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Nutrients 2017, 9(10), 1153; doi:10.3390/nu9101153

Multivariable Analysis of Nutritional and Socio-Economic Profiles Shows Differences in Incident Anemia for Northern and Southern Jiangsu in China

1
South Australian Health and Medical Research Institute (SAHMRI), Adelaide SA 5000, Australia
2
School of Biological Sciences, University of Adelaide, Adelaide SA 5005, Australia
3
Department of Nutrition and Foodborne Disease Prevention, Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing 210009, China
4
School of Medicine, University of Adelaide, Adelaide SA 5005, Australia
5
Computational Medicine, Faculty of Medicine, University of Oulu and Biocenter Oulu, 90014 Oulu, Finland
*
Author to whom correspondence should be addressed.
Received: 2 August 2017 / Revised: 6 September 2017 / Accepted: 19 October 2017 / Published: 21 October 2017
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Abstract

Anemia is a prevalent public health problem associated with nutritional and socio-economic factors that contribute to iron deficiency. To understand the complex interplay of risk factors, we investigated a prospective population sample from the Jiangsu province in China. At baseline, three-day food intake was measured for 2849 individuals (20 to 87 years of age, mean age 47 ± 14, range 20–87 years, 64% women). At a five-year follow-up, anemia status was re-assessed for 1262 individuals. The dataset was split and age-matched to accommodate cross-sectional (n = 2526), prospective (n = 837), and subgroup designs (n = 1844). We applied a machine learning framework (self-organizing map) to define four subgroups. The first two subgroups were primarily from the less affluent North: the High Fibre subgroup had a higher iron intake (35 vs. 21 mg/day) and lower anemia incidence (10% vs. 25%) compared to the Low Vegetable subgroup. However, the predominantly Southern subgroups were surprising: the Low Fibre subgroup showed a lower anemia incidence (10% vs. 27%), yet also a lower iron intake (20 vs. 28 mg/day) compared to the High Rice subgroup. These results suggest that interventions and iron intake guidelines should be tailored to regional, nutritional, and socio-economic subgroups. View Full-Text
Keywords: anemia; subtypes; subgroups; China; grains; Jiangsu; geographical divide; iron; rice; wheat anemia; subtypes; subgroups; China; grains; Jiangsu; geographical divide; iron; rice; wheat
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Mutter, S.; Casey, A.E.; Zhen, S.; Shi, Z.; Mäkinen, V.-P. Multivariable Analysis of Nutritional and Socio-Economic Profiles Shows Differences in Incident Anemia for Northern and Southern Jiangsu in China. Nutrients 2017, 9, 1153.

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