Dietary Iron Intake in Women of Reproductive Age in Europe: A Review of 49 Studies from 29 Countries in the Period 1993–2015

OBJECTIVE: Assessment of dietary iron intake in women of reproductive age in Europe. DESIGN: Review. SETTING: Literature search of dietary surveys reporting intake of iron using PubMed, Internet browsers, and national nutrient databases in the period 1993–2015. SUBJECTS: Women of reproductive age. RESULTS: 49 dietary surveys/studies in 29 European countries were included. Belgium, Bosnia, Denmark, Hungary, Italy, Northern Ireland, Serbia, Scotland, Sweden, Switzerland, United Kingdom/England, and Wales reported a median/mean iron intake of 7.6–9.9 mg/day. Finland, Iceland, Ireland, the Netherlands, Norway, Poland, and Spain reported an intake of 10.0–10.7 mg/day. Austria, Estonia, France, and Russia reported an intake of 11.0–11.9 mg/day. Latvia and Germany reported an intake of 12.0–12.2 mg/day. Croatia, Lithuania, Portugal, and Slovakia reported an intake of 15.9–19.0 mg/day. The percentage of dietary iron consisting of heme iron, reported in 7 studies, varied from 4.3% in United Kingdom to 25% in Spain. Nutrient density for iron (mg iron/10 MJ, median/mean) varied from 11.8 in Sweden to 23.0 in Lithuania. The correlation between nutrient density and dietary iron was significant (p=0.0006). In most countries, the majority of women had a dietary iron intake below 15 mg/day. In Belgium, Denmark, Hungary, and Sweden, 91–95% of women had an intake below 15 mg/day. In Ireland and Germany, 61–78% had an intake below 15 mg/day. CONCLUSIONS: In Europe, 61–97% of women have a dietary iron intake below 15 mg/day. This contributes to a low iron status in many women. We need common European standardized dietary methods, uniform dietary reference values, and uniform statistical methods to perform intercountry comparisons.