Progress 10/01/11 to 09/30/15
Outputs
Target Audience:1) Health professionals attending the Pacific Coast College Health Association Meeting (85 total attendees from western region colleges and universities). 2) Researchers and health professionals attending the Mountain West Clinical Translation Research Conference (35 attendees). 3) Health professionals, extension specialists, and the general public who are subscribed to the "Got Nutrients?" daily tip (over 2000 people received 24 daily tips related to this project's goals). 4) Approximately 180 students received clinical counseling on iron deficiency. Changes/Problems:
Nothing Reported
What opportunities for training and professional development has the project provided?
Nothing Reported
How have the results been disseminated to communities of interest?Various aspects of this project's results were communicated to college-based health professionals and academic faculty with a one-hour presentation at the Pacific Coast College Health Association annual meeting (85 people). A presentation on the underdiagnoses of iron deficiency was given to researchers and health professionals at the 2nd Annual Meeting of the Mountain West Clinical Translational Research Infrastructure Network meeting (35 people). A workshop was conducted on the necessity to consider meeting human nutrient needs when making environmental sustainability decisions at the 3rd Annual Hawaii Sustainability in Higher Education Summit at the University of Hawaii. Approximately 2,000 subscribers to the "Got Nutrients?" daily tips received 24 daily tips on issues related to iron nutrition. These subscribers are a combination of nutrition extension specialists, health professionals, professors, students, and the general public. The general public in Hawaii was targeted through nine newspaper articles in the Honolulu Star-Advertiser. Each issue had a combined print and digital circulation of about 210,000 copies (total circulation). What do you plan to do during the next reporting period to accomplish the goals?
Nothing Reported
Impacts
What was accomplished under these goals?
1) Twenty-four "Nutrition Tips" on iron-related health topics were sent by email to over 2000 subscribers to the "Got Nutrients?" "Daily Tip" and posted to the "Got Nutrients?" website. 2) Nine newspaper articles addressed various aspects of iron nutrition and consequences of deficiency. 3) One presentation was given at the October, 2014 Pacific Coast College Health Association annual conference. 4) One presentation was given at theMountain West Clinical Translation Research Infrastructure Network 2nd annual meeting in June 2015. 5) One presentation was given at the 3rd Annual Hawaii Sustainability in Higher Education Summit in February 2015. 6) Our continuing review of the biomedical literature on iron status and its relationship to various signs, symptoms, and medical conditions continues to indicate that iron deficiency without anemia is at least as common as the more frequently diagnosed "overt iron deficiency" (iron deficiency anemia). In addition, our review identified a broad spectrum of iron-related signs, symptoms, and medical conditions that frequently may not be recognized as iron-related conditions. Non-anemic iron deficiency should be evaluated in people suffering from conditions such as fatigue, dizziness, shortness of breath, heart palpitations, headaches, sleep problems, restless legs syndrome, intestinal problems, hair thinning, thyroid problems, swallowing problems, weakened immune function, and mental, emotional, and learning problems (to name a few). This project continues to develop a detailed quantification of the types and numbers of signs, symptoms, and medical conditions potentially linked to low iron status to be catalogued and summarized for publication. Although this project is officially completed, the work accomplished to date will lead to a variety of future publications and educational outreach.
Publications
- Type:
Other
Status:
Published
Year Published:
2014
Citation:
Titchenal, C.A. and Dobbs, J.C. (2014) Extreme 'clean' eating may exclude essential nutrients. Honolulu Star-Advertiser newspaper, 10/14/2014.
- Type:
Other
Status:
Published
Year Published:
2015
Citation:
Titchenal, C.A. and Dobbs, J.C. (2015) Research in 2014 prompted new look at nutrient needs. Honolulu Star-Advertiser newspaper, 1/13/2015.
- Type:
Other
Status:
Published
Year Published:
2015
Citation:
Titchenal, C.A. and Dobbs, J.C. (2015) Sustainability must meet supply and nutrient needs, Honolulu Star-Advertiser newspaper, 3/10/2015.
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2015
Citation:
Dobbs, J. and Vincent, D. (2015) Is human health and survival a part of environmental sustainability? 3rd Annual Hawaii Sustainability in Higher Education Summit. Feb. 26-28, 2015. University of Hawaii at Manoa.
