Skip to main content
Top
Published in: BMC Public Health 1/2013

Open Access 01-12-2013 | Research article

Higher n3-fatty acid status is associated with lower risk of iron depletion among food insecure Canadian Inuit women

Authors: Jennifer A Jamieson, Harriet V Kuhnlein, Hope A Weiler, Grace M Egeland

Published in: BMC Public Health | Issue 1/2013

Login to get access

Abstract

Background

High rates of iron deficiency and anemia are common among Inuit and Arctic women despite a traditional diet based on animal source foods. However, representative data on iron status and relevant determinants for this population are lacking. The objectives were to determine the prevalence of anemia and depletion of iron stores, then to identify correlates of iron status in non-pregnant Canadian Inuit women.

Methods

In a cross-sectional survey of 1550 women in the International Polar Year Inuit Health Survey, 2007-2008, hemoglobin, serum ferritin, soluble transferrin receptor (on a subset), C-reactive protein (CRP), RBC fatty acid composition, and H pylori serology were analyzed on fasting venous blood. Sociodemographic, food security status, anthropometric, dietary, and health data were collected. Correlates of iron status were assessed with multivariate linear and logistic models.

Results

Anemia was observed in 21.7% and iron deficient erythropoiesis in 3.3% of women. For women with CRP ≤ 10 mg/L (n = 1260) 29.4% had depleted iron stores. Inadequate iron intakes were observed in 16% of premenopausal and <1% of postmenopausal women. Among food insecure women, higher long-chain (n-3) polyunsaturated fatty acid (LC-PUFA) status, which reflects a more traditional food pattern, was associated with reduced risk of iron depletion.

