Question 3
Why do you think African American women are at a higher risk for anemia compared to Hispanic/Latinos, Asians, and non-Hispanic Whites? In addition, why do you think the use of a multivitamin/mineral supplement is not associated with lower rates of anemia for all ethnicities/races?
posted by MelanieP @ 10:35 AM
29 comments
29 Comments:
Nutrition-related anemia is caused by long-term inadequate intake of vitamin B-12, vitamin C, folate, iron and protein, therefore these individuals' diets were lacking in these nutrients. I believe that multivitamin/mineral supplements are not always taken consistently, therefore wouldn’t be associated with lower rates of anemia for all ethnicities/races. Also, like many have mentioned in previous blogs, commonly some people who consume multivitamin/mineral supplements may feel that the supplements replace the need for adequate dietary intake.
African American women may be more at risk because their diets do not supply adequate amounts of B12, folate, and iron, their genetic makeup or a combination. I will have to agree with Liz on the vitamin/mineral supplements as well, they may not be taking them regularly or they may have inadequate nutrients from food and the vitamin simply doesn't supply them with enough nutrients.
African American women may be at a higher risk for anemiabecause their cultural diet may lack sufficient amounts of iron compared to that of compared to hispanic/latinos, asians, and non-hispanic whites.
The multivitamin/mineral supplements may not have adequate amounts of nutrients to supply the anemic invididuals. Those found to be anemic may also need further testing to identify the presence or lack of Intrinsic Factor (IF). This is where the Schilling test could come into play. Complications with IF will help determine the need for alternative methods of supplementation (intravenous.
It’s possible that socioeconomic could be related to African American women being at a higher risk for anemia. As the study states, there was an inverse relationship between socioeconomic status and anemia occurrence. This population may not be able to afford the foods that primarily contain iron and especially B-12 such as meats. I think that the reason the multivitamin/mineral supplement was not related to a lower rate of anemia could be because of an absorption problem such as lack of intrinsic factor, as previously mentioned as a possible issue. An undiagnosed absorption problem would mean that the supplements would be less affective and therefore would not decrease the anemia occurrence.
Like Liz stated, anemia stems from inadequate intake of vitamin B12, vitamin C, folate, iron and protein. These nutrients must be lacking in these women’s diets. It is possible that they do not have access to foods high in these nutrients due to socioeconomic or location issues. It is also possible that these women are not consuming a well-balanced diet due to lack of education on current dietary recommendations. There are a variety of reasons why these individuals may not be getting the needed nutrients, but it is difficult to determine a specific reason without additional research.
The difference may be explained by disproportionate rates of ethnicities in socioeconomic groups. African Americans may be more representative of the lower socioeconomic group, which is inversely associated with anemia. As for supplementation, there was no controls over what type of supplement was taken, and absorption rates and bioavailability of different brands of supplements can be significantly varied.
Amy, I agree that cultural diversity strongly relates to nutrient intake based on cuisine. This definitely has impact on micronutrient intake and even willingness to supplement.
I have to agree with everyone who said that African American women are most likely at higher risk for anemia due to socioeconomic status. Foods high in iron often times are not cheap such as meats or leafy greens like spinach so purchasing these items may not be as convenient as items such as boxed dinners that have very little iron at all. I also think education level plays a large role going along with socioeconomic status and quite possibly genetics. African Americans are already at a higher risk for sickle cell anemia and thalassemia due to genetics so it was not surprising to read that they are more at risk of developing anemia compared to other ethnicities. As for the use of multivitamins, I would again have to agree with those who said that often times people are not consistently taking their vitamins plus, with all supplements, there's always the possibility you're excreting more than your absorbing. There is a lot that goes into adequately absorbing and utilizing iron so often times just taking an iron pill is not good enough. Which brings us back to the important point of last month's blog, food is always your best bet!
The cultural foods that African American women typically eat may be lower in Vitamin B 12, Vitamin C, folate, iron and protein and therefore put them at higher risk for anemia. With the supplements, people may be forgetting to take them or perhaps they are just excreting most of the vitamins out instead of absorbing them. There are also different forms of multivitamins and mineral supplements with different doses, and they may not understand what is appropriate to take for anemia.
Brooke brought up a good point when she pointed out that the study showed an inverse relationship between SES and anemia occurence. Protein sources do typically cost more and may be something many people have to limit in their shopping due to budgets. Brooke also mentioned that this could be why supplementation is not effective, because they cannot absorb them due to a lack of intrinsic factor. I think this is a great point, and something I did not initially think of!
Rose, I agree that the difference may be a result of many different reasons. Additional research could be conducted in this area. Also, I agree with Amy and Sarah that one’s culture relates to dietary intake and could be the cause of a diet lacking in iron.
It seems as though the foods consumed by this population are lower in vit B12 & c, iron, and protein, whether for cultural or socioeconomic reasons. As for the MVI, there are many types of MVIs on the market currently, with varying amounts of different nutrients. Of course, MVIs typically do not contain calories or protein, and weight had an inverse relationship with anemia rates overall, so this may have also played a role. MVIs are often not taken on a regular basis as well.
