Academy of Science of South Africa Consensus Study on Improved Nutritional Assessment of Micronutrients: Iron

Abstract

Objectives: The academy of Science of South Africa commissioned a consensus study on improved nutritional assessment of micronutrients in the country. For iron the objectives were to, evaluate usefulness of available indicators for South Africa and other African countries facing similar challenges, review the type and quality of research information on iron status in South Africa and formulate recommendations on suitability and work required for more effective monitoring of iron status and possible gains from intervention programmes. Methods: The study was done by reviewing research that has been done in relation to iron status primarily in South Africa. Results: Haemoglobin, Serum Ferritin (SF) and transferrin receptor were the most commonly used indicators in addition to dietary intake. There was lack of consistency in the use of acute phase proteins to address infection and inflammation making interpretation of SF difficult against the background of high infection prevalence eg. HIV/AIDS, worm infestation and obesity. The study found a strong bias toward low socio-economic sectors of the population while the national food fortification programme exposes the entire population to multiple micronutrients including iron. Some studies reported that some pockets of the population may be at risk of iron overload. Conclusions: Regular monitoring across population subgroups is recommended. Standard mechanisms to correct SF for inflammation/infection should be explored for more effective monitoring of interventions. Pockets of the population with potential risk of iron overload require attention.