Conclusions

Iron depletion and anemia are a concern for Inuit women despite adequate total dietary iron intake primarily from heme sources. The high prevalence of H. pylori exposure, together with dietary iron adequacy, suggests an inflammation-driven iron deficiency and mild anemia. The anti-inflammatory properties of LC-PUFA may be important for iron status in this population.
Appendix
Available only for authorised users
Literature
1.
go back to reference Lynch S: Iron Metabolism. Nutritional Anemia. Edited by: Kraemer K, Zimmermann MB. 2007, Basel: Sight and Life Press, 59-76. Lynch S: Iron Metabolism. Nutritional Anemia. Edited by: Kraemer K, Zimmermann MB. 2007, Basel: Sight and Life Press, 59-76.
2.
go back to reference Kuhnlein HV, Receveur O, Soueida R, Berti P: Unique patterns of dietary adequacy in three cultures of Canadian Arctic indigenous peoples. Publ Health Nutr. 2008, 11: 349-360.CrossRef Kuhnlein HV, Receveur O, Soueida R, Berti P: Unique patterns of dietary adequacy in three cultures of Canadian Arctic indigenous peoples. Publ Health Nutr. 2008, 11: 349-360.CrossRef
3.
go back to reference Petersen KM, Parkinson AJ, Nobmann ED, Bulkow L, Yip R, Mokdad A: Iron deficiency anemia among Alaska Natives may be due to fecal loss rather than inadequate intake. J Nutr. 1996, 126: 2774-2783.PubMed Petersen KM, Parkinson AJ, Nobmann ED, Bulkow L, Yip R, Mokdad A: Iron deficiency anemia among Alaska Natives may be due to fecal loss rather than inadequate intake. J Nutr. 1996, 126: 2774-2783.PubMed
4.
go back to reference Nutrition Canada: Iron. Eskimo Survey Reports: a report from Nutrition Canada by the Bureau of Nutritional Sciences. 1975, Ottawa: Information Canada, 111-125. Nutrition Canada: Iron. Eskimo Survey Reports: a report from Nutrition Canada by the Bureau of Nutritional Sciences. 1975, Ottawa: Information Canada, 111-125.
5.
go back to reference Plante C, Blanchet C, O'Brien H: Iron deficiency and anemia among women in Nunavik. Qanuippitaa? How are we?. 2007, Quebec City: Institut national de sante publique du Quebec; Nunavik Refional Board of Health and Social Services Plante C, Blanchet C, O'Brien H: Iron deficiency and anemia among women in Nunavik. Qanuippitaa? How are we?. 2007, Quebec City: Institut national de sante publique du Quebec; Nunavik Refional Board of Health and Social Services
6.
go back to reference Valberg L, Birkett N, Haist J, Zamecnik J, Pelletier O: Evaluation of the body iron status of native Canadians. Can Med Assoc J. 1979, 120: 285-289.PubMedPubMedCentral Valberg L, Birkett N, Haist J, Zamecnik J, Pelletier O: Evaluation of the body iron status of native Canadians. Can Med Assoc J. 1979, 120: 285-289.PubMedPubMedCentral
7.
go back to reference Jamieson JA, Kuhnlein HV: The paradox of anemia with high meat intake: a review of the multifactorial etiology of anemia in the Inuit of North America. Nutr Rev. 2008, 66: 256-271. 10.1111/j.1753-4887.2008.00030.x.CrossRefPubMed Jamieson JA, Kuhnlein HV: The paradox of anemia with high meat intake: a review of the multifactorial etiology of anemia in the Inuit of North America. Nutr Rev. 2008, 66: 256-271. 10.1111/j.1753-4887.2008.00030.x.CrossRefPubMed
8.
go back to reference Kuhnlein HV, Receveur O: Local cultural animal food contributes high levels of nutrients for Arctic Canadian Indigenous adults and children. J Nutr. 2007, 137: 1110-1114.PubMed Kuhnlein HV, Receveur O: Local cultural animal food contributes high levels of nutrients for Arctic Canadian Indigenous adults and children. J Nutr. 2007, 137: 1110-1114.PubMed
9.
go back to reference Kuhnlein HV, Receveur O, Soueida R, Egeland GM: Arctic Indigenous Peoples experience the nutrition transition with changing dietary patterns and obesity. J Nutr. 2004, 134: 1447-1453.PubMed Kuhnlein HV, Receveur O, Soueida R, Egeland GM: Arctic Indigenous Peoples experience the nutrition transition with changing dietary patterns and obesity. J Nutr. 2004, 134: 1447-1453.PubMed
10.
go back to reference Milman N, Byg K, Mulvad G, Pedersen H, Bjerregaard P: Iron status markers in 224 indigenous Greenlanders: influence of age, residence and traditional foods. Eur J Hematol. 2001, 66 (2): 115-125. 10.1034/j.1600-0609.2001.00312.x.CrossRef Milman N, Byg K, Mulvad G, Pedersen H, Bjerregaard P: Iron status markers in 224 indigenous Greenlanders: influence of age, residence and traditional foods. Eur J Hematol. 2001, 66 (2): 115-125. 10.1034/j.1600-0609.2001.00312.x.CrossRef
11.
