Understanding the determinants of hemoglobin and iron status: adolescent-adult women comparisons in SANHANES-1

The study compared hemoglobin (Hb) and serum ferritin levels between adolescent and adult women with different body mass indices, dietary intake, and sociodemography. A secondary analysis of data for 3177 South African women 15 years of age who participated in the SANHANES-1 study was undertaken. Abnormal Hb and serum ferritin were based on the World Health Organization's criteria for nonpregnant women aged 15 years. Data were analyzed using STATA version 11. Overall, anemia was detected in 740 (23.3%) participants. Of the individuals in the sub sample (n=1123, 15-35 years) who had serum ferritin measured, 6.0% presented with iron depletion (ID) and 10.8% presented with iron-deficiency anemia (IDA). The highest prevalences of anemia, ID, and IDA were in 15- to 18-year-olds (11.2%, 8.8%, and 20.2%, respectively). Black young adults (19-24 years) were up to 40 times more likely to present with ID compared with their non-black counterparts.While overweight adolescents were three times more likely to be anemic, overweight and obese young adults, as well as obese older adults (25-35 years), were less likely to be anemic compared with normal-weight women of all age groups. Over consumption of dietary fat increased ID by up to 54- and 11-fold (adolescents and 25- to 35-year-olds, respectively). In South Africa, anemia is most prevalent in adolescents and black women. Anemia is also an indicator of over consumption of dietary fat and a marker of socioeconomic disadvantage.