I think there is a certain genetic factor that always is a wild card. Other examples are type 2 diabetes and lactose intolerant. African American could just be more prone. I believe that multivitamin when taking daily in conjunction with a healthy diet can help reduce the anemia rate. Those are two variable that we are unsure of though.
Cultural foods that some of you are bringing up is definately another variable that play a role. Those micronutrients might not be rich in many of the foods found in traditional dishes. Good point.
As noted in the findings, there was an inverse relationship between weight and risk for anemia. African Americans already have a pre-exisiting risk factor for diseases such as obesity, hypertension, and according to this study, anemia. As far as taking a multi-vitamin supplement, it is unclear if the researchers were able to regulate or discuss the different types of multi-vitamin and their usage (as Michela mentioned the different dosage and mineral/vitamin content can vary across the board). Additionally, having co-morbidities may lead to absorption problems too.
I agree with what everyone has said above. I think a little bit of everything from cultural cuisine, genetics, and socioeconomic status place African American women at a higher risk for anemia. As mentioned before, there are so many types of multivitamins that it is hard to know which one will work best for each individual. Some people may absorb some better than others and different brands may be better absorbed than others based upon how they are processed. Typically the more expensive brands of multivitamins are made from more easily absorbed forms of vitamins and minerals which brings us back to the differences in socioeconomic status.
I think that genetics play a large role in this question and that part of the problem may have been the fact that hemoglobin concentration was the only defining criteria used to determine anemia. Diet would certainly play a role too. As already mentioned, supplements vary in quantity, quality, absorbability, and may be used in place of a healthy diet. All of these factors could impact results.
Bethany, I thought you made an interesting point by bringing up genetics and the prevalence of thalassemia and sickle cell anemia. I also wasn't very surprised to read that African American women experienced higher rates of anemia for that reason. The researchers explain that hemoglobin concentration may vary because of genetic factors and that it may not be the best way to evaluate anemia in a multiracial/ethnic population.
African-American women are likely more at risk for anemia due to the foods that are consistently consumed in their diet. Genetics may also play a role in how this population absorbs certain nutrients. Also, I believe that multivitamin/mineral supplementation may not reduce the risk for anemia due to inconsistency with taking the supplement and possible replacement of the supplement for nutrient-dense food and beverages.
I like Michela's point about the possibility of African Americans' cultural foods being lower in some nutrients. This is something I did not previously think about. I believe it would make a very interesting study to observe different cultures' typical food intake and determine the nutrient composition in order to observe which nutrients are rich and which are lacking in specific cultures.
I have to agree with Kevin and Kathy, that genetics play a huge role and there is still a lot we don't know or are still learning with genetics links
I definitely agree with Sarah G and everyone else who mentioned the varying brands and types of multivitamins available on the market could effect the MVI and anemia relationship. I did not think about this point when answering the question previously and it definitely is a valid answer as to why taking a multivitamin was not associated with lower incidence of anemia. We all know that vitamins/mineral supplements are not regulated, therefore it is always a risk taking them because you never really know what you're going to get. Plus, many people, myself included, struggle with remembering to take their vitamins consistently so that too could have had a major effect on the results. Even if I have only taken 3 MVIs in two weeks, I still respond with "yes" I take a MVI when asked by my doctor or other interested parties.
I believe that African American women may be more at risk due to thier dietary intakes. Multivitamin supplements can provide the nutrients necessary to deter anemia.
Amy, you bring up a good point with the cultural components of an African American diet. This may require nutritional intervention and educational advances as well as vitamin and mineral supplementation.
Not all multivitamin contain iron, which could lead to low iron consumption. People frequently report not taking their vitamin/mineral supplements on daily basis as well. African American women may also be less likely to consume sufficient sources of vitamin B-12. vitamin C, folate, and iron causing deficiencies.
Brooke makes as interesting point that socioeconomic factors play a role in these specific deficiencies. Perhaps they cannot afford these items or choose poor sources. The lack of or reduced intrinsic factor is an interesting suggestion, I have never read anything that tied a specific population with low intrinsic factor.
The cultural diet practices of this population must not provide these women with good sources of anemia-preventative foods. The use of a multivitamin/mineral supplement is probably not associated with lower anemia rates based on differences in frequency and quality.
I think African American women are at a higher risk for anemia compared to other ethnicities due to a combination of socioeconomic status (which was inversely correlated with incidence of anemia) and the typical diet of that culture, which may be lower in iron or other nutrients thereby resulting in greater numbers of anemic women. As for the vitamin and mineral supplementation, I agree with others that have said that people may not always take their vitamin and mineral supplements and would not benefit from them as much as they could or it may related to how those nutrients are absorbed by each individual.
I think the role that genetics plays was a great point to bring up. This is something that we as future dietetics practitioners really need to be aware of. It's necessary to consider the cultural diversity and differences that your target audience may represent when making nutrition recommendations.
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