Predictors of antenatal alcohol use among Australian women: a prospective cohort study.

OBJECTIVE: To identify predictors of antenatal alcohol consumption among women who usually consume alcohol. DESIGN: Prospective cohort study. SETTING: Australian Longitudinal Study on Women's Health (ALSWH). POPULATION OR SAMPLE: A total of 1969 women sampled from the ALSWH 1973-78 cohort. METHODS: Women were included if they were pregnant in 2000, 2003, 2006 or 2009. The relationship between antenatal alcohol consumption and sociodemographics, reproductive health, mental health, physical health, health behaviours, alcohol guidelines and healthcare factors was investigated using a multivariate logistic regression model. MAIN OUTCOME MEASURES: Alcohol use during pregnancy. RESULTS: Most (82.0%) women continued to drink alcohol during pregnancy. Women were more likely to drink alcohol during pregnancy if they had consumed alcohol on a weekly basis before pregnancy (odds ratio [OR] 1.47; 95% confidence interval [95% CI] 1.13-1.90), binge drank before pregnancy (OR 2.28; 95% CI 1.76-2.94), or if they were pregnant while alcohol guidelines recommended low alcohol versus abstinence (OR 1.60; 95% CI 1.26-2.03). Drinking during pregnancy was less likely if women had a Health Care Card (OR 0.63; 95% CI 0.45-0.88) or if they had ever had fertility problems (OR 0.64; 95% CI 0.48-0.86). CONCLUSIONS: Most Australian women who drank alcohol continued to do so during pregnancy. Prepregnancy alcohol consumption was one of the main predictors of antenatal alcohol use. Alcohol guidelines, fertility problems and Health Care Card status also impacted antenatal alcohol consumption.

Evaluation of steam pasteurization in controlling Salmonella serotype Enteritidis on raw almond surfaces.

AIM: To investigate the efficacy of steam pasteurization for reducing Salmonella serotype Enteritidis on raw almond surfaces. METHODS AND RESULTS: Nonpareil almonds were inoculated to 10(7-8) CFU g(-1) with a Salm. Enteritidis cocktail (Salm. Enteritidis 43353, ME-13, ME-14) or Salm. Enteritidis phage type 30, dried overnight and subjected to steam treatments through a pilot-sized vertical pasteurization machine for 5, 15, 25, 35, 45, 55 and 65 s to investigate the effect of steam on a single layer of almond. Survival of Salm. Enteritidis was evaluated with tryptic soy agar and xylose lysine desoxycholate overlay for total and healthy cells, respectively. No significant differences (P > 0.05) in reduction were observed between the Salm. Enteritidis cocktail and Salm. Enteritidis PT 30 inoculum. Reduction of Salm. Enteritidis increased as a function of treatment time, with 25 s being sufficient to achieve a 5-log reduction. Discolouration and visible formation of wrinkles were observed following steam pasteurization of more than 35 s. CONCLUSIONS: Steam pasteurization of 25 s is sufficient to achieve a 5-log reduction of Salm. Enteritidis inoculated on raw almonds without visual quality degradation. SIGNIFICANCE AND IMPACT OF THE STUDY: Steam pasteurization is an effective alternative to reduce or prevent Salm. Enteritidis contamination on raw almonds.

Short communication: low-fat ice cream flavor not modified by high hydrostatic pressure treatment of whey protein concentrate.