go back to reference Milman N, Byg K, Mulvad G, Pedersen H, Bjerregaard P: Haemoglobin concentrations appear to be lower in indigenous Greenlanders than in Danes: assessment of haemoglobin in 234 Greenlanders and in 2804 Danes. Eur J Haematol. 2001, 67: 23-29. 10.1034/j.1600-0609.2001.067001023.x.CrossRefPubMed Milman N, Byg K, Mulvad G, Pedersen H, Bjerregaard P: Haemoglobin concentrations appear to be lower in indigenous Greenlanders than in Danes: assessment of haemoglobin in 234 Greenlanders and in 2804 Danes. Eur J Haematol. 2001, 67: 23-29. 10.1034/j.1600-0609.2001.067001023.x.CrossRefPubMed
12.
go back to reference Plante C, Blanchet C, Rochette L, O'Brien H: Prevalence of anemia among Inuit women in Nunavik, Canada. Int J Circumpolar Health. 2011, 70: 154-165.CrossRefPubMed Plante C, Blanchet C, Rochette L, O'Brien H: Prevalence of anemia among Inuit women in Nunavik, Canada. Int J Circumpolar Health. 2011, 70: 154-165.CrossRefPubMed
13.
go back to reference Zienczuk N, Egeland GM: Association between socioeconomic status and overweight among Inuit adults: International Polar Year Inuit Health Survey, 2007-2008. Int J Circumpolar Health. 2012, 71: 1-7.CrossRefPubMed Zienczuk N, Egeland GM: Association between socioeconomic status and overweight among Inuit adults: International Polar Year Inuit Health Survey, 2007-2008. Int J Circumpolar Health. 2012, 71: 1-7.CrossRefPubMed
14.
go back to reference Zimmerman MB, Zeder C, Muthayya S, Winichagoon P, Chaouki N, Aeberli I, Hurrell RF: Adiposity in women and children from transition countries predicts decreased iron absorption, iron deficiency and a reduced response to iron fortification. Int J Obes. 2008, 32: 1098-1104. 10.1038/ijo.2008.43.CrossRef Zimmerman MB, Zeder C, Muthayya S, Winichagoon P, Chaouki N, Aeberli I, Hurrell RF: Adiposity in women and children from transition countries predicts decreased iron absorption, iron deficiency and a reduced response to iron fortification. Int J Obes. 2008, 32: 1098-1104. 10.1038/ijo.2008.43.CrossRef
15.
go back to reference Tussing-Humphreys L, Nemeth E, Fantuzzi G, Guzman G, Holterman AX, Braunschweig C: Elevated systemic hepcidin and iron depletion in obese premenopausal females. Obesity (Silver Spring). 2010, 18: 1449-1456. 10.1038/oby.2009.319.CrossRef Tussing-Humphreys L, Nemeth E, Fantuzzi G, Guzman G, Holterman AX, Braunschweig C: Elevated systemic hepcidin and iron depletion in obese premenopausal females. Obesity (Silver Spring). 2010, 18: 1449-1456. 10.1038/oby.2009.319.CrossRef
16.
go back to reference Bersamin A, Luick BR, King IB, Stern JS, Zidenberg-Cherr S: Westernizing diets influence fat intake, red blood cell fatty acid composition, and health in remote Alaskan Native communities in the center for Alaska Native health study. J Am Diet Assoc. 2008, 108: 266-273. 10.1016/j.jada.2007.10.046.CrossRefPubMed Bersamin A, Luick BR, King IB, Stern JS, Zidenberg-Cherr S: Westernizing diets influence fat intake, red blood cell fatty acid composition, and health in remote Alaskan Native communities in the center for Alaska Native health study. J Am Diet Assoc. 2008, 108: 266-273. 10.1016/j.jada.2007.10.046.CrossRefPubMed
17.
go back to reference Egeland GM, Cao Z, Young T: Hypertriglyceridemic-waist phenotype and glucose intolerance among Canadian Inuit: the International Polar Year Inuit Health Survey for Adults 2007-2008. CMAJ. 2011, 183: E553-E558.CrossRefPubMedPubMedCentral Egeland GM, Cao Z, Young T: Hypertriglyceridemic-waist phenotype and glucose intolerance among Canadian Inuit: the International Polar Year Inuit Health Survey for Adults 2007-2008. CMAJ. 2011, 183: E553-E558.CrossRefPubMedPubMedCentral
18.
go back to reference World Health Organization: Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation (WHO Technical Report Series 894). 2000, Geneva: World Health Organization World Health Organization: Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation (WHO Technical Report Series 894). 2000, Geneva: World Health Organization
19.
go back to reference Nestel P: Adjusting Hemoglobin Values in Program Surveys. 2002, Washington, D.C.: International Nutritional Anemia Consultative Group Nestel P: Adjusting Hemoglobin Values in Program Surveys. 2002, Washington, D.C.: International Nutritional Anemia Consultative Group
20.
go back to reference Gibson RS: Assessment of Iron Status. Principles of Nutritional Assessment. 2005, New York: Oxford University Press, 443-476. 2 Gibson RS: Assessment of Iron Status. Principles of Nutritional Assessment. 2005, New York: Oxford University Press, 443-476. 2
