OBJECTIVES: The purpose of this study was to compare selected iron markers (serum iron, total iron-binding capacity (TIBC), transferrin and ferritin concentration, transferrin saturation, and free haemoglobin) in children from marginalised Roma communities (MRCs) with children from the majority population and explore their associations with diet composition. METHODS: We obtained cross-sectional data (questionnaires, blood samples from children) from 119 mother-child dyads from MRCs and the majority population. Group differences were tested using Chi-square and Mann-Whitney U tests. Associations of belonging to MRCs and diet with iron markers (transferrin, ferritin, TIBC, serum iron, transferrin saturation) were examined using bootstrapped linear regression models, and mediation analyses assessed whether eating habits mediated group differences. RESULTS: Statistically significant differences between children from MRCs, and the majority were found in serum transferrin, ferritin, and TIBC levels. The more frequent consumption of sweetened drinks, sweets, and salty snacks is associated with lower levels of transferrin, and more frequent consumption of dairy products is associated with higher levels of total iron-binding capacity. Current breastfeeding was found to be negatively associated with ferritin. Consumption of sweets and salty snacks partially mediates the differences in transferrin between children from MRCs and the majority. CONCLUSIONS: Our findings suggest that the observed low ferritin levels, elevated TIBC, and reduced transferrin saturation in Roma children are likely indicative of early-stage iron deficiency, potentially driven by underlying malnutrition. This study underscores the significant disparities in iron metabolism between children from MRCs and those from the majority population, primarily driven by social determinants of health, including diet composition.

Clinic of Vascular Surgery Faculty of Medicine PJ Safarik University and East Slovak Institute of Cardiovascular Diseases Kosice 040 11 Slovakia

Department of Health Psychology and Research Methodology Faculty of Medicine PJ Safarik University 041 11 Kosice Slovakia

Department of Medical and Clinical Biochemistry Faculty of Medicine PJ Safarik University 041 11 Kosice Slovakia

Olomouc University Social Health Institute Palacky University in Olomouc 771 11 Olomouc Czech Republic

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