The purpose of this study was to examine flavor binding of high hydrostatic pressure (HHP)-treated whey protein concentrate (WPC) in a real food system. Fresh Washington State University (WSU, Pullman) WPC, produced by ultrafiltration of separated Cheddar cheese whey, was treated at 300 MPa for 15 min. Commercial WPC 35 powder was reconstituted to equivalent total solids as WSU WPC (8.23%). Six batches of low-fat ice cream were produced: A) HHP-treated WSU WPC without diacetyl; B) and E) WSU WPC with 2 mg/L of diacetyl added before HHP; C) WSU WPC with 2 mg/L of diacetyl added after HHP; D) untreated WSU WPC with 2 mg/L of diacetyl; and F) untreated commercial WPC 35 with 2 mg/L of diacetyl. The solution of WSU WPC or commercial WPC 35 contributed 10% to the mix formulation. Ice creams were produced by using standard ice cream ingredients and processes. Low-fat ice creams containing HHP-treated WSU WPC and untreated WSU WPC were analyzed using headspace-solid phase microextraction-gas chromatography. Sensory evaluation by balanced reference duo-trio test was carried out using 50 untrained panelists in 2 sessions on 2 different days. The headspace-solid phase microextraction-gas chromatography analysis revealed that ice cream containing HHP-treated WSU WPC had almost 3 times the concentration of diacetyl compared with ice cream containing untreated WSU WPC at d 1 of storage. However, diacetyl was not detected in ice creams after 14 d of storage. Eighty percent of panelists were able to distinguish between low-fat ice creams containing untreated WSU WPC with and without diacetyl, confirming panelists' ability to detect diacetyl. However, panelists were not able to distinguish between low-fat ice creams containing untreated and HHP-treated WSU WPC with diacetyl. These results show that WPC diacetyl-binding properties were not enhanced by 300-MPa HHP treatment for 15 min, indicating that HHP may not be suitable for such applications.

Influence of salt-to-moisture ratio on starter culture and calcium lactate crystal formation.

The occurrence of L(+)-lactate crystals in hard cheeses continues to be an expense to the cheese industry. Salt tolerance of the starter culture and the salt-to-moisture ratio (S:M) in cheese dictate the final pH of cheese, which influences calcium lactate crystal (CLC) formation. This research investigates these interactions on the occurrence of CLC. A commercial starter was selected based on its sensitivity to salt, less than and greater than 4.0% S:M. Cheddar cheese was made by using either whole milk (3.25% protein, 3.85% fat) or whole milk supplemented with cream and ultrafiltered milk (4.50% protein, 5.30% fat). Calculated amounts of salt were added at milling (pH 5.40 +/- 0.02) to obtain cheeses with less than 3.6% and greater than 4.5% S:M. Total and soluble calcium, total lactic acid, and pH were measured and the development of CLC was monitored in cheeses. All cheeses were vacuum packaged and gas flushed with nitrogen gas and aged at 7.2 degrees C for 15 wk. Concentration of total lactic acid in high S:M cheeses ranged from 0.73 to 0.80 g/100 g of cheese, whereas that in low S:M cheeses ranged from 1.86 to 1.97 g/100 g of cheese at the end of 15 wk of aging because of the salt sensitivity of the starter culture. Concentrated milk cheeses with low and high S:M exhibited a 30 to 28% increase in total calcium (1,242 and 1,239 mg/100 g of cheese, respectively) compared with whole milk cheeses with low and high S:M (954 and 967 mg/100 g of cheese, respectively) throughout aging. Soluble calcium was 41 to 35% greater in low S:M cheeses (low-salt whole milk cheese and low-salt concentrated milk cheese; 496 and 524 mg/100 g of cheese, respectively) compared with high S:M cheeses (high-salt whole milk cheese and high-salt concentrated milk cheese; 351 and 387 mg/100 g of cheese, respectively). Because of the lower pH of the low S:M cheeses, CLC were observed in low S:M cheeses. However, the greatest intensity of CLC was observed in gas-flushed cheeses made with milk containing increased protein concentration because of the increased content of calcium available for CLC formation. These results show that the occurrence of CLC is dependent on cheese milk concentration and pH of the cheese, which can be influenced by S:M and cheese microflora.

Cheese pH, protein concentration, and formation of calcium lactate crystals.

