Iron deficiency in Europe
Paul Preziosi, Pilar Galan
Unité de Surveillance et d’Epidémiologie Nutritionnelle (USEN) InVS/Institut Scientifique et Technique de la Nutrition et de l'Alimentation, CNAM, 5 rue Vertbois, F-75003 Paris, France
Short Title: Iron deficiency
Keywords : Iron deficiency, iron intake, serum ferritin, anemia
Europe, iron deficiency is considered to be one of the main nutritional
deficiency disorders affecting large fractions of the population, particularly
such physiological groups as children, menstruating women and pregnant women.
Some factors such as type of contraception in women, blood donation or minor
pathological blood loss (haemorrhoids, gynaecological bleeding…) considerably
increase the difficulty of covering iron needs. Moreover, women, especially
adolescents consuming low-energy diets, vegetarians and vegans are at high risk
of iron deficiency.
Although there is no evidence that an absence of iron stores has any adverse consequences, it does indicate that iron nutrition is borderline, since any further reduction in body iron is associated with a decrease in the level of functional compounds such as haemoglobin.
The prevalence of iron-deficient anaemia has slightly decreased in infants and menstruating women. Some positive factors may have contributed to reducing the prevalence of iron-deficiency anaemia in some groups of population : the use of iron-fortified formulas and iron-fortified cereals ; the use of oral contraceptives and increased enrichment of iron in several countries ; and the use of iron supplements during pregnancy in some European countries.
It is possible to prevent and control iron deficiency by counseling individuals and families about sound iron nutrition during infancy and beyond, and about iron supplementation during pregnancy, by screening persons on the basis of their risk for iron deficiency, and by treating and following up persons with presumptive iron deficiency. This may help to reduce manifestations of iron deficiency and thus improve public health. Evidence linking iron status with risk of cardiovascular disease or cancer is unconvincing and does not justify changes in food fortification or medical practice, particularly because the benefits of assuring adequate iron intake during growth and development are well established. But stronger evidence is needed before rejecting the hypothesis that greater iron stores increase the incidence of CVD or cancer. At present, currently available data do not support radical changes in dietary recommendations. They include all means for increasing the content of dietary factors enhancing iron absorption or reducing the content of factors inhibiting iron absorption. Increased knowledge and increased information about factors may be important tools in the prevention of iron deficiency in Europe.
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