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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
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School of Biological Sciences, University of Adelaide, Adelaide SA 5005, Australia
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Department of Nutrition and Foodborne Disease Prevention, Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing 210009, China
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School of Medicine, University of Adelaide, Adelaide SA 5005, Australia
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Computational Medicine, Faculty of Medicine, University of Oulu and Biocenter Oulu, 90014 Oulu, Finland
*
Author to whom correspondence should be addressed.
Nutrients 2017, 9(10), 1153; https://doi.org/10.3390/nu9101153
Received: 2 August 2017 / Revised: 6 September 2017 / Accepted: 19 October 2017 / Published: 21 October 2017
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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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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