The occurrence of calcium lactate crystals (CLC) in hard cheeses is a continual expense to the cheese industry, as consumers fail to purchase cheeses with this quality defect. This research investigates the effects of the protein concentration of cheese milk and the pH of cheese on the occurrence of CLC. Atomic absorption spectroscopy was used to determine total and soluble calcium concentrations in skim milk (SM1, 8.7% total solids), and skim milk supplemented with nonfat dry milk (CSM1, 13.5% total solids). Calcium, phosphorus, lactic acid, and citrate were determined in cheeses made with skim milk (SM2, 3.14% protein), skim milk supplemented with ultrafiltered milk (CSM2, 6.80% protein), and nonfat dry milk (CSM3, 6.80% protein). Supplementation with nonfat dry milk increased the initial total calcium in CSM1 (210 mg/100 g of milk) by 52% compared with the total calcium in SM1 (138 mg/100 g of milk). At pH 5.4, soluble calcium concentrations in CSM1 were 68% greater than soluble calcium in SM1. In cheeses made from CSM2 and CSM3, total calcium was 26% greater than in cheeses made from SM2. As the pH of cheeses made from SM2 decreased from 5.4 to 5.1, the concentration of soluble calcium increased by 61.6%. In cheeses made from CSM2 and CSM3, the concentrations of soluble calcium increased by 41.4 and 45.5%, respectively. Calcium lactate crystals were observed in cheeses made from SM2 at and below pH 5.1, whereas CLC were observed in cheeses from CSM2 and CSM3 at and below pH 5.3. The increased presence of soluble calcium can potentially cause CLC to occur in cheese manufactured with increased concentrations of milk solids, particularly at and below pH 5.1.

Differences in mail and telephone responses to self-rated health: use of multiple imputation in correcting for response bias.

OBJECTIVES: To estimate differences in self-rated health by mode of administration and to assess the value of multiple imputation to make self-rated health comparable for telephone and mail. METHODS: In 1996, Survey 1 of the Australian Longitudinal Study on Women's Health was answered by mail. In 1998, 706 and 11,595 mid-age women answered Survey 2 by telephone and mail respectively. Self-rated health was measured by the physical and mental health scores of the SF-36. Mean change in SF-36 scores between Surveys 1 and 2 were compared for telephone and mail respondents to Survey 2, before and after adjustment for sociodemographic and health characteristics. Missing values and SF-36 scores for telephone respondents at Survey 2 were imputed from SF-36 mail responses and telephone and mail responses to sociodemographic and health questions. RESULTS: At Survey 2, self-rated health improved for telephone respondents but not mail respondents. After adjustment, mean changes in physical health and mental health scores remained higher (0.4 and 1.6 respectively) for telephone respondents compared with mail respondents (-1.2 and 0.1 respectively). Multiple imputation yielded adjusted changes in SF-36 scores that were similar for telephone and mail respondents. CONCLUSIONS AND IMPLICATIONS: The effect of mode of administration on the change in mental health is important given that a difference of two points in SF-36 scores is accepted as clinically meaningful. Health evaluators should be aware of and adjust for the effects of mode of administration on self-rated health. Multiple imputation is one method that may be used to adjust SF-36 scores for mode of administration bias.

Enhanced lactose cheese milk does not guarantee calcium lactate crystals in finished cheddar cheese.

Three experimental batches of Cheddar cheese were manufactured in duplicate, with standardization of the initial cheese-milk lactose content to high (5.24%), normal (4.72%, control), and low lactose (3.81%). After 35 d of aging at 4.4 degrees C, the cheeses were subjected to temperature abuse (24 h at 21 degrees C, unopened) and contamination (24 h at 21 degrees C, packages opened and cheeses contaminated with crystal-containing cheese). After aging for 167 d, residual cheese lactose (0.08 to 0.43%) and L(+)-lactate concentrations (1.37 to 1.60%) were high and D(-)-lactate concentrations were low (<0.03%) for all cheeses. No significant differences in lactose concentrations were attributable to temperature abuse or contamination. No significant differences in L(+)- or D(-)-lactate concentrations were attributable to temperature abuse. However, concentrations of L(+)-lactate were significantly lower and D(-)-lactate were significantly higher in contaminated cheeses than in control cheeses, indicating inoculation (at d 35) with heterofermentative nonstarter lactic acid bacteria able to racemize L(+)-lactate to D(-)-lactate. The fact that none of the cheeses exhibited crystals after 167 d demonstrates that high cheese milk or residual lactose concentrations do not guarantee crystal formation. Contamination with nonstarter lactic acid bacteria can significantly contribute to D(-)-lactate accumulation in cheese.

