Hostname: page-component-8448b6f56d-dnltx Total loading time: 0 Render date: 2024-04-24T00:04:19.530Z Has data issue: false hasContentIssue false
  • English
  • Français

Iron nutrition in the UK: getting the balance right

Published online by Cambridge University Press:  07 March 2007

Susan J. Fairweather-Tait
Susan J. Fairweather-Tait*
Affiliation:
Institute of Food Research, Norwich, NR4 7UA, UK
*
Corresponding author: Professor Susan Fairweather-Tait, fax +44 1603 452578, email sue.fairweather-tait@bbsrc.ac.uk
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Fe homeostasis is considered in the context of the UK diet, using information on Fe intake and status from the National Diet and Nutrition Surveys. The importance of assessing Fe availability rather than total Fe intake is discussed. Dietary and host-related factors that determine Fe bioavailability (Fe utilised for Hb production) are reviewed using information from single-meal studies. When adaptive responses are taken into consideration, foods associated with higher Fe status include meat (haem-Fe and the ‘meat factor’) and fruits and fruit juice (vitamin C). Foods that may have a negative impact include dairy products (Ca), high-fibre foods (phytate) and tea and coffee (polyphenols), but the effects are more apparent in groups with marginal Fe deficiency, such as women of childbearing age. Analysis of dietary intake data on a meal-by-meal basis is needed to predict the influence of changing dietary patterns on Fe nutrition in the UK. Current information suggests that in the UK Fe deficiency is a greater problem than Fe overload.

Keywords

Fe intake and statusBioavailability of FeFe-deficiency riskDietary patterns
Type
Symposium on ‘Micronutrient interactions and public health’
Information
Proceedings of the Nutrition Society , Volume 63 , Issue 4 , November 2004 , pp. 519 - 528
Copyright
Copyright © The Nutrition Society 2004

References

Alexander, D, Ball, MJ & Mann, J (1994) Nutrient intake and haematological status of vegetarians and age-sex matched omnivores. European Journal of Clinical Nutrition 48, 538–546Google ScholarPubMed
Ball, MJ & Bartlett, MA (1999) Dietary intake and iron status of Australian vegetarian women. American Journal of Clinical Nutrition 70, 353–358CrossRefGoogle ScholarPubMed
Ballot, D, Baynes, RD, Bothwell, TH, Gillooly, M, MacFarlane, BJ, MacPhail, AP et al. (1987) The effects of fruit juices and fruits on the absorption of iron from a rice meal. British Journal of Nutrition 57, 331–343CrossRefGoogle ScholarPubMed
Barrett, JFR, Whittaker, PG, Williams, JG & Lind, T (1994) Absorption of non-haem iron from food during normal pregnancy. British Medical Journal 309, 79–82CrossRefGoogle ScholarPubMed
Bates, CJ, Thurnham, DJ, Bingham, SA, Margetts, BM & Nelson, M (1997) Biochemical markers of nutrient intake. In Design Concepts in Nutritional Epidemiology, 2nd ed., pp. 70–240 [Margetts, BM and Nelson, M, editors]. Oxford: Oxford University Press.Google Scholar
Baynes, RD, Bothwell, TH, Bezwoda, WR, MacPhail, AP & Derman, DP (1987) Relationship between absorption of inorganic and food iron in field studies. Annals of Nutrition and Metabolism 31, 109–116CrossRefGoogle ScholarPubMed