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2014
Citation:
Dyer, M. and Dobbs, J. (2014) The Role of Diet in Sleep and Depression. 2014 Pacific College Health Association Annual Conference, Oct. 13-15, 2015, Seattle, WA.
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2015
Citation:
Dobbs, J., Hill, B.P., and Titchenal, C.A. (2015) Reliance on CBC blood values significantly under-diagnoses iron deficiency. 2nd Annual Meeting of the Mountain West Clinical Translational Research Infrastructure Network, June 8-10, 2015, Las Vegas, NV.
- Type:
Other
Status:
Published
Year Published:
2015
Citation:
Titchenal, C.A. and Dobbs, J.C. (2015) Proper nutrition can help blood donors with iron loss, Honolulu Star-Advertiser newspaper, 4/14/2015.
- Type:
Other
Status:
Published
Year Published:
2015
Citation:
Titchenal, C.A. and Dobbs, J.C. (2015) Iron deficiency can lead to multiple problems, Honolulu Star-Advertiser newspaper, 4/28/2015.
- Type:
Other
Status:
Published
Year Published:
2015
Citation:
Titchenal, C.A. and Dobbs, J.C. (2015) Expecting, lactating moms should boost iodine intake, Honolulu Star-Advertiser newspaper, 5/12/2015.
- Type:
Other
Status:
Published
Year Published:
2015
Citation:
Titchenal, C,A. and Dobbs, J.C. (2015) Food cravings are common, particularly among dieters, Honolulu Star-Advertiser newspaper, 5/26/2015.
- Type:
Other
Status:
Published
Year Published:
2015
Citation:
Titchenal, C.A. and Dobbs, J.C. (2015) Ensure your food intake yields essential nutrients, Honolulu Star-Advertiser newspaper, 9/8/2015.
- Type:
Other
Status:
Published
Year Published:
2015
Citation:
Titchenal, C.A. and Dobbs, J.C. (2015) U.S. dietary goals guidance fails to address iron deficit, Honolulu Star-Advertiser newspaper, 9/22/2015.
- Type:
Other
Status:
Published
Year Published:
2015
Citation:
Titchenal, C.A. and Dobbs, J.C. (2015) Dealing with dizziness, vertigo can be challenging, Honolulu Star-Advertiser newspaper, 9/27/2015.
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Progress 10/01/13 to 09/30/14
Outputs
Target Audience: 1) Health professionals attending the Pacific Coast College Health Association Meeting (93 total attendees from western region colleges and universities). 2) Health professionals attending the Hawaii Society of Respiratory Care Annual Conference (300 attendees, primarily respiratory therapists working in Hawaii). 3) Bariatric surgery patients at Pali Momi Medical Center, Aiea, HI (38 attendees, patients and health professionals). 4) Health professionals, extension specialists, and the general public who are subscribed to the "Got Nutrients?" daily tip (over 1800 people received 39 daily tips related to this project's goals). 5) Approximately 170 students received clinical counseling on iron deficiency. Changes/Problems:
Nothing Reported
What opportunities for training and professional development has the project provided?
Nothing Reported
How have the results been disseminated to communities of interest? Various aspects of this project's developing results were communicated within two one-hour presentations to university- and college-based health professionals and academic faculty who attended the Pacific Coast College Health Association annual meeting (93 people). Approximately 1800 subscribers to the "Got Nutrients?" daily tips received 39 daily tips on issues related to iron nutrition. These subscribers are a combination of nutrition extension specialists, health professionals, professors, students, and the general public. The general public in Hawaii was targeted through six newspaper articles in the Honolulu Star-Advertiser. Each issue has a print circulation of about 118,000 copies and an online digital circulation of about 74,000 (192,000 total circulation). What do you plan to do during the next reporting period to accomplish the goals? The next phase of this project will focus on writing and publishing our research results, conducting workshops with Hawaii medical professionals to increase awareness of the health issues related to non-anemic iron deficiency, and communicate the applied aspects of our results to decision makers at major health insurance agencies in Hawaii.
Impacts
What was accomplished under these goals?