21.
go back to reference Jamieson JA, Weiler HA, Kuhnlein HV, Egeland GM: Traditional food intake is correlated with iron stores in Canadian Inuit men. J Nutr. 2012, 142: 764-770. 10.3945/jn.111.140475.CrossRefPubMed Jamieson JA, Weiler HA, Kuhnlein HV, Egeland GM: Traditional food intake is correlated with iron stores in Canadian Inuit men. J Nutr. 2012, 142: 764-770. 10.3945/jn.111.140475.CrossRefPubMed
22.
go back to reference Gibson RS: Measuring food consumption of individuals. Principles of Nutritional Assessment. 2005, New York: Oxford University Press, 41-64. 2 Gibson RS: Measuring food consumption of individuals. Principles of Nutritional Assessment. 2005, New York: Oxford University Press, 41-64. 2
23.
go back to reference Carriquiry A: Assessing the prevalence of nutrient inadequacy. Publ Health Nutr. 1998, 2: 23-33. Carriquiry A: Assessing the prevalence of nutrient inadequacy. Publ Health Nutr. 1998, 2: 23-33.
25.
go back to reference Anctil M: Nunavut Inuit Health Survey 2004 - Survey Highlights. Qanuippitaa? How are we?. Edited by: Dupont M, Papineau E, Anctil M. 2008, Quebec City: Institut national de sante publique du Quebec; Nunavik Regional Board of Health and Social Services Anctil M: Nunavut Inuit Health Survey 2004 - Survey Highlights. Qanuippitaa? How are we?. Edited by: Dupont M, Papineau E, Anctil M. 2008, Quebec City: Institut national de sante publique du Quebec; Nunavik Regional Board of Health and Social Services
26.
go back to reference Statistics Canada: Aboriginal Peoples Survey Community Profiles. Aboriginal Peoples Survey. 2001, Ottawa: Statistics Canada Statistics Canada: Aboriginal Peoples Survey Community Profiles. Aboriginal Peoples Survey. 2001, Ottawa: Statistics Canada
27.
go back to reference Nord M, Andrews M, Carlson S: Household food security in the United States, 2005. Economic Research Service ERR-29. 2006, Washington, D.C: United States Department of Agriculture Nord M, Andrews M, Carlson S: Household food security in the United States, 2005. Economic Research Service ERR-29. 2006, Washington, D.C: United States Department of Agriculture
28.
go back to reference Egeland GM, Pacey A, Cao Z, Sobol I: Food insecurity among Inuit preschoolers: Nunavut Inuit Child Health Survey, 2007–2008. CMAJ. 2010, 182: 243-248.CrossRefPubMedPubMedCentral Egeland GM, Pacey A, Cao Z, Sobol I: Food insecurity among Inuit preschoolers: Nunavut Inuit Child Health Survey, 2007–2008. CMAJ. 2010, 182: 243-248.CrossRefPubMedPubMedCentral
29.
go back to reference Beard J, Han O: Systemic iron status. Biochim Biophys Acta. 2009, 1790: 584-588. 10.1016/j.bbagen.2008.09.005.CrossRefPubMed Beard J, Han O: Systemic iron status. Biochim Biophys Acta. 2009, 1790: 584-588. 10.1016/j.bbagen.2008.09.005.CrossRefPubMed
30.
go back to reference Institute of Medicine Food and Nutrition Board: Iron: Dietary Reference Intakes for vitamin A. vitamin K, arsenic, boron, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. 2001, Washington, D.C: National Academy Press, 290-393. Institute of Medicine Food and Nutrition Board: Iron: Dietary Reference Intakes for vitamin A. vitamin K, arsenic, boron, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. 2001, Washington, D.C: National Academy Press, 290-393.
31.
go back to reference Suominen P, Punnonen K, Rajamaki A, Irjala K: Serum transferrin receptor and transferrin receptor-ferritin index identify healthy subjects with subclinical iron deficits. Blood. 1998, 92: 2934-2939.PubMed Suominen P, Punnonen K, Rajamaki A, Irjala K: Serum transferrin receptor and transferrin receptor-ferritin index identify healthy subjects with subclinical iron deficits. Blood. 1998, 92: 2934-2939.PubMed
32.
go back to reference Schwarz P, Kübler JA, Strnad P, Müller K, Barth TF, Gerloff A, Feick P, Peyssonnaux C, Vaulont S, Adler G, Kulaksiz H: Hepcidin is localised in gastric parietal cells, regulates acid secretion and is induced by Helicobacter pylori infection. Gut. 2012, 61: 193-201. 10.1136/gut.2011.241208.CrossRefPubMed Schwarz P, Kübler JA, Strnad P, Müller K, Barth TF, Gerloff A, Feick P, Peyssonnaux C, Vaulont S, Adler G, Kulaksiz H: Hepcidin is localised in gastric parietal cells, regulates acid secretion and is induced by Helicobacter pylori infection. Gut. 2012, 61: 193-201. 10.1136/gut.2011.241208.CrossRefPubMed
33.
go back to reference Scientific Advisory Committee on Nutrition: Iron and health. 2010, Norwich, UK: The Stationery Office Scientific Advisory Committee on Nutrition: Iron and health. 2010, Norwich, UK: The Stationery Office