Beshara, S, Sörenson, J, Lubberink, M, Tolmachev, V, Långström, B, Antoni, G, Danielson, B & Lundqvist, H (2003) Pharmacokinetics and red cell utilization of 52 Fe/ 59 Fe-labelled iron polymaltose in anaemic patients using positron emission tomography. British Journal of Haematology 120, 853–859CrossRefGoogle Scholar
Beutler, E, Hoffbrand, AV & Cook, JD (2003) Hematology (American Society of Hematology) 1, 40–61CrossRefGoogle Scholar
Bezwoda, W, Charlton, R, Bothwell, T, Torrance, J & Mayet, F (1978) Gastric hydrochloric acid and iron absorption. Journal of Laboratory and Clinical Medicine 92, 108–116Google Scholar
Bjorn-Rasmussen, E, Hallberg, L, Isaksson, B & Arridsson, B (1974) Application of the two-pool extrinsic tag method to measure haem and non-haem iron absorption from the whole diet. Journal of Clinical Investigation 53, 247–255CrossRefGoogle Scholar
Borel, MJ, Smith, SM, Derr, J & Beard, J (1992) Day-to-day variation in iron-status indices in healthy men and women. American Journal of Clinical Nutrition 55, 729–735Google Scholar
Bothwell, TH, Charlton, RW, Cook, JD & Finch, CA (1979) Iron Metabolism in Man. London: Blackwell Scientific Publications.Google Scholar
Brune, M, Rossander, L & Hallberg, L (1989) Iron absorption and phenolic compounds: importance of different phenolic structures. European Journal of Clinical Nutrition 43, 547–558Google ScholarPubMed
Brune, M, Rossander-Hulthen, L, Hallberg, L, Gleerup, A & Sandberg, AS (1992) Iron absorption from bread in humans: inhibiting effects of cereal fiber, phytate and inositol phosphates with different numbers of phosphate groups. Journal of Nutrition 122, 442–449CrossRefGoogle ScholarPubMed
Burt, MJ, George, PM, Upton, JD, Collett, JA, Frampton, CM, Chapman, TM, Walmsley, TA & Chapman, BA (1998) The significance of haemochromatosis gene mutations in the general population: implications for screening. Gut 43, 830–836CrossRefGoogle ScholarPubMed
Calvin, J, Neale, G, Fotherby, KJ & Price, CP (1988) The relative merits of acute phase proteins in the recognition of inflammatory conditions. Annals of Clinical Biochemistry 25, 60–66CrossRefGoogle ScholarPubMed
Carpenter, CE & Mahoney, AW (1989) Proteolytic digestion of meat is not necessary for iron solubilization. Journal of Nutrition 119, 1418–1422CrossRefGoogle Scholar
Cook, JD, Dassenko, SA & Lynch, SR (1991) Assessment of the role of nonheme-iron availability in iron balance. American Journal of Clinical Nutrition 54, 717–722CrossRefGoogle ScholarPubMed
Cook, JD, Flowers, CH & Skikne, BS (2003) The quantitative assessment of body iron. Blood 101, 3359–3364CrossRefGoogle ScholarPubMed
Cook, JD & Monsen, ER (1976) Food iron absorption. I. Use of semisynthetic diet to study absorption of nonheme iron. American Journal of Clinical Nutrition 28, 1289–1295CrossRefGoogle Scholar
Cook, JD & Monsen, ER (1977) Vitamin C, the common cold, and iron absorption. American Journal of Clinical Nutrition 30, 235–241CrossRefGoogle ScholarPubMed
Dacie, JV & Lewis, SM (1995) Practical Haematology, 8th ed. Edinburgh: Churchill Livingstone.Google Scholar
Derman, DP, Ballot, D, Bothwell, TH, Macfarlane, BJ, Baynes, RD, Macphail, AP, Gillooly, M, Bothwell, JE, Bezwoda, WR & Mayet, F (1987) Factors influencing the absorption of iron from soya-bean protein products. British Journal of Nutrition 57, 345–353CrossRefGoogle ScholarPubMed
