The initial term and concept was nutritional anemias. Although this term is not commonly used today, it lives on in the name
of the International Nutritional Anemia Consultative Group (INACG).3
Nutritional anemia was defined in a 1968 WHO technical report as “a
condition in which the hemoglobin content of the blood
is lower than normal as a result of a deficiency of
one or more essential nutrients, regardless of the cause of such
deficiency.”
To determine which nutritional
deficiencies were most responsible, WHO coordinated a series of studies
in pregnant women in
which anemia, serum folate, transferrin saturation
and serum B-12 were assessed. They concluded that “Iron deficiency was
present in 40–99% of the pregnant women studied and
was undoubtedly responsible for the major proportion of anemia” (WHO 1968).
The evidence that led them to that conclusion is shown in Figure 1.
Certainly the authors were impressed by the prevalence of iron
deficiency, which was ∼10 times higher than that of folate
deficiency or vitamin B-12 deficiency based on
their indicators. However, the relation between anemia prevalence and
iron
deficiency prevalence is not apparent when the data
are compared among populations. Within-population correlation
coefficients
with hemoglobin were published for the study in
Vellore, India. There was a strong correlation between hemoglobin and
transferrin
saturation (r = 0.56, P < 0.001), but the correlation with serum folate was even stronger (r = 0.82, P < 0.001). There was no significant correlation between serum vitamin B-12 and hemoglobin (Baker and DeMaeyer 1979). read more
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