University of Oulu

Mutter S, Casey AE, 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(10):1153.

Multivariable analysis of nutritional and socio-economic profiles shows differences in incident anemia for Northern and Southern Jiangsu in China

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Author: Mutter, Stefan1,2; Casey, Aaron E.1,2; Zhen, Shiqi3;
Organizations: 1South Australian Health and Medical Research Institute (SAHMRI)
2School of Biological Sciences, University of Adelaide
3Department of Nutrition and Foodborne Disease Prevention, Jiangsu Provincial Centre for Disease Control and Prevention
4School of Medicine, University of Adelaide
5Computational Medicine, Faculty of Medicine, University of Oulu and Biocenter Oulu
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1 MB)
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Language: English
Published: Multidisciplinary Digital Publishing Institute, 2017
Publish Date: 2018-01-17


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.

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Series: Nutrients
ISSN: 2072-6643
ISSN-E: 2072-6643
ISSN-L: 2072-6643
Volume: 9
Issue: 10
Article number: 1153
DOI: 10.3390/nu9101153
Type of Publication: A1 Journal article – refereed
Field of Science: 3142 Public health care science, environmental and occupational health
Copyright information: © 2017 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 (