Clinically diagnosed iron and iodine deficiencies and disorders in the entire population of US military service members from 1997 to 2015

Abstract

Objective: Iron and/or iodine deficiencies can have multiple serious adverse health outcomes, but examination of incidence rates of these deficiencies have rarely been conducted in any large population. This study examined incidence rates, temporal trends, and demographic factors associated with medically-diagnosed iron and iodine deficiencies/disorders in United States (US) military service members (SMs). Design: The Defense Medical Epidemiological Database (DMED) was queried for medical visits of active duty SMs to obtain specific International Classification of Diseases, Version 9, codes involving clinically-diagnosed iron and iodine deficiencies/disorders. Setting: Analysis of existing database (DMED). Participants: Entire population of US military service members from 1997 to 2015 (average N per yr=1,382,266, 15% women). Results: Overall incidence rates for iron and iodine were 104 and 36 cases/100,000 person-years, respectively. Over the 19-year period, rates for iron disorders increased steadily (108% for men, 177% for women). Rates for iodine disorders also increased steadily for men (91%), but for women there was an initial rise followed by a later decline. Overall, women’s rates were 12 and 10 times higher than men’s for iron and iodine, respectively. Compared to whites, blacks and those of other races had higher rates of deficiencies of both minerals. Incidence rates for iodine deficiency increased substantially with age. Conclusion: The overall incidence of clinically-diagnosed iron and iodine deficiency among SMs was low, but increased over the 19 years examined and certain demographic groups were at significantly greater risk. Given the unexpected increases in incidence of these mineral disorders increased surveillance may be appropriate.

Iodine and Iodine Deficiency: A Comprehensive Review of a Re-Emerging Issue

“…In the U.S. in 2011-2012, 38% of the population had a UIC of <100 and were therefore classified as iodine deficient [23]. In the total U.S. military population, from 1997-2015, the incidence of clinically diagnosed iodine deficiency substantially increased in males but overall was more common in females and racial minorities [24]. Hypothyroidism, a symptom of severe iodine deficiency, is present in approximately 5% of the U.S. population.…”

Sex differences in iron status during military training: a prospective cohort study of longitudinal changes and associations with endurance performance and musculoskeletal outcomes

“…Suboptimal Fe status leads to poorer endurance and cognitive performance, lethargy and fatigue and impaired aerobic adaptations to training (6) and may contribute to poorer musculoskeletal outcomes including poorer vitamin D status (2) , lower bone mineral density (2,3) and increased injury risk (8,9) . There are well-described differences in Fe status between men and women; more women than men have Fe deficiency and Fe deficiency anaemia in the general (7,10) and military (11) populations. Premenopausal women are at high risk of Fe deficiency due to menstrual blood loss and insufficient dietary Fe intake to meet these increased Fe requirements from menstrual bleeding (6,12) .…”

“…There are well-described differences in Fe status between men and women; more women than men have Fe deficiency and Fe deficiency anaemia in the general ( 7 , 10 ) and military ( 11 ) populations. Premenopausal women are at high risk of Fe deficiency due to menstrual blood loss and insufficient dietary Fe intake to meet these increased Fe requirements from menstrual bleeding ( 6 , 12 ) .…”

Estado nutricional de iodo e fatores associados, socioecônomicos, demográficos, de saúde e nutricionais em agricultores familiares da região geográfica imediata de Viçosa-MG

“…Figure 1 shows the selection processes. Regarding the assessment of the risk of bias, according to the study design, all cross-sectional studies , basic clinical trials [44][45][46] and cohort [47][48][49] were at risk of bias.…”

“…The studies were published between 1993 11 and 2021 [35][36][37] , being 69.2% (n=27) , 15.4% (n=6) 38-43 , 7.7% (n=3) [44][45][46] and 7.7% (n=3) [47][48][49] corresponding to cross-sectional design, case control, clinical trial and cohort studies, respectively. In relation to sample composition, 12.9% (n=5) 19,22,28,36,41 of the studies were conducted with women only, 2.6% (n=1) 14 with men, and the remaining with both sexes.…”