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Dos Santos TLF, Ataide TDR, De Carli E, Bueno NB, Bádue GS, Florêncio TMDMT, Silva-Neto LGR. The concentration of hemoglobin is associated with the dietary iron availability, food insecurity and the use of oral contraceptives among women in socially vulnerable areas of a capital city in northeastern Brazil. Br J Nutr 2024; 132:946-955. [PMID: 39417491 DOI: 10.1017/s0007114524001375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2024]
Abstract
This study aimed to assess hemoglobin concentration and its association with oral contraceptive (OC) use, food insecurity (FI) and dietary iron availability (DIA) in adult women of reproductive age (20-44 years). This is a population-based cross-sectional study that analysed 505 women living in favelas and urban communities in a capital city in northeastern Brazil. Hemoglobin concentration was determined using capillary blood samples. FI and DIA were assessed using the Brazilian Food Insecurity Scale and the 24-h food recall, respectively. Association analysis was carried out using logistic regression. A directed acyclic graph (DAG) was designed to illustrate the causal paths between hemoglobin concentration and DIA. A significance level of 5 % was adopted. Low hemoglobin concentrations (11·2 g/dl: (1·79)) and a high prevalence of anaemia (64·0 %) were observed; 28·7 % used OC (28·7 %) and 76·4 % were in FI. An average energetic intake of 1495 kcal/d (482·0) and 0·46 mg/d (0·27) of DIA were also observed. In the DAG-guided multivariable analysis, it was observed that hemoglobin concentrations ≥ 12 mg/dl were directly associated with higher DIA (OR: 1·67; 95 % CI (1. 08, 2·59)) and OC use (OR: 1·67; 95 % CI (1·10, 2·55)) and inversely associated with mild FI (OR: 0·60; 95 % CI (0·37, 0·96)) or severe FI (OR: 0·37; 95 % CI: (0·18, 0·76)). Women taking OC and with a higher DIA were less likely to have low hemoglobin concentrations, while those in the context of FI were in the opposite situation.
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Affiliation(s)
- Thays Lane Ferreira Dos Santos
- Programa de Pós-Graduação em Nutrição, Escola Paulista de Medicina, Universidade Federal de São Paulo, R. Botucatu, 740-Vila Clementino, São Paulo, SP04023-062, Brasil
- Programa de Pós-Graduação em Nutrição, Faculdade de Nutrição, Universidade Federal de Alagoas, Avenida Lourival Melo Mota, s/n. Tabuleiro dos Martins, Maceió, AL, CEP: 57072-900, Brasil
| | - Terezinha da Rocha Ataide
- Programa de Pós-Graduação em Nutrição, Faculdade de Nutrição, Universidade Federal de Alagoas, Avenida Lourival Melo Mota, s/n. Tabuleiro dos Martins, Maceió, AL, CEP: 57072-900, Brasil
| | - Eduardo De Carli
- Faculdade de Saúde Pública, Universidade de São Paulo, Av. Dr. Arnaldo, 715 - São Paulo, SP, CEP - 01246-90, Brasil
| | - Nassib Bezerra Bueno
- Programa de Pós-Graduação em Nutrição, Escola Paulista de Medicina, Universidade Federal de São Paulo, R. Botucatu, 740-Vila Clementino, São Paulo, SP04023-062, Brasil
- Programa de Pós-Graduação em Nutrição, Faculdade de Nutrição, Universidade Federal de Alagoas, Avenida Lourival Melo Mota, s/n. Tabuleiro dos Martins, Maceió, AL, CEP: 57072-900, Brasil
| | - Gabriel Soares Bádue
- Programa de Pós-Graduação em Nutrição, Faculdade de Nutrição, Universidade Federal de Alagoas, Avenida Lourival Melo Mota, s/n. Tabuleiro dos Martins, Maceió, AL, CEP: 57072-900, Brasil
| | - Telma Maria de Menezes Toledo Florêncio
- Programa de Pós-Graduação em Nutrição, Escola Paulista de Medicina, Universidade Federal de São Paulo, R. Botucatu, 740-Vila Clementino, São Paulo, SP04023-062, Brasil
- Programa de Pós-Graduação em Nutrição, Faculdade de Nutrição, Universidade Federal de Alagoas, Avenida Lourival Melo Mota, s/n. Tabuleiro dos Martins, Maceió, AL, CEP: 57072-900, Brasil
| | - Luiz Gonzaga Ribeiro Silva-Neto
- Programa de Pós-Graduação em Nutrição, Escola Paulista de Medicina, Universidade Federal de São Paulo, R. Botucatu, 740-Vila Clementino, São Paulo, SP04023-062, Brasil
