Relationship Between Obesity and Iron Deficiency Among Children: A Scoping Review
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Abstract
Obesity, the fifth leading cause of global mortality, is a low-grade inflammatory chronic illness that linked to conditions such as iron deficiency (ID). A higher prevalence of ID may be found in children with obesity. This review aimed to examine the relationship between obesity and ID in children. A systematic search was conducted in PubMed, Scopus, and Google Scholar, following PRISMA-ScR guidelines. From 2057 articles identified, 11 relevant studies were included. Findings indicate that children with higher Body Mass Index (BMI) are at increased risk for ID. Elevated serum ferritin and hepcidin levels were noted in obese children due to inflammatory responses. A higher prevalence of iron deficiency was found in children with obesity, and overweight and obese children were at higher risk of iron deficient as compared to normal weight and underweight children. Further research is necessary to elucidate the underlying mechanisms connecting obesity and ID.
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Zulfarina MS, Sharif R, Mokhtar SA, Shuid AN, Naina-Mohamed I. Lifestyle indices of body composition and obesity risk and prevalence among multi-ethnic adolescents in Malaysia. Frontiers in Pediatrics. 2022;10:899014. doi: 10.3389/fped.2022.899014
World Health Organization. Obesity and overweight. 2020. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
Centers for Disease Control and Prevention National Center for Health Statistics. Growth Charts - Homepage. www.cdc.gov. 2019. Available from: http://www.cdc.gov/growthcharts/CDC
Sahoo K, Sahoo B, Choudhury AK, Sofi NY, Kumar R, Bhadoria AS. Childhood obesity: causes and consequences. Journal of family medicine and primary care. 2015;4(2):187-92. doi: 10.4103/2249-4863.154628
The GBD 2015 Obesity Collaborators. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. New England Journal of Medicine. 2017;377(1):13–27. Available from: https://www.nejm.org/doi/full/10.1056/NEJMoa1614362
Abarca-Gómez L, Abdeen ZA, Hamid ZA, Abu-Rmeileh NM, Acosta-Cazares B, Acuin C, et al. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. The Lancet. 2017;390(10113):2627–42. Available from: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32129-3/fulltext
Aloufi ME, Aljaed NM, Aloufi RA, Jafri SA, Jafri SA, Elnashar MA. Prevalence of Iron Deficiency anemia in Obese Children in Taif Area - Saudi Arabia. The Egyptian Journal of Hospital Medicine. 2018;73(5):6744–52. doi: 10.21608/ejhm.2018.16177
Lobstein T, Brinsden H. Atlas of childhood obesity. World Obesity Federation. 2019;211:380. Available from: https://s3-eu-west-1.amazonaws.com/wof-files/11996_Childhood_Obesity_Atlas_Report_ART_V2.pdf
Kumar S, Kelly AS. Review of childhood obesity: from epidemiology, etiology, and comorbidities to clinical assessment and treatment. In Mayo Clinic Proceedings 2017;92(2):251-265. doi: 10.1016/j.mayocp.2016.09.017
Blüher M. Obesity: global epidemiology and pathogenesis. Nature Reviews Endocrinology. 2019;15(5):288-98. doi: 10.1038/s41574-019-0176-8
Aigner E, Feldman A, Datz C. Obesity as an emerging risk factor for iron deficiency. Nutrients. 2014;6(9):3587-600. doi: 10.3390/nu6093587
Mantadakis E, Chatzimichael E, Zikidou P. Iron deficiency anemia in children residing in high and low-income countries: risk factors, prevention, diagnosis and therapy. Mediterranean journal of hematology and infectious diseases. 2020;12(1). doi: 10.4084%2FMJHID.2020.041
World Health Organization. Prevention and control of iron-deficiency anaemia in women and children: report of the UNICEF. 2011. Available from: https://iris.who.int/bitstream/handle/10665/108513/E73102.pdf?sequence=1&isAllowed=y
Moscheo C, Licciardello M, Samperi P, La Spina M, Di Cataldo A, Russo G. New insights into iron deficiency anemia in children: a practical review. Metabolites. 2022;12(4):289. doi: 10.3390/metabo12040289
Gedfie S, Getawa S, Melku M. Prevalence and associated factors of iron deficiency and iron deficiency anemia among under-5 children: a systematic review and meta-analysis. Global pediatric health. 2022;9:2333794X221110860. doi: 10.1177/2333794X221110860
