• Clinical and Experimental Pediatrics
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• 제45권3호
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• pp.362-369
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• 2002

목 적 : 빈혈은 아직도 전세계적으로 가장 흔히 볼 수 있는 영양결핍으로 특히 청소년기 여아에 많이 발생하는데, 그 원인은 철분의 불충분한 섭취, 빠른 성장에 따른 철분 필요량 증가 및 월경으로 인한 혈액 손실을 들 수 있다. 본 연구는 건강하게 보이는 중학생 및 고교의 여학생에 있어서 지난 10년간에 걸친 빈혈 및 철분에 관한 영양상태의 발표를 종합하였다. 방 법: 1990년 대구지역에서 도시와 농촌의 여학생에 대해, 1997년 부천지역 여학생에 대해, 1999년 울산지역에서 도시와 농촌지역 여학생에 대해, 2000년 인천에서 도시와 농촌의 여학생에 대해 혈액학적 조사와 신체 계측 그리고 설문지를 통한 조사가 이루어졌다. 빈혈은 혈색소 11.5 g/dL 미만으로 정의하였다. 철 결핍은 혈청 ferritin이 10 ng/mL 미만인 경우로 정의하였고, IDA는 혈색소가 최저 기준치 이하이면서 MCV 78 fL 미만, ferritin 10 ng/mL 미만, 또는 transferrin 포화도 10% 미만인 경우로 정의하였다. 결 과 : 1) 도시와 농촌간의 혈색소 평균치에는 유의할 만한 차이가 없었고, 연령이 증가함에 따라 평균 혈색소의 감소를 볼 수 있었다. 2) 전체적인 빈혈의 유병율은 1990년 13.4%, 1997년 6.9%, 1999년 6.0%, 2000년 5.7%로 감소하는 소견을 보이고 있고, 각각의 조사에서는 연령이 증가함에 따라 유병율도 증가하였다. 특히 여고생에서의 빈혈의 유병율은 1997년 10.1%, 2000년 12.6%로 높게 나타났다. 3) 철 결핍 유병율은 1990년 36.1%에 비해 1997년과 1999년은 13.9%, 13.3%로 감소하는 소견을 보이나 2000년 연구에서는 23.2%로 증가되었다. 4) 연도별 IDA의 유병율은 1990년에는 10.0%, 1997년 4.6%, 1999년 8.3%, 2000년 6.1%로 일정 하지는 않으나 감소하는 소견을 보이고 있고, 연령이 증가하면서 유병율이 증가하는 것을 볼 수 있다. 결 론 : 중, 고교 여학생에 있어서 10년 전에 비하여 철분 영양은 개선되었지만, 농촌과 도시에 관계없이 빈혈 및 철 결핍이 빈발하였고, 청소년기 연령이 올라갈수록 더욱 현저하였다. 더욱이 최근의 다이어트 풍조와 영양섭취의 불균형을 고려할 때, 다른 영양소의 부족 역시 우려할만한 것으로 사료된다. 따라서 중학교 3학년 이상의 여학생과 빈혈의 위험군에 대해서는 선별검사가 요구되며, 아울러 지속적이며 효과적인 영양 교육과 철분지표와 영양지식에 대한 평가가 필요할 것으로 사료된다.

• 대한지역사회영양학회지
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• 제8권2호
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• pp.160-170
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• 2003

Pregnant women in South Korea are a highly risk group fur iron deficiency anemia. Previous studies indicated that the 24-hour recall method was insensitive in distinguishing iron deficiency anemic women from normal women. This method is also impractical to when used at community health centers where no public health dietitians are employed. The objective of this study was to develop a convenient tool to evaluate the usual iron (Fe) intake of pregnant women. The study participants were 115 pregnant women (age 23 to 37 years) at gestational stage of 13 to 24 weeks. Anemic subjects were classified on the basis of their serum ferritin < 12.0 ${\mu}$g/L and hemoglobin < 12.0 g/dL levels. Food frequency questionnaires with 46, 29, and 15 commonly consumed food items were used to measure the usual intake of iron of the subjects. Hemoglobin and serum ferritin were measured from fasting blood samples. Nutrients intake was assessed on three consecutive days using the 24-hour recall method and the food record method. The iron index score calculated using the food frequency method showed a significantly positive correlation with iron intake for the three days dietary intake. The iron index showed a significantly difference (p < 0.05) between the normal and anemic groups. However, there was no significant difference in the iron intake between the anemic and the normal women as measured by the 24-hour recall and food record method. Our study indicated that the 29-food items questionnaire could be used as a screening tool to identify poor dietary intake of iron. (Korean J Community Nutrition 8(2) : 160170, 2003)

