A new study published in The Journal of Nutrition identified factors related to increased prevalence of iron deficiency anemia in the United States population.

Iron deficiency, the most common diet-related cause of anemia worldwide, is typically attributed to low iron intake, impaired iron absorption, and/or excessive iron loss iron from the body. The prevalence of iron deficiency anemia and its related mortality rate are on the rise in the United States and the causes are unclear. To assess temporal (time-related) changes in iron fortification, iron intake, iron status and iron deficiency anemia in the United States between 1999 and 2018, researchers Hongbing Sun (Rider University) and Connie Weaver (Purdue University) examined trends and related factors associated with iron deficiency anemia prevalence in the total US population.  In addition, a variety of large, robust data sets were used to assess temporal changes of dietary iron intake and U.S. food iron concentrations.

Data from the National Health and Nutrition Examination Survey (NHANES 1999-2018) were obtained to assess changes in daily dietary iron intake and measures of iron status. NHANES is a nationwide survey conducted in the United States to assess health and nutritional status. Iron deficiency anemia-related mortality rates from the Centers for Disease Control and Prevention, and iron concentrations of U.S. food products from the USDA between 1999 and 2018 were also analyzed.

Between 1999 and 2015, 15% of the 5510 food items assessed had lower iron content and 10% had increased iron content. Decreases in iron intake by males and females (6.6% and 9.5%, respectively) appeared to be driven by a 15% decrease in beef intake and a 22% increase in chicken intake. Trends of rising mortality rates related to iron deficiency anemia, the rising prevalence of people with anemia in the U.S. population, and the likely links to the declining dietary iron intake and reduced iron concentration in U.S. food products are of great concern.

A corresponding editorial by Ian Griffin and Marta Rogido (Biomedical Research Institute of New Jersey) attributes the results of this study to changes in nutrient intakes and predicts that this trend is likely to accelerate in the future.


Hongbing S. Weaver CM. Decreased Iron Intake Parallels Rising Iron Deficiency Anemia and Related Mortality Rates in the US Population. The Journal of Nutrition, Volume 151, Issue 7, July 2021, Pages 1947–1955, https://doi.org/10.1093/jn/nxab064.

Griffin IJ, Rogido M.  Temporal Trends in Iron Intake, Iron Fortifiation, and Iron Deficiency. The Journal of Nutrition, Volume 151, Issue 7, July 2021, Pages 1686–1687, https://doi.org/10.1093/jn/nxab141.

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