Disler, PB, Lynch, SR, Charlton, RW, Torrance, JD, Bothwell, TH, Walker, RB & Mayet, F (1975) The effect of tea on iron absorption. Gut 16, 193–200CrossRefGoogle ScholarPubMed
Donovan, UM & Gibson, RS (1995) Iron and zinc status of young women aged 14 to 19 years consuming vegetarian and omnivorous diets. Journal of the American College of Nutrition 14, 463–472CrossRefGoogle Scholar
Doyle, W, Crawley, H, Robert, H & Bates, CJ (1999) Iron deficiency in older people: interactions between food and nutrient intakes with biochemical measures of iron; further analysis of the National Diet and Nutrition Survey of people aged 65 years and over. European Journal of Clinical Nutrition 53, 552–559CrossRefGoogle ScholarPubMed
Finch, CA, Deubelbeiss, K, Cook, JD, Eschbach, JW, Harker, LA, Funk, DD, Marsaglia, G, Hillman, RS, Slichter, S, Adamson, JW, Ganzoni, A & Biblett, ER (1970) Ferrokinetics in man. Medicine (Baltimore) 49, 17–53CrossRefGoogle ScholarPubMed
Finch, S, Doyle, W, Lowe, C, Bates, CJ, Prentice, A, Smithers, G & Clarke, PC (1998) National Diet and Nutrition Survey: People Aged 65 Years and Over London: The Stationery OfficeGoogle Scholar
Fleming, DJ, Jacques, PF, Dallal, GE, Tucker, KL, Wilson, PWF & Wood, RJ (1998) Dietary determinants of iron stores in a free-living elderly population: The Framingham Heart Study. American Journal of Clinical Nutrition 67, 722–733CrossRefGoogle Scholar
Fox, TE, Eagles, J, Fairweather-Tait, SJ (1998) Bioavailability of iron glycine as a fortificant in infant foods. American Journal of Clinical Nutrition 67, 664–668CrossRefGoogle ScholarPubMed
Frazer, DM, Wilkins, SJ, Becker, EM, Murphy, TL, Vulpe, CD, McKie, AT & Anderson, GJ (2003) A rapid decrease in the expression of DMT1 and Dcytb but not Ireg1 or hephaestin explains the mucosal block phenomenon of iron absorption. Gut 52, 340–346CrossRefGoogle ScholarPubMed
Galan, P, Yoon, HC, Preziosi, P, Viteri, F, Valeix, P, Fieux, B, Briancon, S, Malvy, D, Roussel, AM, Favier, A & Hercberg, S (1998) Determining factors in the iron status of adult women in the SU.VI.MAX study. Supplementation en VItamines et Mineraux AntioXydants. European Journal of Clinical Nutrition 52, 383–388CrossRefGoogle ScholarPubMed
Gillooly, M, Bothwell, TH, Torrance, JD, MacPhail, AP, Derman, DP, Bezwoda, WR, Mills, W, Charlton, RW & Mayet, F (1983) The effects of organic acids, phytates and polyphenols on the absorption of iron from vegetables. British Journal of Nutrition 49, 331–342CrossRefGoogle ScholarPubMed
Glahn, RP, Wien, EM, Van, Campen, DR, Miller DD (1996) Caco-2 cell iron uptake from meat and casein digests parallels in vivo studies: use of a novel in vitro method for rapid estimation of iron bioavailability. Journal of Nutrition 126, 332–339CrossRefGoogle ScholarPubMed
Gregory, J, Foster, K, Tyler, H & Wiseman, M (1990) The Dietary and Nutritional Survey of British Adults, London: H. M. Stationery Office.Google Scholar
Gregory, J, Lowe, S, Bates, CJ, Prentice, A, Jackson, LV, Smithers, G, Wenlock, R & Farron, M (2000) National Diet and Nutrition Survey: Young People Aged 4 to 18 Years. London: The Stationery Office.Google Scholar
Guillygomarc'h, A, Christian, J, Romain, M, Vincnet, Q, Veronique, D & Deugnier, Y (2003) Circadian variations of transferrin saturation levels in iron-overloaded patients: implications for the screening of C282Y-linked haemochromatosis. British Journal of Haematology 120, 359–363CrossRefGoogle ScholarPubMed
