Nutrients other than iron are also essential for preventing anemia, particularly nutrients required for healthy red blood cell (RBC) production, which is key for maintaining sufficient RBCs to offset red cell or blood loss. Deficiency of vitamin A has been associated with disruption of iron mobilization. Deficiencies of folate and vitamin B12 are leading determinants of nutritional anemia caused by a disrupted synthesis of RBCs. Deficiency of these key nutrients can be caused by inadequate intake, malabsorption, or increased utilization or demand.
Other nutrient deficiencies, such as protein-energy malnutrition, deficiencies of other essential vitamins (riboflavin, pyridoxine, thiamine), fat-soluble vitamins (E), or other trace elements (copper, zinc, selenium) typically constitute, in general, only a small fraction of the anemia causes. However, in some countries or situations, deficiency of any of these micronutrients may contribute to a larger proportion of the anemia burden than is typically expected. As an example, riboflavin is being considered as a contributor to anemia in sub-Saharan Africa and Southeast Asia.
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