Cardiac pathology and adult aboriginal mortality: a coronial study of sudden and external cause deaths in the top end of the Northern Territory in 1990.

A retrospective review of coronial records was performed for 179 adult decedents who came to coronial autopsy in 1990 and who had been living in the Top End of the Northern Territory at the time of death. The directly standardized rate of autopsy-examined sudden death was 7.4 times higher for Aboriginal people than for non-Aboriginal people. Coronary atherosclerosis was the cause of 37% (14/38) of the Aboriginal sudden deaths and 52% (16/31) of the non-Aboriginal sudden deaths. Evidence of coronary atherosclerosis rose with age and was seen more frequently in those dying suddenly compared to those dying of external causes. When directly standardized, the rate of autopsy-examined sudden death attributable to ischemic heart disease was 5.5 times higher for Aboriginal people than for non-Aboriginal people. Contrary to a previously published statement, there is considerable overlap between Aboriginal and non-Aboriginal heart weights, with 75% (55/73) of Aboriginal decedents and 84% (89/106) of non-Aboriginal decedents having heart weights between 250 and 500 g. We concluded that the rate of autopsy-examined sudden death from all causes, and specifically from ischemic heart disease, was much higher in Aboriginal people. However in a case of sudden death a presumptive clinical diagnosis of ischemic heart disease prior to autopsy is not justified in either Aboriginal or non-Aboriginal people, due to the high prevalence of other fatal conditions. The diagnosis of pathologically increased heart weight, which is critical in the assessment of sudden death, should be made on the same basis in both Aboriginal and non-Aboriginal people.

A new video-synchronized multichannel biomedical data acquisition system.

This data acquisition system records video frames onto a video tape, and simultaneously acquires biomedical data along with video time codes onto a computer hard disk to achieve a 30-min video-synchronized data recording with a summed data rate of 2.16 Mbit/s. A time-code-bridge-file created during acquisition matches each video frame-start with the corresponding index number of the acquired data. The mean synchronization accuracy of the system is 0.22 ms.

Beta-lactoglobulin molten globule induced by high pressure.

Beta-lactoglobulin (beta-LG) was treated with high hydrostatic pressure (HHP) at 600 MPa and 50 degrees C for selected times as long as 64 min. The intrinsic tryptophan fluorescence of beta-LG indicated that HHP treatment conditions induced a conformational change. HHP treatment conditions also promote a 3-fold increase in the extrinsic fluorescence of 1-anilinonaphthalene-8-sulfonate and a 2.6-fold decrease for cis-paraneric acid, suggesting an increase in accessible aromatic hydrophobicity and a decrease in aliphatic hydrophobicity. Far-ultraviolet circular dichroism (CD) spectra reveal that the secondary structure of beta-LG converts from native beta-sheets to non-native alpha-helices following HHP treatment, whereas near-ultraviolet CD spectra reveal that the native tertiary structure of beta-LG essentially disappears. Urea titrations reveal that native beta-LG unfolds cooperatively, but the pressure-treated molecule unfolds noncooperatively. The noncooperative state is stable for 3 months at 5 degrees C. The nonaccessible free thiol group of cysteine121 in native beta-LG became reactive to Ellman's reagent after adequate HHP treatment. Gel electrophoresis with and without beta-mercaptoethanol provided evidence that the exposed thiol group was lost concomitant with the formation of S-S-linked beta-LG dimers. Overall, these results suggest that HHP treatments induce beta-LG into hydrophobic molten globule structures that remain stable for at least 3 months.

