Relating the Bangladeshi Diet to Iron Deficiency

This chapter develops a comprehensive longitudinal model for the proximate determinants of hemoglobin concentration using three repeated observations on 514 women in Bangladesh. The explanatory variables in the model were nutrient intakes, including bioavailable iron; anthropometric measurement; morbidity involving blood loss; and intake of iron tablets. Bioavailable iron, women’s height and midupper-arm circumference, and intake of iron tablets were significant predictors of hemoglobin concentration. These empirical estimates of the effects of foods in the diet on iron status and other variables allowed a comparison of the benefits and costs of various types of interventions to reduce iron deficiency. An increased iron intake achieved via breeding iron-dense rice would enhance the subjects’ iron status; iron tablets would be important for pregnant women. A cost-benefit analysis shows that plant breeding is a viable, low-cost strategy that can complement existing interventions. INTRODUCTION Poor diet quality and low bioavailability of dietary iron are important factors contributing to iron-deficiency anemia (IDA). However, few studies have attempted to measure the effects of foods in the diet on iron status, as compared with iron supplements and other types of interventions designed to reduce iron deficiency. Such estimates are essential for evaluating the relative benefits and costs of various types of interventions. SUBJECTS AND METHODS Food intake data were collected for a group of rural Bangladeshi women. Information from the data on nutrients and other compounds consumed was substituted into algorithms developed for calculating iron bioavailability in the presence of enhancers such as meat and vitamin C. The algorithms were recently extended to incorporate the inhibitory effects of phytates that chelate iron, thereby reducing its absorption (Tseng et al. 1997). This gave an estimate of the amount of bioavailable iron