34.
go back to reference Tussing-Humphreys L, Pusatcioglu C, Nemeth E, Braunschweig C: Rethinking iron regulation and assessment in iron deficiency, anemia of chronic disease, and obesity: introducing hepcidin. J Acad Nutr Diet. 2012, 112: 391-400. 10.1016/j.jada.2011.08.038.CrossRefPubMedPubMedCentral Tussing-Humphreys L, Pusatcioglu C, Nemeth E, Braunschweig C: Rethinking iron regulation and assessment in iron deficiency, anemia of chronic disease, and obesity: introducing hepcidin. J Acad Nutr Diet. 2012, 112: 391-400. 10.1016/j.jada.2011.08.038.CrossRefPubMedPubMedCentral
35.
go back to reference Makhoul Z, Kristal AR, Gulati R, Luick B, Bersamin A, O’Brien D, Hopkins SE, Stephensen CB, Stanhope KL, Havel PJ, Boyer B: Associations of obesity with triglycerides and C-reactive protein are attenuated in adults with high red blood cell eicosapentaenoic and docosahexaenoic acids. Eur J Clin Nutr. 2011, 65: 808-817. 10.1038/ejcn.2011.39.CrossRefPubMedPubMedCentral Makhoul Z, Kristal AR, Gulati R, Luick B, Bersamin A, O’Brien D, Hopkins SE, Stephensen CB, Stanhope KL, Havel PJ, Boyer B: Associations of obesity with triglycerides and C-reactive protein are attenuated in adults with high red blood cell eicosapentaenoic and docosahexaenoic acids. Eur J Clin Nutr. 2011, 65: 808-817. 10.1038/ejcn.2011.39.CrossRefPubMedPubMedCentral
36.
go back to reference Zhou YE, Kubow S, Egeland GM: Highly unsaturated n-3 fatty acid status of Canadian Inuit: International Polar Year Inuit Health Survey, 2007-2008. Int J Circumpolar Health. 2011, 70: 498-510.CrossRefPubMed Zhou YE, Kubow S, Egeland GM: Highly unsaturated n-3 fatty acid status of Canadian Inuit: International Polar Year Inuit Health Survey, 2007-2008. Int J Circumpolar Health. 2011, 70: 498-510.CrossRefPubMed
37.
go back to reference Harris WS, Pottala JV, Varvel SA, Borowski JJ, Ward JN, McConnell JP: Erythrocyte omega-3 fatty acids increase and linoleic acid descreases with age: Observations from 160,000 paitents. Prostaglandins Leukot Essent Fatty Acids. 2013, 10.1016/j.plefa.2012.12.004. Harris WS, Pottala JV, Varvel SA, Borowski JJ, Ward JN, McConnell JP: Erythrocyte omega-3 fatty acids increase and linoleic acid descreases with age: Observations from 160,000 paitents. Prostaglandins Leukot Essent Fatty Acids. 2013, 10.1016/j.plefa.2012.12.004.
38.
go back to reference Lucas M, Proust F, Blanchet C, Ferland A, Déry S, Abdous B, Dewailly E: Is marine mammal fat or fish intake most strongly associated with omega-3 blood levels among the Nunavik Inuit?. Prostaglandins Leukot Essent Fatty Acids. 2010, 83: 143-150. 10.1016/j.plefa.2010.06.006.CrossRefPubMed Lucas M, Proust F, Blanchet C, Ferland A, Déry S, Abdous B, Dewailly E: Is marine mammal fat or fish intake most strongly associated with omega-3 blood levels among the Nunavik Inuit?. Prostaglandins Leukot Essent Fatty Acids. 2010, 83: 143-150. 10.1016/j.plefa.2010.06.006.CrossRefPubMed
39.
go back to reference Kuhnlein HV, Erasmus B, Spigelski D: Indigenous peoples' food systems: the many dimensions of culture, diversity and environment for nutrition and health. 2009, Rome: FAO Nutrition and Consumer Protection Division Kuhnlein HV, Erasmus B, Spigelski D: Indigenous peoples' food systems: the many dimensions of culture, diversity and environment for nutrition and health. 2009, Rome: FAO Nutrition and Consumer Protection Division
40.
go back to reference Parkinson AJ, Gold BD, Bulkow L, Wainwright RB, Swaminathan B, Khanna B, Petersen KM, Fitzgerald MA: High prevalence of Helicobacter pylori in the Alaska Native population and association with low serum ferritin levels in young adults. Clin Diagn Lab Immunol. 2000, 7: 885-888.PubMedPubMedCentral Parkinson AJ, Gold BD, Bulkow L, Wainwright RB, Swaminathan B, Khanna B, Petersen KM, Fitzgerald MA: High prevalence of Helicobacter pylori in the Alaska Native population and association with low serum ferritin levels in young adults. Clin Diagn Lab Immunol. 2000, 7: 885-888.PubMedPubMedCentral
Metadata
Title
Higher n3-fatty acid status is associated with lower risk of iron depletion among food insecure Canadian Inuit women
Authors
Jennifer A Jamieson
Harriet V Kuhnlein
Hope A Weiler
Grace M Egeland
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2013
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-13-289

Other articles of this Issue 1/2013

BMC Public Health 1/2013 Go to the issue