Iron deficiency anaemia affects more than 51% of women in the state of Karnataka alone, according to the National Family Health Survey 4 (NFHS 4). In an effort to combat the rising levels of iron deficiency anaemia in the country, the Indian Council of Medical Research (ICMR) had in 2010 recommended that 21 mg per deciliter of iron was to be taken daily. However, a study published earlier this month in the Journal of Nutrition questions whether this may be leading to excess levels of iron in a small proportion of women in the state.
Though a revised recommended daily allowance (RDA) of 15 mg was given by the ICMR, the new study argues against the standard. The first argument posed by the study is that the RDA suggested by the ICMR is based on the assumption that an individual is not getting enough iron in their diet. The study argues that blood loss due to menstruation or worm infestations is not taken into account when determining what the standard RDA should be.
The study also looked into the existing iron supplementation methods and analysed the benefits of the same. Using this data, researchers from Bengaluru’s St John’s Research Institute were able to determine that some of the existing fortification and supplementation methods may actually put some women at the risk of having excess levels of iron in their body. These doctors stress the need for a more precise form of supplementation of iron to women according to their specific needs.
Gynaecologists, however, disagree and argue that the study focuses on a rather negligible portion of the population.
“In practice, iron deficiency is seen on a much larger scale than iron excess. That is why we routinely screen pregnant women for iron deficiency, to ensure that there are no complications due to that during childbirth,” explains Dr Hema Divakar, Federation of Obstetric and Gynaecological Societies of India (FOGSI) ambassador to the International Federation of Gynaecology and Obstetrics.
“Ten years ago, anywhere up to 80% of women were presenting with anaemia. That is, those with haemoglobin levels of less than 11, as per the World Health Organisation standard. Today, that has come down to maybe about 50% of women, but this is still a large section,” Dr Hema says, adding, “The risk of developing iron overload remains low, in practice, and we should not be highlighting it as a serious issue.”