Kassebaum NJ, Jasrasaria R, Naghavi M, Wulf SK, Johns N, Lozano R, et al. A systematic analysis of global anemia burden from 1990 to 2010. Blood, the Journal of the American Society of Hematology. 2014;123(5):615-24. doi: 10.1182/blood-2013-06-508325
Hamed ER, Sallam SF, Hamdy HA, El Shafie AI, El Kassas GM, Khairy SA, et al. Serum hepcidin level and iron status in a sample of obese Egyptian children. Medical Research Journal. 2015;14(1):7-11. doi: 10.1097/01.MJX.0000464332.84361.87
Alshwaiyat NM, Ahmad A, Wan Hassan WM, Al-Jamal HA. Association between obesity and iron deficiency. Experimental and therapeutic medicine. 2021;22(5):1268. doi: 10.3892/etm.2021.10703
Egwurugwu JN, Ekweogu CN, Nwamkpa P, Ohamaeme MC, Ugwuezumba PC, Ogunnaya FU. Association between serum phosphate and iron concentrations with body mass index in a population of adults in Orlu, Imo State, Nigeria. Nigerian Journal of Experimental and Clinical Biosciences. 2018;6(1):1-7. doi: 10.4103/njecp.njecp_8_18
Kaner G, Pekcan G, Pamuk G, Pamuk BO, Amoutzopoulos B. Is iron deficiency related with increased body weight? A cross-sectional study. Prog Nutr. 2016;18(2):102.
Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group* T. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Annals of internal medicine. 2009;151(4):264-9. doi: 10.1371/journal.pmed.1000097
Joanna Briggs Institute. Joanna Briggs Institute reviewers’ manual: 2014 edition. 2014. Australia: The Joanna Briggs Institute, 88-91.
Pollock D, Peters MD, Khalil H, McInerney P, Alexander L, Tricco AC, et al. Recommendations for the extraction, analysis, and presentation of results in scoping reviews. JBI evidence synthesis. 2023;21(3):520-32. doi: 10.11124/JBIES-22-00123
United Nations. General Assembly. Convention on the Rights of the Child, 20 November 1989. Annual review of population law. 1989;16:95-501. Available from: https://www.ohchr.org/en/instruments-mechanisms/instruments/convention-rights-child
Atrushi AM, Armishty FS, Saleh SA, Abdulrahman MS. The association between iron deficiency anemia and obesity in children. J Contemp Med Sci. 2022;8(4):220. doi: 10.22317/jcms.v8i4.1236
Borkhoff SA, Parkin PC, Birken CS, Maguire JL, Macarthur C, Borkhoff CM. Examining the Double Burden of Underweight, Overweight/Obesity and Iron Deficiency among Young Children in a Canadian Primary Care Setting. Nutrients. 2023;15(16):3635. doi: 10.3390/nu15163635
Doğan G, Andiran N, Celik N, Uysal S. Iron parameters, prohepcidin and soluble transferrin receptor levels in obese children. Minerva Pediatr. 2016;72:175-181. doi: 10.23736/S0026-4946.16.04273-0
Panichsillaphakit E, Suteerojntrakool O, Pancharoen C, Nuchprayoon I, Chomtho S. The Association between hepcidin and iron status in children and adolescents with obesity. Journal of Nutrition and Metabolism. 2021; 2021(1):9944035. doi: 10.1155/2021/9944035
Sal E, Yenicesu I, Celik N, Pasaoglu H, Celik B, Pasaoglu OT, et al. Relationship between obesity and iron deficiency anemia: is there a role of hepcidin? Hematology. 2018; 23(8):542-548. doi: 10.1080/10245332.2018.1423671
Abd-El Wahed MA, Mohamed MH, Ibrahim SS, El-Naggar WA. Iron profile and dietary pattern of primary school obese Egyptian children. Journal of the Egyptian Public Health Association. 2014 Aug; 89(2):53–59. doi: 10.1097/01.EPX.0000451827.84315.5c
Suteerojntrakool O, Khongcharoensombat T, Chomtho S, Bongsebandhu-Phubhakdi C, Tempark T, Fewtrell M. Anthropometric Markers and Iron Status of 6–12-Year-Old Thai Children: Associations and Predictors. Journal of Nutrition and Metabolism. 2021;2021(1):9629718. doi: 10.1155/2021/9629718
Gattermann N, Muckenthaler MU, Kulozik AE, Metzgeroth G, Hastka J. The evaluation of iron deficiency and iron overload. Deutsches Ärzteblatt International. 2021;118(49):847. doi: 10.3238/arztebl.m2021.0290
Muriuki JM, Mentzer AJ, Webb EL, Morovat A, Kimita W, Ndungu FM, et al. Estimating the burden of iron deficiency among African children. BMC medicine. 2020;18:1-4. doi: 10.1186/s12916-020-1502-7
Cheng HL. Obesity, Iron and Young Women: Studies Investigating the Nutritional Implications of Excess Adiposity on Iron Status in Young Women. 2014.
