Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-25T06:01:11.442Z Has data issue: false hasContentIssue false
  • English
  • Français

Folate deficiency is associated with nutritional anaemia in Lebanese women of childbearing age

Published online by Cambridge University Press:  02 January 2007

Lynn Al Khatib ,
Omar Obeid ,
Abla-Mehio Sibai ,
Malek Batal ,
Nada Adra  and
Nahla Hwalla
Lynn Al Khatib*
Affiliation:
Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut, 1107-2020, Lebanon
Omar Obeid
Affiliation:
Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut, 1107-2020, Lebanon
Abla-Mehio Sibai
Affiliation:
Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
Malek Batal
Affiliation:
Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut, 1107-2020, Lebanon
Nada Adra
Affiliation:
Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut, 1107-2020, Lebanon
Nahla Hwalla*
Affiliation:
Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut, 1107-2020, Lebanon
*
*corresponding author: Email [email protected]
*corresponding author: Email [email protected]
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.
Objective

The objective of this study was to identify the determinants of anaemia in Lebanese women of childbearing age attending health centres in Lebanon.

Design

Cross-sectional study carried out between May and December 2003. Anthropometric measurements as well as sociodemographic, health and dietary intake data were collected using a questionnaire. Haemoglobin (Hb), plasma ferritin, plasma folate and vitamin B12 were assessed using standard laboratory methods.

Setting

Governmental health centres in Lebanon.

Subjects

Four hundred and seventy non-pregnant Lebanese women aged 15–45 years.

Results

Anaemia (Hb <12 g dl−1) and iron deficiency (ferritin <15 μg l−1) were prevalent in 16.0 and 27.2% of the study sample, respectively. Of the total sample, 7.7% had iron-deficiency anaemia. The percentage of women with either Hb or ferritin deficiency or both was 35.6%. Plasma folate and vitamin B12 deficiency was reported in 25.1 and 39.4%, respectively, and 12.6% of the women had both folate and vitamin B12 deficiencies. Of the anaemic group, 48.0% of the women had iron deficiency. The intake of iron was lower in iron-deficient than in non-deficient women and a positive relationship was shown between folate intake and its corresponding serum levels. Regression analysis showed that ferritin, plasma folate and family history of anaemia were significant determinants of the anaemia in the sample of women.

Conclusions

Anaemia not related to iron deficiency was partly explained by plasma folate deficiency. Measures to control folate and iron deficiency should be considered.

Keywords

AnaemiaIronFerritinFolateWomen of childbearing ageLebanon
Type
Research Article
Information
Public Health Nutrition , Volume 9 , Issue 7 , October 2006 , pp. 921 - 927
Copyright
Copyright © The Authors 2006

