ORIGINAL ARTICLE
The impact of weight loss diet programs on anemia, nutrient deficiencies, and organ dysfunction markers among university female students: A cross-sectional study
 
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1
Department of Medical Analysis, Princess Aisha Bint Al-Hussein College of Nursing and Medical Sciences, Al-Hussein Bin Talal University, Ma’an, JORDAN
 
2
Department of Biology, College of Science, Al-Hussein Bin Talal University, Ma’an, JORDAN
 
 
Online publication date: 2022-11-28
 
 
Publication date: 2023-01-01
 
 
Electron J Gen Med 2023;20(1):em436
 
KEYWORDS
ABSTRACT
Practicing restricted weight loss diet programs (WLDPs) without proper supervision can result in nutritional deficiency, which can lead to the development of several nutritional disorders. The current cross-sectional study aimed to investigate the impact of WLDPs practiced by university female students on the prevalence of micronutrient deficiencies, anemia, and organs dysfunction, and to assess the association of identified anomalies with dieting practices and dietary habits of university female students. A total of 185 (105 dieting and 80 non-dieting) volunteers’ female students at Al-Hussein Bin Talal University participated in this study. After the participants answered a questionnaire, blood samples were collected for hematological and biochemical analysis, and the body mass index (BMI) was determined. The results show that there were no significant differences between dieting and non-dieting groups in biochemical markers of kidney and liver functions as well as serum levels of copper, zinc, and folate. On the other hand, dieting participants exhibited significantly lower level of hemoglobin, serum ferritin, iron, and vitamin B12 than encounter group (p<0.05). Attempting WLDPs significantly increased the prevalence of anemia (46.7%), iron deficiency (57.1%), and iron deficiency anemia (IDA) (41.9%), comparing to non-dieting students (28.7%, 33.8%, and 15.0%, respectively) (p<0.005). Chi-square test showed that the development of anemia among dieting girls was significantly dependence of several factors including BMI category, source and duration of the diet programs, and skipping breakfast (p<0.05). In conclusion, young girls attempting WLDPs without professional guidance are more prone to the risk of nutrients deficiencies and the development nutritional disorders like IDA. An educational program should be employed to teach young females on when and how to adopt healthy WLDPs.
 
REFERENCES (56)
1.
Barroso TA, Marins LB, Alves R, Gonçalves ACS, Barroso SG, de Souza Rocha G. Association of central obesity with the incidence of cardiovascular diseases and risk factors. Int J Cardiovasc Sci. 2017;30(5):416-24. https://doi.org/10.5935/2359-4....
 
2.
Piché M-E, Tchernof A, Després J-P. Obesity phenotypes, diabetes, and cardiovascular diseases. Circ Res. 2020;126(11):1477-500. https://doi.org/10.1161/CIRCRE... PMid:32437302.
 
3.
Koliaki C, Spinos T, Spinou Μ, Brinia Μ-E, Mitsopoulou D, Katsilambros N. Defining the optimal dietary approach for safe, effective, and sustainable weight loss in overweight and obese adults. Healthcare (Basel). 2018;6(3):73. https://doi.org/10.3390/health... PMid:29958395 PMCid:PMC6163457.
 
4.
Shapses SA, Riedt CS. Bone, body weight, and weight reduction: What are the concerns? J Nutr. 2006;136(6):1453-6. https://doi.org/10.1093/jn/136... PMid:16702302 PMCid:PMC4016235.
 
5.
Lim Y-S, Park N-R, Jeon S-B, Jeong S-Y, Tserendejid Z, Park H-R. Analysis of weight control behaviors by body image perception among Korean women in different age groups: Using the 2010 Korea national health and nutrition examination survey data. Korean J Community Nutr. 2015; 20(2):141-50. https://doi.org/10.5720/kjcn.2....
 
6.
Lee J, Lee Y. The association of body image distortion with weight control behaviors, diet behaviors, physical activity, sadness, and suicidal ideation among Korean high school students: A cross-sectional study. BMC Public Health. 2015;16(1):1-10. https://doi.org/10.1186/s12889... PMid:26772963 PMCid:PMC4714421.
 
7.
Sagar A. Long term health risks due to impaired nutrition in women with a past history of bulimia nervosa. 2005. Available at: https://escholarship.org/ (Accessed 17 October 2022).
 
