Brussaard J H, Brants H A, Bouman M, Löwik M R
TNO Nutrition and Food Research Institute, Zeist, The Netherlands.
Eur J Clin Nutr. 1997 Nov;51 Suppl 3:S51-8.
To assess the adequacy of iron intake and status, the prevalence of marginal iron status, the physiological and lifestyle factors influencing iron status and the role of dietary factors affecting the bioavailability of iron among Dutch adults.
Food consumption was measured with 3 d diet records. Iron status and prevalence of iron deficiency and iron accumulation were evaluated using different criteria. Physical, biochemical and lifestyle characteristics were determined and relationships with iron status were evaluated by bi- and multivariate regression analysis.
A sample of 444 adults, aged 20-79 y stratified for sex and 10 y age classes, with an overrepresentation of people with a low habitual intake of vitamin B6.
Average iron intake was higher than the recommended daily allowance for the Netherlands in all sex-age groups except women aged 20-49, in which group average iron intake was 23% below the recommendation. Early iron deficiency, as reflected in low ferritin levels, was not found among men aged 20-49, but was observed in 5% of women aged 50-79, 11% of men aged 50-79, and 16% of women aged 20-49. Iron deficiency anaemia as reflected in low haemoglobin levels was found in 0-5% of the age-sex groups. Among men and women, 16% and 13% of variance in haemoglobin level, respectively, could be explained by physiological and dietary factors. For ferritin, the proportions were 36% and 34%, respectively. Iron status was correlated negatively with the vegetable fraction of the diet, and positively with factors from the animal fraction (haem iron, animal protein, meat). Further, haemoglobin was positively correlated with body weight among men, and with both age and use of oral contraceptives among women. Both among men and women, blood donorship in the six months prior to the study was negatively associated with serum ferritin levels.
Women aged 20-49 are the adult sex-age group with the greatest risk of developing (an early stage of) iron depletion. The most important dietary factors influencing the iron status are the type of iron (haem/non-haem) and factors affecting the bioavailability of iron.
评估荷兰成年人铁摄入量和铁状态是否充足、边缘性铁状态的患病率、影响铁状态的生理和生活方式因素以及影响铁生物利用度的膳食因素的作用。
通过3天饮食记录来测量食物摄入量。使用不同标准评估铁状态以及缺铁和铁蓄积的患病率。确定身体、生化和生活方式特征，并通过双变量和多变量回归分析评估与铁状态的关系。
选取444名20 - 79岁的成年人作为样本，按性别和10岁年龄组分层，维生素B6习惯性摄入量低的人群占比过高。
除20 - 49岁女性外，所有性别年龄组的平均铁摄入量均高于荷兰的每日推荐摄入量，该年龄组女性的平均铁摄入量比推荐量低23%。20 - 49岁男性中未发现早期缺铁（以低铁蛋白水平为指标），但在50 - 79岁女性中有5%、50 - 79岁男性中有11%以及20 - 49岁女性中有16%的人出现早期缺铁。以低血红蛋白水平为指标的缺铁性贫血在各年龄性别组中的发生率为0 - 5%。在男性和女性中，血红蛋白水平变异的16%和13%分别可由生理和膳食因素解释。对于铁蛋白，这一比例分别为36%和34%。铁状态与饮食中的蔬菜比例呈负相关，与动物性食物部分的因素（血红素铁、动物蛋白、肉类）呈正相关。此外，男性中血红蛋白与体重呈正相关，女性中血红蛋白与年龄和口服避孕药的使用均呈正相关。在男性和女性中，研究前六个月的献血行为均与血清铁蛋白水平呈负相关。
20 - 49岁女性是最有可能出现（早期）铁耗竭的成年性别年龄组。影响铁状态的最重要膳食因素是铁的类型（血红素铁/非血红素铁）以及影响铁生物利用度的因素。
