Sjöberg A, Hulthén L
Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Eur J Clin Nutr. 2015 Apr;69(4):494-500. doi: 10.1038/ejcn.2014.291. Epub 2015 Jan 28.
BACKGROUND/OBJECTIVES: Sifted flour was fortified with carbonyl iron for 50 years in Sweden. This study evaluates changes in food habits, intake of iron, factors affecting iron absorption and iron status after the discontinuation of the general iron fortification in adolescents with the highest requirements.
SUBJECTS/METHODS: A total of 2285 15- to 16-year-old students in 1994 (634 girls and 611 boys) and in 2000 (534 girls and 486 boys) in 13 schools in Gothenburg, Sweden, were included in two cross-sectional surveys assessing food habits with diet history interviews and iron deficiency defined with serum ferritin stores ⩽ 15 μg/l and no preceding infection.
In girls, iron deficiency increased from 37 to 45%, while in boys, it was stable at 23%. Total iron intake decreased from 15.7 to 9.5 mg/day and 22.5 to 13.9 mg/day in girls and boys, respectively. Cereals were the main iron source. Among girls, the increase of fish and decrease of calcium intake may not counteract the effect of decreased intake of fortification iron. Among boys, more meat, less calcium and more vitamin C may have favoured the bioavailability of iron.
The discontinuation of the general iron fortification resulted in a 39% decrease in total iron intake and iron deficiency increased substantially in girls. However, in boys no change in iron deficiency was observed. Whether this was a result of changed bioavailability of dietary iron or simultaneous changes of non-dietary factors remains to be explored.
背景/目的：在瑞典，筛过的面粉用羰基铁强化了50年。本研究评估了在需求最高的青少年中停止一般铁强化后，饮食习惯、铁摄入量、影响铁吸收的因素以及铁状态的变化。
受试者/方法：1994年和2000年，瑞典哥德堡13所学校的2285名15至16岁学生（1994年634名女孩和611名男孩，2000年534名女孩和486名男孩）被纳入两项横断面调查，通过饮食史访谈评估饮食习惯，并根据血清铁蛋白储存量≤15μg/l且无先前感染来定义缺铁。
女孩的缺铁率从37%升至45%，而男孩的缺铁率稳定在23%。女孩和男孩的总铁摄入量分别从15.7毫克/天降至9.5毫克/天和从22.5毫克/天降至13.9毫克/天。谷物是主要的铁来源。在女孩中，鱼类摄入量增加和钙摄入量减少可能无法抵消强化铁摄入量减少的影响。在男孩中，更多的肉类、更少的钙和更多的维生素C可能有利于铁的生物利用度。
停止一般铁强化导致总铁摄入量减少39%，女孩的缺铁情况大幅增加。然而，男孩的缺铁情况未观察到变化。这是膳食铁生物利用度改变的结果还是非膳食因素同时改变的结果，仍有待探索。
