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      Dysregulated Iron Metabolism-Associated Dietary Pattern Predicts an Altered Body Composition and Metabolic Syndrome

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          Abstract

          Diet plays an important role in the development of obesity and may contribute to dysregulated iron metabolism (DIM). A cross-sectional survey of 208 adults was conducted in Taipei Medical University Hospital (Taipei, Taiwan). A reduced-rank regression from 31 food groups was used for a dietary pattern analysis. DIM was defined as at least four of the following criteria: serum hepcidin (men >200 ng/mL and women >140 ng/mL), hyperferritinemia (serum ferritin of >300 ng/mL in men and >200 ng/mL in women), central obesity, non-alcoholic fatty liver disease, and two or more abnormal metabolic profiles. Compared to non-DIM patients, DIM patients were associated with an altered body composition and had a 4.52-fold (95% confidence interval (CI): (1.95–10.49); p < 0.001) greater risk of metabolic syndrome (MetS) after adjusting for covariates. A DIM-associated dietary pattern (high intake of deep-fried food, processed meats, chicken, pork, eating out, coffee, and animal fat/skin but low intake of steamed/boiled/raw foods and dairy products) independently predicted central obesity (odds ratio (OR): 1.57; 95% CI: 1.05–2.34; p < 0.05) and MetS (OR: 1.89; 95% CI: 1.07–3.35; p < 0.05). Individuals with the highest DIM pattern scores (tertile 3) had a higher visceral fat mass (%) (β = 0.232; 95% CI: 0.011–0.453; p < 0.05) but lower skeletal muscle mass (%) (β = −1.208; 95% CI: −2.177–−0.239; p < 0.05) compared to those with the lowest DIM pattern scores (tertile 1). In conclusion, a high score for the identified DIM-associated dietary pattern was associated with an unhealthier body composition and a higher risk of MetS.

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          Most cited references28

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          Review on iron and its importance for human health

          It is well-known that deficiency or over exposure to various elements has noticeable effects on human health. The effect of an element is determined by several characteristics, including absorption, metabolism, and degree of interaction with physiological processes. Iron is an essential element for almost all living organisms as it participates in a wide variety of metabolic processes, including oxygen transport, deoxyribonucleic acid (DNA) synthesis, and electron transport. However, as iron can form free radicals, its concentration in body tissues must be tightly regulated because in excessive amounts, it can lead to tissue damage. Disorders of iron metabolism are among the most common diseases of humans and encompass a broad spectrum of diseases with diverse clinical manifestations, ranging from anemia to iron overload, and possibly to neurodegenerative diseases. In this review, we discuss the latest progress in studies of iron metabolism and bioavailability, and our current understanding of human iron requirement and consequences and causes of iron deficiency. Finally, we discuss strategies for prevention of iron deficiency.
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            Application of a new statistical method to derive dietary patterns in nutritional epidemiology.

            Because foods are consumed in combination, it is difficult in observational studies to separate the effects of single foods on the development of diseases. A possible way to examine the combined effect of food intakes is to derive dietary patterns by using appropriate statistical methods. The objective of this study was to apply a new statistical method, reduced rank regression (RRR), that is more flexible and powerful than the classic principal component analysis. RRR can be used efficiently in nutritional epidemiology by choosing disease-specific response variables and determining combinations of food intake that explain as much response variation as possible. The authors applied RRR to extract dietary patterns from 49 food groups, specifying four diabetes-related nutrients and nutrient ratios as responses. Data were derived from a nested German case-control study within the European Prospective Investigation into Cancer and Nutrition-Potsdam study consisting of 193 cases with incident type 2 diabetes identified until 2001 and 385 controls. The four factors extracted by RRR explained 93.1% of response variation, whereas the first four factors obtained by principal component analysis accounted for only 41.9%. In contrast to principal component analysis and other methods, the new RRR method extracted a significant risk factor for diabetes.
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              Hepcidin in the diagnosis of iron disorders.

              The discovery of the iron-regulatory hormone hepcidin in 2001 has revolutionized our understanding of iron disorders, and its measurement should advance diagnosis/treatment of these conditions. Although several assays have been developed, a gold standard is still lacking, and efforts toward harmonization are ongoing. Nevertheless, promising applications can already be glimpsed, ranging from the use of hepcidin levels for diagnosing iron-refractory iron deficiency anemia to global health applications such as guiding safe iron supplementation in developing countries with high infection burden.
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                Author and article information

                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                11 November 2019
                November 2019
                : 11
                : 11
                : 2733
                Affiliations
                [1 ]Department of Nutrition Science, Faculty of Medicine, Brawijaya University, Malang 65145, Indonesia; anggunrindangcempaka@ 123456gmail.com
                [2 ]School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 110, Taiwan
                [3 ]Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei 110, Taiwan; m003089010@ 123456tmu.edu.tw
                [4 ]Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
                [5 ]Department of Emergency and Critical Care Medicine, Taipei Medical University Hospital, Taipei 110, Taiwan; traumayuan@ 123456gmail.com
                [6 ]Department of Public Health, College of Medicine, Taipei Medical University, Taipei 110, Taiwan; baich@ 123456tmu.edu.tw
                [7 ]Department of Public Health, College of Public Health, Taipei Medical University, Taipei 110, Taiwan
                [8 ]Department of Medical Elementology, Peoples’ Friendship University of Russia (RUDN University), Moscow 117198, Russia; tinkov.a.a@ 123456gmail.com (A.A.T.); skalnylab@ 123456gmail.com (A.V.S.)
                [9 ]Laboratory of Biotechnology and Applied Bioelementology, Yaroslavl State University, Yaroslavl 150003, Russia
                [10 ]Laboratory of Molecular Dietology, IM Sechenov First Moscow State Medical University, Moscow 119146, Russia
                [11 ]Graduate Institute of Metabolism and Obesity Sciences, College of Nutrition, Taipei Medical University, Taipei 110, Taiwan
                [12 ]Nutrition Research Center, Taipei Medical University Hospital, Taipei 110, Taiwan
                [13 ]Chinese Taipei Society for the Study of Obesity (CTSSO), Taipei 11031, Taiwan
                Author notes
                [* ]Correspondence: susanchang@ 123456tmu.edu.tw ; Tel.: +886-(2)-2736-1661 (ext. 6542); Fax: +886-(2)2737-3112
                [†]

                These authors contributed equally to this work.

                Author information
                https://orcid.org/0000-0002-0692-0559
                https://orcid.org/0000-0002-4658-1088
                https://orcid.org/0000-0003-0348-6192
                https://orcid.org/0000-0001-8608-9349
                Article
                nutrients-11-02733
                10.3390/nu11112733
                6893840
                31717994
                a7b54b87-8fd1-425d-9938-44fb223a13cc
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 19 October 2019
                : 06 November 2019
                Categories
                Article

                Nutrition & Dietetics
                central obesity,dysregulated iron metabolism,hepcidin,ferritin,dietary pattern,visceral fat,skeletal muscle mass,metabolic syndrome

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