Skip to main content
    • Aa
    • Aa
  • Access
  • Cited by 55
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Angeli, Adeline Lainé, Fabrice Lavenu, Audrey Ropert, Martine Lacut, Karine Gissot, Valérie Sacher-Huvelin, Sylvie Jezequel, Caroline Moignet, Aline Laviolle, Bruno and Comets, Emmanuelle 2016. Joint Model of Iron and Hepcidin During the Menstrual Cycle in Healthy Women. The AAPS Journal, Vol. 18, Issue. 2, p. 490.

    Goldstein, Erica R. 2016. Exercise-Associated Iron Deficiency. Strength and Conditioning Journal, Vol. 38, Issue. 2, p. 24.

    Harvey, Thierry Zkik, Asmaa Auges, Marie and Clavel, Thierry 2016. Assessment of iron deficiency and anemia in pregnant women: an observational French study. Women's Health, Vol. 12, Issue. 1, p. 95.

    Harvey-Leeson, Sarah Karakochuk, Crystal Hawes, Meaghan Tugirimana, Pierrot Bahizire, Esto Akilimali, Pierre Michaux, Kristina Lynd, Larry Whitfield, Kyly Moursi, Mourad Boy, Erick Foley, Jennifer McLean, Judy Houghton, Lisa Gibson, Rosalind and Green, Tim 2016. Anemia and Micronutrient Status of Women of Childbearing Age and Children 6–59 Months in the Democratic Republic of the Congo. Nutrients, Vol. 8, Issue. 2, p. 98.

    Jackson, Jacklyn Williams, Rebecca McEvoy, Mark MacDonald-Wicks, Lesley and Patterson, Amanda 2016. Is Higher Consumption of Animal Flesh Foods Associated with Better Iron Status among Adults in Developed Countries? A Systematic Review. Nutrients, Vol. 8, Issue. 2, p. 89.

    Lopez, Anthony Cacoub, Patrice Macdougall, Iain C and Peyrin-Biroulet, Laurent 2016. Iron deficiency anaemia. The Lancet, Vol. 387, Issue. 10021, p. 907.

    Deldicque, Louise and Francaux, Marc 2015. Recommendations for Healthy Nutrition in Female Endurance Runners: An Update. Frontiers in Nutrition, Vol. 2,

    Hussain, Nadia 2015. Haemoglobin A1c and Iron Deficiency Anaemia our Understanding Through the Decades. Romanian Journal of Diabetes Nutrition and Metabolic Diseases, Vol. 22, Issue. 3,

    Inoue, Hirofumi Kobayashi, Ken-Ichi Ndong, Moussa Yamamoto, Yuji Katsumata, Shin-Ichi Suzuki, Kazuharu and Uehara, Mariko 2015. Activation of Nrf2/Keap1 signaling and autophagy induction against oxidative stress in heart in iron deficiency. Bioscience, Biotechnology, and Biochemistry, Vol. 79, Issue. 8, p. 1366.

    Sim, Marc Dawson, Brian Landers, Grant Swinkels, Dorine W. Tjalsma, Harold Yeap, Bu B. Trinder, Debbie and Peeling, Peter 2015. Oral contraception does not alter typical post-exercise interleukin-6 and hepcidin levels in females. Journal of Science and Medicine in Sport, Vol. 18, Issue. 1, p. 8.

    Susnea, Iuliana and Weiskirchen, Ralf 2015. Trace metal imaging in diagnostic of hepatic metal disease. Mass Spectrometry Reviews, p. n/a.

    Toxqui, Laura and Vaquero, M. 2015. Chronic Iron Deficiency as an Emerging Risk Factor for Osteoporosis: A Hypothesis. Nutrients, Vol. 7, Issue. 4, p. 2324.

    2015. Scientific Opinion on Dietary Reference Values for iron. EFSA Journal, Vol. 13, Issue. 10, p. 4254.

    2015. Scientific Opinion on Dietary Reference Values for magnesium. EFSA Journal, Vol. 13, Issue. 7, p. 4186.

    Beck, Kathryn L. Conlon, Cathryn A. Kruger, Rozanne Heath, Anne-Louise M. Matthys, Christophe Coad, Jane Jones, Beatrix and Stonehouse, Welma 2014. Blood Donation, Being Asian, and a History of Iron Deficiency Are Stronger Predictors of Iron Deficiency than Dietary Patterns in Premenopausal Women. BioMed Research International, Vol. 2014, p. 1.

