@article{3158824,
    title = "The double burden of obesity and iron deficiency on children and
adolescents in Greece: the Healthy Growth Study",
    author = "Manios, Y. and Moschonis, G. and Chrousos, G. P. and Lionis, C. and and Mougios, V. and Kantilafti, M. and Tzotzola, V. and Skenderi, K. P. and and Petridou, A. and Tsalis, G. and Sakellaropoulou, A. and Skouli, G. and and Katsarou, C.",
    journal = "Journal of Human Nutrition and Dietetics",
    year = "2013",
    volume = "26",
    number = "5",
    pages = "470-478",
    publisher = "Wiley",
    doi = "10.1111/jhn.12025",
    keywords = "adolescents; children; diet; inflammation; iron deficiency; obesity",
    abstract = "Background: Some small cohort studies have noted that obesity co-exists
with lower serum iron levels. The present study aimed to examine the
association between being overweight and iron deficiency (ID) in a large
cohort of Greek children and adolescents.
Methods: A representative sample of 2492 primary schoolchildren aged
9-13 years old was examined. Anthropometric, biochemical, clinical,
dietary intake and physical activity data were collected.
Results: The prevalence of ID and iron deficiency anaemia (IDA) was
higher in obese boys and girls compared to their normal-weight peers (P
< 0.05). Serum ferritin was higher in obese compared to normal-weight
boys (P = 0.024) and higher in obese compared to normal-weight and
overweight girls (P = 0.001). By contrast, a negative association was
found between transferrin saturation and adiposity in both boys and
girls (P = 0.001 and P = 0.005). Furthermore, obese girls had
significantly higher fibre intake than normal-weight girls (P = 0.048)
and also overweight and obese boys and girls recorded significantly
fewer pedometer steps than their normal-weight peers (P < 0.001).
Finally, obesity more than doubled the likelihood of ID in both boys
(odds ratio = 2.83; 95% confidence inteval = 1.65-4.85) and girls (odds
ratio = 2.03; 95% confidence interval = 1.08-3.81) after controlling
for certain lifestyle and clinical indices as potential confounders.
Conclusions: The present study shows that obese children and adolescents
were at greater risk for ID and IDA than their normal-weight peers. Low
grade inflammation induced by excessive adiposity may be a reason for
the observed low iron levels. This is also strengthened by the elevated
serum ferritin levels, comprising an acute phase protein that is
plausibly increased in inflammation."
}