• 대한두개안면성형외과학회지
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• 제22권1호
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• pp.33-37
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• 2021

Background: Children with cleft lip and/or palate can be undernourished due to feeding difficulties after birth. A vicious cycle ensues where malnutrition and low body weight precludes the child from having the corrective surgery, in the absence of which the child fails to gain weight. This study aimed to identify the proportion of malnutrition, including the deficiency of major micronutrients, namely iron, folate and vitamin B12, in children with cleft lip and/or palate and thus help in finding out what nutritional interventions can improve the scenario for these children. Methods: All children less than 5 years with cleft lip and/or cleft palate attending our institute were included. On their first visit, following were recorded: demographic data, assessment of malnutrition, investigations: complete blood count and peripheral blood film examination; serum albumin, ferritin, iron, folate, and vitamin B12 levels. Results: Eighty-one children with cleft lip and/or palate were included. Mean age was 25.37±21.49 months (range, 3-60 months). In 53% of children suffered from moderate to severe wasting, according to World Health Organization (WHO) classification. Iron deficiency state was found in 91.6% of children. In 35.80% of children had vitamin B12 deficiency and 23.45% had folate deficiency. No correlation was found between iron deficiency and the type of deformity. Conclusion: Iron deficiency state is almost universally present in children with cleft lip and palate. Thus, iron and folic acid supplementation should be given at first contact to improve iron reserve and hematological parameters for optimum and safe surgery.

• 가정의학회지
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• 제39권6호
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• pp.370-374
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• 2018

Background: Iron is an essential element for women of reproductive age, especially in the period before and during the pregnancy. This study investigates the consumption of iron to prevent iron deficiency anemia among pregnant women visiting Neyshabur healthcare centers based on the theory of planned behavior. Methods: In this experimental study, data were collected through a questionnaire survey. It included 160 pregnant women who were receiving maternity services at twelve healthcare centers in the city of Neyshabur in Iran between 2015 and 2017. The participants' demographic and anthropometric characteristics, Using the theory of planned behavior, and blood lab examination results, including ferritin levels were measured and the data were analyzed using IBM SPSS ver. 22.0 (IBM Corp., Armonk, NY, USA). Results: The average scores of knowledge, attitude, perceived behavioral control, subjective norms, and intention categories for the intervention group were meaningfully increased after the participants received education on iron supplementation (P<0.05). However, these changes were not found to be significant in the control group (P>0.05). No statistically significant difference was obtained in the subjective norms category between the two groups after the education intervention (P=0.92). Conclusion: Based on the experimental effects of education encouraging iron supplementation in pregnant women, it is suggested that workshops promoting iron supplementation should be conducted in health centers with the aim of preventing widespread iron deficiency anemia.

• Journal of Nutrition and Health
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• 제4권1호
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• pp.1-19
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• 1971

