RBC. respectively. The mean Protoporphyrin concentration of non-anemic (above 15% transferrin saturation) donors was slightly higher than the results of normal adult males.

• Clinical and Experimental Pediatrics
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• v.58 no.8
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• pp.283-287
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• 2015

Purpose: We assessed the relationships between iron and vitamin D statuses in breastfed infants and their mothers and evaluated the determinants of iron and vitamin D deficiencies in breastfed infants. Methods: Seventy breastfed infants aged 4-24 months and their mothers participated in this study from February 2012 to May 2013. Complete blood counts, total iron binding capacity, and levels of C-reactive protein, iron, ferritin, calcium, phosphate, alkaline phosphatase, and 25-hydroxyvitamin D (25(OH)D) in infants and their mothers were measured. Results: A history of maternal prepregnancy anemia was associated with lower ferritin and 25(OH)D levels in both infants and their mothers. The 25(OH)D level of infants correlated with maternal 25(OH) D levels. The independent risk factors for iron deficiency in breastfed infants were the duration of breastfeeding (odds ratio [OR], 6.54; 95% confidence interval [CI], 1.09-39.2; P=0.04) and infant body weight (OR, 2.65; 95% CI, 1.07-6.56; P=0.04). The determinants for vitamin D deficiency were the infant's age (OR, 0.15; 95% CI, 0.02-0.97; P=0.046) and maternal 25(OH)D level (OR, 0.74; 95% CI, 0.59-0.92; P=0.01). Conclusion: A maternal history of prepregnancy anemia requiring iron therapy was associated with lower current ferritin and 25(OH)D levels in both infants and their mothers. Therefore, physicians should monitor not only iron but also vitamin D levels in infants who are breastfed by mothers who had prepregnancy anemia.