{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T13:19:55Z","timestamp":1783171195861,"version":"3.54.6"},"reference-count":39,"publisher":"Elsevier BV","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2027,5,19]],"date-time":"2027-05-19T00:00:00Z","timestamp":1810684800000},"content-version":"am","delay-in-days":352,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R01DK122216"],"award-info":[{"award-number":["R01DK122216"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The American Journal of Clinical Nutrition"],"published-print":{"date-parts":[[2026,6]]},"DOI":"10.1016\/j.ajcnut.2026.101326","type":"journal-article","created":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T06:09:33Z","timestamp":1777097373000},"page":"101326","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Differential associations between menstrual blood loss scores and iron status in East Asian and Northern European individuals: findings from a cross-sectional analysis of the Iron Genes in East Asian and Northern European Adults Study (FeGenes) cohort"],"prefix":"10.1016","volume":"123","author":[{"given":"Min-Ruei","family":"Lee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexa","family":"Barad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Bender","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Thompson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenglong","family":"Gu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva K","family":"Pressman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0954-1706","authenticated-orcid":false,"given":"Kimberly O","family":"O\u2019Brien","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ajcnut.2026.101326_bib1","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1002\/ijgo.14950","article-title":"Overview of iron deficiency and iron deficiency anemia in women and girls of reproductive age","volume":"162","author":"Derman","year":"2023","journal-title":"Int. J. Gynaecol. Obstet."},{"issue":"9","key":"10.1016\/j.ajcnut.2026.101326_bib2","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2024.33126","article-title":"Absolute and functional iron deficiency in the US, 2017-2020","volume":"7","author":"Tawfik","year":"2024","journal-title":"JAMA Netw. Open."},{"key":"10.1016\/j.ajcnut.2026.101326_bib3","series-title":"WHO guideline on use of ferritin concentrations to assess iron status in individuals and populations [Internet]","year":"2020"},{"key":"10.1016\/j.ajcnut.2026.101326_bib4","series-title":"Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc","year":"2001"},{"issue":"3","key":"10.1016\/j.ajcnut.2026.101326_bib5","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1016\/0002-9343(68)90069-7","article-title":"Body iron excretion in man: a collaborative study","volume":"45","author":"Green","year":"1968","journal-title":"Am. J. Med."},{"issue":"3","key":"10.1016\/j.ajcnut.2026.101326_bib6","doi-asserted-by":"crossref","first-page":"320","DOI":"10.3109\/00016346609158455","article-title":"Menstrual blood loss\u2013a population study. Variation at different ages and attempts to define normality, Acta","volume":"45","author":"Hallberg","year":"1966","journal-title":"Obstet. Gynecol. Scand."},{"issue":"2","key":"10.1016\/j.ajcnut.2026.101326_bib7","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/j.ajcnut.2024.10.014","article-title":"Characterization of iron status biomarkers and hematological indices among young adults of East Asian or northern European ancestry: A cross-sectional analysis from the Iron Genes in East Asian and northern European Adults Study (FeGenes)","volume":"121","author":"Barad","year":"2025","journal-title":"Am. J. Clin. Nutr."},{"issue":"2","key":"10.1016\/j.ajcnut.2026.101326_bib8","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/j.ajcnut.2024.11.015","article-title":"Differences in nonheme iron absorption between healthy adults of East Asian or northern European ancestry from the Iron Genes in East Asian and northern European Adults Study (FeGenes): a cross-sectional stable iron isotope study","volume":"121","author":"Barad","year":"2025","journal-title":"Am. J. Clin. Nutr."},{"issue":"2","key":"10.1016\/j.ajcnut.2026.101326_bib9","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/j.ajcnut.2024.10.018","article-title":"Iron regulatory hormones and their associations with iron status biomarkers among healthy adults of East Asian or northern European ancestry: A cross-sectional comparison from the Iron Genes in East Asian and northern European Adults Study (FeGenes)","volume":"121","author":"Barad","year":"2025","journal-title":"Am. J. Clin. Nutr."},{"issue":"4","key":"10.1016\/j.ajcnut.2026.101326_bib10","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1007\/s40471-023-00332-0","article-title":"Determinants and assessment of menstrual blood flow","volume":"10","author":"Liang","year":"2023","journal-title":"Curr. Epidemiol. Rep."},{"issue":"10","key":"10.1016\/j.ajcnut.2026.101326_bib11","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1093\/oxfordjournals.aje.a008868","article-title":"Ethnic differences in the duration and amount of menstrual bleeding during the postmenarcheal period","volume":"144","author":"Harlow","year":"1996","journal-title":"Am. J. Epidemiol."