Estimation of the Burden of Iron Deficiency Anemia in France from Iron Intake: Methodological Approach

Juliana De Oliveira Mota, Patrick Tounian, Sandrine Guillou, Fabrice Pierre, Jeanne-Marie Membré, Juliana De Oliveira Mota, Patrick Tounian, Sandrine Guillou, Fabrice Pierre, Jeanne-Marie Membré

Abstract

: Dietary iron deficiency (ID) is the first nutritional deficiency in the world, in terms of disability adjusted life years (DALY). This nutritional deficiency may lead to anemia, especially among children, adolescents, and adult women. The aim of this study was to build an original probabilistic model to quantitatively assess the ID, the iron deficiency anemia (IDA) and the subsequent health burden in France expressed in DALY, per age class and gender. The model considered the distribution of absorbed iron intake, the iron requirement distribution established by the European Food Safety Authority and the iron status in France. Uncertainty due to lack of data and variability due to biological diversity were taken into account and separated using a second-order Monte Carlo procedure. A total of 1290 (95% CI = 1230-1350) IDA cases corresponding to 16 (95% CI = 11-20) DALY were estimated per 100,000 individuals per year. The major contributors to IDA burden were menstruating females aged from 25 to 44 years old. Then, a consumption scenario was built with ground beef as intake, an increase in red meat consumption to 100 g/d would not eliminate entirely the IDA burden. The quantitative methodology applied here for France could be reused for other populations.

Keywords: DALY; anemia; iron deficiency; probabilistic model; risk assessment; second-order Monte Carlo simulation.

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Flowchart of the assessment model of iron deficiency anemia disease per year in France per age class and gender. White rectangles with dashed line correspond to the “Inputs”, full line to “Intermediate calculation”. Light grey rectangles correspond to the “Final output”. Absorbed iron corresponds to the mean absorbed values provided by European Food Safety Authority (EFSA) considering both heme and non-heme iron.
Figure 2
Figure 2
Estimated number of DALY from iron deficiency anemias in France for young children (three to six) and adolescent females (15–17) according to ground beef consumption scenarios. Results expressed per 100,000 individuals per year. Full lines represent the 95% uncertainty around the mean value.
Figure 3
Figure 3
Estimated number of DALY from iron deficiency anemias in France for adult males and females according to ground beef consumption scenarios. Results expressed per 100,000 individuals per year. Full lines represent the 95% uncertainty around the mean value.

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