Hallberg, L, Brune, M & Rossander, L (1989) Iron absorption in man: ascorbic acid and dose-dependent inhibition by phytate. American Journal of Clinical Nutrition 49, 140–144CrossRefGoogle ScholarPubMed
Hallberg, L & Hulthen, L (2000) Prediction of dietary iron absorption: an algorithm for calculating absorption and bioavailability of dietary iron. American Journal of Clinical Nutrition 71, 1147–1160CrossRefGoogle ScholarPubMed
Hallberg, L & Hulthen, L (2002) Perspectives on iron absorption. Blood Cells, Molecules and Diseases 29, 562–573CrossRefGoogle ScholarPubMed
Hallberg, L, Hulthen, L & Gramatkovski, E (1997) Iron absorption from the whole diet in men: how effective is the regulation of iron absorption. American Journal of Clinical Nutrition 66, 347–356CrossRefGoogle ScholarPubMed
Hallberg, L & Rossander, L (1984) Improvement of iron nutrition in developing countries: comparison of adding meat, soy protein, ascorbic acid, citric acid, and ferrous sulphate on iron absorption from a simple Latin American-type of meal. American Journal of Clinical Nutrition 39, 577–583CrossRefGoogle ScholarPubMed
Hallberg, L, Rossander-Hulthen, L, Brune, M & Gleerup, A (1992) Calcium and iron absorption: mechanism of action and nutritional importance. European Journal of Clinical Nutrition 46, 317–327Google ScholarPubMed
Hallberg, L, Rossander-Hulthen, L, Brune, M & Gleerup, A (1993) Inhibition of haem-iron absorption in man by calcium. British Journal of Nutrition 69, 533–540CrossRefGoogle Scholar
Heath, ALM, Fairweather-Tait, SJ (2002) Clinical implications of changes in the modern diet: iron intake, absorption and status. Best Practice and Research Clinical Haematology 15, 225–241CrossRefGoogle ScholarPubMed
Heath, AL, Fairweather-Tait, SJ (2003) Health implications of iron overload: the role of diet and genotype. Nutrition Reviews 61, 45–62CrossRefGoogle ScholarPubMed
Heath, A-LM, Skeaff, CM & Gibson, RS (2000) The relative validity of a computerized food frequency questionnaire for estimating intake of dietary iron and its absorption modifiers. European Journal of Clinical Nutrition 54, 592–599CrossRefGoogle ScholarPubMed
Henderson, L, Gregory, J & Swan, G (2002) The National Diet and Nutrition Survey: Adults Aged 19 to 64 Years. Types and Quantities of Foods Consumed. London: The Stationery Office.Google Scholar
Holland, B, Welch, AA, Unwin, ID, Buss, DH, Paul, AA & Southgate, DAT (1991) McCance and Widdowson's The Composition of Foods. 5th ed. Cambridge: Royal Society of Chemistry and MAFF.Google Scholar
Huh, EC, Hotchkiss, A, Brouillette, J & Glahn, RP (2004) Carbohydrate fractions from cooked fish promote iron uptake by Caco-2 cells. Journal of Nutrition 134, 1681–1689CrossRefGoogle ScholarPubMed
Hulthen, L, Lindstedt, G, Lundberg, P-A & Hallberg, L (1998) Effect of mild infection on serum ferritin concentration – clinical and epidemiological implications. European Journal of Clinical Nutrition 52, 376–379CrossRefGoogle ScholarPubMed
Hunt, JR, Mullen, LM, Lykken, GI, Gallagher, SK & Nielsen, FH (1990) Ascorbic acid: effect on ongoing iron absorption and status in iron-depleted young women. American Journal of Clinical Nutrition 51, 649–655CrossRefGoogle ScholarPubMed
