Estimation of the Burden of Iron Deficiency Anemia in France from Iron Intake: Methodological Approach

Abstract

Dietary iron deficiency (ID) is the first nutritional deficiency in the world, in terms of disability adjusted life years (DALY). This nutritional deficiency may lead to anemia, especially among children, adolescents, and adult women. The aim of this study was to build an original probabilistic model to quantitatively assess the ID, the iron deficiency anemia (IDA) and the subsequent health burden in France expressed in DALY, per age class and gender. The model considered the distribution of absorbed iron intake, the iron requirement distribution established by the European Food Safety Authority and the iron status in France. Uncertainty due to lack of data and variability due to biological diversity were taken into account and separated using a second-order Monte Carlo procedure. A total of 1290 (95% CI = 1230–1350) IDA cases corresponding to 16 (95% CI = 11–20) DALY were estimated per 100,000 individuals per year. The major contributors to IDA burden were menstruating females aged from 25 to 44 years old. Then, a consumption scenario was built with ground beef as intake, an increase in red meat consumption to 100 g/d would not eliminate entirely the IDA burden. The quantitative methodology applied here for France could be reused for other populations.

Factors associated with iron deficiency and how they can be used in blood donor selection processes

“…Overall, the prevalence of ID and IDA were significantly higher in females compared to males (3)(11)(13)(14)(17)(25)(26). One study concluded that there are, however, differences in the risk factors even among reproductive aged women by successfully identifying several significant risk factors in the older population (22-49 years) but not finding any variables for predicting IDA in the younger study population (12-21 years) (23).…”

“…One of the studies found ID prevalence to be the highest in the younger age group and decreasing with age(17). For females prevalence of both ID and IDA was significantly higher in reproductive age compared to older age groups (3)(13)(16)(17)(21)(22).…”

“…ID and IDA were found to be associated with menstrual blood loss, both when menstrual blood loss was self-reported and by measured blood loss(7)(8)(14)(16)(18)(21). Menstruation in women aged 25-44 years was the greatest contributor to the disease burden of IDA (DALY, disease adjusted life year) (17). The amount of years menstruating was also associated with IDA(23).…”

Fatores associados à anemia em adolescentes escolares: Um estudo transversal

“…A prevalência da anemia entre adolescentes do sexo feminino é também descrita em estudos internacionais de base populacional, a exemplo do ENSANUT MC 2016, cuja prevalência em adolescentes de ambos os sexos foi de 9,6% [IC95% 7,8,11,8] e no sexo feminino de 12% (De la Cruz-Góngora, 2018). Urrechaga et al, [2016] seja devido ao consumo insuficiente de ferro e restrições alimentares para perda de peso, seja pelo estirão do crescimento, pela maturação sexual ou pela menarca, que provoca eliminação de ferro orgânico (Alquaiz et al, 2015;Bird et al, 2017;Mota et al, 2019;Skolmowska & Glabska, 2019;Wirth et al, 2017).…”

“…As condições socioeconômicas e a escolaridade materna são fatores determinantes para a prevalência da anemia em adolescentes, por se associarem ao baixo consumo de alimentos ricos em ferro biodisponível, às condições precárias de saneamento e moradia, e ao maior risco de infecções parasitárias (Bezerra et al, 2018;Mota et al, 2019;Spezia et al, 2018) Esta relação foi encontrada em vários estudos (Prasanth, 2017;Shaka & Wondimagegne, 2018;Thomas et al, 2015). No entanto, a associação da anemia com esses fatores não foi constatada nesta pesquisa, à semelhança de outras publicações (Bezerra et al, 2018;De la Cruz-Góngora et al, 2016).…”