背景:绝经前女性的铁摄入量需求分布不对称,这使评估铁不足患病率的EAR(估计平均需求)切点方法无效。因此,必须使用比顿的全概率方法(PA)。虽然PA需要有关整个铁摄入量需求分布的信息,欧洲食品安全局(EFSA)仅提供了EAR(第50百分位数),第90,95(PRI)和97.5百分位数。
目的:本研究旨在可靠地估计使用PA的绝经前女性铁不足的患病率,根据EFSA制定的摄入量要求,并将结果与EAR切点法获得的结果进行比较。
方法:习惯性铁摄入量是使用统计计划来评估饮食暴露(SPADE)计算的,数据来自2012-2016年荷兰国家食物消费调查的484名女性(20-45岁)。应用了EFSA的铁要求(包括额外获得的信息)。将来自PA的结果与用EAR切点法获得的结果进行比较。敏感性分析检查了较低的铁摄入量分布对PA和EAR切点方法之间估计的不足摄入量差异的影响。
结果:与EAR切点法相比,使用PA时,荷兰绝经前女性的铁不足患病率高出两倍。使用EFSA的参考值。敏感性分析表明,EAR切点方法也可能导致摄入量分布较低的人群的过度估计。
结论:本研究通过使用有关EFSA参考值的全部需求分布的额外衍生信息,为使用PA方法提供了一个示例。结果再次显示EAR切点法不适合计算绝经前女性铁不足的患病率。因此,我们建议得出膳食参考值的机构提供使用正确方法确定人群摄入量不足所需的所有信息。
The iron intake requirement distribution for premenopausal females is not symmetric, which invalidates the EAR cut-point approach for assessing the prevalence of iron inadequacy. Therefore, Beaton\'s Full Probability Approach (PA) must be used. Although the PA requires information on the entire iron intake requirement distribution, the European Food Safety Authority (
EFSA) only provided the EAR (50th percentile), 90th, 95th (population reference intake), and 97.5th percentiles.
This study aimed to reliably estimate the prevalence of iron inadequacy in premenopausal females using the PA, based on the intake requirements established by
EFSA, and compare the results with those obtained from the EAR cut-point method.
Habitual iron intakes were calculated using the statistical program to assess dietary exposure with data from 484 females (20-45 y) from the Dutch National Food Consumption Survey 2012-2016. Iron requirements of
EFSA (including additionally obtained information) were applied. Results from the PA were compared to results obtained with the EAR cut-point method. Sensitivity analyses examined the impact of lower iron intake distributions on differences in estimated inadequate intakes between PA and EAR cut-point methods.
A 2-fold higher prevalence of iron inadequacy among Dutch premenopausal females was observed when employing the PA compared to the EAR cut-point method, using
EFSA\'s reference values. Sensitivity analysis showed that the EAR cut-point method could also result in large overestimations for populations with lower intake distributions.
This study provided an example of using the PA method by using additionally derived information on the full requirement distribution underlying
EFSA\'s reference values. Results showed once more the unsuitability of the EAR cut-point method to calculate the prevalence of iron inadequacy in premenopausal females. Hence, we recommend that institutions deriving dietary reference values provide all the information needed to use the correct method to determine inadequate intakes in the population.