1) Thirty-nine "Nutrition Tips" on iron-related health topics were sent by email to over 1800 subscribers to the "Got Nutrients?" "Daily Tip" and posted to the "Got Nutrients?" website. 2) Six newspaper articles addressed various aspects of iron nutrition and consequences of deficiency. 3) Two presentations were given at the November, 2013 Pacific Coast College Health Association annual conference. 4) Two activities were conducted on nutrition and health: one with 35 bariatric surgery patients and 3 associated health professionals; the other with 475 Monsanto employees and family members on the island of Oahu. 5) Our continuing review of the biomedical literature on iron status and its relationship to various signs, symptoms, and medical conditions continues to indicate that iron deficiency without anemia is at least as common as the more frequently diagnosed "overt iron deficiency" (iron deficiency anemia). In addition, our review identified a broad spectrum of iron-related signs, symptoms, and medical conditions that frequently may not be recognized as iron-related conditions. Non-anemic iron deficiency should be evaluated in people suffering from conditions such as fatigue, dizziness, shortness of breath, heart palpitations, headaches, sleep problems, restless legs syndrome, intestinal problems, hair thinning, thyroid problems, swallowing problems, weakened immune function, and mental, emotional, and learning problems (to name a few). This project continues to develop a detailed quantification of the types and numbers of signs, symptoms, and medical conditions potentially linked to low iron status to be catalogued and summarized for publication. 6) Completion of a graduate student's master's thesis that analyzed data from the National Health and Nutrition Examination Survey found that common blood values used to diagnose iron deficiency failed to identify substantial numbers of people that are iron deficient based on serum ferritin level. For example, the majority of females, age 20 to 39, with clinically low serum ferritin, had normal hemoglobin and hematocrit. Typically, this would result in a lack of diagnosis of iron deficiency in iron deficient individuals.
Publications
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2013
Citation:
Dobbs, J.C,, and Titchenal, C.A. 2013. Are your Diet and Supplement Recommendations Sabotaging Efforts to Achieve or Maintain a Healthy Weight? 2013 PCCHA Annual Conference, Nov. 3-6, Anaheim, CA.
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2013
Citation:
Titchenal, C.A., and Dobbs, J.C. 2013. Non-Celiac Gluten Sensitivity: Theory, Reality and Practice. 2013 PCCHA Annual Conference, Nov. 3-6, Anaheim, CA.
- Type:
Theses/Dissertations
Status:
Published
Year Published:
2014
Citation:
Hill, BP. 2014 (May). Do Current Medical Procedures Sufficiently Diagnose Iron Deficiency? Masters Thesis, University of Hawaii at Manoa.
- Type:
Other
Status:
Published
Year Published:
2014
Citation:
Titchenal, C.A., Dobbs, J.C. (2014). Dietary supplements help fill gaps, but use caution. Honolulu Star-Advertiser newspaper, 7/8/2014.
- Type:
Other
Status:
Published
Year Published:
2014
Citation:
Titchenal, C.A., Dobbs, J.C. (2014). Beef is a source of protein, and cattle can help the land. Honolulu Star-Advertiser newspaper, 8/12/2014.
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2014
Citation:
Titchenal, C.A. (2014). Nutrition in Respiratory Health & Disease. 41st Annual Hawaii State Respiratory Care Conference. Sept 30, 2014.
- Type:
Other
Status:
Published
Year Published:
2014
Citation:
Titchenal, C.A., Dobbs J.C. (2014). Low iron after pregnancy a problem for many women. Honolulu Star-Advertiser newspaper, 1/28/2014.
- Type:
Other
Status:
Published
Year Published:
2014
Citation:
Titchenal, C.A., Dobbs, J.C. (2014). Focus human food needs on nutrients, not animals. Honolulu Star-Advertiser newspaper, 2/25/2014.
- Type:
Other
Status:
Published
Year Published:
2014
Citation:
Titchenal, C.A., Dobbs, J.C. (2014). Neglecting your iron intake can lead to serious problems. Honolulu Star-Advertiser newspaper, 3/11/2014.
- Type:
Other
Status:
Published
Year Published:
2014
Citation:
Titchenal, C.A., Dobbs, J.C. (2014). Consuming coffee and tea comes with downsides, too. Honolulu Star-Advertiser newspaper, 6/24/2014.
