Exploring the Clinical and Social Drivers of Iron Status in Women of Reproductive Age

Abstract

Australian studies report iron deficiency (ID) is increasing in young women. We aimed to identify the nutritional and wellbeing impact of increasing dietary pork or taking iron supplements; iron status and B vitamin relationships; eating behaviours affecting iron status; and forces affecting iron intake of young women. Females (control, pork diet and iron supplement sets) in a 12w RCT completed questionnaires (FFQ, wellbeing and activity); three 7-day food diaries and gave repeated blood samples. A sequential qualitative case study of 3 generations of women identified influences of eating behaviour. Previously influences were derived from adolescent studies. Of the 65 RCT women (24.6±4.4y; 21.8±2.8kg/m2) 23% were ID. Pork significantly increases Hb but not ferritin with 500g/w; increases fruit intake; reduces snack food; increases nutritionally complete meals; stops meal omission; and the supplement increases Hb and ferritin- all P<0.001. Student wellbeing significantly improved differently in both interventions. Student intakes fail to meet EAR for folate (13.6%) and vitamins B6 (4.5%) and B12 (31.8%). Eating behaviours defy nutritionally complete diets. Vitamin B12 intakes from unexpected sources include energy drinks. OCPs lower serum vitamin B12 (P=0.042). Variability in serum vitamins B6, B12 and folate support ≥ 4 samples be collected before clinical decision making. Case study data disclosed the forces influencing eating behaviours as education, mothers and sensory appeal of red meats. A mother’s understanding of iron metabolism, their food literacy and preference for meats have a high impact on their daughters. Yet daughters are open to remodeling - a new direction for nutritionists. Reduced food literacy has had negative impact on iron intake. Research on bio-availability of non-animal iron sources and sensory characteristics of meats needs to continue.