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United States Department of Agriculture

Agricultural Research Service

Research Project: CHILDHOOD DIETARY INTAKE, DIETARY GUIDELINES ADHERENCE, AND EXCESS ADIPOSITY

Location: Food Processing and Sensory Quality Research

Title: Anemia in postmenopausal women: dietary inadequacy or non-dietary factors

Authors
item Tussing Humphreys, Lisa
item Braunschweig, Carol -

Submitted to: Journal Of The American Dietetic Association
Publication Type: Review Article
Publication Acceptance Date: December 30, 2010
Publication Date: April 1, 2011
Citation: Tussing Humphreys, L.M., Braunschweig, C.L. 2011. Anemia in postmenopausal women: dietary inadequacy or non-dietary factors. Journal Of The American Dietetic Association. 111(4):528-531.

Interpretive Summary: Postmenopausal women are disproportionately affected by anemia, and the prevalence in females > 65 years of age in the United States is approximately 10%. Anemia in older populations is associated with poor diet, blood loss, genetics, poor absorption, iron retention in cells, renal problems, and other less common problems. Findings reported by colleagues illustrated that anemia, based on hemoglobin < 12 mg/dL, was more prevalent in women with poor dietary intake of iron, folate, and vitamin B12. Interestingly, average intake of all nutrients met or exceeded the recommended amount even in the anemia groups. This raises the question of how dietary intake alone could be responsible for the anemia observed. The answer likely lies in a fair proportion of the classified anemias being related to non-dietary factors, such as; anemia of chronic disease, obesity, or decreased nutrient absorption, limitations of the dietary assessment tool used, or insensitivity of hemoglobin as measure of dietary deficiency. Precise assessment of anemia in older individuals should be through use of clinical tests assessing for iron status, inflammation, markers of disease progression, and diet, so that type of anemia, as well as the cause can be identified.

Technical Abstract: Postmenopausal women are disproportionately affected by anemia, and the prevalence in females > 65 years of age in the United States is approximately 10%. The manifestation of anemia in older populations is associated with dietary inadequacy, blood loss, genetics, alterations in bioavailability, renal insufficiency, and other less common mechanisms. Findings reported by colleagues illustrated that incident and persistent anemia, based on hemoglobin < 12 mg/dL, was more prevalent in women with inadequate dietary intake of iron, folate, and vitamin B12. Interestingly, mean intake of all nutrients of interest met or exceeded the DRIs, even in the anemia groups. This raises the question of how dietary intake alone could be responsible for the incident and persistent anemia observed. The answer likely lies in a fair proportion of the classified anemias being related to non-dietary factors; such as, anemia of chronic disease, obesity, or altered nutrient absorption, limitations of the dietary assessment tool used, or insensitivity of hemoglobin as measure of dietary deficiency. Precise assessment of anemia in older individuals should be through use of hematologic parameters, clinical indicators of inflammation, markers of disease progression, as well as diet, so that type of anemia as well as the etiology can be identified.

Last Modified: 7/25/2014
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