Hurrell, RF, Reddy, MB, Burri, J & Cook, JD (2002) Phytate degradation determines the effect of industrial processing and home cooking on iron absorption from cereal-based foods. British Journal of Nutrition 88, 117–123CrossRefGoogle ScholarPubMed
Hurrell, RF, Reddy, M & Cook, JD (1999) Inhibition of non-haem iron absorption in man by polyphenolic-containing beverages. British Journal of Nutrition 81, 289–295CrossRefGoogle Scholar
Hurrell, RF, Reddy, MB, Juillerat, M-A & Cook, JD (2003) Degradation of phytic acid in cereal porridges improves iron absorption by human subjects. American Journal of Clinical Nutrition 77, 1213–1219CrossRefGoogle ScholarPubMed
Jackson, HA, Carter, K, Darke, C, Guttridge, MG, Ravine, D, Hutton, RD, Napier, JA & Worwood, M (2001) HFE mutations, iron deficiency and overload in 10,500 blood donors. British Journal of Haematology 114, 474–484CrossRefGoogle Scholar
Jacobs, A & Miles, PM (1970) The formation of iron complexes with bile and bile constituents. Gut 11, 732–734CrossRefGoogle ScholarPubMed
Kuhn, IN, Monsen, ER, Cook, JD & Finch, CA (1968) Iron absorption in man. Journal of Laboratory and Clinical Medicine 71, 715–721Google ScholarPubMed
Labbe, RF, Vreman, HJ & Stevenson, DK (1999) Zinc protoporphyrin: a metabolite with a mission. Clinical Chemistry 45, 2060–2072CrossRefGoogle ScholarPubMed
Layrisse, M, Martinez-Torres, C, Leets, I, Taylor, P & Ramirez, J (1984) Effect of histidine, cysteine, glutathione or beef on iron absorption in humans. Journal of Nutrition 114, 217–223CrossRefGoogle ScholarPubMed
Lee, CJ, Lawler, GS & Panemangalore, M (1987) Nutritional status of middle-aged and elderly females in Kentucky in two seasons: Part 2. Hematological parameters. Journal of the American College of Nutrition 6, 217–222CrossRefGoogle ScholarPubMed
Leong, W-I & Lonnerdal, B (2004) Hepcidin, the recently identified peptide that appears to regulate iron absorption. Journal of Nutrition 134, 1–4CrossRefGoogle ScholarPubMed
Lynch, SR, Beard, JL, Dassenko, SA & Cook, JD (1984) Iron absorption from legumes in humans. American Journal of Clinical Nutrition 40, 42–47CrossRefGoogle ScholarPubMed
Lynch, SR, Skikne, BS & Cook, JD (1989) Food iron absorption in idiopathic hemochromatosis. Blood 74, 2187–2193CrossRefGoogle ScholarPubMed
McKie, AT, Barrow, D, Latunde-Dada, GO, Rolfs, A, Sager, G, Mudaly, E, et, al. (2001) An iron-regulated ferric reductase associated with the absorption of dietary iron. Science 291, 1755–1759CrossRefGoogle ScholarPubMed
Macfarlane, BJ, Bezwoda, WR, Bothwell, TH, Baynes, RD, Bothwell, JE, MacPhail, AP, Lamparelli, RD & Mayet, F (1988) Inhibitory effect of nuts on iron absorption. American Journal of Clinical Nutrition 47, 270–274CrossRefGoogle ScholarPubMed
Mattys, C, Pynaert, I, Roe, M, Fairweather-Tait, SJ, Heath, A-LM, De Heanauw, S (2004) Validity and reproducibility of a computerised tool for assessing the iron, calcium and vitamin C intake of Belgian women European Journal of Clinical Nutrition – advance online publicationCrossRefGoogle Scholar
Minihane, AM, Fairweather-Tait, SJ (1998) Effect of calcium supplementation on daily nonheme-iron absorption and long-term iron status. American Journal of Clinical Nutrition 68, 96–102CrossRefGoogle ScholarPubMed
Miret, S, Simpson, RJ & McKie, AT (2003) Physiology and molecular biology of dietary iron absorption. Annual Reviews of Nutrition 23, 283–301CrossRefGoogle Scholar
