Annals of Family Medicine -- Comments for Mainous et al., 3 (2) 131-137

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Original Research:
Arch G. Mainous, III, James M. Gill, and Charles J. Everett
Transferrin Saturation, Dietary Iron Intake, and Risk of Cancer
Ann Fam Med 2005; 3: 131-137 [Abstract] [Full text] [PDF]

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Electronic letters published:

Science?: Susan Peloquin (6 February 2006)

Dietary iron - was it fully assessed? Why was it taken?: Andreas Cohrssen (5 April 2005)

Science? 6 February 2006

Susan Peloquin,
Chicago, USA
concerned consumer
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Re: Science?

I must start by saying that I am not a scientist, but have an interest in research of hemochromatosis. I cannot believe that you have done this study based on one 24 hour dietary assessment. The amount of dietary iron in my diet varies greatly from one day to the next depending on whether I ate fortified cereal or yogurt for breakfast. I am assuming that the people who participated in this study could likely be the same. I would think that you would need several dietary status surveys done over the course of this study to get a true idea of the amount of dietary iron consumed in this study, especially when the number of people with high transferrin saturation and high dietary iron was so low (1%).
Competing interests: None declared

Dietary iron - was it fully assessed? Why was it taken? 5 April 2005

Andreas Cohrssen,
New York, NY, USA
Beth Israel Medical Center; Institute for Urban Family Health
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Re: Dietary iron - was it fully assessed? Why was it taken?

Mainous et al. found an interesting potential association between serum transferrin, dietary iron intake and a diagnosis of cancer.
In the method section I could not identify if confounders of dietary iron intake such as supplemental iron (multivitamins, iron tablets) was accounted for as well as intake of Vitamin C which would enhance resorption of iron. Lack of inclusion of such data would diminish the strength of the presented data.
In addition, I would like to know if current or past anemia was assessed. Many patients deal with anemia by increasing their dietary iron intake or take iron supplements. Anemia in older patients could be a warning sign of a slowly growing cancer, such as colon [1] or bladder cancer. Increased iron intake could then be a marker for the patient's dietary adjustment to a developing cancer.
[1] Acher PL. Al-Mishlab T. Rahman M. Bates T. Iron-deficiency anaemia and delay in the diagnosis of colorectal cancer. Colorectal Disease. 5(2):145-8, 2003 Mar.
Competing interests: None declared