8.
Nuttall FQ. Body mass index: Obesity, BMI, and health: A critical review. Nutr Today. 2015;50(3):117-28. https://doi.org/10.1097/NT.000... PMid:27340299 PMCid:PMC4890841.
 
9.
NHLBI N. Clinical guidelines of the idenification, evaluation, and treatment of overweight and obesity in adults–The evidence report. National Institutes of Health. Obes Res. 1998;Suppl 2:51S-209S.
 
10.
Kim S-y, Kim M. Weight-loss diets among female Korean adolescents: A pilot study based on a social media platform. Br Food J. 2021;124(9):2629-48. https://doi.org/10.1108/BFJ-05....
 
11.
Tuffa TA, Gebreyesus SH, Endris BS, Getnet Y, Abebe DS. Unhealthy weight control behaviors among Ethiopian female adolescents. Int J Eat Disord. 2020;53(4):525-32. https://doi.org/10.1002/eat.23... PMid:31944363.
 
12.
Daee A, Robinson P, Lawson M, Turpin JA, Gregory B, Tobias JD. Psychologic and physiologic effects of dieting in adolescents. South Med J. 2002;95(9):1032-42. https://doi.org/10.1097/000076... PMid:12356104.
 
13.
Lee K-M, Seo M-S, Shim J-Y, Lee Y-J. Body weight status misperception and its association with weight control behaviours, depressive mood, and psychological distress in nulliparous normal-weight young women. Ann Hum Biol. 2015;42(6):528-32. https://doi.org/10.3109/030144... PMid:26065691.
 
14.
Alexi J, Palermo R, Rieger E, Bell J. Evidence for a perceptual mechanism relating body size misperception and eating disorder symptoms. Eat Weight Disord. 2019;24(4):615-21. https://doi.org/10.1007/s40519... PMid:30758775.
 
15.
Chaitoff A, Swetlik C, Ituarte C, et al. Associations between unhealthy weight-loss strategies and depressive symptoms. Am J Prev Med. 2019;56(2):241-50. https://doi.org/10.1016/j.amep... PMid:30661572.
 
16.
Badrin S, Daud N, Ismail SB. Body weight perception and weight loss practices among private college students in Kelantan State, Malaysia. Korean J Fam Med. 2018;39(6):355-9. https://doi.org/10.4082/kjfm.1... PMid:29983039 PMCid:PMC6250941.
 
17.
Armstrong B, Westen SC, Janicke DM. The role of overweight perception and depressive symptoms in child and adolescent unhealthy weight control behaviors: A mediation model. J Pediatr Psychol. 2014;39(3):340-8. https://doi.org/10.1093/jpepsy... PMid:24344072.
 
18.
Strychar I. Diet in the management of weight loss. CMAJ. 2006;174(1):56-63. https://doi.org/10.1503/cmaj.0... PMid:16389240 PMCid:PMC1319349.
 
19.
Arsyad A, Idris I, Rasyid AA, et al. Long-term ketogenic diet induces metabolic acidosis, anemia, and oxidative stress in healthy wistar rats. J Nutr Metab. 2020;2020:3642035. https://doi.org/10.1155/2020/3... PMid:32685205 PMCid:PMC7341377.
 
20.
Calton JB. Prevalence of micronutrient deficiency in popular diet plans. J Int Soc Sports Nutr. 2010;7:24. https://doi.org/10.1186/1550-2... PMid:20537171 PMCid:PMC2905334.
 
21.
Truby H, Hiscutt R, Herriot AM, et al. Commercial weight loss diets meet nutrient requirements in free living adults over 8 weeks: A randomised controlled weight loss trial. Nutr J. 2008;7:25. https://doi.org/10.1186/1475-2... PMid:18764946 PMCid:PMC2551603.
 
22.
Jeon S, Cho K, Ok G, Lee S, Park H. Weight loss practice, nutritional status, bone health, and injury history: A profile of professional jockeys in Korea. J Exerc Nutrition Biochem. 2018;22(3):27-34. https://doi.org/10.20463/jenb.... PMid:30343556 PMCid:PMC6199486.
 
23.
Gaudiani JL, Mehler PS. Rare medical manifestations of severe restricting and purging: “Zebras,” missed diagnoses, and best practices. Int J Eat Disord. 2016;49(3):331-44. https://doi.org/10.1002/eat.22... PMid:26592986.
 
24.
Chan L-N, Mike LA. The science and practice of micronutrient supplementations in nutritional anemia: An evidence‐based review. JPEN J Parenter Enteral Nutr. 2014;38(6):656-72. https://doi.org/10.1177/014860... PMid:24847050.
 
