Why is Iron Deficiency More Common in Black People?

By Dr. Jake Rabinowitz


  • Black people experience higher rates of iron deficiency than other races. 
  • Increased iron deficiency in black people is not caused by diet or other lifestyle choices. 
  • Genetic differences cause people of African ancestry to absorb and utilize iron different than other races. 
  • The increased melanin in dark skin reduces vitamin D absorption, which may contribute to low iron levels.  
  • Iron supplementation is a safe way for many black people to achieve optimal iron levels. 

Do black people experience the highest rates of iron deficiency?

In U.S. public health surveys, non-Hispanic black individuals have been reported as having ~3x more anemia than other ethnic groups. An analysis of data recorded by the U.S. government across five National Health and Nutrition Examination Surveys (NHANES) between 2003 and 2012 found a 14.9% prevalence of anemia among non-hispanic black people, with prevalence of only 4.0% (non-hispanic white), 5.1% (hispanic), and 6.1% in other groups. These surveys included over 40,000 people, which is a large enough sample size to make the results conclusive. Because iron deficiency is the most common cause of anemia, it is safe to conclude that black people experience the highest rates of iron deficiency. 

Are black people anemic due to their diets?

Because iron is ingested through food, public health professionals have studied whether dietary trends among black people influences their high rates of anemia and iron deficiency.  To study this, researchers compared dietary habits and corresponding blood parameters for black and white populations, analyzing over 2,500 subjects based on another government dataset from the NHANES II survey.  The data found that the black participants had lower hemoglobin levels (hemoglobin is a blood protein that includes iron) at most levels of dietary iron intake. They concluded that genetic and/or environmental factors, rather than diet, were the main factor driving increased iron deficiency in black populations. 

Do genetic factors influence how black people utilize iron?

With dietary causes ruled out, researchers moved onto genetic analyses to try and understand why black people have the highest rates of anemia and iron deficiency. Their results indeed show that DNA related to iron absorption is different in black people than in other groups. One study looked alleles (which  are versions of genes) related to iron imbalance — having iron deficiency or iron overload. Comparing African genes to those of Europeans, South Asians, and East Asians, they found that Africans were consistently over-represented or under-represented in many genes related to iron status. A different study focused on African-Americans found that the degree of African ancestry correlated with lower iron levels. 

Is anemia related to protection against blood-borne illnesses?

Though it’s not known why African and black people have different genetics when it comes to absorbing and using iron, some people theorize it is related to protection against blood-borne illnesses. For example, having the sickle-cell anemia trait can provide protection against malaria. Another gene (called G6DP) that was over-represented in people of African descent is related to how blood is recycled and generated. If this theory is true, it would mean that hereditary trends across generations of black people favored protection against malaria and other blood-based diseases, at the expense of having more elevated iron levels. 

Does Vitamin D relate to levels of anemia in black populations?

It’s known that dark pigmentation reduces how much vitamin D the skin produces in response to sunlight. Thus, black people are more likely than other ethnicities to have vitamin D deficiency, and vitamin D deficiency has increasingly been linked to anemia. Vitamin D can stimulate the production of new blood, and it also reduces inflammation, which can inhibit iron absorption. Therefore, the lack of vitamin D among black populations may contribute to their increased prevalences of anemia and iron deficiency. 

How can black people reverse their anemia and iron deficiency?

It can seem daunting to fix a condition that is so widespread and might even be hard-coded into a genetic makeup. That’s why Smart Eats is here to help. Our iron-fortified protein and electrolyte powders provide highly absorbed and easily tolerated iron in tasty drink mixes that are easy to use. Try Iron Lift or Iron Hydration today and you can feel better within a month. 

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  • Dr. Jake Rabinowitz

    Dr. Jake Rabinowitz is a chemical engineer, PhD, and founder of Smart Eats, where he develops nutrition products with an industry-leading food scientist and a renowned gastrointestinal doctor / nutritionist. You can learn more about Jake's work career on his LinkedIn Profile and his highly-cited research contributions on his Google Scholar Profile.

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