Iron Deficiency Anemia Recommended Guidelines for the Prevention, Detection, and Management Among U.S. Children and Women of Childbearing Age (1993) / Chapter Skim
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MAJOR ISSUES
MAJOR ISSUES
Pages 2-10
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From page 2... ...
food supply shall remain at current levels. In view of concerns about the adverse health effects attributable to the consumption of large amounts of iron, the committee believes that increasing the amount of fortification or the range of fortified products for the general population is not an appropriate public health strategy for preventing iron deficiency anemia (however, it may prove desirable to consider iron fortification of other foods specifically targeted at certain subgroups [e.g., infants]
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From page 3... ...
Subsequent sections of the report discuss four major issues that the committee considered: · defining iron deficiency anemia and the effects of different criteria on its estimated prevalence, · determining the prevalence of iron deficiency anemia and considering its public health importance, · developing methods for delivering iron to children and women, and · determining the efficacy and safety of different interventions. These issues and the committee's conclusions follow.
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From page 4... ...
. Iron deficiency anemia refers to an anemia that is associated with additional laboratory evidence of iron depletion as a result of one or more of the following tests results: low serum ferritin concentration, low transferrin saturation, or an elevation in the erythrocyte protoporphyrin level.
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From page 5... ...
For nutritional survey purposes, the combination of transferrin receptor, serum ferritin, and hemoglobin concentration determinations is likely to provide an excellent depiction of iron status (Cook et al., 1993~. Prevalence of Anemia as a Public Health Problem Current information on the prevalence of iron deficiency anemia in the United States comes from data collected between 1976 and 1980 as part of NHANES II.
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From page 6... ...
NHANES II and preliminary NHANES III data show that 4 to 10 percent of U.S. women of childbearing age have iron deficiency anemia on the basis of two or three abnormal values for the surveyed indicators of iron status (see above)
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From page 7... ...
has renewed interest in the role of iron in chronic disease. In the study of Salonen and colleagues, the central question was relatively straightforward: Is excess body iron, as indicated by the plasma ferritin concentration, a significant positive risk factor for myocardial infarction?
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From page 8... ...
Because the CDC plans to use the committee's draft recommendations to develop guidelines for public health clinics and clinicians in private practice nationwide, the committee recommends that the proposed procedure be evaluated, particularly with respect to costs and benefits, before implementation in the public and private sectors. Such standards for basic requirements for screening have recently been outlined by Rush (1993)
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From page 9... ...
The present population-based approach has two components providing education to promote the consumption of iron-rich foods and increasing the iron content of the food supply. The therapeutic approach for delivering iron is through the voluntary or prescribed use of supplemental iron preparations.
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From page 10... ...
Supplementation for Women Recommendations for the prescription of iron supplements have little prospect for success in preventing iron deficiency anemia unless they are accompanied by compliant behavior. Research shows that compliance is generally very inconsistent even for relatively simple drug regimens (Haynes et al., 19791.
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