25.
Beard JL. Iron requirements in adolescent females. J Nutr. 2000;130(2):440S-2S.https://doi.org/10.1093/jn/130... PMid:10721923.
 
26.
Al-Awwad NJ, Ayoub J, Barham R, et al. Review of the nutrition situation in Jordan: Trends and way forward. Nutrients. 2022;14(1):135. https://doi.org/10.3390/nu1401... PMid:35011008 PMCid:PMC8746685.
 
27.
Jordan Ministry of Health. National micronutrient survey Jordan 2010. 2011. Available at: https://www.gainhealth.org/res... (Accessed 17 October 2022).
 
28.
Althunibat O, Saghir S, Aladaileh S, et al. Distribution and association of weight-loss diet programs with body mass index and health status among students at Al-Hussein Bin Talal University, Jordan. Electron J Gen Med. 2022;19(6):em414. https://doi.org/10.29333/ejgm/....
 
29.
Alkerwi A, Shivappa N, Crichton G, Hébert JR. No significant independent relationships with cardiometabolic biomarkers were detected in the observation of cardiovascular risk factors in Luxembourg study population. Nutri Res. 2014;34(12):1058-65. https://doi.org/10.1016/j.nutr... PMid:25190219 PMCid:PMC4329249.
 
30.
WHO. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. World Health Organization; 2011. Available at: https://apps.who.int/iris/hand... (Accessed 17 October 2022).
 
31.
WHO. WHO guideline on use of ferritin concentrations to assess iron status in populations. World Health Organization; 2020. Available at: https://www.who.int/publicatio... (Accessed 17 October 2022).
 
32.
Islam R, Islam R, Shalahuddin Qusar MMA, et al. Alterations of serum macro-minerals and trace elements are associated with major depressive disorder: A case-control study. BMC Psychiatry. 2018;18(1):94. https://doi.org/10.1186/s12888... PMid:29631563 PMCid:PMC5891975.
 
33.
Willoughby D, Hewlings S, Kalman D. Body composition changes in weight loss: Strategies and supplementation for maintaining lean body mass, a brief review. Nutrients. 2018;10(12):1876. https://doi.org/10.3390/nu1012... PMid:30513859 PMCid:PMC6315740.
 
34.
Saydam BK, Genc RE, Sarac F, Turfan EC. Prevalence of anemia and related factors among women in Turkey. Pak J Med Sci. 2017;33(2):433-8. https://doi.org/10.12669/pjms.... PMid:28523051 PMCid:PMC5432718.
 
35.
Abdo N, Douglas S, Batieha A, et al. The prevalence and determinants of anaemia in Jordan. East Mediterr Health J. 2019;25(5):341-9. https://doi.org/10.26719/emhj.... PMid:31364759.
 
36.
Abu-Baker NN, Eyadat AM, Khamaiseh AM. The impact of nutrition education on knowledge, attitude, and practice regarding iron deficiency anemia among female adolescent students in Jordan. Heliyon. 2021;7(2):e06348. https://doi.org/10.1016/j.heli... PMid:33718648 PMCid:PMC7920873.
 
37.
Departmet of Statistics. Jordan population and family health survey 2017-18. 2019. Available at: https://dhsprogram.com/pubs/pd... (Accessed 17 October 2022).
 
38.
Bianchi VE. Role of nutrition on anemia in elderly. Clin Nutr ESPEN. 2016;11:e1-11. https://doi.org/10.1016/j.clne... PMid:28531420.
 
39.
Al-Alimi AA, Bashanfer S, Morish MA. Prevalence of iron deficiency anemia among university students in Hodeida Province, Yemen. Anemia. 2018;2018:4157876. https://doi.org/10.1155/2018/4... PMid:29850236 PMCid:PMC5937585.
 
40.
Vehapoglu A, Ozgurhan G, Demir AD, et al. Hematological indices for differential diagnosis of Beta thalassemia trait and iron deficiency anemia. Anemia. 2014;2014:576738. https://doi.org/10.1155/2014/5... PMid:24818016 PMCid:PMC4003757.
 
41.
Cornelissen KK, Gledhill LJ, Cornelissen PL, Tovée MJ. Visual biases in judging body weight. Br J Health Psychol. 2016;21(3):555-69. https://doi.org/10.1111/bjhp.1... PMid:26857215.
 
42.
Brooks KR, Mond JM, Stevenson RJ, Stephen ID. Body image distortion and exposure to extreme body types: Contingent adaptation and cross adaptation for self and other. Front Neurosci. 2016;10:334. https://doi.org/10.3389/fnins.... PMid:27471447 PMCid:PMC4946181.
 
43.
Syed A, Zeb F, Khan S, et al. Exploration of eating disorders, nutritional and health status based on eating attitude test-26 amongst university adolescent girls. J Food Nutr Res. 2018;6(7):464-70. https://doi.org/10.12691/jfnr-....
 
44.
Al-Eisawi Z, Rababah E. The burden of anaemia among women in Jordan. Curr Women’s Health Rev. 2020;16(3):220-8. https://doi.org/10.2174/157340....
 
45.
Butryn M, Kerrigan S, Kelly M. Self-guided weight loss. In: Cash T, editor. Encyclopedia of body image and human appearance. Elsevier; 2012. p. 718-23. https://doi.org/10.1016/B978-0....
 
46.
St Jeor ST, Howard BV, Prewitt TE, et al. Dietary protein and weight reduction: A statement for healthcare professionals from the Nutrition Committee of the Council on Nutrition, Physical Activity, and Metabolism of the American Heart Association. Circulation. 2001;104(15):1869-74. https://doi.org/10.1161/hc4001... PMid:11591629.
 
47.
Sundgot-Borgen J, Meyer NL, Lohman TG, et al. How to minimise the health risks to athletes who compete in weight-sensitive sports review and position statement on behalf of the Ad Hoc Research Working Group on Body Composition, Health and Performance, under the auspices of the IOC Medical Commission. Br J Sports Med. 2013;47(16):1012-22. https://doi.org/10.1136/bjspor... PMid:24115480.
 
48.
Pollitt E. The developmental and probabilistic nature of the functional consequences of iron-deficiency anemia in children. J Nutr. 2001;131(2):669S-75S. https://doi.org/10.1093/jn/131... PMid:11160597.
 
49.
McCann JC, Ames BN. An overview of evidence for a causal relation between iron deficiency during development and deficits in cognitive or behavioral function. Am J Clin Nutr. 2007;85(4):931-45. https://doi.org/10.1093/ajcn/8... PMid:17413089.
 
50.
Abalkhail B, Shawky S. Prevalence of daily breakfast intake, iron deficiency anaemia and awareness of being anaemic among Saudi school students. Int Jo Food Sci Nutr. 2002;53(6):519-28. https://doi.org/10.1080/096374... PMid:12590747.
 
51.
Al Hassan NN. The prevalence of iron deficiency anemia in a Saudi university female students. J Microsc Ultrastruct. 2015;3(1):25-8. https://doi.org/10.1016/j.jmau... PMid:30023178 PMCid:PMC6014218.
 
52.
Keski-Rahkonen A, Kaprio J, Rissanen A, Virkkunen M, Rose RJ. Breakfast skipping and health-compromising behaviors in adolescents and adults. Eur J Clin Nutr. 2003;57(7):842-53. https://doi.org/10.1038/sj.ejc... PMid:12821884.
 
53.
Rampersaud GC, Pereira MA, Girard BL, Adams J, Metzl JD. Breakfast habits, nutritional status, body weight, and academic performance in children and adolescents. J Am Diet Assoc. 2005;105(5):743-60. https://doi.org/10.1016/j.jada... PMid:15883552.
 
54.
Matthys C, De Henauw S, Bellemans M, De Maeyer M, De Backer G. Breakfast habits affect overall nutrient profiles in adolescents. Public Health Nutr. 2007;10(4):413-21. https://doi.org/10.1017/S13689... PMid:17362538.
 
55.
Garzon S, Cacciato PM, Certelli C, Salvaggio C, Magliarditi M, Rizzo G. Iron deficiency anemia in pregnancy: Novel approaches for an old problem. Oman Med J. 2020;35(5):e166. https://doi.org/10.5001/omj.20... PMid:32953141 PMCid:PMC7477519.
 
56.
Prochaska MT, Huisingh-Scheetz M, Meltzer D. Sex differences in fatigue and symptoms of anemia in relation to hemoglobin level in hospitalized patients. Ann Hematol. 2022;101(8):1873-5. https://doi.org/10.1007/s00277... PMid:35403850 PMCid:PMC9353505.
 
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