Prevalence of anemia among Inuit women in Nunavik, Canada.

Objectives: To assess the prevalence and main types of anemia present among non-pregnant Inuit women of Nunavik using a representative sample.

Study Design: A cross-sectional population-based study. Methods. Iron status was assessed in 466 women aged 18-74 who participated in the 2004 Nunavik Inuit Health Survey. The presence of different types of anemia has been evaluated based on available biochemical indicators of vitamins and of iron status. The correlation between iron status indicators, vitamin status parameters, inflammation markers and heavy metal concentrations was also assessed.

Results: Anemia was present in 43% of the Inuit women in Nunavik and 21% suffered from iron deficiency anemia (IDA). The main type of anemia present among women 18-49 years old was IDA (61% of anemia cases) while anemic women 50 years and over suffered mainly from anemia related to chronic inflammation (ACI) (42%). Over 99% of women had normal values for vitamin A, vitamin B12 and folate. Of interest is that ferritin was positively correlated with blood mercury and lead levels.

Conclusion: The prevalence of anemia in Nunavik women is similar to levels observed in non-industrialized countries and represents a severe public health problem that should be further investigated. The most prevalent type of anemia in these women shifted from IDA to ACI with age. Vitamin A, vitamin B12 and folate deficiencies do not constitute a widespread problem and their contribution to anemia is probably minimal. Sources of heavy metals are also major sources of iron in the diet of Nunavik women which could explain the positive association found between heavy metals and iron status.