title: Sharply higher rates of iron deficiency in obese Mexican women and children are predicted by obesity-related inflammation rather than by differences in dietary iron intake.
abstract: BACKGROUND
  Obese individuals may be at increased risk of iron deficiency (ID), but it is unclear whether this is due to poor dietary iron intakes or to adiposity-related inflammation.
  
  
  OBJECTIVE
  The aim of this study was to examine the relations between body mass index (BMI), dietary iron, and dietary factors affecting iron bioavailability, iron status, and inflammation [C-reactive protein (CRP)] in a transition country where obesity and ID are common.
  
  
  METHODS
  Data from the 1999 Mexican Nutrition Survey, which included 1174 children (aged 5-12 y) and 621 nonpregnant women (aged 18-50 y), were analyzed.
  
  
  RESULTS
  The prevalence of obesity was 25.3% in women and 3.5% in children. The prevalence of ID was significantly (P < 0.05) higher in obese women and children compared with normal-weight subjects [odds ratios (95% CIs): 1.92 (1.23, 3.01) and 3.96 (1.34, 11.67) for women and children, respectively]. Despite similar dietary iron intakes in the 2 groups, serum iron concentrations were lower in obese women than in normal-weight women (62.6 ± 29.5 compared with 72.4 ± 34.6 μg/dL; P = 0.014), and total-iron-binding capacity was higher in obese children than in normal-weight children (399 ± 51 compared with 360 ± 48 μg/dL; P < 0.001). CRP concentrations in obese women and children were 4 times those of their normal-weight counterparts (P < 0.05). CRP but not iron intake was a strong negative predictor of iron status, independently of BMI (P < 0.05).
  
  
  CONCLUSIONS
  The risk of ID in obese Mexican women and children was 2-4 times that of normal-weight individuals at similar dietary iron intakes. This increased risk of ID may be due to the effects of obesity-related inflammation on dietary iron absorption. Thus, ID control efforts in Mexico may be hampered by increasing rates of adiposity in women and children.
authors.affiliation: Division of Human Nutrition, Wageningen University, Netherlands. anacarla.cepedalopez@wur.nl
authors.forename: Ana C
authors.initials: AC
authors.lastname: Cepeda-Lopez
authors.forename: Saskia Jm
authors.initials: SJ
authors.lastname: Osendarp
authors.forename: Alida
authors.initials: A
authors.lastname: Melse-Boonstra
authors.forename: Isabelle
authors.initials: I
authors.lastname: Aeberli
authors.forename: Francisco
authors.initials: F
authors.lastname: Gonzalez-Salazar
authors.forename: Edith
authors.initials: E
authors.lastname: Feskens
authors.forename: Salvador
authors.initials: S
authors.lastname: Villalpando
authors.forename: Michael B
authors.initials: MB
authors.lastname: Zimmermann
mesh_terms: D000293:Adolescent; D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000150:complications / Q000453:epidemiology*; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003906:Developing Countries; D004032:Diet / Q000009:adverse effects; D005260:Female; D019456:Health Transition; D006801:Humans; D007249:Inflammation / Q000150:complications; D007501:Iron / Q000097:blood; D019266:Iron, Dietary / Q000008:administration & dosage* / Q000378:metabolism; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009749:Nutrition Surveys; D009752:Nutritional Status; D009765:Obesity / Q000097:blood / Q000150:complications* / Q000453:epidemiology / Q000276:immunology*; D015995:Prevalence; D055815:Young Adult
chemical_list: D019266:Iron, Dietary; D002097:C-Reactive Protein; D007501:Iron