IRON-DEFICIENCY ANEMIA AMONG ALASKA NATIVES MAY BE DUE TO FECAL LOSS RATHER THAN INADEQUATE INTAKE

To define more fully the nature of a persistently high prevalence of i ron deficiency anemia observed among Alaska Native children, we examin ed dietary iron intake, hemoglobin concentrations, and storage iron (s erum ferritin) based on multiple cross-sectional surveys of Alaska Nat ives between 1983 and 1989. Approximately 30 to 50% of the children st udied < 12 y of age had depleted iron stores. Anemia and depleted iron stores also were prevalent among adult men and women, about twice as prevalent as in the U.S. population based on the Second National Healt h and Nutrition Examination Survey (NHANES II). The higher rate of iro n deficiency, occurring even when the dietary assessment found Alaska Native iron intake to be higher than the U.S. average with an ample in take of food high in bioavailable iron, suggests blood loss as a possi ble cause of the unusual pattern of iron deficiency observed. In a pil ot study of stool blood loss in two villages, 65% of the samples had a significantly elevated stool heme concentration. Further investigatio n of iron deficiency due to gastrointestinal blood loss for the Alaska Native is warranted.