Low dietary iron availability is a major cause of anemia: a nutrition survey in the Lindi District of Tanzania

Tatala, Simon; Svanberg, Ulf; Mduma, Benedicta

doi:10.1093/ajcn/68.1.171

Cited by 163 publications

(143 citation statements)

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“…No relationship was observed between schistosomiasis and anaemia, which is consistent with some other studies (Be®®-Mengue et al, 1993;Olsen et al, 1998), but differs from others (Tatala et al, 1998;Stoltzfus et al, 1997b). The present study was not designed to measure intensity.…”

Section: Stunting and Anaemia In African Schoolchildrensupporting

confidence: 91%

Age patterns in stunting and anaemia in African schoolchildren: a cross-sectional study in Tanzania

et al. 2000

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Objective: To describe the nutritional status of schoolchildren from a rural area of Tanzania, with a particular emphasis on older adolescents to determine the timing of the growth spurt and differences by sex. Design: A cross-sectional survey using a randomly selected sample. Subjects: Six thousand eight hundred and one children aged 7 ± 18 y randomly selected from those enrolled in standards 2 ± 5 in 59 primary schools in Magu District, Tanzania. Results: Overall, 52.5% of children were stunted and 43.0% were underweight, with signi®cantly more boys stunted and underweight than girls. Z-scores of height-for-age for both boys and girls decreased progressively between 7 and 12 y. After 12 y the height-for-age z-scores of girls show a marked upturn, whilst z-scores for boys continue to decrease throughout the school-aged years until 16 y when a slight upturn is observed. Anaemia (Hb`120 gaL) was present in 62.6% of children, with the prevalence decreasing with age. Anaemia improved throughout the school years for boys, but did not for girls. Age, sex and hookworm infection were signi®cant predictors of anaemia. Conclusion: Stunting and anaemia are exceptionally common conditions in African schoolchildren. The ®ndings highlight important differences between boys and girls, which are suggestive of compensatory growth at 12 y for girls and at 16 y for boys, although it remains unclear whether boys will catch up in height at older ages. Sponsorship: Funding was provided by the Wellcome Trust.

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Section: Stunting and Anaemia In African Schoolchildrensupporting

confidence: 91%

Age patterns in stunting and anaemia in African schoolchildren: a cross-sectional study in Tanzania

et al. 2000

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“…SES, either defined by the type of school attended (ie public vs private), by the region of residence (ie rural vs urban) or by the level of parental education (primary school vs University), has been pointed out by many investigators, as an important determinant of the elevated prevalence of iron deficiency and iron deficiency anaemia among the less privileged school-aged children in developing countries (Soekarjo et al, 2001;Abalkhail & Shawky, 2002;Kilinc et al, 2002;Musaiger, 2002;Hashizume et al, 2003). Furthermore, the higher incidence of iron deficiency reported for adolescent schoolgirls, compared to boys (Tatala et al, 1998;Abalkhail & Shawky, 2002;Kilinc et al, 2002;Musaiger, 2002;Hashizume et al, 2004), shows that female gender exerts an extra effect on the prevalence of this medical condition, probably due to accessional iron losses through menstruation. The findings of the current study indicated that both SES and gender might need closer surveillance, in order to better understand the factors associated with the high prevalence of iron deficiency among urban schoolchildren in Turkey.…”

Section: Discussionmentioning

confidence: 99%

“…Iron deficiency is probably the most prevalent and common micronutrient deficiency in the developing world today (Tatala et al, 1998;Asobayire et al, 2001;Abalkhail & Shawky, 2002;Hashizume et al, 2003). The detrimental public health effects of iron deficiency include anaemia, decreased intellectual and work performance as well as functional alterations of the small bowel (Oski, 1993).…”

Section: Introductionmentioning

confidence: 99%

“…Poor diet quality and low dietary iron bioavailability are the principal factors that contribute to the increased incidence of iron deficiency (Tatala et al, 1998). The bioavailability of haem iron, present in animal products, is high with absorption rates of 20-30%, whereas the bioavailability of nonhaem iron is determined by the presence of enhancing or inhibiting factors (Hurrell, 1997).…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of iron deficiency among schoolchildren of different socio-economic status in urban Turkey

