According to the authors, the WHI study represents one of the most comprehensive sources of diet, health and general information ever collected in the U.S., including data over a 9-year period. Dietary intake data were collected using a Food Frequency Questionnaire (FFQ), while not precise in terms of nutrient exposure, can be completed independently by study participants with minimal instruction. The FFQ estimates intake of over 85 nutrients.
The authors conclude that, "Efforts to identify anemia that may be responsive to modifiable factors such as diet to improve health outcomes are needed. Additional efforts to regularly evaluate postmenopausal women for anemia should be considered and should be accompanied by an assessment of dietary intake to determine adequacy of intake of anemia-associated nutrients including iron, vitamin B12 and folate. While the type of anemia is often designated by a more comprehensive biochemical assessment than hemoglobin alone, nutritional therapy to improve overall nutrient-density and quality of the diet should also be a clinical focus."
In an accompanying editorial, Lisa Tussing-Humphreys, PhD, RD, Research Nutritionist, U.S. Department of Agriculture-Agricultural Research Service, Baton Rouge, and Carol Braunschweig, PhD, RD, Assistant Professor, Department of Kinesiology and Nutrition, University of Illinois, Chicago, comment that "the study by Thomson and colleagues extends the literature by providing one of the largest prospective assessments of diet and anemia in US postmenopausal women." They acknowledge that anemia in older individuals is frequently linked to non-nutritional causes. Data required to interpret and classify the type of anemia and evaluate non-diet-related factors associated with anemia were not assessed in all women enrolled in the WHI-OS cohort, as acknowledged by Thomson and colleagues, and therefore not ev
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