Iron status of a healthy French population: factors determining biochemical markers.

The iron status of a representative population sample in a district of Paris area (France) was assessed using a biochemical and dietary approach. Complete data were obtained for 1,108 subjects 6 months to 97 years old. Total iron intake increased up to adolescence and then remained stable in adult life. Iron intake was higher in men than in women. Most children and menstruating women presented a dietary iron intake below the recommended allowances. While anemia was not very common, iron deficiency (defined as the existence of at least two abnormal values in the four independent indicators of iron status: serum ferritin, erythrocyte protoporphyrin, transferrin saturation and MCV) was particularly common in infants, young children, menstruating women and elderly men. Serum ferritin, erythrocyte protoporphyrin and transferrin saturation were significantly correlated with inflammatory markers. Significant correlations were found between dietary total iron and serum ferritin (r = 0.29, p < 0.001) and hemoglobin (r = 0.44, p < 0.001). After adjustment for age, sex and inflammation, using multiple linear regression models, the relationship between both heme and nonheme iron intake and serum ferritin remained significant. Serum ferritin and hemoglobin levels were negatively correlated with calcium and phosphorus intake.

[Nutritional requirements of adults and intakes recommended for the satisfaction of these requirements]. / Les besoins nutritionnels de l'adulte et les apports conseillés pour la satisfaction de ces besoins.

Physicians are increasingly asked by patients or healthy subjects and by responsible people in communities to provide information on food consumption and health and to transmit data on foods that are regarded as suitable. International committees of specialists in FAO and WHO and national committees have examined the results of research on nutritional requirements as well as those of clinical and epidemiological studies on the relationship between food consumption profiles and state of health. They have issued documents in which the recommended intakes of proteins, minerals ans vitamins are presented in relation to age, sex, physiological status and activity. The figures given in these documents are "reference values" and not standards.

[Dietary intake in a representative sample of the population of Val-de Marne: II. Supply of macronutrients]. / Apports nutritionnels d'un échantillon représentatif de la population du Val-de-Marne: II. Les apports en macronutriments.

This paper describes an assessment of the nutritional value (carbohydrates, proteins, fats) of food intake studied in a population residing in the Val-de-Marne district of the Paris region. Data were collected from 1,108 subjects, aged 6 months to 97 years, randomly selected from the public telephone directories of 12 of the 47 towns and cities in the district. Dietary intake was evaluated from individual home interviews by specialized dietitians, using the dietary history method. Age was shown to be a major determinant of macro nutrient intake (expressed in absolute value) in both sexes. The amount of food consumed differed between men and women. Expressed as a relative value of energy intake (after exclusion of alcohol-related calories), the proportion of different macronutrients was similar in all age groups, for both sexes, and was not in agreement with recommended dietary allowances: too high levels of fats and insufficient levels of carbohydrates, especially starch.

[Dietary intake of a representative sample of the population of Val-de-Marne; III. Mineral and vitamin intake]. / Apports nutritionnels d'un échantillon représentatif de la population du Val-de-Marne: III. Les apports en minéraux et vitamines.

Mineral and vitamin intakes were assessed among 1108 subjects, aged 6 months to 97 years in 12 of 47 towns and cities in the district of Val-de-Marne (Paris area), using the telephone directory as random sampling base. Micronutrients intake was evaluated by individual interviews at home by specialized dietitians (dietary history method). Mineral and vitamin intake was found to vary widely with age. In absolute value, overall mineral and vitamin dietary intakes was higher in men than in women (except for vitamin C). Conversely, the dietary density for mineral and vitamins was higher in females. For a large part of the studied population, it would appear difficult to satisfy recommended dietary allowances for many micronutrients (iron, zinc, vit. B1, B6, C, A et E). These results bring to light possible difficulties in covering certain mineral and vitamin requirements in the French population.

Factors affecting iron stores in French female students.

