{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:06:01Z","timestamp":1785434761374,"version":"3.56.0"},"reference-count":58,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Noncommunicable Chronic Diseases-National Science and Technology Major Project","award":["2024ZD0524500"],"award-info":[{"award-number":["2024ZD0524500"]}]},{"name":"Noncommunicable Chronic Diseases-National Science and Technology Major Project","award":["2024ZD052450X"],"award-info":[{"award-number":["2024ZD052450X"]}]},{"DOI":"10.13039\/501100020084","name":"Guangzhou Municipal Science and Technology Bureau","doi-asserted-by":"publisher","award":["2023A03J0940"],"award-info":[{"award-number":["2023A03J0940"]}],"id":[{"id":"10.13039\/501100020084","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020084","name":"Guangzhou Municipal Science and Technology Bureau","doi-asserted-by":"publisher","award":["2023A03J0451"],"award-info":[{"award-number":["2023A03J0451"]}],"id":[{"id":"10.13039\/501100020084","id-type":"DOI","asserted-by":"publisher"}]},{"award":["2023A03J0940"],"award-info":[{"award-number":["2023A03J0940"]}],"id":[{"id":"https:\/\/ror.org\/0560dtp08","id-type":"ROR","asserted-by":"publisher"}]},{"award":["2023A03J0451"],"award-info":[{"award-number":["2023A03J0451"]}],"id":[{"id":"https:\/\/ror.org\/0560dtp08","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Key Project of Medicine Discipline of Guangzhou","award":["2025-2027-12"],"award-info":[{"award-number":["2025-2027-12"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Iron deficiency (ID) progresses through three stages: iron deficiency stores (IDS), iron deficiency erythropoiesis (IDE), and iron deficiency anemia (IDA). Neglecting subclinical ID may be harmful to school-aged children and increase the public health burden. Although diet is a key modifiable factor, most studies only focus on overall ID or merely the clinical IDA stage. This study combines a dietary index with pattern analysis to take advantage of their complementary strengths and explore their associations with ID progression. Methods: This cross-sectional study included 2493 participants from rural Guangzhou between June 2022 and May 2023. Demographic, lifestyle, anthropometric, and dietary data were collected via structured questionnaires. Blood samples were analyzed for iron status. Factor analysis identified dietary patterns, and the Chinese Dietary Guidelines Index for Children and Adolescents [CDGI(2021)-C] assessed dietary quality. We used ordinal logistic regression, multivariable logistic regression, and restricted cubic spline (RCS) models to examine dietary associations with ID stages. Results: IDS, IDE, and IDA proportions were 68.22%, 17.45%, and 14.33%, respectively. All four dietary patterns correlated positively with CDGI(2021)-C, most strongly for the fruit\u2013vegetable (rs = 0.552) and cereal\u2013tuber\u2013legume patterns (rs = 0.386). Higher CDGI(2021)-C (OR = 0.852, 95% CI: 0.751\u20130.966, p-trend = 0.012), fruit\u2013vegetable (OR = 0.866, 95%CI: 0.748\u20130.993, p-trend = 0.047), and meat\u2013offal patterns (OR = 0.733, 95%CI: 0.611\u20130.868, p-trend &lt; 0.001) were inversely associated with advancing ID stages, while the snack\u2013fast food pattern was positively associated (OR = 1.233, 95% CI: 1.094\u20131.381, p-trend &lt; 0.001). In IDS, higher adherence to CDGI(2021)-C, fruit\u2013vegetable, and meat\u2013offal patterns was associated with lower odds (all p-trend &lt; 0.05). RCS showed nonlinear associations for the snack\u2013fast food and cereal\u2013tuber\u2013legume patterns, with risk peaking at moderate-to-high adherence to these patterns (both p-nonlinear &lt; 0.05). In IDE and IDA, the snack\u2013fast food pattern risk rose steeply at moderate-to-high adherence (p-nonlinear = 0.036), whereas the cereal\u2013tuber\u2013legume pattern\u2019s ORs fluctuated near 1 (p-nonlinear = 0.020). Conclusions: Dietary pattern and index analyses showed consistent associations across ID stages. Adherence to dietary guidelines slows ID progression, especially in early subclinical stages. More fruits, vegetables, and heme-iron-rich foods, alongside less fast food and snacks, slow ID progression. Though dietary intervention effects weaken in later stages, reducing fast food and snacks confers long-term benefits. These findings inform targeted nutrition policies to prevent ID progression in children.<\/jats:p>","DOI":"10.3390\/nu18101620","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T12:30:51Z","timestamp":1779280251000},"page":"1620","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations of Dietary Patterns and Dietary Index with Iron Deficiency Across Different Stages Among Children Aged 9\u201317 Years in Guangzhou, China: A Cross-Sectional Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4851-4660","authenticated-orcid":false,"given":"Jie","family":"Huang","sequence":"first","affiliation":[{"name":"Guangzhou Center for Disease Control and Prevention (Guangzhou Health Supervision Institute), Guangzhou 510440, China"},{"name":"Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention (Guangzhou Health Supervision Institute), Guangzhou 510440, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinhan","family":"Fu","sequence":"additional","affiliation":[{"name":"Sanshui District Center for Disease Control and Prevention, Foshan 528199, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bingyu","family":"Liuzhang","sequence":"additional","affiliation":[{"name":"Guangzhou Center for Disease Control and Prevention (Guangzhou Health Supervision Institute), Guangzhou 510440, China"},{"name":"School of Public Health, Southern Medical University, Guangzhou 510515, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunzi","family":"Zeng","sequence":"additional","affiliation":[{"name":"Guangzhou Center for Disease Control and Prevention (Guangzhou Health Supervision Institute), Guangzhou 510440, China"},{"name":"Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention (Guangzhou Health Supervision Institute), Guangzhou 510440, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiyun","family":"Luo","sequence":"additional","affiliation":[{"name":"Guangzhou Center for Disease Control and Prevention (Guangzhou Health Supervision Institute), Guangzhou 510440, China"},{"name":"Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention (Guangzhou Health Supervision Institute), Guangzhou 510440, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8847-4541","authenticated-orcid":false,"given":"Yujie","family":"Peng","sequence":"additional","affiliation":[{"name":"Guangzhou Center for Disease Control and Prevention (Guangzhou Health Supervision Institute), Guangzhou 510440, China"},{"name":"Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention (Guangzhou Health Supervision Institute), Guangzhou 510440, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyan","family":"Wang","sequence":"additional","affiliation":[{"name":"Guangzhou Center for Disease Control and Prevention (Guangzhou Health Supervision Institute), Guangzhou 510440, China"},{"name":"Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention (Guangzhou Health Supervision Institute), Guangzhou 510440, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhifeng","family":"Li","sequence":"additional","affiliation":[{"name":"Guangzhou Center for Disease Control and Prevention (Guangzhou Health Supervision Institute), Guangzhou 510440, China"},{"name":"Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention (Guangzhou Health Supervision Institute), Guangzhou 510440, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuting","family":"Qin","sequence":"additional","affiliation":[{"name":"Guangzhou Center for Disease Control and Prevention (Guangzhou Health Supervision Institute), Guangzhou 510440, China"},{"name":"Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention (Guangzhou Health Supervision Institute), Guangzhou 510440, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanzhen","family":"Zhong","sequence":"additional","affiliation":[{"name":"Guangzhou Center for Disease Control and Prevention (Guangzhou Health Supervision Institute), Guangzhou 510440, China"},{"name":"School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiwei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Guangzhou Center for Disease Control and Prevention (Guangzhou Health Supervision Institute), Guangzhou 510440, China"},{"name":"Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention (Guangzhou Health Supervision Institute), Guangzhou 510440, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhoubin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Guangzhou Center for Disease Control and Prevention (Guangzhou Health Supervision Institute), Guangzhou 510440, China"},{"name":"Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention (Guangzhou Health Supervision Institute), Guangzhou 510440, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2648-2162","authenticated-orcid":false,"given":"Longying","family":"Zha","sequence":"additional","affiliation":[{"name":"School of Public Health, Southern Medical University, Guangzhou 510515, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7355-4640","authenticated-orcid":false,"given":"Yan","family":"Li","sequence":"additional","affiliation":[{"name":"Guangzhou Center for Disease Control and Prevention (Guangzhou Health Supervision Institute), Guangzhou 510440, China"},{"name":"Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention (Guangzhou Health Supervision Institute), Guangzhou 510440, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0098-2997(00)00006-6","article-title":"The roles of iron in health and disease","volume":"22","author":"Lieu","year":"2001","journal-title":"Mol. Asp. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/S0140-6736(20)32594-0","article-title":"Iron deficiency","volume":"397","author":"Pasricha","year":"2021","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Wang, L., Liang, D., Huangfu, H., Shi, X., Liu, S., Zhong, P., Luo, Z., Ke, C., and Lai, Y. (2024). Iron Deficiency: Global Trends and Projections from 1990 to 2050. Nutrients, 16.","DOI":"10.3390\/nu16203434"},{"key":"ref_4","first-page":"108","article-title":"Neurodevelopmental Impairments as Long-term Effects of Iron Deficiency in Early Childhood: A Systematic Review","volume":"42","author":"Theola","year":"2025","journal-title":"Balk. Med. J."},{"key":"ref_5","first-page":"113","article-title":"Effects of Iron Deficiency on Organ Function and Related Research Methods","volume":"36","author":"Wang","year":"2009","journal-title":"Foreign Med. Sci. (Sect. Hyg.)"},{"key":"ref_6","first-page":"1","article-title":"Expert consensus on the prevention and treatment of iron deficiency and iron deficiency anemia in children","volume":"34","author":"Qing","year":"2023","journal-title":"Chin. J. Woman Child Health Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1001\/jamapediatrics.2024.1095","article-title":"Effect of Low-Dose Iron Supplementation on Early Development in Breastfed Infants: A Randomized Clinical Trial","volume":"178","author":"Svensson","year":"2024","journal-title":"Jama Pediatr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e71110","DOI":"10.1002\/fsn3.71110","article-title":"Prevalence and Risk Factors of Iron Deficiency and Iron Deficiency Anemia in Preschool Children of China: A Prospective Observational Study","volume":"13","author":"Gu","year":"2025","journal-title":"Food Sci. Nutr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"fmae047","DOI":"10.1093\/tropej\/fmae047","article-title":"Prevalence and associated factors of anaemia and iron-deficiency anaemia among adolescent Sudanese schoolchildren: A cross-sectional study","volume":"71","author":"Osman","year":"2024","journal-title":"J. Trop. Pediatr."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Mondon, C., Tan, P.Y., Chan, C.L., Tran, T.N., and Gong, Y.Y. (2024). Prevalence, determinants, intervention strategies and current gaps in addressing childhood malnutrition in Vietnam: A systematic review. BMC Public Health, 24.","DOI":"10.1186\/s12889-024-18419-8"},{"key":"ref_11","first-page":"1876","article-title":"Meta-analysis on prevalence of iron deficiency anemia in Chinese children aged 0\u201314 years from 2000 to 2020","volume":"41","author":"Liu","year":"2020","journal-title":"Chin. J. Sch. Health"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Chen, Z., Yang, H., Wang, D., Sudfeld, C.R., Zhao, A., Xin, Y., Chen, J.C., Fawzi, W.W., Xing, Y., and Li, Z. (2022). Effect of Oral Iron Supplementation on Cognitive Function among Children and Adolescents in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis. Nutrients, 14.","DOI":"10.3390\/nu14245332"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"An, R., Shen, J., Zhang, Z., Lim, M.T., and Huynh, D.T.T. (2024). Effect of Oral Nutritional Supplementation on Health-Related Outcomes and Nutritional Biomarkers in Children and Adolescents with Undernutrition: A Systematic Review and Meta-Analysis. Nutrients, 16.","DOI":"10.3390\/nu16172970"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"20441","DOI":"10.1021\/acsomega.2c01833","article-title":"Iron Absorption: Factors, Limitations, and Improvement Methods","volume":"7","author":"Piskin","year":"2022","journal-title":"ACS Omega"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"128","DOI":"10.23736\/S2724-5276.21.06214-9","article-title":"Immunomodulatory diet in pediatric age","volume":"73","author":"Verduci","year":"2021","journal-title":"Minerva Pediatr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1111\/j.1753-4887.2004.tb00040.x","article-title":"Empirically derived eating patterns using factor or cluster analysis: A review","volume":"62","author":"Newby","year":"2004","journal-title":"Nutr. Rev."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"4115","DOI":"10.1007\/s00394-021-02545-9","article-title":"Advances in dietary pattern analysis in nutritional epidemiology","volume":"60","author":"Schulz","year":"2021","journal-title":"Eur. J. Nutr."},{"key":"ref_18","first-page":"334","article-title":"Research Progress on A Priori Dietary Pattern Index Scales","volume":"48","author":"Liao","year":"2019","journal-title":"J. Hyg. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.clnesp.2022.02.003","article-title":"Nutritional status and adherence to the mediterranean diet in children with epilepsy","volume":"48","author":"Kaner","year":"2022","journal-title":"Clin. Nutr. Espen"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"dyab168.185","DOI":"10.1093\/ije\/dyab168.185","article-title":"1055 The applicability of the Healthy Eating Index to measure Iranian diet quality","volume":"50","author":"Sara","year":"2021","journal-title":"Int. J. Epidemiol."},{"key":"ref_21","first-page":"181","article-title":"Establishment and application of dietary guideline index for Chinese children and adolescents aged 7\u201317","volume":"51","author":"Hu","year":"2022","journal-title":"J. Hyg. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00394-024-03526-4","article-title":"Dietary patterns and bone density among school-aged children: A cross-sectional study in China","volume":"64","author":"Tan","year":"2024","journal-title":"Eur. J. Nutr."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1007\/s00394-025-03630-z","article-title":"Iron insight: Exploring dietary patterns and iron deficiency among teenage girls in Sweden","volume":"64","author":"Stubbendorff","year":"2025","journal-title":"Eur. J. Nutr."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1007\/s13668-025-00671-y","article-title":"Plant-Based Diet and Risk of Iron-deficiency Anemia. A Review of the Current Evidence and Implications for Preventive Strategies","volume":"14","author":"Bertotti","year":"2025","journal-title":"Curr. Nutr. Rep."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Fu, J., Zeng, C., Huang, J., Guo, J., Su, Z., Luo, S., Zhang, W., Zhang, Z., Zhu, H., and Li, Y. (2024). Dietary patterns and association with Iron deficiency among children and adolescents aged 9\u201317\u2009years in rural Guangzhou, China: A cross-sectional study. Front. Nutr., 11.","DOI":"10.3389\/fnut.2024.1443849"},{"key":"ref_26","unstructured":"Zhan, S., Ye, D., and Tan, H. (2017). Epidemiology, People\u2019s Health Publishing House."},{"key":"ref_27","first-page":"924","article-title":"Iron store status of children aged 6 to 17 years in Beijing in 2016-2017","volume":"52","author":"Huang","year":"2023","journal-title":"J. Hyg. Res."},{"key":"ref_28","first-page":"45","article-title":"Investigation of Iron Nutritional Status among Children Aged 2\u201312 Years in Guangzhou","volume":"40","author":"Huang","year":"2023","journal-title":"Stud. Trace Elem. Health"},{"key":"ref_29","first-page":"1182","article-title":"Analysis of micronutrients in whole blood of 28986 children in Dongguan","volume":"25","author":"Cheng","year":"2021","journal-title":"Chin. J. Lab. Diagn."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"660","DOI":"10.2471\/BLT.07.043497","article-title":"Development of a WHO growth reference for school-aged children and adolescents","volume":"85","author":"Onyango","year":"2007","journal-title":"Bull. World Health Organ."},{"key":"ref_31","unstructured":"National Heath and Family Planning Commission of the People\u2019s Republic of China (2025, December 15). Chronic Disease and Nutrition Monitoring Work Plan for Chinese Residents (Trial). Available online: https:\/\/www.chinanutri.cn\/tzgg_6537\/tzgg_102\/201412\/t20141231_108847.html."},{"key":"ref_32","unstructured":"World Health Organization (2025, December 20). WHO Guidance Helps Detect Iron Deficiency and Protect Brain Development. Available online: https:\/\/www.who.int\/news\/item\/20-04-2020-who-guidance-helps-detect-iron-deficiency-and-protect-brain-development."},{"key":"ref_33","unstructured":"(2015). Method for Iron Deficiency Screening (Standard No. WS\/T465-2015)."},{"key":"ref_34","unstructured":"Chinese Nutrition Society (2023). Dietary Reference Intakes for Chinese Residents (2023 Edition), People\u2019s Health Publishing House."},{"key":"ref_35","unstructured":"World Health Organization (2026, January 31). Haemoglobin Concentrations for the Diagnosis of Anaemia and Assessment of Severity. Available online: https:\/\/www.who.int\/publications\/i\/item\/WHO-NMH-NHD-MNM-11.1."},{"key":"ref_36","first-page":"115","article-title":"Iron status and effect of early iron supplementation on sub-clinical iron deficiency in rural school-age children from mountainous areas of Beijing","volume":"37","author":"Lin","year":"2003","journal-title":"Chin. J. Prev. Med."},{"key":"ref_37","unstructured":"Mu, J. (2017). Analysis the Prevalence Rate of Iron Deficiency and Relevant Factors of Iron Deficiency Anemia Aged 6~12 Yeas Old in Lanzhou and Dongxiang. [Master\u2019s Thesis, Lanzhou University]."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"4027","DOI":"10.7189\/jogh.16.04027","article-title":"Global prevalence of iron deficiency anaemia among children aged 5\u201312 years: A systematic review and meta-analysis","volume":"16","author":"Sukwuttichai","year":"2026","journal-title":"J. Glob. Health"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Fiani, D., Engler, S., Ni, Y., Fields, S., and Calarge, C. (2024). Iron Deficiency and Internalizing Symptoms Among Adolescents in the National Health and Nutrition Examination Survey. Nutrients, 16.","DOI":"10.3390\/nu16213643"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"490","DOI":"10.5455\/annalsmedres.2020.02.116","article-title":"Prevalence of anemia and iron deficiency anemia among elementary school children in Turkey","volume":"28","author":"Emre","year":"2021","journal-title":"Ann. Med. Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1670","DOI":"10.3945\/jn.116.235127","article-title":"Serum Zinc Is a Major Predictor of Anemia and Mediates the Effect of Selenium on Hemoglobin in School-Aged Children in a Nationally Representative Survey in New Zealand","volume":"146","author":"Houghton","year":"2016","journal-title":"J. Nutr."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"44","DOI":"10.32539\/bji.v11i1.222","article-title":"Analysis of Menstrual Periods, Menstrual Cycle, Menstrual Pain and Body Mass Index with the Incidence of Anemia in Adolescent Girls","volume":"11","author":"Karinda","year":"2025","journal-title":"Biomed. J. Indones."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1016\/j.tjnut.2023.11.030","article-title":"Iron Deficiency and Vitamin D Deficiency Are Associated with Sleep in Females of Reproductive Age: An Analysis of NHANES 2005\u20132018 Data","volume":"154","author":"Jansen","year":"2024","journal-title":"J. Nutr."},{"key":"ref_44","unstructured":"Zhang, L. (2020). Study on the Influence Factors and Intervention Effect of Anemia in a Higher Vocational College. [Master\u2019s Thesis, Southeast University]."},{"key":"ref_45","first-page":"116","article-title":"Status and Influencing Factors of Anemia Among Children and Adolescents Aged 6\u201317 Years in Yunnan Province","volume":"39","author":"Yang","year":"2024","journal-title":"Matern. Child Health Care China"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e13892","DOI":"10.1111\/obr.13892","article-title":"Association of iron deficiency and anemia with obesity among children: A systematic review and meta-analysis","volume":"26","author":"Sachdeva","year":"2025","journal-title":"Obes. Rev."},{"key":"ref_47","first-page":"519","article-title":"Association Between Obesity and Iron Deficiency in School-Age Children and Adolescents","volume":"46","author":"Li","year":"2024","journal-title":"Acta Nutr. Sin."},{"key":"ref_48","first-page":"1916","article-title":"Study on the association between systemic immune-inflammation index and metabolic types and characteristics of obesity in children and adolescents","volume":"59","author":"Wan","year":"2025","journal-title":"Chin. J. Prev. Med."},{"key":"ref_49","unstructured":"Sun, Y. (2022). Effects of 6-Weeks Moderate-Intensity Continuous Training on Plasma Inflammatory Factors and Iron Metabolism Homeostasis in Adolescents. [Master\u2019s Thesis, Beijing Sport University]."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1498","DOI":"10.1016\/j.ajcnut.2025.08.006","article-title":"Associations between intakes of food groups recommended by the Dietary Guidelines for Americans and iron status in subsets of the United States population: A cross-sectional study","volume":"122","author":"Barney","year":"2025","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"148058","DOI":"10.1016\/j.foodchem.2026.148058","article-title":"Vitamin C in fruits and vegetables: Stability, processing effects, analytical detection, nutrient interactions, bioavailability, and health implications","volume":"505","author":"Verma","year":"2026","journal-title":"Food Chem."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1111\/nbu.12643","article-title":"Factors affecting iron absorption and the role of fortification in enhancing iron levels","volume":"48","author":"Perera","year":"2023","journal-title":"Nutr. Bull."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Malik, Z.I., Ghafoor, M.U., Shah, S.H.B.U., Abid, J., Farooq, U., and Ahmad, A.M.R. (2025). Unlocking iron: Nutritional origins, metabolic pathways, and systemic significance. Front. Nutr., 12.","DOI":"10.3389\/fnut.2025.1637316"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Harder, N.H.O., Hieronimus, B., Stanhope, K.L., Shibata, N.M., Lee, V., Nunez, M.V., Keim, N.L., Bremer, A., Havel, P.J., and Heffern, M.C. (2020). Effects of Dietary Glucose and Fructose on Copper, Iron, and Zinc Metabolism Parameters in Humans. Nutrients, 12.","DOI":"10.3390\/nu12092581"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Rahmawati, D.P., Indarto, D., and Hanim, D. (2021). Fast Food Consumption and Snacking in Female Adolescents and Their Correlation with Hemoglobin Levels. Proceedings of the International Conference on Health and Medical Sciences (AHMS 2020), Atlantis Press.","DOI":"10.2991\/ahsr.k.210127.025"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Soans, J.S., Noronha, J.A., Mundkur, S.C., Nayak, B.S., Garg, M., Jathanna, R.D., and Mathias, E.G. (2025). Mapping evidence on the impact of junk food on anaemia among adolescent and adult population: A scoping review. BMC Nutr., 11.","DOI":"10.1186\/s40795-025-01079-1"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Smith, T.J., Hess, S.Y., Agdeppa, I.A., Goyena, E., Gelli, A., and Olney, D.K. (2024). Diets, Fruit and Vegetable Intake and Nutritional Status Among Children, Adolescents and Adults in the Philippines: A Scoping Review. Matern. Child Nutr., e13786.","DOI":"10.1111\/mcn.13786"},{"key":"ref_58","first-page":"763","article-title":"Modern Understanding and Treatment Progress of Iron Deficiency Anemia","volume":"36","author":"Zhang","year":"2023","journal-title":"J. Clin. Hematol."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/10\/1620\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T12:44:25Z","timestamp":1779281065000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/10\/1620"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,20]]},"references-count":58,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["nu18101620"],"URL":"https:\/\/doi.org\/10.3390\/nu18101620","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,20]]}}}