Nutritional anemia is an important nutritional problem affecting large population groups in most developing countries. Nutritional anemia is caused by the absence of any dietary essential involed in hemoglobin formation or by poor absorption of these dietary components. The most likely causes are lack of dietary iron, and folate, vitamin $B_{12}$ and high qualify protein. Anemia is considered to be a late mainfeastation of nutritional deficiencies, and even mild anemia is not the earilest sign of such a deficiency. Therefore, the object of therapy is to correct underlying deficiency rather than merely its manifestation. Iron deficiency anemia is generally much the most common form of anemia. And it is very prevalent particularly in pregnant women and young children, especially under five year of life. According to the rapid growth rate of infants, dietary iron should he provided for infants over three months of age in adequate amounts for the synthesis of hemoglobin required by the increasing blood volume and for the demands of newly formed cells. The principal causes of iron deficiency anemia are an inadequate dietary iron content, interference with absorption of iron from the intestine, excessive losses of iron from the body, disturbance of iron metabolism by infection, and social and cultural environments. The present study is planned to obtain informations concerning nutritional anemia through anthropometric and biochemical determinations for the assessment of nutriture in pre-school children. Determination was taken in 226 pre-school children in ruraI arae in 1968, 122 pre-school children in 1970, and 1526 hospitalized pre-school children in 1970. The results of this study are as follows; (1) According to Iowa Malnutrition Borderline (85 percentile) for weight, the proportions of underweighed pre-school boys and girls in rural area were 47.2% and 46.2% in1968, and were 36.1% and 51.8% in 1970. According to Iowa Malnutrition Borderline for height, the proportions of underheight boys and girls in rural area were 30.5% and 33.7%, and were 26.2% and 21.8% in 1970. Malnutrition scores of underweight for height values of boys and girls in rural area were 19.3 and 17.3 in 1968, and the scores of boys and girls were 15.6 and 15.5 in 1970. (2) The mean hemoglobin values of boys and girls in rural area were $11.2{\pm}1.8g/100ml\;and\;11.4{\pm}1.6g/100ml$ in 1968. In 1970, the mean values of boys and girls in rural area were $11.3{\pm}1.3g/100ml\;and\;11.7{\pm}2.4g/100ml$. The mean hemoglobin values of hospitalized boys and girls were $11.9{\pm}2.2g/100ml\;and\;11.7{\pm}2.4g/100ml$ in 1970. It is found that 92 of 215 children (42.7%) in rural area had concentrations of hemoglobin less than 11.0g/100ml in 1968. In 1970, 55 of 121 children (45.4%) in rural area and 559 of 1526 hospitalized children (36.6%) had concentrations of hemoglobin less than 11.0g/100ml. (3) The mean hematocrit levels of hospitalized boys and girls were $35{\pm}26.8%\;and\;35.4{\pm}6.4%$ in 1970. And 443 of 1334 hospitalized children (33.2%) had hematocrit values below 33%. (4) The average mean corpuscular hemoglobin concentration levels of hospitalized boys and girls were $32.4{\pm}2.2\;and\;32.3{\pm}2.2$ in 1970. And 1016 of 1352 hospitalized children (75.1%) had the mean corpuscular hemoglobin values below 34. (5) The mean iron values of young children in rural area and hospitalized children were $62.0{\pm}6.3{\mu}g/100ml\;and\;60.7{\pm}22.8{\mu}g/100ml$. The proportions of anemia cases below $50{\mu}g/100ml$ in rural area was 37.9%, and 34.3% in hospitalized children. (6) The mean total iron binding capacity of young children in rural area was $376{\pm}57.88{\mu}g/100ml,\;and\;342.2{\pm}6.15{\mu}g/100ml$ in hospitalized children. (7) The average transferrin saturation percentage of young children in rural area was $16.9{\pm}4.7%,\;and\;18.0{\pm}8.4%$ in hospitalized children. The proportions of anemia cases below 15% of young chi1dren in rural area and hospitalized children were 48.3% and 41.2%. Therefore, authors wish to recommend that the following further studies should be undertaken: (1) Standardization of simplied laboratory examination of nutritional anemia. (2) The prevalence of nutritional anemia and the requirements of iron, folate, and vitamin $B_{12}$ of pre-school children. (3) The content and absorption of iron in Korean food. (4) The pathogenesis of nutritional anemia and prevention of parasitic disease. (5) Maternal health and nutrition education.

• 대한지역사회영양학회지
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• 제8권1호
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• pp.26-32
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• 2003

This study was designed to assess the nutritional iron status and anemia of middle school girls. Three-hundred-fifty- three female subjects in Ulsan metropolitan city were evaluated using a questionnaire, and hematological indices. The average height and weight of the respondents were 157.19 $\pm$ 5.57 cm and 51.06 $\pm$ 9.42 kg respectively. The average Body Mass Index (BMI, $kg/m^2$) was 20.63 $\pm$ 3.23, which was within the normal range. With regard to clinical symptoms, the greatest number of respondents reported that they experienced 'decreased ability to concentrate'. The total caloric intake of each subject was 1743.28 $\pm$ 343.47 kcal(83.01% of the Korean RDA) and the calcium intake was 634.98 $\pm$ 201.43 mg (79.37% of the Korean RDh) . The mean daily intake of iron was 14.76 : 4.36 mg (92.25% of the Korean RDh) and the heme iron intake was 6.12 $\pm$ 2.30 mg, which was 41.5% of the total iron intake. The average hemoglobin (Hb) concentration of the subjects was 13.24 $\pm$ 1.01 g/dl, and the average hematocrit (Hct) level was 37.79 $\pm$ 4.10%. The transferrin saturation {TS (%)} was 19.41 $\pm$ 9.21%, and the ferritin level was 26.26 $\pm$ 18.60 ng/ml. The iron deficiency anemia among the subjects was estimated at 6.1% by using Hb (< 12 g/ml), 20.5% by using Hct (< 36%), 30.8% by using 75 (< 14%) , and 23.1% by using ferritin (< 12 ng/ml) The total iron binding capacity (TIBC) showed a negative correlation with the Hb, iron, ferritin and 75. With regard to the correlation between blood biochemistry and clinical symptoms related to anemia, the Hb concentration was negatively correlated with 'pale face'(p < 0.05) . In addition, the level of iron was significantly and negatively correlated with 'poor memory' (p<0.01) and the ferritin concentration was negatively correlated with 'no appetite '(p < 0.05) ,'pale face (p < 0.05) . These results suggest that the prevalence of iron deficiency among middle school girls is very high; therefore, guidelines on dietary support and nutritional education to improve their dietary iron status should be provided.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제10권1호
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• pp.60-65
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• 2007