Serum ferritin and haematological variables were determined in 476 healthy French students (21.3 +/- 0.2 years). Information was collected on the duration of menses and contraceptive uses. Dietary intakes were assessed by the dietary history method in a randomized subsample of 157 women. The proportion of anaemic subjects was low, but 16 per cent of women had exhausted iron stores (serum ferritin less than or equal to 12 micrograms/l). Duration of menses was negatively correlated with serum ferritin concentration. The mean iron intake was 10.92 +/- 0.02 mg/d. Only fewer than 5 per cent of the students had daily iron intakes corresponding to the recommended dietary allowances for menstruating women (greater than or equal to 16 mg/d). There was a positive correlation between energy consumption and iron intake (r = 0.79, P less than 10(-9) ). Tea and dairy products intakes appeared to have a significant negative correlation with serum ferritin. The positive correlation between serum ferritin and haemoglobin suggests that decreased or depleted iron stores are associated with suboptimal haemoglobin values. This raises the problem of the definition of normal serum ferritin and haemoglobin values in menstruating women.

Effects of iron supplementation on serum ferritin and other hematological indices of iron status in menstruating women.

Serum ferritin, hemoglobin, serum iron and transferrin iron-binding capacity were evaluated in 107 healthy female students. 21 women had a serum ferritin of 12 micrograms/l or less, corresponding to an exhaustion of body iron stores. After 1 month of iron supplementation, significant increase of hemoglobin concentration and decrease of total iron-binding capacity were observed. Mean serum ferritin had increased from 24 to 41 micrograms/l, and all women had a serum ferritin above 12 micrograms/l. 1 month after the end of the trial, serum ferritin fell significantly. This study points out the problem of serum ferritin reference values and the definition of normal iron stores in menstruating women.

[Relations between iron levels in mothers and in their newborn infants]. / Relations entre le statut en fer de la mère et du nouveau-né.

The iron levels were evaluated in 124 pregnant women towards the end of their pregnancies and in their newborn babies in 4 maternity units in Paris and in the surroundings. Two-third of the women studied had total absence of iron reserves (shown by a serum ferritin level less than or equal to 12 micrograms/l). Those who were at the greatest risk of having iron deficiency or anaemia were immigrant, non continental french and multiparous women. The tissue reserves of iron in the newborn are not directly linked to the levels of iron in the mother but are probably linked to the foetal and maternal haemoglobin-synthesis.

[Dietary iron intake in a population of French women of reproductive age]. / Apports alimentaires en fer dans une population de femmes françaises en âge de procréer.

Dietary iron intake has been estimated in 337 healthy, menstruating women, of high social conditions by dietary histories. The mean daily iron intake was 11 +/- 0.13 mg, of which 33% was supplied by meat and fish, whereas fruits and vegetables supplied 29%. The mean daily energy intake was 2,088 +/- 27 kcal (8,723 +/- 113 kJ). In 96.5% of the women, iron intake was lower than the Recommended Dietary Allowances (16-18 mg daily). There was a significantly positive correlation between energy intake and iron intake (r = 0.77; p less than 10(-9]. Therefore, the low iron intake may be considered as a consequence of a decrease in the energy intake observed during the last decades in industrialized countries. Iron fortification of one or several foods seems to be advisable to compensate, at least, partly iron intake deficiency.

[The most frequent errors committed in infant nutrition; possible pathogenic effects]. / Les erreurs les plus fréquemment commises dans l'alimentation du nourrisson; effets pathogènes éventuels.

The two initial years of life represent a period of growth and development which is not only extremely rapid, but is also a period of acquisition of alimentary behavior. We will not consider the problems posed by infant malnutrition in developing countries. In industrialized countries, mothers often fail to recognize the characteristics of different types of milk. Their children are consequently over-nourished frequently, but unconsciously. Certain foods of the infant diet contain relatively large quantities of sodium or sucrose. It is difficult to establish if this would engender a particular behavior towards salt or sugar, but the information available enables directives to be given both to the food industry and to mothers. Although little work has been done on the subject, it would be important to know the influence of the nursery (where numerous infants are kept 5 days a week from the age of two months onwards) and the primary school on the acquisition of alimentary behavior.