Morck, TA, Lynch, SR & Cook, JD (1983) Inhibition of food iron absorption by coffee. American Journal of Clinical Nutrition 37, 416–420CrossRefGoogle ScholarPubMed
Murphy, S, Curran, MD, McDougall, N, Callender, ME, O'Brien, CJ & Middleton, D (1998) High incidence of the Cys 282 Tyr mutation in the HFE gene in the Irish population – implications for haemochromatosis. Tissue Antigens 52, 484–488CrossRefGoogle ScholarPubMed
O'Neil-Cutting, MA & Crosby, WH (1987) Blocking of iron absorption by a preliminary oral dose of iron. Archives of Internal Medicine 147, 489–491CrossRefGoogle Scholar
Oski, FA (1993) Iron deficiency in infancy and childhood. New England Journal of Medicine 329, 190–193Google ScholarPubMed
Pan, WH & Habicht, JP (1991) The non-iron-deficiency-related difference in haemoglobin concentration distribution between blacks and whites and between men and women. American Journal of Epidemiology 134, 1410–1416CrossRefGoogle ScholarPubMed
Preziosi, P, Hercberg, S, Galan, P, Devanlay, M, Cherouvrier, F & Dupin, H (1994) Iron status of a healthy French population: factors determining biochemical markers. Annals of Nutrition and Metabolism 38, 192–202CrossRefGoogle ScholarPubMed
Prynne, CJ, Paul, AA, Price, GM, Day, KC, Hilder, WS & Wadsworth, MEJ (1999) Food and nutrient intake of a national sample of 4-year-old children in 1950: comparison with the 1990's. Public Health Nutrition 2, 537–547CrossRefGoogle Scholar
Punnonen, K, Irjala, K & Rajamaki, A (1997) Serum transferrin receptor and its ratio to serum ferritin in the diagnosis of iron deficiency. Blood 89, 1052–1057CrossRefGoogle ScholarPubMed
Reddy, MB & Cook, JD (1997) Effect of calcium intake on nonheme-iron absorption from a complete diet. American Journal of Clinical Nutrition 65, 1820–1825CrossRefGoogle ScholarPubMed
Reddy, MB, Hurrell, RF & Cook, JD (2000) Estimation of nonheme-iron bioavailability from meal composition. American Journal of Clinical Nutrition 71, 937–943CrossRefGoogle ScholarPubMed
Ruston, D, Hoare, J, Henderson, L, Gregory, J, Bates, CJ, Prentice, A, Birch, M, Swan, G & Farron, M (2004) The National Diet and Nutrition Survey: Adults Aged 19 to 64 Years. London: The Stationery Office.Google Scholar
Sandberg, A-S, Brune, M, Carlsson, N-G, Hallberg, L, Skoglund, E, Rossander-Hulthen, L (1999) Inositol phosphates with different numbers of phosphate groups influence iron absorption in humans. American Journal of Clinical Nutrition 70, 240–246CrossRefGoogle ScholarPubMed
Skikne, B & Baynes, RD (1994) Iron absorption. In Iron Metabolism in Health and Disease, p. 177 [Brock, JH, Halliday, JW, Pippard, MJ, Powell, LW, editors]. London: WB Saunders.Google Scholar
Skikne, BS & Cook, JD (1992) Effect of enhanced erythropoiesis on iron absorption. Journal of Laboratory and Clinical Medicine 20, 746–751Google Scholar
Sokoll, LJ, Dawson-Hughes, B (1992) Calcium supplementation and plasma ferritin concentrations in premenopausal women. American Journal of Clinical Nutrition 56, 1045–1048CrossRefGoogle ScholarPubMed
Suominen, P, Punnonen, K, Rajamaki, A & Irjala, K (1998) Serum transferrin receptor and transferrin receptor-ferritin index identify healthy subjects with subclinical iron deficits. Blood 92, 2934–2939CrossRefGoogle ScholarPubMed