The effect of retail store managers on aboriginal diet in remote communities.

Key nutrient densities of the diet of two remote northern coastal Aboriginal communities were measured using the store-turnover method during the periods that three store managers were responsible for each store respectively. Individual store managers were a greater determinant of nutrient density than the community itself. Furthermore, nutrient densities tended to be highest in both communities when their stores were administered by one particular store manager. The results support the notion that store managers wield considerable power over the food supply of remote Aboriginal communities, and raise questions concerning the ability of Aboriginal community members to influence their own food supplies in retail stores. However, the study also confirms that store managers can be important allies in efforts to improve Aboriginal dietary intake.

Evaluating the protective capacity of two-post ROPS for a seat-belted occupant during a farm tractor overturn.

This study evaluated the effectiveness of a commercial rollover protective structure (ROPS) and size-extended ROPS in protecting a 95th percentile male operator during tractor overturns. Six rear upset tests (commercial ROPS) and ten side upset tests (commercial and size-extended ROPS) were conducted. A 95th percentile instrumented male manikin was used in all tests. Head injury criterion (HIC15), 80 g limit on resultant head acceleration, neck injury criterion (Nij), and peak axial force (extension-compression) were employed to evaluate injury potential. In all rear tests, the manikin's head impact with the ground was within the tolerance limits for head/neck injuries. Based on limited trials in the side tests, the study observed a small to moderate chance of neck injuries under the commercial and size-extended ROPS conditions; the injury risk was not statistically significant between these two test conditions. This study identified a risk of non-fatal injuries for large-size operators in side overturns, although the prevention effectiveness of commercial versus size-extended ROPS cannot be determined without further testing. These findings may have implications for future ROPS designs.

Birth size of Australian aboriginal babies.

OBJECTIVES: (i) To describe birth size of Aboriginal babies by sex, gestational age, and Aboriginality; (ii) to analyse the results with reference to standards of ponderal index and birthweight for gestational age. SUBJECTS: 570 liveborn singletons routinely delivered at Royal Darwin Hospital between January 1987 and March 1991, and recorded in the Delivery Suite Register as being born to an Aboriginal mother. MAIN OUTCOME MEASURES: Weight, length and head circumference at birth. RESULTS: The mean birthweight was 3098 g (standard deviation, 601 g), peak gestational age was 39 weeks, 13% were low birthweight and 7% were preterm. Preterm rates did not differ significantly for sex and Aboriginality. Babies without a non-Aboriginal ancestor had a lower mean birthweight and at term, were significantly smaller than babies with a non-Aboriginal ancestor as assessed by mean birthweight, length, head circumference and ponderal index. More than a quarter of babies (27%) without a non-Aboriginal ancestor were below the 10th percentile of birthweight for gestational age, compared with 14.2% of babies with a non-Aboriginal ancestor. CONCLUSIONS: On the basis of postnatal clinical estimates of gestational age, Aboriginal babies have a preterm rate of 7% and Aboriginal babies without a non-Aboriginal ancestor are smaller in size at birth than babies with a non-Aboriginal ancestor.

Wrist postures while keyboarding: effects of a negative slope keyboard system and full motion forearm supports.

Video-motion analysis was used to analyse hand/wrist posture for subjects typing at a 101-key QWERTY keyboard on a 68 cm high worksurface. Three conditions were tested: subjects typed at the keyboard without arm support, subjects typed with adjustable full motion forearm supports, and subjects typed with an adjustable negative slope keyboard support system. The average declination of the negative slope keyboard support chosen by subjects was 12 degrees below horizontal, which flattened the angle of the key tops. Ulnar deviation was comparable in all conditions and averaged 13 degrees for the right hand and 15 degrees for the left hand. Full motion forearm supports did not significantly affect any postural measures. Dorsal wrist extension averaged 13 degrees when typing with or without the full motion forearm supports, but this was reduced to an average -1 degree with the use of the negative slope keyboard support system. Subjects chose to sit at a distance of 79 cm from the computer screen when using the negative slope keyboard system compared with 69 cm without this.

