(P24-011-23) Intake of Certain Food Groups Encouraged by the Dietary Guidelines for Americans Are Associated With Iron Status in Specific Groups of the US Population

Objectives: To determine how food groups recommended in the Dietary Guidelines for Americans (DGAs) support iron status of the US population.

Methods: The 2015 Healthy Eating Index (HEI) assesses diet quality and encourages intake of some foods and discourages others based on the DGAs. Total HEI and component scores (total vegetables, greens/beans, total fruit, whole fruit, whole grains, dairy, total protein foods, seafood/plant proteins, fatty acids, sodium, refined grains, saturated fats, added sugars), markers of iron status [ferritin, serum iron, transferrin saturation, total body iron (TBI), transferrin receptor (TfR)], and their associations were assessed in children (1-5 y, n = 3559) and females of reproductive age (12-49 y, n = 9106) using NHANES 2003-10 and 2015-18 and in males (12+ y, n = 2322) using NHANES 2017-18. Exclusion criteria included inflammation, infection, liver disease, recent blood donation, and currently pregnant/lactating. Diet was assessed from individual usual intake and HEI calculated using the multivariate Markov Chain Monte Carlo method. Multivariate regressions determined associations between HEI scores and markers of iron status. Age, ethnicity, BMI, poverty income ratio, supplemental iron, and vitamin C intake were covariates.

Results: Total HEI score was not associated with iron status. Total protein food score was associated with improved iron status in children (TBI: β = 0.44, TfR: β = –0.26, P < 0.02 for both), females (ferritin: β = 8.3, serum iron: β = 6.1, TBI: β = 1.1, TfR: β = –0.32, P < 0.008 for all), and males (ferritin: β = 81, TBI: β = 2.9, TfR: β = –0.37, P < 0.02 for all). Whole grain score was associated with lower iron status in males (ferritin: β = –14, TBI: β = –0.44, P < 0.003 for both), but not children or females. Dairy score was associated with lower iron status in children (ferritin: β = –1.9, TBI: β = –0.31, TfR: β = 0.10, P < 0.001 for all) and males (ferritin: β = –12, TBI: β = –0.20, P < 0.004 for both), but not females.

Conclusions: While total HEI score was not associated with iron status, total protein score was associated with improved iron status, and whole grains and dairy scores were associated with lower iron status.

Funding Sources: Supported by intramural funds to SRH and by USARMRDC; views expressed are not official US Army, DoD, or government policy.