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    Iron deficiency and risk factors in pre-menopausal females living in Auckland, New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Nutrition and Dietetics, Massey University, Albany, New Zealand
    (Massey University, 2019) Lim, Kimberley
    Background: Iron Deficiency (ID) is the most common nutrient deficiency worldwide, affecting one third of the world’s population. In New Zealand (NZ), the highest rates are found within pre-menopausal females, with previously identified risk factors for ID including low meat intake, heavy menstruation and blood donation. Emerging risk factors such as inflammation and obesity are yet to be explored in NZ, along with the master hormone of iron regulation, hepcidin. Objectives: To describe iron and hepcidin status within premenopausal females, and identify risk factors for ID. Methods: Females (n=170) aged 18–45 were recruited. Biomarkers of iron status were measured: Serum ferritin (Sf), haemoglobin, soluble transferrin receptor, hepcidin as well as inflammatory markers C-reactive protein and interluekin-6. Body composition was measured using bioelectrical impedance analysis, and lifestyle factors were assessed using questionnaires, including a previously validated food frequency questionnaire. Variables known to potentially influence iron status were entered into multiple linear regression analysis to identify predictors of Sf. Results: Iron deficiency was confirmed in 55.8% of participants (Sf < 30µg·L-1). Prevalence of ID did not differ significantly (p=0.141) between South Asians (64.3%), NZ Europeans (51.6%), and those of other ethnicities (45.5%). Hepcidin concentrations were higher in those who were iron sufficient (Sf ≥ 30µg·L-1) (6.62nM vs 1.17nM, p<0.001). South Asian females had higher hepcidin (8.78nM) concentrations, compared to NZ Europeans (6.28nM) and those of other ethnicities (4.89nM) (p=0.026). The higher hepcidin concentrations in South Asian participants are possibly associated with these participants having a higher BMI (p<0.001), body fat percentage (p<0.001) and interlukein-6 (p<0.001) than NZ Europeans and other ethnicities. Hepcidin (β=0.082, p<0.001) and frequency of meat intake (β=0.058, p=0.001) were identified as significant predictors of Sf in NZ Europeans. Hepcidin was the only identified predictor of Sf in South Asians (β=0.138, p<0.001) and those of other ethnicities (β=0.117, p<0.002). Conclusion: The study confirms a positive relationship between hepcidin and Sf in NZ females, highlighting hepcidin’s potential as an emerging biomarker to identify ID. Furthermore, there were differences in hepcidin levels between ethnicities, which may be linked to higher levels of body fat and inflammation.
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    The effect of a meat extract on iron absorption in young women : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Human Nutrition at Massey University, Palmerston North Campus, New Zealand
    (Massey University, 2007) Beck, Kathryn Louise
    Iron deficiency is a global problem for which determinants and solutions need to be investigated. The first part of this study assessed the iron status and dietary intakes of 85 non vegetarian women aged 18-40 years living in the Manawatu region. Exclusion criteria included pregnancy or breastfeeding in the past 12 months, smoking, excess alcohol consumption and recent blood donation. Dietary intakes were estimated using a 24 hour recall and a non validated food frequency questionnaire. Serum ferritin (SF), haemoglobin (Hb), C-reactive protein, height, weight and supplement use were measured. Two women (2.4%) had iron deficiency anaemia (SF<12µg/L and Hb< 120g/L) and 9 women (10.6%) had depleted iron stores (SF<20µg/L). All other women had normal iron stores (SF>20µg/L). The daily mean and median iron intakes were 12.7±6.2mg and 10.8mg. 71 women (83.5%) consumed less than the Recommended Dietary Intake (RDI) of 18mg iron per day and 21.2% consumed less than the Estimated Average Requirement (EAR) of 8mg iron per day. Serum ferritin was positively associated with age and total dietary iron intake. No statistically significant relationship was found between serum ferritin and Body Mass Index or exercise, or daily intakes of energy, protein, haem iron, red meat, total meat, vitamin C, vitamin A, total tea, coffee, alcohol, fibre or calcium (p>.05). Eighteen women who had low iron stores (SF<30µg/L) were selected to take part in a second study to investigate the effect of a meat extract (<0.5kDa sarcoplasmic fraction) on non haem iron absorption. Each subject consumed a sodium caseinate meal, a meat meal or a sodium caseinate meal containing the meat extract. Each meal was labeled with 8.5mg 57 Fe and each subject received 0.5mg 58 Fe administered by intravenous infusion. Fourteen days later iron absorption from these meals was determined using ratios of stable isotopes of iron incorporated into the red blood cells. Iron status was significantly inversely related to iron absorption. After adjusting to a serum ferritin of 40µ/L, iron absorption was 3.8% from the sodium caseinate meal, 3.9% from the meat meal and 5.1% from the meal containing the meat extract. These values were not significantly different from one another (p>.05).