An evaluation of three methods used to assess the gestational age of aboriginal neonates.

Many Aboriginal women do not recall their last menstrual period date, so alternative methods of estimating gestational age are necessary for optimal obstetric and neonatal care. In this retrospective review of 605 Aboriginal infants born at the Royal Darwin Hospital, the gestational age was estimated by the Dubowitz method and compared with available gestational age estimates from first fundal height and first ultrasound measurement. There was good agreement between the Dubowitz and ultrasound estimates of gestational age with best agreement occurring when ultrasound was done in the first trimester and worst agreement in the third trimester. Agreement between fundal height and Dubowitz estimates was poor but the measurement of fundal height was not standardized. When accurate last menstrual period information is absent, these findings suggest that good estimates of gestational age in Aboriginal neonates can be determined from the Dubowitz assessment at birth and from ultrasound measurements taken in the first trimester.

In Vitro Effect of Bean Amylase Inhibitor on Insect Amylases 1.

The activity of a bean amylase inhibitor against amylases extracted from several insects was tested. Amylases extracted from Mediterranean flour moth larvae ( Anagasta kuhniella ), red flour beetle adults ( Tribolium castaneum ), both adults and larvae of Tribolium confusum (confused flour beetle) and yellow mealworm larvae ( Tenebrio molitor ) were inhibited while adult granary weevil ( Sitophilus granarius ) amylase was not inhibited by the bean inhibitor. The T. molitor amylase interaction with the bean inhibitor was studied further. Inhibition of the Tenebrio enzyme is expressed slowly at pH 5.4, but lowering the pH or raising the ionic strength of incubation media caused a marked increase in rate of expression of the inhibition.

Hospitalisation patterns in children from 10 aboriginal communities in the Northern Territory.

OBJECTIVE: To describe childhood hospitalisation patterns in rural Aboriginal communities in the Northern Territory. DESIGN: Longitudinal data for 1976-1985 were collected retrospectively between March 1986 and December 1987. COHORT: All children born between 1 January 1976 and 31 December 1985 and identified in records at 10 community health centres were included in the study, except for 30 children who were residents of more than one community. Records of hospital admissions were ascertained for the remaining 2254 children until five years of age or 31 December 1985, whichever was earlier. RESULTS: Mean admission rates for Aboriginal children aged 0-1 year were two to three times the national average, and there was a fourfold excess in the number of days in hospital and the number of deaths before the age of five years for Aboriginal infants. Admission rates varied by community, age, year and sex: at 0-6 months of age, rates for communities ranged from a minimum of 0.21 to a maximum of 1.46 admissions per child-year at risk and mean rates increased from 0.50 per year in 1976 to 1.05 in 1985; mean admission rates declined from 0.84 per child-year at age 0-6 months to 0.12 at age 37-60 months. Boys were admitted to hospital more frequently than girls. For communities, hospital stay ranged from a minimum of 2.7 to a maximum of 15.3 hospital days per child-year at risk. CONCLUSIONS: Differences of up to sevenfold in hospitalisation rates between communities highlight the potential for primary and secondary prevention of childhood disease in Aboriginal communities.

Elevated serum creatine kinase (CK-MM) in petrol sniffers using leaded or unleaded fuel.

This study examined blood lead and creatine kinase levels in a group of 24 Australian Aboriginal males admitted to the hospital for treatment of severe petrol sniffing related illness after using only leaded petrol and 27 sniffers, 16 ex-sniffers and 13 non-sniffers from an isolated Aboriginal community using only unleaded petrol. Creatine kinase levels (which were nearly all creatine kinase-skeletal muscle isoenzyme indicating skeletal muscle damage) were correlated with blood lead levels and were elevated in active sniffers of leaded petrol on admission to hospital but were also increased in those sniffing unleaded petrol in the remote community. After fourteen days in hospital, median creatine kinase levels of leaded petrol sniffers dropped rapidly to levels similar to those of ex-sniffers and non-sniffers while median blood lead levels decreased but still remained higher than the other three groups. The data suggest that elevated creatine kinase associated with petrol sniffing may be due to compounds in petrol other than the lead additives, possibly volatile hydrocarbon components. Elevated creatine kinase may be useful in detecting current petrol sniffing activity, particularly in locations using unleaded petrol.

