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Iron Nutrition Does Not Account for the Hemoglobin Differences between Blacks and Whites

Epidemiology Branch, Division of Nutrition, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control, Atlanta, GA 30333 ^* Nutrition Program, School of Public Health, University of California, Berkeley, CA 94720

Many researchers have reported lower hemoglobin concentrations in blacks than in whites, but the reason for this difference is unknown. Data for 2515 persons (in 3–12 y and 18–45 y age groups) from the Second National Health and Nutrition Examination Survey (NHANES II) were evaluated to investigate the roles of iron intake and biochemical iron status indicators in explaining black and white differences in hemoglobin concentration. Dietary iron intake was estimated from one 24-h food recall, and hemoglobin, serum ferritin, transferrin saturation and erythrocyte protoporphyrin were measured by standard laboratory methods. Hemoglobin levels were substantially lower in black children (120.3 g/L) than in white children (126.8 g/L). Hemoglobin concentrations were also lower in black women (128.4 g/L) than in white women (133.9 g/L), and in black men (144.8 g/L) than in white men (153.2 g/L). Blacks had lower hemoglobin concentration than whites at most levels of dietary iron intake, serum ferritin, transferrin saturation and erythrocyte protoporphyrin. Despite their lower hemoglobin levels, blacks had higher serum ferritin levels than whites. These results suggest that the difference in hemoglobin concentrations between blacks and whites in the United States is the result of factors other than iron intake and iron status. More specific investigations of both the genetic and environmental determinants of iron utilization in blacks are needed.

KEY WORDS: • NHANES II • hemoglobin • race • iron deficiency • serum ferritin

¹ To whom correspondence and reprint requests should be addressed.

Manuscript received 27 September 1991. Revision accepted 28 February 1992.