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Biomed Res Int. 2013;2013:423263. doi: 10.1155/2013/423263. Epub 2013 Dec 23.

Association of iron depletion with menstruation and dietary intake indices in pubertal girls: the healthy growth study.

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Department of Nutrition, Harokopio University of Athens, 70 El.Venizelou Avenue, Kallithea, 17671 Athens, Greece.
Department of Public Health and Nutrition, Zayed University, Abu Dhabi 144534, UAE.
Department of Pathology, General Hospital of Volos, 38222 Volos, Greece.
Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, 71003 Crete, Greece.
First Department of Pediatrics, University of Athens Medical School, Athens, Aghia Sophia Children's Hospital, 11527 Athens, Greece.


The aim of the present study was to investigate the associations of iron depletion (ID) with menstrual blood losses, lifestyle, and dietary habits, in pubertal girls. The study sample comprised 1222 girls aged 9-13 years old. Biochemical, anthropometrical, dietary, clinical, and physical activity data were collected. Out of 274 adolescent girls with menses, 33.5% were found to be iron depleted (defined as serum ferritin < 12 μg/L) compared to 15.9% out of 948 girls without menses. Iron-depleted girls without menses were found to have lower consumption of poultry (P = 0.017) and higher consumption of fruits (P = 0.044) and fast food (P = 0.041) compared to their peers having normal iron status. Multivariate logistic regression analysis showed that girls with menses were 2.57 (95% CI: 1.37, 4.81) times more likely of being iron depleted compared to girls with no menses. Iron depletion was found to be associated with high calcium intake, high consumption of fast foods, and low consumption of poultry and fruits. Menses was the only factor that was found to significantly increase the likelihood of ID in these girls. More future research is probably needed in order to better understand the role of diet and menses in iron depletion.

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