Khan A, Khan WM, Ayub M, Humayun M, Haroon M. Ferritin is a marker of inflammation rather than iron deficiency in overweight and obese people. Journal of obesity. 2016;2016(1):1937320. doi: 10.1155/2016/1937320
Ghadiri-Anari A, Nazemian N, Vahedian-Ardakani HA. Association of body mass index with hemoglobin concentration and iron parameters in Iranian population. International Scholarly Research Notices. 2014;2014(1):525312. doi: 10.1155/2014/525312
Faruqi A, Zubair M, Mukkamalla SK. Iron-Binding Capacity. InStatPearls [Internet] [cited 2024 May 2]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559119/#:~:text=Iron%2Dbinding%20capacity%3A%20255%20to,111%20to%20343%20mcg%2FdL.
Banach W, Nitschke K, Krajewska N, Mongiałło W, Matuszak O, Muszyński J, et al. The Association between Excess Body Mass and Disturbances in Somatic Mineral Levels. International Journal of Molecular Sciences [Internet]. 2020 [cited 2022 Jul 8];21(19):E7306. Available from: https://pubmed.ncbi.nlm.nih.gov/33022938/
Cepeda-Lopez AC, Zimmermann MB, Wussler S, Melse-Boonstra A, Naef N, Mueller SM, et al. Greater blood volume and Hb mass in obese women quantified by the carbon monoxide-rebreathing method affects interpretation of iron biomarkers and iron requirements. International Journal of Obesity. 2018;43(5):999–1008. doi: 10.1038/s41366-018-0127-9
Berton PF, Gambero A. Hepcidin and inflammation associated with iron deficiency in childhood obesity-A systematic review. Jornal de Pediatria. 2024;100(2):124-131. doi: 10.1016/j.jped.2023.06.002
Parrettini S, Cavallo M, Gaggia F, Calafiore R, Luca G. Adipokines: a rainbow of proteins with metabolic and endocrine functions. Protein and peptide letters. 2020;27(12):1204-1230. doi: 10.2174/0929866527666200505214555
Purdy JC, Shatzel JJ. The hematologic consequences of obesity. European journal of haematology. 2021 Mar;106(3):306-319. doi: 10.1111/ejh.13560
Teng IC, Tseng SH, Aulia B, Shih CK, Bai CH, Chang JS. Can diet-induced weight loss improve iron homoeostasis in patients with obesity: A systematic review and meta-analysis. Obesity Reviews. 2020 Dec;21(12):e13080. doi: 10.1111/obr.13080
Cabañas Pujadas G, Ortiz-Marrón H, Ortiz-Pinto MA, García Gscheidle A, de la Calle Tejerina P, Donoso-Navarro E, et al. Changes in obesity and iron deficiency between 4 and 9 years of age. Longitudinal study of childhood obesity (ELOIN). International Journal of Obesity. 2022;46(11):1992–1999. doi: 10.1038/s41366-022-01196-y
Sypes EE, Parkin PC, Birken CS, Carsley S, MacArthur C, Maguire JL, et al. Higher body mass index is associated with iron deficiency in children 1 to 3 years of age. The Journal of Pediatrics. 2019;207:198-204. doi: 10.1016/j.jpeds.2018.11.035
Zheng H, Long W, Tan W, Yang C, Cao M, Zhu Y. Anaemia, iron deficiency, iron-deficiency anaemia and their associations with obesity among schoolchildren in Guangzhou, China. Public Health Nutrition. 2020;23(10):1693-1702. doi: doi:10.1017/S1368980019003604