    Beck, Kathryn Conlon, Cathryn Kruger, Rozanne and Coad, Jane 2014. Dietary Determinants of and Possible Solutions to Iron Deficiency for Young Women Living in Industrialized Countries: A Review. Nutrients, Vol. 6, Issue. 9, p. 3747.

    Blanco-Rojo, Ruth Toxqui, Laura López-Parra, Ana Baeza-Richer, Carlos Pérez-Granados, Ana Arroyo-Pardo, Eduardo and Vaquero, M. 2014. Influence of Diet, Menstruation and Genetic Factors on Iron Status: A Cross-Sectional Study in Spanish Women of Childbearing Age. International Journal of Molecular Sciences, Vol. 15, Issue. 3, p. 4077.

    Jaouen, Klervia and Balter, Vincent 2014. Menopause effect on blood Fe and Cu isotope compositions. American Journal of Physical Anthropology, Vol. 153, Issue. 2, p. 280.

    McClung, James P. Gaffney-Stomberg, Erin and Lee, Jane J. 2014. Female athletes: A population at risk of vitamin and mineral deficiencies affecting health and performance. Journal of Trace Elements in Medicine and Biology, Vol. 28, Issue. 4, p. 388.

    Toxqui, Laura Pérez-Granados, Ana M Blanco-Rojo, Ruth Wright, Ione and Vaquero, M Pilar 2014. A simple and feasible questionnaire to estimate menstrual blood loss: relationship with hematological and gynecological parameters in young women. BMC Women's Health, Vol. 14, Issue. 1,


Impact of menstrual blood loss and diet on iron deficiency among women in the UK


Women of childbearing age are at risk of Fe deficiency if insufficient dietary Fe is available to replace menstrual and other Fe losses. Haem Fe represents 10–15 % of dietary Fe intake in meat-rich diets but may contribute 40 % of the total absorbed Fe. The aim of the present study was to determine the relative effects of type of diet and menstrual Fe loss on Fe status in women. Ninety healthy premenopausal women were recruited according to their habitual diet: red meat, poultry/fish or lacto-ovo-vegetarian. Intake of Fe was determined by analysing 7 d duplicate diets, and menstrual Fe loss was measured using the alkaline haematin method. A substantial proportion of women (60 % red meat, 40 % lacto-ovo-vegetarian, 20 % poultry/fish) had low Fe stores (serum ferritin <10 μg/l), but the median serum ferritin concentration was significantly lower in the red meat group (6·8 μg/l (interquartile range 3·3, 16·25)) than in the poultry/fish group (17·5 μg/l (interquartile range 11·3, 22·4) (P<0·01). The mean and standard deviation of dietary Fe intake were significantly different between the groups (P=0·025); the red meat group had a significantly lower intake (10·9 (sd 4·3) mg/d) than the lacto-ovo-vegetarians (14·5 (sd 5·5) mg/d), whereas that of the poultry/fish group (12·8 (sd 5·1) mg/d) was not significantly different from the other groups. There was no relationship between total Fe intake and Fe status, but menstrual Fe loss (P=0·001) and dietary group (P=0·040) were significant predictors of Fe status: poultry/fish diets were associated with higher Fe stores than lacto-ovo-vegetarian diets. Identifying individuals with high menstrual losses should be a key component of strategies to prevent Fe deficiency.

    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Impact of menstrual blood loss and diet on iron deficiency among women in the UK
      Your Kindle email address
      Available formats
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Impact of menstrual blood loss and diet on iron deficiency among women in the UK
      Available formats
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Impact of menstrual blood loss and diet on iron deficiency among women in the UK
      Available formats
Corresponding author
*Corresponding author: Dr Linda Harvey, fax +44 (0) 1603 507723, email
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

JW Anderson , EC Konz & DJA Jenkins (2000) Health advantages and disadvantages of weight-reducing diets: a computer analysis and critical review. J Am Coll Nutr 19, 578590.

NC Andrews (1999) Disorders of iron metabolism. N Engl J Med 341, 19861995.

I Bairati , B Herbeth , Spyckerelle , J Didelotbarthelemy , P Galan , S Hercberg , JP Christides & GP Decourcy (1989) Dietary intake and other determinants of iron and folate status in female adolescents. J Clin Biochem Nutr 7, 143151.

GV Callard , FS Litovsky & LJ DeMerre (1966) Menstruation in women with normally or artificially controlled cycles. Fert Steril 17, 684688.

P Carter (1971) Spectrophotometric determination of serum iron at the submicrogram level with a new reagent (ferrozine). Anal Biochem 40, 450458.

