Iron deficiency anemia and India's efforts to reduce it
What it found
Iron deficiency anemia remains a major problem in India, affecting many children and women, and programs to add more iron to diets have not been enough on their own.
The authors say multiple factors beyond iron intake are involved.
What they found
Studies in people
Iron intake and anemia
In India, dietary iron intake is often less than 50% of recommended levels. However, surveys found that women in Gujarat with higher iron intake (23 mg per day) had more anemia (55%) than women in Kerala with lower intake (11 mg per day) and less anemia (33%).
Anemia in India
Surveys from 2019 to 2021 found that 67.1% of children under 3 years, 52% of pregnant women, and 57% of women aged 15 to 49 years in India have anemia. This is an increase from earlier surveys.
Millets and iron
A review of 22 studies found that eating millets regularly increased hemoglobin levels by 13.2% and serum ferritin by 54.7%. Millets are traditional grains with higher iron content than rice and wheat.
Studies in people and animals
Risk factors beyond diet
Factors like vitamin A deficiency, infections, inflammation, and genetic conditions can affect how the body absorbs and uses iron. These factors help explain why anemia persists even when iron intake is increased.
Other findings
Programs to reduce anemia
India has run many programs since 1970 to give iron supplements and fortified foods. Despite these efforts, anemia rates have not gone down and have even increased in recent years.
Diagnosing iron deficiency
Doctors use blood tests like hemoglobin, ferritin, and transferrin saturation to diagnose iron deficiency. However, ferritin can be unreliable during inflammation, so multiple markers are now recommended.
What the authors conclude
“The imbalance between iron intake/absorption/storage and iron utilization/loss culminates into IDA.”
Also in their conclusions
- They say that improving iron intake alone has not been enough to reduce iron deficiency anemia.
- They call for new programs that address the many factors contributing to anemia, including diet, infections, and socioeconomic conditions.
- They advise that strategies should be tailored to local diets and cultures and include poverty reduction, food security, and better health services.
How it was done
Iron deficiency anemia has reached epidemic levels in developing countries and is a major global public health problem, especially affecting young children and women of childbearing age. The authors wanted to examine why programs to increase iron intake have not been sufficient to reduce it.
The authors reviewed studies and government programs in India aimed at reducing iron deficiency anemia, looking at dietary surveys, health surveys, and intervention programs from 1963 to 2021. They examined risk factors, diagnostic methods, and the effectiveness of various strategies.
What it can’t tell you
- This is a review of existing studies and programs, so it cannot prove what will work best in the future.
- The findings are based on data from India, so they may not apply to other countries with different diets and health systems.
- The paper does not test new treatments or interventions, so it cannot show cause and effect for any specific approach.
Who paid
- Conflicts
- The authors declare no conflict of interest.
- Authors work at
- The Ohio State University, USA
The paper
- Title
- Iron Deficiency Anemia: Efficacy and Limitations of Nutritional and Comprehensive Mitigation Strategies
- Type
- ReviewThe authors read earlier studies and describe what they found. It isn’t a new study.
- Evidence
- Studies in people · animals · lab
- Summarised from
- Full text
- Cite
- Kumar SB, Arnipalli SR, Mehta P, Carrau S, Ziouzenkova O (2022). Iron Deficiency Anemia: Efficacy and Limitations of Nutritional and Comprehensive Mitigation Strategies. Nutrients. doi:10.3390/nu14142976Free full textPubMed 35889932DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error