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Mare KU, Aychiluhm SB, Sabo KG, Tadesse AW, Kase BF, Ebrahim OA, Tebeje TM, Mulaw GF, Seifu BL. Determinants of anemia level among reproductive-age women in 29 Sub-Saharan African countries: A multilevel mixed-effects modelling with ordered logistic regression analysis. PLoS One 2023; 18:e0294992. [PMID: 38019840 PMCID: PMC10686498 DOI: 10.1371/journal.pone.0294992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 11/13/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Despite the implementation of different nutritional and non-nutritional interventions, 43% of reproductive-age women in Africa suffer from anemia. Recent evidence also shows that none of the Sub-Saharan African (SSA) countries are on the track to achieve the nutrition target of 50% anemia reduction by 2030. To date, information on the level of anemia and its determinants among reproductive-age women at the SSA level is limited. Thus, this study aimed to estimate the pooled prevalence of anemia level and its determinants in SSA countries. METHODS We used a pooled data of 205,627 reproductive-age women from the recent demographic and health surveys of 29 SSA countries that were conducted between 2010-2021. A multilevel mixed-effects analysis with an ordered logistic regression model was fitted to identify determinants of anemia level and the deviance value was used to select the best-fitted model. First, bivariable ordinal logistic regression analysis was done and the proportional odds assumption was checked for each explanatory variable using a Brant test. Finally, in a multivariable multilevel ordinal logistic regression model, a p-value<0.05 and AOR with the corresponding 95% CI were used to identify determinants of anemia level. All analyses were done using Stata version 17 software. RESULTS The pooled prevalence of anemia among women of reproductive age in SSA was 40.5% [95% CI = 40.2%-40.7%], where 24.8% [95% CI: 24.6%-25.0%], 11.1% [95% CI = 10.9%-11.2%], and 0.8% [95% CI = 0.7%-0.8%] had mild, moderate, and severe anemia, respectively. The prevalence significantly varied from the lowest of 13% in Rwanda to the highest of 62% in Mali, and anemia was found as a severe public health problem (prevalence of ≥ 40%) in 18 countries. The regression result revealed that polygamous marriage, women and husband illiteracy, poor household wealth, shorter birth interval, non-attendance of antenatal care, underweight, unimproved toilet and water facilities, and low community-level women literacy were positively linked with high anemia level. Additionally, the likelihood of anemia was lower in women who were overweight and used modern contraception. CONCLUSIONS Overall results showed that anemia among women of reproductive age is a severe public health problem in SSA countries, affecting more than four in ten women. Thus, enhancing access to maternal health services (antenatal care and contraception) and improved sanitation facilities would supplement the existing interventions targeted to reduce anemia. Moreover, strengthening women's education and policies regulating the prohibition of polygamous marriage are important to address the operational constraints.
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Affiliation(s)
- Kusse Urmale Mare
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Setognal Birara Aychiluhm
- Department of Epidemiology & Biostatistics, Institute of Public Health, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kebede Gemeda Sabo
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Abay Woday Tadesse
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Bizunesh Fentahun Kase
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Oumer Abdulkadir Ebrahim
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Tsion Mulat Tebeje
- School of Public Health, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
| | - Getahun Fentaw Mulaw
- School of Public Health, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Beminate Lemma Seifu
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
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Qiu F, Wu L, Yang G, Zhang C, Liu X, Sun X, Chen X, Wang N. The role of iron metabolism in chronic diseases related to obesity. Mol Med 2022; 28:130. [PMID: 36335331 PMCID: PMC9636637 DOI: 10.1186/s10020-022-00558-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 10/14/2022] [Indexed: 11/08/2022] Open
Abstract
Obesity is one of the major public health problems threatening the world, as well as a potential risk factor for chronic metabolic diseases. There is growing evidence that iron metabolism is altered in obese people, however, the highly refined regulation of iron metabolism in obesity and obesity-related complications is still being investigated. Iron accumulation can affect the body’s sensitivity to insulin, Type 2 diabetes, liver disease and cardiovascular disease. This review summarized the changes and potential mechanisms of iron metabolism in several chronic diseases related to obesity, providing new clues for future research.
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