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    Iron status and factors influencing iron status of Solomon Islands women living in New Zealand : a thesis presented in the partial fulfillment of the requirements for the degree of Masters of Science (Human Nutrition), Massey University, Albany, New Zealand
    (Massey University, 2012) Kafa, Rosemary I'ilu
    Iron deficiency is a global problem among women of reproductive age, particularly in developing countries. A recent survey from the Solomon Islands reported that 44% of women of reproductive aged were anaemic. Currently nothing is known about the iron status of women from the Solomon Islands living in New Zealand (NZ). Aim: This study aims to assess and compare iron status and factors influencing iron status of Solomon Islands with Caucasian women living in and around Auckland, NZ. Methods: This was a cross-sectional study comparing 40 Solomon Islands women with 80 age-matched Caucasian women living in and around Auckland. Serum ferritin (SF), C-reactive protein (CRP) and haemoglobin (Hb) were analyzed. Iron status was defined as: iron replete (SF > 20 µg/L + Hb > 120 g/L), iron deficiency (ID) (SF < 20 µg/L + Hb > 120 g/L) and iron deficiency anaemia (IDA) (SF < 20 µg/L + Hb < 120 g/L). Participants with CRP >10 mg/L were excluded from this study. Dietary assessment was conducted using a computerised iron food frequency questionnaire including questions on dietary habits, purposely to assess foods affecting iron status. In addition, a 24-hour dietary recall was used to assess the average daily nutrient intake of Solomon Islands women. Demographic and body composition data were also collected together with data on other factors affecting iron status such as blood loss and general health history. Results: No significant difference in the prevalence of low iron stores + IDA was found in Solomon Islands and Caucasian women (17 vs. 23%, p=0.478). The frequency of red meat, prepared meat and offal, and all white meat consumption did not differ between the two groups (p=0.187). There was a significant difference in fish/seafood consumption (p=0.001), Solomon Islands women consumed fish/seafood more frequently than Caucasian women. Solomon Islands women also consumed medium-high vitamin C fruits more frequently (p=0.002) and dairy products less frequently (p=0.001) than Caucasian women. No significant difference (p=0.872) was identified in the frequency of intake of beverages containing polyphenol between the two groups. But the analysis of individual beverages showed that Solomon Islands women more frequently consumed black tea compared to Caucasian women, the similar practice was identified from the dietary habit assessment where 40% of Solomon Islands women drank black tea an hour before or after evening meals. Fewer Solomon Islands women consumed multivitamins/minerals than Caucasian women (12.8% vs. 66.7% respectively) and none of the Solomon Islands women reported taking dietary supplements compared to 44% Caucasian women. In regards to menstrual blood loss, although there was no significant difference between the two groups in overall menstrual blood loss units, Caucasian women reported on average 1 day longer menstrual period than Solomon Islands women. A small number of women in each group had previously donated blood, but in every case it had taken place more than 6 months prior to this study. Contraceptive use was significantly lower among Solomon Islands women compared to Caucasian women (p=0.001). Body mass index and waist circumferences were significantly higher (p=0.001 and p=0.001 respectively) in the Solomon Islands women compared to the Caucasian women. Conclusion: The iron status of Solomon Islands and Caucasian women did not differ, but there was variability between groups in the intake of foods and behaviours that are known to influence iron status. This study found both protective and non-protective factors for ID among Solomon Islands women, although the correlation of those factors with iron status were not able to be assessed due to a relatively small sample size and low prevalence of ID/IDA. This study therefore concludes that ID was not a concern for Solomon Islands women living in NZ, and that the prevalence was lower in this group than in women living in the Solomon Islands. This is possibly the result of adapting to different dietary habits and behaviours, increased accessibility to animal sources of iron, and high intakes of vitamin C-rich foods in their host country.