Iron status of toddlers, nonpregnant females, and pregnant females in the United States

Abstract

Background: Total-body iron stores (TBI), which are calculated from serum ferritin and soluble transferrin receptor concentrations, can be used to assess the iron status of populations in the United States.Objective: This analysis, developed to support workshop discussions, describes the distribution of TBI and the prevalence of iron deficiency (ID) and ID anemia (IDA) among toddlers, nonpregnant females, and pregnant females. Design: We analyzed data from NHANES; toddlers aged 12-23 mo (NHANES 2003(NHANES -2010, nonpregnant females aged 15-49 y (NHANES 2007(NHANES -2010, and pregnant females aged 12-49 y (NHANES 1999(NHANES -2010. We used SAS survey procedures to plot distributions of TBI and produce prevalence estimates of ID and IDA for each target population. All analyses were weighted to account for the complex survey design.Results: According to these data, ID prevalences (6 SEs) were 15.1% 6 1.7%, 10.4% 6 0.5%, and 16.3% 6 1.3% in toddlers, nonpregnant females, and pregnant females, respectively. ID prevalence in pregnant females increased significantly with each trimester (5.3% 6 1.5%, 12.7% 6 2.3%, and 27.5% 6 3.5% in the first, second, and third trimesters, respectively). Racial disparities in the prevalence of ID among both nonpregnant and pregnant females exist, with Mexican American and non-Hispanic black females at greater risk of ID than non-Hispanic white females. IDA prevalence was 5.0% 6 0.4% and 2.6% 6 0.7% in nonpregnant and pregnant females, respectively. Conclusions: Available nationally representative data suggest that ID and IDA remain a concern in the United States. Estimates of ironreplete status cannot be made at this time in the absence of established cutoffs for iron repletion based on TBI. The study was registered at clinicaltrials.gov as NCT03274726.Am J Clin Nutr 2017;106 (Suppl):1640S-6S.

Prevalence of iron deficiency in 62,685 women of seven race/ethnicity groups: The HEIRS Study

“…Among the present women ages 25-54 y, the prevalence of ID was significantly greater in Hispanic and black women than white and Asian women. In NHANES 1999-2000 and NHANES 2003-2010, the prevalence of ID was greater among non-Hispanic black and Mexican-American women than among non-Hispanic white women [8,25]. Among US women ages 22-44 y identified as Mexican Americans, Puerto Ricans, or Cubans, the prevalence of low iron status was greatest in Mexican Americans [26].…”

Integrating themes, evidence gaps, and research needs identified by workshop on iron screening and supplementation in iron-replete pregnant women and young children

“…Further, TBI has been evaluated only in a small number of adults, none of whom were pregnant (28). The measure is attractive, however, as it reflects the full range of iron stores from depleted (ID, IDA) to replete to excess even though agreed-on cutoffs for replete and excess have not been established (29).…”

How I approach iron deficiency with and without anemia

“…2 In the United States, it affects approximately 3% of children age 1 to 2 years and 5% of adolescent females. 3 ID alone is estimated at 10% to 13% in these groups. IDA has been associated with lower scores on tests of mental and motor development, which may persist over time.…”

“…According to the World Health Organization, iron deficiency (ID) is the 10th most common modifiable risk factor for early death worldwide . In the United States, it affects approximately 3% of children age 1 to 2 years and 5% of adolescent females . ID alone is estimated at 10% to 13% in these groups.…”