CA Flowers , M Kuizon , JL Beard , BS Skikne , AM Covell & JD Cook (1986) A serum ferritin assay for prevalence studies of iron deficiency. Am J Hematol 23, 141151.

Food and Nutrition Board/Institute of Medicine (2000) Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium and Zinc. A Report of the Panel on Micronutrients, Subcommittees on Upper Reference Levels of Nutrients and of Interpretation and Uses of Dietary Reference Intakes, and the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. Washington, DC: National Academy Press.

JV Gomez-Basauri & JM Regenstein (1992) Processing and frozen storage effects on the iron content of cod and mackerel. J Food Sci 57, 13321336.

L Hallberg (1995) Results of surveys to assess iron status in Europe. Nutr Rev 53, 314322.

L Hallberg , A-M Hogdahl , L Nilsson & G Rybo (1966) Menstrual blood loss – a population study. Variations at different ages and attempts to define normality. Acta Obstet Gynecol Scand 45, 320351.

L Hallberg & L Nilsson (1964a) Determination of menstrual blood loss. Scand J Clin Lab Invest 16, 244248.

L Hallberg & L Nilsson (1964 b) Constancy of individual menstrual blood loss. Acta Obstet Gynecol Scand 43, 352359.

D Han , KW McMillin , JS Godber , TD Bidner , MT Younathan , DL Marshall & LT Hart (1993) Iron distribution in heated beef and chicken muscles. J Food Sci 58, 697700.

A-LM Heath , CM Skeaff & R Gibson (1998) Validation of a questionnaire method for estimating extent of menstrual blood loss in young adult women. J Trace Elem Med Biol 12, 231235.

JM Higham & RW Shaw (1999) Clinical associations with objective menstrual blood volume. Eur J Obstet Gynecol 82, 7376.

L Hulthen , G Lindstedt , P-A Lundberg & L Hallberg (1998) Effect of mild infection on serum ferritin concentration – clinical and epidemiological implications. Eur J Clin Nutr 52, 7679.

MA Kenney (1985) Factors related to iron nutrition of adolescent females. Nutr Res 5, 157166.

G Larsson , I Milsom , G Lindstedt & G Rybo (1992) The influence of a low-dose combined oral contraceptive on menstrual blood loss and iron status. Contraception 46, 327334.

RA Lawrenson , GM Leydon , TJ Williams , RB Newson & MD Feher (1999) Patterns of contraception in UK women with type 1 diabetes mellitus: a GP database study. Diabet Med 16, 395399.

N Milman , J Clausen & K-E Byg (1998) Iron status in 268 Danish women aged 18–30 years: influence of menstruation, contraceptive method, and iron supplementation. Ann Hematol 77, 1319.

N Milman , N Rosdahl , N Lyhne , T Jorgensen & N Graudal (1993) Iron status in Danish women aged 35–65 years: relation to menstruation and method of contraception. Act Obstet Gynecol Scand 72, 601605.

I Milsom , K Andersson , K Jonasson , G Lindstedt & G Rybo (1995) The influence of the Gyne-T 380S IUD on menstrual blood loss and iron status. Contraception 52, 175179.

A Morabia , MS Bernstein , S Heritier & S Beer-Borst (1999) A Swiss population based assessment of dietary habits before and after the March 1996 ‘mad cow disease’ crisis. Eur J Clin Nutr 53, 158163.

J Newton , G Barnard & W Collins (1977) A rapid method for measuring menstrual blood loss using automatic extraction. Contraception 16, 269282.

RW Purchas , DC Simcock , TW Knight & BHP Wilkinson (2003) Variation in the form of iron in beef and lamb meat and losses of iron during cooking and storage. Int J Food Sci Technol 38, 82837.

G Rybo & L Hallberg (1966) Influence of heredity and environment on normal menstrual blood loss. Acta Obstet Gynecol Scand 45, 389410.

GO Walters , FM Miller & M Worwood (1973) Serum ferritin concentration and iron stores in normal subjects. J Clin Pathol 26, 770772.

JB Whitfield , S Treloar , G Zhu , LW Powell & NG Martin (2003) Relative importance of female specific and non-female specific effects on variation in iron stores between women. Br J Haematol 120, 860866.

KM Wyatt , PW Dimmock , TJ Walker & PMS O'Brien (2001) Determination of total menstrual blood loss. Fertil Steril 76, 125131.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
  • URL: /core/journals/british-journal-of-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *