THE EFFECTS OF IRON STATUS ON MOOD, STRESS, AND QUALITY OF LIFE IN WOMEN OF REPRODUCTIVE AGE

Open Access
Author:
Seiger, Emily Rebekah
Area of Honors:
Nutritional Sciences
Degree:
Bachelor of Science
Document Type:
Thesis
Thesis Supervisors:
  • Laura E Murray-Kolb, Thesis Supervisor
  • Alison Diane Gernand, Honors Advisor
Keywords:
  • iron
  • iron supplementation
  • mood
  • stress
  • quality of life
  • women of reproductive age
  • affective outcomes
  • nutrition
Abstract:
BACKGROUND: Results from studies examining the relationship between iron and stress, iron and mood, and iron and quality of life in women of reproductive age (WRA) are inconsistent. We hypothesized that iron supplementation in iron deficient WRA would improve overall mood and quality of life and decrease feelings of stress compared to placebo in iron sufficient participants. METHODS: WRA were recruited from Penn State University (n=33) and upon their initial visit, asked to complete questionnaires assessing the affective outcomes of mood via the Profile of Mood States (POMS), stress via the Perceived Stress Scale (PSS), and quality of life via the WHO Quality of Life (WHOQOL-BREF) and the SF36v2 Quality of Life (SF36v2). Their iron status was also measured via hemoglobin (Hb), ferritin (Ft), transferrin receptor (TfR), hematocrit (Hct), and alpha-1-acid-glycoprotein (AGP) at the initial visit through a blood screening. Participants categorized as iron sufficient (Hb > 12.0 g/dL, Ft > 20 μg/L, TfR < 8 mg/L) were instructed to take placebo, gelatin pills, daily for 4 months and participants categorized as iron depleted but not anemic (Hb > 12.0 g/dL, Ft < 20 μg/L, TfR > 8) were instructed to take 60 mg ferrous sulfate daily for 4 months. Participants were blinded to their treatment. After 4 months, participants returned and their iron status was re-assessed and they completed the same questionnaires (POMS, PSS, WHOQOL-BREF, and SF36v2). Statistical analyses included ANOVA/ANCOVA for cross-sectional analyses within a time point as well as an analysis in difference over time (subtracting baseline from endline), and Stepwise Regression. Data were analyzed using these statistical tests with groups categorized as iron deficient and iron sufficient, as well as categorized as responders and non-responders based on changes in ferritin (Ft) for one analysis and hemoglobin (Hb) for another. RESULTS: Iron had a significant role in improving the affective outcomes stress, mood, and quality of life. Specifically, iron treatment in iron deficient WRA improved feelings of Physical Functioning and Social Functioning and decreased feelings of Bodily Pain, Stress, Tension, Anger, Depression, Confusion and overall Mood Disturbance compared to placebo given to iron sufficient women. Participants whose Hb status improved over time (irrespective of treatment) experienced improvements in Social Functioning, Physical Health, and Social Health and decreases in Bodily Pain, Role limitations due to Emotional health, Stress, Tension, Anger, Fatigue, Depression, Confusion and overall Mood Disturbance compared to placebo. Participants whose Ft status improved (irrespective of treatment) experienced improvements in Social Functioning, Physical Health, Psychological Health, and Social Health and decreases in Bodily Pain, Role limitations due to Emotional health, Tension, Anger, Depression, and overall Mood Disturbance compared to placebo. CONCLUSIONS: This study contributes to the evidence that iron, specifically treatment with iron via supplementation, is a promising mechanism for improving the affective outcomes of mood, stress, and quality of life in iron deficient WRA. However, given our sample size, more studies are needed to truly understand the effects of iron on affective outcomes in WRA.