The overall objective of this application is to characterize current patterns and determinants of iron status in women of reproductive age (12-49 years), using nationally representative data from the recently completed (1988-94) NHANES III. Iron status will be defined in terms of biochemical indicators: serum ferritin, transferrin saturation, erythrocyte porphyrin, mean corpuscular volume and hemoglobin.
The Specific Aims i nclude the identification of subgroups at risk for iron deficiency or excess, quantification of trends in iron status over the past 20 years by comparison to results from previous NHANES surveys and assessment of the contributions of supplement use and dietary sources (especially fortified products) to iron intake and status. Dietary data will be based on 24 hour recall and food frequency questionnaires. The sociodemographic correlates of iron deficiency and excess will be identified using multivariate techniques such as logistic regression and general linear models. Sample weights and Strata and Pseudo Primary Sampling Units will be used for calculating variance estimates using the program SUDAAN, which can account for the complex study design of the HANES datasets. Similarly, all the final logistic and ordinary least squares models will also be tested using SUDAAN. The investigators state that this project will help ascertain whether iron deficiency remains a major public health problem in the United States. It will provide an up-to-date picture of iron status among women, including the prevalence of iron excess, which is regarded as an emerging health problem. High iron stores are perceived to increase the risks of hereditary hemochromatosis and chronic disease. Although causality cannot be established due to the limitations of the NHANES, the examination of the strength and direction of the associations of iron excess with predisposing factors for and/or chronic disease is expected to improve significantly current understanding of this emerging area of concern and will be useful for identifying groups at risk and for guiding future research. The investigators state that in summary, the project is expected to provide information that can be used to examine policy options and develop guidelines to ensure adequate but safe iron status for women of reproductive age.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
First Independent Research Support & Transition (FIRST) Awards (R29)
Project #
5R29HD034531-04
Application #
6387819
Study Section
Epidemiology and Disease Control Subcommittee 2 (EDC)
Program Officer
Grave, Gilman D
Project Start
1998-05-15
Project End
2003-04-30
Budget Start
2001-05-01
Budget End
2002-04-30
Support Year
4
Fiscal Year
2001
Total Cost
$107,605
Indirect Cost
Name
Emory University
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
042250712
City
Atlanta
State
GA
Country
United States
Zip Code
30322
Garcia-Guerra, Armando; Neufeld, Lynnette M; Hernandez-Cordero, Sonia et al. (2009) Prenatal multiple micronutrient supplementation impact on biochemical indicators during pregnancy and postpartum. Salud Publica Mex 51:327-35
Moriarty-Craige, Siobhan E; Ramakrishnan, Usha; Neufeld, Lynnette et al. (2004) Multivitamin-mineral supplementation is not as efficacious as is iron supplementation in improving hemoglobin concentrations in nonpregnant anemic women living in Mexico. Am J Clin Nutr 80:1308-11
Ramakrishnan, Usha; Neufeld, Lynnette M; Gonzalez-Cossio, Teresa et al. (2004) Multiple micronutrient supplements during pregnancy do not reduce anemia or improve iron status compared to iron-only supplements in Semirural Mexico. J Nutr 134:898-903
Ramakrishnan, Usha; Aburto, Nancy; McCabe, George et al. (2004) Multimicronutrient interventions but not vitamin a or iron interventions alone improve child growth: results of 3 meta-analyses. J Nutr 134:2592-602
Cogswell, Mary E; Kettel-Khan, Laura; Ramakrishnan, Usha (2003) Iron supplement use among women in the United States: science, policy and practice. J Nutr 133:1974S-1977S
Ramakrishnan, Usha; Frith-Terhune, Amy; Cogswell, Mary et al. (2002) Dietary intake does not account for differences in low iron stores among Mexican American and non-Hispanic white women: Third National Health and Nutrition Examination Survey, 1988-1994. J Nutr 132:996-1001
Ramakrishnan, Usha; Kuklina, Elena; Stein, Aryeh D (2002) Iron stores and cardiovascular disease risk factors in women of reproductive age in the United States. Am J Clin Nutr 76:1256-60
Ramakrishnan, Usha; Yip, Ray (2002) Experiences and challenges in industrialized countries: control of iron deficiency in industrialized countries. J Nutr 132:820S-4S
Frith-Terhune, A L; Cogswell, M E; Khan, L K et al. (2000) Iron deficiency anemia: higher prevalence in Mexican American than in non-Hispanic white females in the third National Health and Nutrition Examination Survey, 1988-1994. Am J Clin Nutr 72:963-8
Ramakrishnan, U; Barnhart, H; Schroeder, D G et al. (1999) Early childhood nutrition, education and fertility milestones in Guatemala. J Nutr 129:2196-202