저자들은 가족 내에서 아동학대로 인해 발생한 치명적인 중증 영양실조를 보인 5세 여아에 동반된 빈혈과 구리 결핍증을 WHO 치료 지침과 구리 보충요법으로 호전시킨 1예를 치험하였기에 보고하는 바이다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제12권sup1호
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• pp.46-52
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• 2009

As the most common nutrition deficiency, iron deficiency not only causes anemia but also influences the central nervous system development. Its pathogenesis is supposed to be the alteration of neurometabolism and neurotransmission in major brain structures, and the disruption of myelination. The first two years after birth is a crucial period for cognitive, behavior, and emotional development with fast brain growth. If iron deficiency occurs in this period, cognitive and psychomotor function cannot be restored in spite of adequate iron supplementation. Thus, iron deficiency in infancy should be considered as a serious disease.

• Journal of Nutrition and Health
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• 제3권3호
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• pp.149-159
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• 1970

This study is to investigate the status of anemia, especially iron deficiency anemia among pre-school children in rural area in Korea. The survey was conducted in Sang-dae Ri, Yusong Myon, Daedok Gun, Chung Chong Nam-Do from July 30 th to August 12th, 1968. The measurements were done of height, weight, hematologist and biochemical levels on ninety-two pre-school children, 47 male, and 45 female, one to six years of age. Hemoglobin was determined by the method of cyanmethemoglobin and hematocrit by micro hematocrit centrifuge. The determination of serum iron, iron-binding capacity was done by the method of Ramsay using bathophenanthroline and the serum albumin was determined by Biuret Reaction. The results of this study are as follows: 1) 54.4 percent of the pre-school children weighed less than 90 percent of the Korean General Standard Weight level. 2) The average hemoglobin level was $11.0{\pm}1.57gm/100ml$, 38.0 percent of the children were anemic with less than 1.0gm/100ml. Of the anemic children 60 percent were below the Korean General Standard Weight level. 3) 27.5 percent of the pre-school children were found to have below 32 percent of a hematocrit values and 28.0 percent showed less than 33 percent in M.C.H.C. These results showed that the incidence of hypochromic anemia in these pre-school children was high. 4) 37.9 percent of these children had a serum iron level less than $50{\mu}g/100ml\;and\;31.0\;percent\;had\;a\;TIBC\;above\;400{\mu}g$ while 48.3 percent showed a transferrin saturation lower than 15 percent. On the basis of these findings, it is concluded than the cause of this anemia was iron deficiency. 5) In this group there was a little evidence of low total serum protein levels. However, 10.4 percent of the children had a deficient serum albumin level, below 2.80 gm/100ml while 51.7 percent had a low level, less than 3.50gm/100ml, and 34.5 percent of the children had a low level of TIBC, less than $350{\mu}g/100ml$, and considering these facts, it is suggested that some of the anemias have a multiple causes through protein deficiency and repeated chronic infection apart from iron deficiency.

• Clinical and Experimental Pediatrics
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• 제55권6호
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• pp.206-211
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• 2012

Purpose: The increasing prevalence of breast feeding has led to concerns about vitamin D deficiency (VDD) and iron deficiency anemia (IDA) in children. We evaluated the prevalence of VDD in a population of Korean children with IDA and assessed the risk factors for VDD in these children. Methods: A total of 79 children who were diagnosed with IDA were prospectively surveyed from April 2010 to March 2011. Data were collected by questionnaire, medical assessment, and laboratory tests, including measurement of 25-hydroxyvitamin D (25OHD), hemoglobin, and wrist radiography. Results: The median age was 22 months and 30% of the subjects were female. Over a half of subjects (58%) had subnormal vitamin D level (25OHD<30 ng/mL), and VDD (25OHD<20 ng/mL) was present in 39% of children. There was no difference in serum hemoglobin level between IDA patients with VDD and those without VDD. Most subjects (89%) were currently or had recently been breastfed and almost all subjects (97%) who had VDD received breastfeeding. Children with VDD were more likely to be younger than 2 years, to have been breastfed, and to have been tested in winter or spring. Multivariable analysis indicated seasonal variation was a significant independent risk factor for VDD in our IDA patients. Conclusion: Our results demonstrated that VDD has a high prevalence in Korean children with IDA. Primary care physicians should be aware of the possibility of VDD in children with IDA and should supplement the vitamin D as well as iron.