The main objective of the present study was to examine the association between dietary Fe intake and dietary predictors of Fe status and Hb concentration among lactating women in Bhaktapur, Nepal. We included 500 randomly selected lactating women in a cross-sectional survey. Dietary information was obtained through three interactive 24 h recall interviews including personal recipes. Concentrations of Hb and plasma ferritin and soluble transferrin receptors were measured. The daily median Fe intake from food was 17·5 mg, and 70 % of the women were found to be at the risk of inadequate dietary Fe intake. Approximately 90 % of the women had taken Fe supplements in pregnancy. The prevalence of anaemia was 20 % (Hb levels < 123 g/l) and that of Fe deficiency was 5 % (plasma ferritin levels < 15 μg/l). In multiple regression analyses, there was a weak positive association between dietary Fe intake and body Fe (β 0·03, 95 % CI 0·014, 0·045). Among the women with children aged < 6 months, but not those with older infants, intake of Fe supplements in pregnancy for at least 6 months was positively associated with body Fe (P for interaction < 0·01). Due to a relatively high dietary intake of non-haem Fe combined with low bioavailability, a high proportion of the women in the present study were at the risk of inadequate intake of Fe. The low prevalence of anaemia and Fe deficiency may be explained by the majority of the women consuming Fe supplements in pregnancy.

Anaemia is prevalent in South East Asia and Fe deficiency (ID) is considered to be the main cause, but the role of subclinical inflammation in the aetiology is uncertain. In the present study, we determined the influence of inflammation on the biomarkers of Fe status in women and children, and herein, we discuss the proportion of anaemia associated with ID. As part of the 2006 Lao People's Democratic Republic (The Lao PDR) National Nutrition Survey, blood collected from 482 young children and 816 non-pregnant women was analysed. Plasma ferritin, transferrin receptor (sTfR), Hb, C-reactive protein (CRP) and α-1-acid glycoprotein (AGP) concentrations were measured. ID was assessed using ferritin concentrations ( < 12 (children) or < 15 (adults) μg/l), sTfR concentrations (>8·3 mg/l) and body Fe stores (BIS < 0). Elevated CRP (>5 mg/l) and/or AGP (>1 g/l) concentrations were used to categorise inflammation status in order to correct the Fe biomarkers for inflammation. Inflammation was present in 14 % of adults and 43 % of children. Anaemia was present in 37·6 % of both women (Hb concentrations < 120 g/l) and children (Hb concentrations < 110 g/l). Correcting ferritin concentrations for inflammation increased the prevalence of ID from 24·3 to 26 % for women and from 18 to 21 % for children (P< 0·001 for both). Ferritin concentrations were more helpful in detecting ID than sTfR concentrations or BIS, but regression analysis found that sTfr concentrations explained more of the variance in Hb concentrations in both women (20 %) and children (17 %) than ferritin concentrations (5 and 1·4 %, respectively). Nevertheless, the total variance in Hb concentrations explained was only 26 and 18 % in women and children, respectively, and other factors may be more important than ID in contributing to anaemia in The Lao PDR.