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Progress 10/01/12 to 09/30/13
Outputs
Target Audience: 1) Seven students have been taking a graduate course on “Using NHANES Data to Explore Nutrient and Health Links” during the Fall 2013 semester. 2) Health professionals attending the Pacific Coast College Health Association Meeting (99 total attendees from 39 colleges and universities). 3) Health professionals, extension specialists, and the general public who are subscribed to the “Got Nutrients?” daily tip (over 1200 people received 15 daily tips related to this project’s goals). 4) Approximately 180 individuals (males and females age 21 to 80 years) who attended one of three presentations on nutrition and health. 5) Approximately 150 students received clinical counseling on iron deficiency. Changes/Problems:
Nothing Reported
What opportunities for training and professional development has the project provided? MS graduate student Brian Hill has analyzed NHANES data on iron status for his MS thesis that is currently being written. Seven students are currently enrolled in a graduate course in which they are receiving training in the management and analysis of NHANES data. Six of the students are conducting projects that focus on iron status and a variety of health problems. How have the results been disseminated to communities of interest? Some preliminary aspects of the project have been included in conference presentations that the Pacific Coast College Health Association annual conference. The attendees are primarily health professionals from college and university health clinics. What do you plan to do during the next reporting period to accomplish the goals? The next phase of this project will explore potential contemporary dietary factors that contribute to poor iron nutrition. Also, we will attempt to identify factors that currently impair diagnosis of non-anemic iron deficiency in symptomatic iron deficient individuals.
Impacts
What was accomplished under these goals?
1) A graduate course was taught on “Using NHANES Data to Explore Nutrient and Health Links” (Food Science & Human Nutrition 682, Special Topics; seven students). 2) Fifteen “Nutrition Tips” on iron-related health topics were sent by email to over 1250 subscribers to the “Got Nutrients?” "Daily Tip" and posted to the “Got Nutrients?” website. 3) Two presentations were given at the 2012 Pacific Coast College Health Association annual conference. 4) Three presentations on nutrition and health were presented to approximately 150 people (two church groups and one fitness center) on the island of Oahu. 5) An extensive review of the biomedical literature on iron status and its relationship to various signs, symptoms, and medical conditions indicates that what is often called “latent iron deficiency” (iron deficiency without anemia) is at least as common as the more frequently diagnosed “overt iron deficiency” (iron deficiency anemia). In addition, our review identified a broad spectrum of iron-related signs, symptoms, and medical conditions that frequently may not be recognized as iron-related conditions. Consequently, the possibility of iron deficiency should be considered in people suffering from conditions such as fatigue, dizziness, shortness of breath, heart palpitations, headaches, sleep problems, restless legs syndrome, intestinal problems, hair thinning, thyroid problems, swallowing problems, weakened immune function, and mental, emotional, and learning problems (to name a few). As this project continues, a more detailed quantification of the types and numbers of signs, symptoms, and medical conditions potentially linked to low iron status will be catalogued and summarized for publication. 6) Analysis of data from the National Health and Nutrition Examination Survey indicates that in females age 20 to 39, approximately 70% of 4,000 iron deficient participants were not anemic.
Publications
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2012
Citation:
Titchenal, C.A. and Dobbs, J.C. Incorporating Common Student Nutrition Beliefs into Clinical Practice. Pacific Coast College Health Association Meeting Las Vegas, Nevada October 14-17 2012.
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2012
Citation:
Dobbs, J.C. and Titchenal, C.A. Nonanemic Iron Deficiency: A Hidden Cause of Gender Inequity in Higher Education. Pacific Coast College Health Association Meeting Las Vegas, Nevada October 14-17 2012.