References

1Allen, LH. Anemia and iron deficiency: effects on pregnancy outcome. American Journal of Clinical Nutrition, 2000; 71 1280S–4S.Google Scholar
2World Health Organization (WHO). Iron Deficiency Anaemia: Assessment, Prevention and Control. A Guide for Programme Managers WHO/NHD/01.3 Geneva: WHO, 2001.Google Scholar
3Allen, L, Casterline-Sabel, J. Prevalence and causes of nutritional anemias. In: Ramakrishnan, U, ed. Nutritional Anemias. Boca Raton, FL: CRC Press, 2001; 7–21.Google Scholar
4Li, GM, Presnell, SR, Gu, L. Folate deficiency, mismatch repair-dependent apoptosis, and human disease. Journal of Nutritional Biochemistry, 2003; 14 568–75.CrossRefGoogle ScholarPubMed
5Zhang, SM, Willett, WC, Selhub, J, Hunter, DJ, Giovannucci, EL, Holmes, MD, et al. Plasma folate, vitamin B 6, vitamin B 12, homocysteine, and risk of breast cancer. Journal of the National Cancer Institute, 2003; 95 373–80.CrossRefGoogle ScholarPubMed
6de la Calle, M, Usandizaga, R, Sancha, M, Magdaleno, F, Herranz, A, Cabrillo, E. Homocysteine, folic acid and B-group vitamins in obstetrics and gynaecology. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 2003; 107 125–34.Google Scholar
7Gu, L, Wu, J, Qiu, L, Jennings, CD, Li, GM. Involvement of DNA mismatch repair in folate deficiency-induced apoptosis small star, filled. Journal of Nutritional Biochemistry, 2002; 13 355–63.CrossRefGoogle ScholarPubMed
8Krishnaswamy, K, Madhavan Nair, K. Importance of folate in human nutrition. British Journal of Nutrition, 2001; 85 S115–24.Google Scholar
9Wartanowicz, M, Ziemlanski, S, Bulhak-Jachymczyk, B, Konopka, L. Assessment of nutritional folate status and selected vitamin status of women of childbearing age. European Journal of Clinical Nutrition, 2001; 55 743–7.Google Scholar
10Ames, BN. DNA damage from micronutrient deficiencies is likely to be a major cause of cancer. Mutation Research, 2001; 475 7–20.CrossRefGoogle Scholar
11Fairbanks, VF. Iron in medicine and nutrition. In: Shils, ME, Olson, JA, Shike, M, Ross, AC, eds. Modern Nutrition in Health and Disease, 9th ed. Philadelphia, PA: Lippincott Williams & Wilkins, 1999; 193–221.Google Scholar
12Yip, R, Ramakrishnan, U. Experiences and challenges in developing countries. Journal of Nutrition, 2002; 132 827S–30S.Google Scholar
13Backstrand, JR, Allen, LH, Black, AK, de Mata, M, Pelto, GH. Diet and iron status of nonpregnant women in rural Central Mexico. American Journal of Clinical Nutrition, 2002; 76 156–64.CrossRefGoogle ScholarPubMed
14Hwalla (Baba), N, Adra, N, Jackson, R. Iron deficiency is an important contributor to anemia among reproductive age women in Lebanon. Ecology of Food and Nutrition, 2004; 43 77–92.Google Scholar
15Turner, AG, Sayed, HA, Houri, M. Sample design and selection procedures, population and housing survey of Lebanon. Unpublished report, United Nations Fund for Population Activities and Ministry of Social Affairs, 1994.Google Scholar
16Carmel, R, Green, R, Rosenblatt, DS, Watkins, D. Update on cobalamin, folate, and homocysteine. Hematology, 2003; 62–81.Google Scholar
17Pellett, P, Shadarevian, S. Food Composition Table for Use in the Middle East, 2nd ed. Beirut: American University of Beirut, 1970.Google Scholar
18Bentley, ME, Griffiths, PL. The burden of anemia among women in India. European Journal of Clinical Nutrition, 2003; 57 52–60.Google Scholar
19Jackson, RT, Al Mousa, Z. Iron deficiency is a more important cause of anemia than hemoglobinopathies in Kuwaiti adolescent girls. Journal of Nutrition, 2000; 130 1212–6.Google Scholar
20Hassan, EO, el-Hussinie, M, el-Nahal, N. The prevalence of anemia among clients of family planning clinics in Egypt. Contraception, 1999; 60 93–9.CrossRefGoogle ScholarPubMed
21Looker, AC, Dallman, PR, Carroll, MD, Gunter, EW, Johnson, CL. Prevalence of iron deficiency in the United Sates. Journal of the American Medical Association, 1997; 277 973– 6.CrossRefGoogle Scholar
22Centers for Disease Control and Prevention. Iron deficiency - United States, 1999–2000. Morbidity and Mortality Weekly Report, 2002; 51 897–9.Google Scholar
23Hallberg, L. Results of surveys to assess iron status in Europe. Nutrition Reviews, 1995; 53 314–22.Google Scholar
24Faquih, AMHijazi, SSQazaq, HSPrevalence of Iron Deficiency Anaemia in Jordan. Amman/Irbid: Department of Nutrition and Food Technology, University of Jordan/Jordan University of Science and Technology, (1999).Google Scholar
25Kilinc, M, Yuregir, GT, Ekerbicer, H. Anaemia and iron-deficiency anaemia in south-east Anatolia. European Journal of Haematology, 2002; 69 280–3.Google Scholar
26Abalkhail, B, Shawky, S. Prevalence of daily breakfast intake, iron deficiency anaemia and awareness of being anaemic among Saudi school students. International Journal of Food Sciences and Nutrition, 2002; 53 519–28.Google Scholar
27Quintas, ME, Requejo, AM, Ortega, RM, Redondo, MR, Lopez-Sobaler, AM, Gaspar, MJ. The female Spanish population: a group at risk of nutritional iron deficiency. International Journal of Food Sciences and Nutrition, 1997; 48 271–9.Google Scholar
28Ferguson, EL, Morison, IM, Faed, JM, Parnell, WR, McKenzie, J, Wilson, NC, et al. Dietary iron intakes and biochemical iron status of 15–49 year old women in New Zealand: is there a cause for concern? New Zealand Medical Journal, 2001; 114 134–8.Google Scholar
29Milman, N, Clausen, J, Byg, KE. Iron status in 268 Danish women aged 18–30 years: influence of menstruation, contraceptive method, and iron supplementation. Annals of Hematology, 1998; 77 13–9.Google Scholar
30Herrmann, W, Obeid, R, Jouma, M. Hyperhomocysteinemia and vitamin B-12 deficiency are more striking in Syrians than in Germans - causes and implications. Atherosclerosis, 2003; 166 143–50.CrossRefGoogle ScholarPubMed
31Schulpis, K, Spiropoulos, A, Gavrilli, S, Karikas, G, Grigori, C, Vlachos, G, et al. Maternal-neonatal folate and vitamin B 12 serum concentrations in Greeks and in Albanian immigrants. Journal of Human Nutrition and Dietetics, 2004; 17 443–8.CrossRefGoogle ScholarPubMed
32Scholl, TO, Reilly, T. Anemia, iron and pregnancy outcome. Journal of Nutrition, 2000; 130 443S–7S.CrossRefGoogle ScholarPubMed
33Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B 6, Folate, Vitamin B 12, Pantothenic Acid, Biotin and Choline, Washington, DC: National Academy Press,1998.Google Scholar
34Adres, E, Loikili, NH, Noel, E, Kaltenbach, G, Ben-Abdelgheni, M, Perrin, AE, et al. Vitamin B 12 (cobalamin) deficiency in elderly patients. Canadian Medical Association Journal, 2004; 171 251–7.CrossRefGoogle Scholar
35Zahed, L. The spectrum of β-thalassemia mutations in the Arab populations. Journal of Biomedicine and Biotechnology, 2001; 1 129–32.Google Scholar
36Tadmouri, G. β-Thalassemia in Lebanon. Sci-Quest, 1995; 5 14–18.Google Scholar
37Klee, GG. Cobalamin and folate evaluation: measurement of methylmalonic acid and homocysteine vs vitamin B(12) and folate. Clinical Chemistry, 2000; 46 1277–83.Google Scholar