et al. 2004

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Objective: To investigate the prevalence of iron deficiency among schoolchildren of different socio-economic status (SES), living in the three largest cities of Turkey. Design: Cross-sectional study. Settings: Primary schools of Istanbul, Ankara and Izmir. Subjects: Schoolchildren aged 12 and 13 y (males: 504; females: 510) from nine primary schools. Inclusion of subjects in the study was on a voluntary basis. Methods: Data were obtained on children SES, anthropometry, haematological and biochemical indices of iron status and consumption of food items related to dietary iron bioavailability. One-way analysis of variance was mainly applied, for the evaluation of the tested hypotheses, using Bonferroni correction in order to take into account the inflation of Type I error. Results: Iron deficiency (serum ferritin o15 mg/l) prevalence was 17.5% among boys and 20.8% among girls. Furthermore, iron deficiency was significantly more prevalent among boys of lower SES, who were also found to have significantly lower levels of serum iron, serum ferritin, transferrin saturation, mean corpuscular haemoglobin and mean corpuscular haemoglobin concentration compared to those of higher SES. In terms of dietary factors affecting iron bioavailability, low SES boys exhibited significantly higher frequency of tea consumption and lower frequency of citrus fruit, red meat and fish consumption, compared to their higher SES counterparts. Conclusion: The prevalence of iron deficiency was relatively high, particularly among lower SES schoolboys. Higher tea and lower citrus fruits, red meat and fish consumption by boys of lower SES may provide an indication about the possible role of certain dietary patterns in the different manifestation of this medical condition among the socio-economic groups. However, further research is needed.

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“…Insufficient intake and poor bioavailability are major causes in developing countries [12][13][14] . Micronutrient content and bioavailability can be improved by either increasing the quantity of a micronutrient or increasing enhancing factors/decreasing inhibiting factors in foods using different techniques or sources.…”

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confidence: 99%

Iron and zinc deficiencies in China: what is a feasible and cost-effective strategy?

Jin

et al. 2008

Public Health Nutr.

135

123

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In order to prioritise interventions for micronutrient deficiencies in China, the populations affected by iron and zinc deficiencies were assessed based on data from the 2002 China National Nutrition and Health Survey. The costs and costeffectiveness of supplementation, food diversification and food fortification were estimated using the standard World Health Organization ingredients approach. Results indicated that 30% of children (,2 years), adults (.60 years), pregnant and lactating women, and 20% of women of reproductive age were anaemic, some 245 million people. Approximately 100 million people were affected by zinc deficiency (zinc intake inadequacy and stunting), the majority living in rural areas. Among interventions on iron and zinc deficiency, biofortification showed the lowest costs per capita, I$0.01 (international dollars), while dietary diversification through health education represented the highest costs at I$1148. The costeffectiveness of supplementation, food fortification and dietary diversification for iron deficiency alone was I$179, I$66 and I$103 per disability-adjusted life-year (DALY), respectively. Data for biofortification were not available. For zinc deficiency, the corresponding figures were I$399, I$153 and I$103 per DALY, respectively. In conclusion, iron and zinc deficiencies are of great public health concern in China. Of the two long-term intervention strategies, i.e. dietary diversification and biofortification with improved varieties, the latter is especially feasible and cost-effective for rural populations. Supplementation and fortification can be used as short-term strategies for specific groups. Keywords Micronutrient deficiencyIron Zinc Cost-effectiveness ChinaThe latest World Health Organization (WHO) estimates reveal that undernutrition is an underlying cause of 53% of all deaths in children ,5 years of age 1 . It has been estimated that more than 2 billion of the world's population, nearly all in developing countries, are irondeficient 2,3 . Billions of individuals are also at risk for zinc deficiency 4 . Micronutrient deficiency not only affects the health and development of people 5-9 , but also hinders the social and economic development of countries. It is estimated that the loss in economic productivity due to iron deficiency in China is more than 3.6% of the gross national product 10 .The causes of micronutrient deficiencies include inadequate intakes, impaired absorption and/or utilisation, excessive losses, increased physiological need or the combination of these factors 11 . Insufficient intake and poor bioavailability are major causes in developing countries [12][13][14] . Micronutrient content and bioavailability can be improved by either increasing the quantity of a micronutrient or increasing enhancing factors/decreasing inhibiting factors in foods using different techniques or sources. Strategies for increasing the effective supply of nutrients fall into two categories, supplementation and food-based approaches. Supplementation is the addition of ...

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Low dietary iron availability is a major cause of anemia: a nutrition survey in the Lindi District of Tanzania

Cited by 163 publications

References 32 publications

Age patterns in stunting and anaemia in African schoolchildren: a cross-sectional study in Tanzania

Age patterns in stunting and anaemia in African schoolchildren: a cross-sectional study in Tanzania

Prevalence of iron deficiency among schoolchildren of different socio-economic status in urban Turkey

Iron and zinc deficiencies in China: what is a feasible and cost-effective strategy?

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