Obesity and iron deficiency anemia: A review of population based studies

Obesity and iron deficiency are amongst the most common nutritional disorders inthe world. However, whether being overweight or obese is associated with increased riskof iron deficiency anemia (IDA) remains undefined. Obesity is associated with increasedrisk of hypoferremia (low serum iron levels) and the risk may increase further in morbidobesity (BMI > 40 kg/m2). On the other hand, obese people tend to have higherhemoglobin and serum ferritin concentrations compared to normal weight people. Sincethe sites for iron storage and erythropoiesis are remote from the intestine, the circulatingpeptide hepcidin is thought to act as the communicating signal between these organs.Adipose tissue is an active endocrine organ which can produce numerous cytokines,adipokines and hormones leading to hepcidin perturbation. Hence, greater adiposity may,directly or indirectly, regulate iron metabolism. The recent advances in the molecularmechanism of iron regulation have also led to the development of alternative irontherapeutic methods for both iron restrictive anemia and/or iron overload. This chapterdiscusses recent advances of obesity and iron metabolism with special focus onpopulation based studies.