New findings1 from a HarvestPlus-commissioned review challenge the prevailing assumption that 50 percent of anemia is attributable to iron deficiency. The systematic review of 23 countries found that iron deficiency accounts for 25 percent of anemia in young children and 37 percent of anemia in women of reproductive age. Moreover, significant variations exist between countries, which may render generalized assumptions misleading. 

How should these findings be interpreted? Should they be acted upon?  We asked nutrition experts for their viewpoints, summarized below.

Join the dialogue. We invite you to email your views on these and other related findings to [email protected] and we will post them here.

What major conclusions can be drawn from this paper?

Dr. Tim Green, South Australian Health and Medical Research Institute & Dr. Crystal Karakochuk, University of British Columbia:
Dr. Omar Dary, United States Agency for International Development (USAID):
Dr. Reina Engle-Stone, University of California, Davis:
Dr. Sorrel Namaste, SPRING:

What do these findings mean for national anemia reduction programs?

Dr. Green & Dr. Karakochuk:
Dr. Dary:
Dr. Engle-Stone:
Dr. Namaste:

What’s next?

Dr. Green & Dr. Karakochuk:
Dr. Dary:
Dr. Engle-Stone:
Dr. Namaste:

1 Petry, Nicolai, et al. "The Proportion of Anemia Associated with Iron Deficiency in Low, Medium, and High Human Development Index Countries: A Systematic Analysis of National Surveys." Nutrients 8.11 (2016): 693.

2 Fernández‐Gaxiola, Ana C., and Luz Maria De‐Regil. "Intermittent iron supplementation for reducing anaemia and its associated impairments in menstruating women." The Cochrane Library(2011).

3 De‐Regil, Luz Maria, et al. "Intermittent iron supplementation for improving nutrition and development in children under 12 years of age." The Cochrane Library (2011).

4 Chichon, Bernardette, et al.  "Assessment of Regression Models for Adjustment of Iron Status Biomarkers for Inflammation in Children with Moderate Acute Malnutrition in Burkina Faso." The Journal of nutrition  147.1 (2016): 125-132.

5 George, Joby, et al. "Genetic hemoglobin disorders, infection, and deficiencies of iron and vitamin A determine anemia in young Cambodian children." The Journal of nutrition 142.4 (2012): 781-787.

6 Karakochuk, Crystal D., et al. "The Homozygous Hemoglobin EE Genotype and Chronic Inflammation Are Associated with High Serum Ferritin and Soluble Transferrin Receptor Concentrations among Women in Rural Cambodia." The Journal of nutrition 145.12 (2015): 2765-2773.

7 Merrill, Rebecca D., et al. "High prevalence of anemia with lack of iron deficiency among women in rural Bangladesh: a role for thalassemia and iron in groundwater." Asia Pacific journal of clinical nutrition 21.3 (2012): 416.

8 Karakochuk, Crystal D., et al. "Elevated levels of iron in groundwater in Prey Veng province in Cambodia: a possible factor contributing to high iron stores in women." Journal of water and health13.2 (2015): 575-586.

9 SPRING. "National and District Tools to Guide Anemia Programming."