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Cited by 407Iron Metabolism and DisordersObesity, Physical Activity, DietHemoglobinopathies and Related Disorders

Overweight children and adolescents: A risk group for iron deficiency

Nead, Karen G., Halterman, Jill S., Kaczorowski, Jeffrey M., Auinger, Peggy, Weitzman, Michael·2004·Pediatrics
DOI 10.1542/peds.114.1.104
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Abstract

Background. The prevalence of obesity has increased at an epidemic rate, and obesity has become one of the most common health concerns in the United States. A few small studies have noted a possible association between iron deficiency and obesity. Objective. To investigate the association between weight status, as measured by body mass index (BMI), and iron deficiency in a nationally representative sample of children and adolescents. Design. National Health and Nutrition Examination Survey III (1988–1994) provides cross-sectional data on children 2 to 16 years of age. Recorded measures of iron status included transferrin saturation, free erythrocyte protoporphyrin levels, and serum ferritin levels. Children were considered iron-deficient if any 2 of these values were abnormal for age and gender. With the use of age- and gender-specific BMI percentiles, at risk for overweight was defined as a BMI of ≥85th percentile and <95th percentile, and overweight was defined as a BMI of ≥95th percentile. The prevalence of iron deficiency was compared across weight groups. Logistic regression was used to estimate the association between iron status and overweight, controlling for age, gender, ethnicity, poverty status, and parental education level. Results. In this sample of 9698 children, 13.7% were at risk for overweight and 10.2% were overweight. Iron deficiency was most prevalent among 12- to 16-year-old subjects (4.7%), followed by 2- to 5-year-old subjects (2.3%) and then 6- to 11-year-old subjects (1.8%). Overweight 2- to 5-year-old subjects (6.2%) and overweight 12- to 16-year-old subjects (9.1%) demonstrated the highest prevalences of iron deficiency. Overall, the prevalence of iron deficiency increased as BMI increased from normal weight to at risk for overweight to overweight (2.1%, 5.3%, and 5.5%, respectively), and iron deficiency was particularly common among adolescents (3.5%, 7.2%, and 9.1%, respectively). In a multivariate regression analysis, children who were at risk for overweight and children who were overweight were approximately twice as likely to be iron-deficient (odds ratio: 2.0; 95% confidence interval: 1.2–3.5; and odds ratio: 2.3; 95% confidence interval: 1.4–3.9; respectively) as were those who were not overweight. Conclusions. In this national sample, overweight children demonstrated an increased prevalence of iron deficiency. Given the increasing numbers of overweight children and the known morbidities of iron deficiency, these findings suggest that guidelines for screening for iron deficiency may need to be modified to include children with elevated BMI.

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  • The risk for iron deficiency, defined as low transferrin saturation and low serum ferritin, is twice as high in overweight adolescents compared to normal weight adolescents.

    “An analysis from the NHANES population found the risk for ID, defined as low transferrin saturation and low serum ferritin, to be twice as high in overweight adolescents compared to normal weight adolescents [27]”

    From Obesity as an emerging risk factor for iron deficiency (2014) · cites this paper as [27]

  • The anatomical location of adipose tissue is of paramount importance for its physiological function, gene expression, and responses to insulin, catecholamines, sex hormones and cortisol.

    “It appears that the anatomical localisation of adipose tissue is of paramount importance in relation to its physiological function, i.e. handling of lipids (lipogenesis, lipolytic activity), expression of multiple genes, and response to insulin, catecholamines, sex hormones and cortisol (51) .”

    From Dietary factors and low-grade inflammation in relation to overweight and obesity (2011) · cites this paper as [51]

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Authors
Nead, K. G., Halterman, J. S., Kaczorowski, J. M., Auinger, P., & Weitzman, M.
Affiliations
  • Yale University (US)
  • University of Rochester (US)
  • American Academy of Pediatrics (US)
ORCID
Venue
Pediatrics
Publisher
American Academy of Pediatrics (AAP)
Published
2004-07-01
Volume
114
Issue
1
Pages
104-108
ISSN
  • 0031-4005 (ISSN-L)
  • 1098-4275
DOI
10.1542/peds.114.1.104
OpenAlex
W2084280754
Cited by
407
References
31
Citations by year
2026: 6 · 2025: 12 · 2024: 13 · 2023: 17 · 2022: 17 · 2021: 21 · 2020: 24 · 2019: 16 · 2018: 17 · 2017: 17 · 2016: 23 · 2015: 31 · 2014: 34 · 2013: 25 · 2012: 21
FWCI
6.27
Type
journal article
Language
en
Open access
closed
Locations
  • PEDIATRICS (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Medicine › Genetics › Hemoglobinopathies and Related Disorders
Keywords
childhood obesity, overweight, adolescents, body mass index, iron status, serum ferritin, transferrin saturation, free erythrocyte protoporphyrin, prevalence, risk factors, sex differences, age differences, socioeconomic status, poverty, parental education, NHANES III, iron intake, iron supplementation, iron deficiency anemia prevention
MeSH terms
Iron Deficiencies, Adolescent, Child, Child, Preschool, Female, Humans, Male, Nutrition Surveys, Obesity, Reference Values, United States, Body Mass Index, Prevalence, Logistic Models, Anemia, Iron-Deficiency

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