An evaluation of unleaded petrol as a harm reduction strategy for petrol sniffers in an aboriginal community.

OBJECTIVE: In mid 1989, leaded petrol was replaced by unleaded petrol to reduce lead toxicity in petrol sniffers in Maningrida, a remote Aboriginal community in Northern Australia. RETROSPECTIVE REVIEWS: Hospital admissions between 1987 and 1992 due to petrol sniffing were compared for Maningrida and a community using only leaded petrol. RESULTS: Admissions from Maningrida decreased significantly following introduction of unleaded petrol (chi 2 on 2df = 22.25, p < 0.001). Lead and hydrocarbon exposures were also compared for three groups from Maningrida (27 sniffers using only unleaded petrol; 15 exsniffers and 13 nonsniffers) and 24 individuals admitted to hospital for petrol sniffing related illness from other communities using only leaded petrol. Median blood lead levels for hospitalized sniffers (using only leaded petrol). Maningrida sniffers (using only unleaded petrol), exsniffers and nonsniffers were 5.06, 1.87, 1.24 and 0.17 microM/L respectively. There were significant differences between blood lead level, delta-aminolevulinic acid dehydratase activity, and free erythrocyte protoporphyrin for sniffers of leaded and unleaded petrol, whereas these indices were not significantly different for current sniffers and exsniffers in Maningrida. Hydrocarbons were only detectable in the blood of active sniffers (toluene < or = 0.5 micrograms/mL; benzene < or = 0.17 micrograms/mL blood; n-hexane not detected). CONCLUSIONS: The elimination of tetraethyl lead from petrol resulted in a significant decrease in hospitalization of petrol sniffers.

Iron deficiency, general health and fatigue: results from the Australian Longitudinal Study on Women's Health.

Associations between self-reported 'low iron', general health and well-being, vitality and tiredness in women, were examined using physical (PCS) and mental (MCS) component summary and vitality (VT) scores from the MOS short-form survey (SF-36). 14,762 young (18-23 years) and 14,072 mid-age (45-50 years) women, randomly selected from the national health insurance commission (Medicare) database, completed a baseline mailed self-report questionnaire and 12,328 mid-age women completed a follow-up questionnaire 2 years later. Young and mid-age women who reported (ever) having had 'low iron' reported significantly lower mean PCS, MCS and VT scores, and greater prevalence of 'constant tiredness' at baseline than women with no history of iron deficiency [Differences: young PCS = -2.2, MCS = -4.8, VT = -8.7; constant tiredness: 67% vs. 45%; mid-age PCS = -1.4, MCS = -3.1, VT = -5.9; constant tiredness: 63% vs. 48%]. After adjusting for number of children, chronic conditions, symptoms and sociodemographic variables, mean PCS, MCS and VT scores for mid-age women at follow-up were significantly lower for women who reported recent iron deficiency (in the last 2 years) than for women who reported past iron deficiency or no history of iron deficiency [Means: PCS--recent = 46.6, past = 47.8, never = 47.7; MCS--recent = 45.4, past = 46.9, never = 47.4; VT--recent = 54.8, past = 57.6, never = 58.6]. The adjusted mean change in PCS, MCS and VT scores between baseline and follow-up were also significantly lower among mid-age women who reported iron deficiency only in the last 2 years (i.e. recent iron deficiency) [Mean change: PCS = -3.2; MCS = -2.1; VT = -4.2]. The results suggest that iron deficiency is associated with decreased general health and well-being and increased fatigue.