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Progress 10/01/11 to 09/30/12
Outputs
OUTPUTS: A comprehensive list of signs, symptoms, and medical conditions related to human iron status was developed by conducting literature searches with Pubmed, Quertle, Web of Science, Psychnet, Google, and Google Scholar. Also, 10 classic iron publications were surveyed for references related to signs, symptoms and medical conditions potentially linked with anemic or non-anemic iron deficiency. Over 3000 scientific references were evaluated. References were found for over 25 signs, symptoms, or medical conditions and represented all vulnerable iron status groups of interest, including children, adolescents, women of child bearing age, athletes, blood donors, vegetarians, and the elderly. Sixty percent of Laboratory, Exam, and Demographic NHANES Data and 10 percent of the Dietary data for NHANES III through 2008 were downloaded, combined, and prepared for use in the JMP/SAS data mining program. A protocol for efficiently using the downloaded NHANES database with JMP/SAS was developed. Five graduate students (one PhD and four MS) and three undergraduate students were trained in using NHANES datasets to explore research questions. One of these graduate students explored iron status relationships with common signs and symptoms which resulted in a master's thesis on the topic. One of the undergraduate students worked on an iron related project evaluating the Internet distribution of an error in iron recommendations for infants. The error was a recommendation for a toxic level of intake that resulted from an error in the units used in a press release from the American Academy of Pediatrics. This project was presented in poster form at the 2012 College of Tropical Agriculture and Human Resources Student Research Symposium. Two posters were presented at the 2012 National Nutrient Databank Conference in Houston, Texas. One poster addressed potential excessive aluminum intake in toddlers (can impair iron status), based on NHANES data analysis. The other poster utilized NHANES data to assess the potential for excess intake of iron and calcium from fortified breakfast cereals. Six newspaper articles were published in the Honolulu Star-Advertiser on topics that explained various signs, symptoms, or medical conditions that are potentially associated with iron nutrition. The Star-Advertiser distributed over 120,000 print copies and 23,000 digital copies of these articles and maintains online copies available to subscribers. This newspaper is estimated to reach about 67% of Oahu adults. Sixteen "Daily Tips" related to iron nutrition issues were posted to the "Got Nutrients" website and emailed to over 800 email subscribers. Four unique bookmarks were designed and are being distributed on an ongoing basis at the University Health Services at Manoa Specialty Clinic. Each of these bookmarks contains one or more "tips" that primarily target young women on the importance of getting adequate dietary iron for health. PARTICIPANTS: C. Alan Titchenal, PI, designed and supervised all aspects of the project, including the writing of all publications. In collaboration with Joannie Dobbs, Co-PI, the PI reviewed and evaluated the iron literature, developed a comprehensive list of signs, symptoms, and medical conditions related to human iron status, and designed an NHANES database management protocol. The PI assisted graduate students in exploring NHANES for research questions, directed one graduate thesis on signs and symptoms associated with iron deficiency in a collage-aged population and directed one undergraduate student in researching an Internet iron error. Joannie Dobbs, Co-PI, was responsible for downloading, combining, and preparing NHANES data and writing the protocol for dataset integration and management. Halina Zaleski collaborated on all research as a statistician. A total of eight students (5 graduate and 3 undergraduate) participated in NHANES related projects. TARGET AUDIENCES: Target audiences include the general public interested in low iron status and health professionals concerned with a healthy diet and preventing or treating iron deficiency. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.
Impacts
No outcomes or impacts were planned for this phase of this project. However, some of the outputs such as the newspaper articles and "Got Nutrients" daily tips may have impacted the knowledge of citizens who accessed these resources.
Publications
- Koshibe, Y. (2012). Prevalence of Signs and Symptoms among Iron Deficient College-age Individuals and its Use as a Predictor of Iron Deficiency. MS Thesis. University of Hawaii at Manoa.
- Dobbs, J.C., Titchenal, C.A. (2012). Kids' nutritional deficits might affect brain health. Honolulu Star-Advertiser, 1/17/2012.
- Dobbs, J.C., Titchenal, C.A. (2012). Postpartum depression common, cause unknown. Honolulu Star-Advertiser, 4/3/2012.
- Dobbs, J.C., Titchenal, C.A. (2012). Nutritional needs of women differ markedly from men's. Honolulu Star-Advertiser, 4/17/2012.
- Dobbs, J.C., Titchenal, C.A. (2012). Vitamin D requires iron aid, and both are often lacking. Honolulu Star-Advertiser, 5/15/2012.
- Dobbs, J.C., Titchenal, C.A. (2012). Sufficient nutrient intake equips body to fight toxins. Honolulu Star-Advertiser, 6/19/2012.
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