Swain, JH, Tabatabai, LB & Reddy, MB (2002) Histidine content of low-molecular-weight beef proteins influences nonheme iron bioavailability in Caco-2 cells. Journal of Nutrition 132, 245–251CrossRefGoogle ScholarPubMed
Taylor, PG, Mendez-Castellano, H, Lopez-Blanco, M, Landaeta-Jiminez, M, Hernandez-Valera, Y, Arenas, O, Martinez-Torres, C & Layrisse, M (1988) Daily physiological iron requirements in children. Journal of the American Dietetic Association 88, 454–458CrossRefGoogle ScholarPubMed
Temme, EHM, Van Hoydonck, PGA (2002) Tea consumption and iron status. European Journal of Clinical Nutrition 56, 379–386CrossRefGoogle ScholarPubMed
Tidehag, P, Hallmans, G, Wing, K, Sjostrom, R, Agren, G, Lundin, E, Zhang, J-X (1996) A comparison of iron absorption from single meals and daily diets using radioFe ( 55 Fe, 59 Fe). British Journal of Nutrition 75, 281–289Google Scholar
Tufts, DA, Haas, JD, Beard, JL & Spielvogel, H (1985) Distribution of haemoglobin and functional consequences of anemia in adult males at high altitude. American Journal of Clinical Nutrition 42, 1–11CrossRefGoogle ScholarPubMed
van de Vijver, LPL, Kardinaal, AFM, Charzewska, J, Rotily, M, Charles, P, Maggiolini, M et al. (1999) Calcium intake is weakly but consistently negatively associated with iron status in girls and women in six European countries. Journal of Nutrition 129, 963–968CrossRefGoogle ScholarPubMed
Van, Tiel, ED, Peeter, PHM, Smit, HA, Nagelkerke, NJD Van, Loon, AJM, Grobbee, DE Bueno-de-Mesquita, HB (2002) Quitting smoking may restore haematological characteristics within five years. Annals of Epidemiology 12, 378–388Google Scholar
Velati, C, Marlianici, E, Rigamonti, D, Barillari, G, Chiavilli, F, Fugiani, P, et, al. (2003) Mutations of the haemochromatosis gene in Italian candidate blood donors with increased transferrin saturation. Hematology Journal 4, 436–440CrossRefGoogle ScholarPubMed
Waalen, J, Felitti, V, Gelbart, T, Ho, NJ & Beutler, E (2002) Penetrance of haemochromatosis. Blood Cells, Molecules and Diseases 29, 418–432CrossRefGoogle Scholar
Walters, GO, Miller, FM & Worwood, M (1973) Serum ferritin concentration and iron stores in normal subjects. Journal of Clinical Pathology 26, 770–772CrossRefGoogle ScholarPubMed
Wintrobe, MM (1981) Clinical Hematology, 8th ed. Philadelphia, PA: Lea & Febiger.Google Scholar
World Health OrganizationWorld Health Organization (2001) Iron deficiency anaemia. Assessment, prevention and control. A guide for programme managers. WHO/UNICEF/UNU http://www.who.int/nut/documents/ida_assessment_prevention_control.pdfGoogle Scholar
World Health Organization World Health Organization (1972) Nutritional Anaemias. WHO Technical Report Series.Geneva:WHO.Google Scholar
Worthington-Roberts, BS, Breskin, MW & Monsen, ER (1988) Iron status of premenopausal women in a university community and its relationship to habitual dietary sources of protein. American Journal of Clinical Nutrition 47, 275–279CrossRefGoogle Scholar
Yip, R (2000) Significance of an abnormally low or high haemoglobin concentration during pregnancy: special consideration of iron nutrition. American Journal of Clinical Nutrition 72 272S – 279SCrossRefGoogle ScholarPubMed
Yip, R, Johnson, C & Dallman, PR (1984) Age-related changes in laboratory values used in the diagnosis of anemia and iron deficiency. American Journal of Clinical Nutrition 39, 427–436Google ScholarPubMed