Determinants of Iron Deficiency and Anemia among Adolescents in a Multi-Cultural Country

Background: Adolescence is a vulnerable period for the development of nutritional anemia. Aim: To evaluate the determinants of iron deficiency, anemia, and associated factors among adolescents who performed routine blood tests in a large district in Israel during 2014. Methods: A community-based cross-sectional observational study was conducted among adolescents aged 11-18 years, belonging to Haifa and west Galilee district of ‘Clalit’ Health Services, who routinely performed blood tests during 2014. The blood tests were investigated for iron deficiency (ferritin<20 ng/mL) or anemia (hemoglobin (HGB)<12 g/dl). Results: Among 22310 adolescents who performed blood tests during 2014, 4116 (18.45%) were found to fulfill the inclusion criteria. 14.8% were boys, 85.2% were girls. 2964 (13.2%) adolescents were anemic, with HGB 12 g/dl, but ferritin levels<20 ng/mL, with mean ferritin level of 14.31 ng/mL. Jews significantly had higher mean MCV values, and higher iron levels as compared to non-Jews. The average HGB levels were the lowest in the age groups of 12.5- 15.5 years, and 15.5-17 years. The severity of the anemia correlated significantly with the gender of the adolescent, females having lower HGB concentrations. Ferritin levels correlated significantly with the gender (higher in males), and age of the adolescents (lower at higher ages). Conclusions: Iron deficiency and anemia are common in adolescents, having serious implications. Awareness to this problem should be raised, and decision makers are encouraged to find ways to prevent detect and treat it.