},{"issue":"5","key":"10.1016\/j.ajcnut.2026.101326_bib12","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1007\/s00394-025-03730-w","article-title":"Dietary intake in East Asian and northern European participants from the FeGenes study","volume":"64","author":"Park","year":"2025","journal-title":"Eur. J. Nutr."},{"issue":"9403","key":"10.1016\/j.ajcnut.2026.101326_bib13","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/S0140-6736(03)15268-3","article-title":"Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies","volume":"363","year":"2004","journal-title":"Lancet"},{"key":"10.1016\/j.ajcnut.2026.101326_bib14","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1186\/1472-6874-14-71","article-title":"A simple and feasible questionnaire to estimate menstrual blood loss: relationship with hematological and gynecological parameters in young women","volume":"14","author":"Toxqui","year":"2014","journal-title":"BMC Womens Health"},{"issue":"9","key":"10.1016\/j.ajcnut.2026.101326_bib15","doi-asserted-by":"crossref","first-page":"3359","DOI":"10.1182\/blood-2002-10-3071","article-title":"The quantitative assessment of body iron","volume":"101","author":"Cook","year":"2003","journal-title":"Blood"},{"issue":"1\u20122","key":"10.1016\/j.ajcnut.2026.101326_bib16","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.cca.2007.04.008","article-title":"Evaluation of an automated soluble transferrin receptor (sTfR) assay on the Roche Hitachi analyzer and its comparison to two ELISA assays","volume":"382","author":"Pfeiffer","year":"2007","journal-title":"Clin. Chim. Acta."},{"key":"10.1016\/j.ajcnut.2026.101326_bib17","doi-asserted-by":"crossref","DOI":"10.1088\/1742-6596\/949\/1\/012009","article-title":"Multicollinearity and regression analysis","volume":"949","author":"Daoud","year":"2017","journal-title":"J. Phys. Conf. Ser."},{"key":"10.1016\/j.ajcnut.2026.101326_bib18","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1186\/1477-7827-8-115","article-title":"Determinants of menarche","volume":"8","author":"Karapanou","year":"2010","journal-title":"Reprod. Biol. Endocrinol."},{"issue":"1","key":"10.1016\/j.ajcnut.2026.101326_bib19","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1002\/ijgo.14660","article-title":"Age of the onset of menarche and its complications: a literature review","volume":"162","author":"Rivas Paz","year":"2023","journal-title":"Int. J. Gynaecol. Obstet."},{"issue":"5","key":"10.1016\/j.ajcnut.2026.101326_bib20","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2024.12854","article-title":"Menarche and time to cycle regularity among individuals born between 1950 and 2005 in the US","volume":"7","author":"Wang","year":"2024","journal-title":"JAMA Netw. Open"},{"issue":"7520","key":"10.1016\/j.ajcnut.2026.101326_bib21","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1038\/nature13545","article-title":"Parent-of-origin-specific allelic associations among 106 genomic loci for age at menarche","volume":"514","author":"Perry","year":"2014","journal-title":"Nature"},{"issue":"6","key":"10.1016\/j.ajcnut.2026.101326_bib22","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1038\/ng.3841","article-title":"Genomic analyses identify hundreds of variants associated with age at menarche and support a role for puberty timing in cancer risk","volume":"49","author":"Day","year":"2017","journal-title":"Nat. Genet."},{"issue":"4","key":"10.1016\/j.ajcnut.2026.101326_bib23","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1093\/humrep\/det011","article-title":"Evaluation of GWAS-identified genetic variants for age at menarche among Chinese women","volume":"28","author":"Delahanty","year":"2013","journal-title":"Hum. Reprod."},{"issue":"7","key":"10.1016\/j.ajcnut.2026.101326_bib24","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0200486","article-title":"The genetic underpinnings of variation in ages at menarche and natural menopause among women from the multi-ethnic Population Architecture using Genomics and Epidemiology (PAGE) Study: a trans-ethnic meta-analysis","volume":"13","author":"Fern\u00e1ndez-Rhodes","year":"2018","journal-title":"PLOS One"},{"issue":"7","key":"10.1016\/j.ajcnut.2026.101326_bib25","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1093\/humrep\/deab086","article-title":"Large trans-ethnic meta-analysis identifies AKR1C4 as a novel gene associated with age at menarche","volume":"36","author":"Sarnowski","year":"2021","journal-title":"Hum. Reprod."},{"issue":"7","key":"10.1016\/j.ajcnut.2026.101326_bib26","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1038\/s41588-024-01798-4","article-title":"Understanding the genetic complexity of puberty timing across the allele frequency spectrum","volume":"56","author":"Kentistou","year":"2024","journal-title":"Nat. Genet."