Double Burden: Obesity Among Iron Deficiency Anemic Nursing Students

Background: The Fourth Thai National Health Examination Survey in 2008-9 reported that the prevalence of the overweight and obese employing the Body Mass Index (BMI) >25 kg/m2 for BMI cut-off points for Asian population was 20.6% among females aged 15-29 years and iron deficiency anemia (IDA) classifying by the World Health Organization (WHO) criteria with Hemoglobin (Hb) < 12 g/dL in women above 15 years of age was 25.3%. Methods: A cross-sectional survey was conducted among 57 females aged 18 – 22 years out of 114 of 1st year nursing students. Hb concentration examination, BMI and self administrated questionnaires were completed on the day of their annual physical checkups. This study aimed to investigate the prevalence of obesity among IDA nursing students at St Theresa International College in Nakhon Nayok Province, Central, Thailand. Results: The prevalence of overweight and obese (BMI > 25 kg/m2 ) was 5.3% while the prevalence of IDA (Hb 27.5) were 28.1, 57.9, 10.5 and 3.4% respectively. Among this group, IDA was found in 12.5, 27.3, 33.3 and 100% in each BMI category respectively. When international classification was used it showed that underweight ( 30.0) was 28.1, 66.7, 3.5 and 1.8 % respectively and IDA was in 12.5, 23.2, 50 and 100% respectively. In this study, it was statistically significant difference between IDA and the non-IDA with the students’ body weight (Kruskal – Wallis test = 4.31, p< 0.05) and between the normal-weight and overweight with the students' duration of menstruation (Kruskal-Wallis H test = 6.54, p < 0.05). Conclusions: Both IDA and obesity are signs of malnutrition. IDA is a condition of undernutrition while obesity is over-nutrition. However it is known that they seem to be bound up with such as poor dietary iron intake, increased iron requirements, and impaired iron absorption in obese individually. Nutrition education should be considered and demonstrate the effectiveness of the program for more understanding of the problem.