Rusty conclusions about iron deficiency

Iron deficiency anaemia is a big problem. WHO estimates that about 2 billion people — that’s roughly one in three — lack enough iron in the diet. And the consequences are grave for health and the economies of developing countries. So of course people are focused on ways to combat iron deficiency. Two hog the limelight: supplementation by adding iron to the diet and biofortification, breeding to add more iron to the staples that make up the diet. A recent paper in The Lancet reviews the story of iron deficiency and how to treat it.1 Perhaps not surprisingly, the study concludes that “targeted iron supplementation, iron fortification of foods, or both, can control iron deficiency in populations”. And yet, having said that “dietary iron bioavailability is low in populations consuming monotonous plant-based diets,” the authors do not appear to have seriously considered the idea of trying to attack that monotony instead. Maybe enriching and diversifying those plant-based diets to include more dark green leafy vegetables and more pulses would be as effective, with additional benefits in other realms. But that kind of intervention isn’t nearly as glamorous, and gets little attention.

Of course, it could be that solving the problem of iron deficiency will just give rise to other difficulties. Another paper suggests that iron deficiency protects us against some of the epidemic contagious diseases that have hitched along as people crowded together in agriculturally-fed cities.2 Maybe iron deficiency — at least in moderation — is a good thing?

  1. Michael B Zimmermann and Richard F Hurrell, Nutritional iron deficiency, The Lancet, 370 (9586), 11 August 2007-17 August 2007, Pp 511-520. []
  2. S Denic and M Agarwal, Nutritional iron deficiency: an evolutionary perspective. Nutrition. 2007, 23:603-14. Epub 2007 Jun 20. []

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