},{"issue":"1","key":"10.1016\/j.ajcnut.2026.101326_bib27","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1186\/s12905-018-0627-8","article-title":"A systematic review of methods to measure menstrual blood loss","volume":"18","author":"Magnay","year":"2018","journal-title":"BMC Womens Health"},{"issue":"1","key":"10.1016\/j.ajcnut.2026.101326_bib28","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1182\/hematology.2024000661","article-title":"Quantifying menorrhagia and overview of nonsurgical management of heavy menstrual bleeding","volume":"2024","author":"Wheeler","year":"2024","journal-title":"Hematology. Am. Soc. Hematol. Educ. Program."},{"issue":"2","key":"10.1016\/j.ajcnut.2026.101326_bib29","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1002\/ijgo.14943","article-title":"Heavy menstrual bleeding, iron deficiency, and iron deficiency anemia: framing the issue","volume":"162","author":"Munro","year":"2023","journal-title":"Int. J. Gynaecol. Obstet."},{"issue":"1","key":"10.1016\/j.ajcnut.2026.101326_bib31","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1136\/bmjsrh-2023-201895","article-title":"Red blood cell capacity of modern menstrual products: considerations for assessing heavy menstrual bleeding","volume":"50","author":"DeLoughery","year":"2024","journal-title":"BMJ Sex Reprod. Health"},{"issue":"6","key":"10.1016\/j.ajcnut.2026.101326_bib32","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1007\/s00404-006-0273-5","article-title":"Influence of usage practices, ethnicity and climate on the skin compatibility of sanitary pads","volume":"275","author":"Farage","year":"2007","journal-title":"Arch. Gynecol. Obstet."},{"issue":"1","key":"10.1016\/j.ajcnut.2026.101326_bib33","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1186\/s12978-024-01910-1","article-title":"The condition of women frequently changing sanitary pads in 28 cities of China: a cross-sectional study","volume":"21","author":"Sun","year":"2024","journal-title":"Reprod. Health"},{"issue":"4","key":"10.1016\/j.ajcnut.2026.101326_bib34","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1007\/s11154-012-9228-2","article-title":"Steroid regulation of menstrual bleeding and endometrial repair","volume":"13","author":"Maybin","year":"2012","journal-title":"Rev. Endocr. Metab. Disord."},{"issue":"4","key":"10.1016\/j.ajcnut.2026.101326_bib35","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2025.5235","article-title":"Uterine fibroid diagnosis by race and ethnicity in an integrated health care system","volume":"8","author":"Mitro","year":"2025","journal-title":"JAMA Netw. Open"},{"issue":"9","key":"10.1016\/j.ajcnut.2026.101326_bib36","doi-asserted-by":"crossref","first-page":"2147","DOI":"10.1158\/1055-9965.EPI-04-0944","article-title":"Racial differences in premenopausal endogenous hormones","volume":"14","author":"Pinheiro","year":"2005","journal-title":"Cancer Epidemiol. Biomarkers Prev."},{"issue":"3","key":"10.1016\/j.ajcnut.2026.101326_bib37","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1002\/ijgo.12666","article-title":"The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years: 2018 revisions","volume":"143","author":"Munro","year":"2018","journal-title":"Int. J. Gynecol. Obstet."},{"key":"10.1016\/j.ajcnut.2026.101326_bib38","series-title":"Physiology, menstrual cycle [Internet]","author":"Thiyagarajan","year":"2024"},{"issue":"1","key":"10.1016\/j.ajcnut.2026.101326_bib39","article-title":"Validation study of a photo-based menstrual blood loss metric","volume":"3","author":"Fahey","year":"2026","journal-title":"O G Open"},{"issue":"6","key":"10.1016\/j.ajcnut.2026.101326_bib40","doi-asserted-by":"crossref","first-page":"101298","DOI":"10.1016\/j.ajcnut.2026.101298","article-title":"A genetic association study of iron absorption in adults of East Asian or Northern European ancestry from the Iron Genes in East Asian and Northern European Adults Study (FeGenes)","volume":"123","author":"Barad","year":"2026","journal-title":"Am. J. Clin. Nutr."}],"container-title":["The American Journal of Clinical Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0002916526001358?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0002916526001358?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T12:46:47Z","timestamp":1783169207000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0002916526001358"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":39,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["S0002916526001358"],"URL":"https:\/\/doi.org\/10.1016\/j.ajcnut.2026.101326","relation":{},"ISSN":["0002-9165"],"issn-type":[{"value":"0002-9165","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Differential associations between menstrual blood loss scores and iron status in East Asian and Northern European individuals: findings from a cross-sectional analysis of the Iron Genes in East Asian and Northern European Adults Study (FeGenes) cohort","name":"articletitle","label":"Article Title"},{"value":"The American Journal of Clinical Nutrition","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ajcnut.2026.101326","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 American Society for Nutrition. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"101326"}}