Are Japanese People Prone to Anemia? Understanding the Risk Factors

November 18, 2025 •

4 min read

Studies have shown that the frequency of anemia in Japan is statistically higher than that of many foreign countries. While Japan is often lauded for its citizens' longevity, a closer look at national health data reveals specific segments of the population, particularly young women and the elderly, are disproportionately affected by this condition. This prevalence is linked to a combination of modern dietary changes and evolving lifestyle factors.

Quick Summary

Anemia is a significant public health issue in Japan, with higher rates observed among women and the elderly. Factors contributing to this include decreased iron intake from modern dietary shifts, low BMI, and chronic health conditions, despite the country's high socioeconomic development. Targeted interventions are necessary for at-risk populations.

Key Points

Anemia is Statistically Higher in Japan: Multiple studies confirm that the prevalence of anemia in Japan is comparatively higher than in many other countries.
Japanese Women are Disproportionately Affected: Japanese women, particularly those of reproductive age, have a much higher prevalence of anemia compared to men.
Dietary Shift is a Major Cause: The shift towards a Westernized diet has led to a significant decrease in average iron intake among Japanese people over the past few decades.
Aging Population and Chronic Disease: As Japan's population ages, chronic kidney disease has become an increasingly prominent cause of anemia in the elderly.
Low BMI in Young Women is a Risk Factor: Societal pressure for thinness has led to underweight and imbalanced dietary patterns among young women, contributing to iron deficiency.
Public Health Focus is Needed: Targeted surveillance and intervention programs, including improved nutritional guidance and modern treatment access, are recommended for high-risk populations.

Prevalence of Anemia in the Japanese Population

For decades, Japan has demonstrated impressive public health outcomes, including a world-leading life expectancy. However, this national success story masks a persistent issue with anemia within specific demographics. Studies indicate that the overall frequency of anemia is higher in Japan compared to many other developed nations. A significant gender disparity is evident, with prevalence and associated health burdens being nearly twice as high in women as in men. For instance, a 2019 survey found that 17.1% of non-pregnant Japanese women aged 20–49 had a hemoglobin level indicative of anemia. Among women of reproductive age (15–49), the World Bank reported an anemia prevalence of 18.7% in 2023.

Another concerning trend is the shifting peak age of the anemia burden towards older age groups, particularly in Japan. As the population ages, the number of elderly individuals affected by chronic conditions that can cause anemia, such as chronic kidney disease, is increasing. These findings highlight that anemia is not a uniform issue across the population but a concentrated problem requiring targeted public health approaches.

Key Contributing Factors to Anemia in Japan

Several interconnected factors contribute to the prevalence of anemia in Japan. While dietary iron deficiency remains the leading cause, modern lifestyle changes have exacerbated the issue.

Dietary Shifts: A major shift has occurred in Japanese eating habits over the past several decades, moving away from a traditional diet rich in iron from seafood and vegetables towards a more Westernized diet higher in fats. This has resulted in a significant decrease in daily iron intake across the population. In 1975, the average daily iron intake was 13.4 mg, which fell to just 7.6 mg by 2020. For young women, this is compounded by a high desire for thinness, which can lead to underweight and imbalanced macronutrient intake, suppressing hemoglobin synthesis.
Demographic Vulnerabilities: Specific groups face heightened risk. Young women of reproductive age are at high risk primarily due to menstrual blood loss and insufficient iron intake. During pregnancy, anemia prevalence is also high, with one 2019 study finding 23.4% of pregnant women (15-49 years) in Japan had anemia. The elderly are another susceptible group, with risk factors like chronic kidney disease and other age-related illnesses contributing to their anemia burden.
Medical Conditions: Besides nutritional deficiencies, underlying medical conditions play a role. A 2019 study on Japanese women aged 35 and over found that those with uterine myoma (a gynecological condition causing heavy menstrual bleeding) had a higher risk of anemia. Other conditions such as aplastic anemia and myelodysplastic syndromes, while less common, are also noted to be relatively frequent in Japan.

Comparison of Risk Factors in Japanese vs. Global Context


Factor	Impact in Japan	Impact in Global Context (General)
Dietary Intake	Shift to Western diet, reduced iron intake, and imbalanced macronutrients are key drivers.	Poverty and food insecurity are primary drivers of nutritional deficiencies.
Socioeconomic Status	High HDI and health service coverage correlate negatively with anemia, but the trend has flattened in recent years, especially in women.	Lower socioeconomic development is strongly linked to higher anemia rates globally.
Cultural Trends	Desire for thinness, particularly among young women, leads to low BMI and poor nutrient intake.	Vary depending on region, but often rooted in a combination of food availability, poverty, and tradition.
Aging Population	Japan's exceptionally aged society means that age-related diseases like chronic kidney disease are increasingly significant causes of anemia.	Age is a factor globally, but the demographic shift towards an older population is especially prominent in Japan.

Addressing Anemia: Prevention and Treatment

Given the specific factors contributing to anemia in Japan, a multi-pronged approach is necessary to improve public health outcomes.

Dietary Interventions

Re-emphasize traditional iron sources: Promote the intake of traditional Japanese foods rich in iron, such as liver, eggs, red meat, fish, and tofu.
Enhance iron absorption: Encourage the consumption of vitamin C-rich foods like fruits and green vegetables, as vitamin C improves non-heme iron absorption.
Discourage restrictive dieting: Implement education campaigns targeted at young women to address the health risks of restrictive dieting and low BMI, which are prevalent in this demographic.
Avoid iron absorption inhibitors: Advise limiting the intake of tannins (found in black tea), calcium, oxalates, and phytates, which can hinder iron absorption.

Public Health and Medical Initiatives

Targeted Screening: Increase screening and awareness, particularly for young women and the elderly, to detect and treat anemia early. A significant portion of individuals with low hemoglobin do not report prior diagnoses.
Advanced Treatment Options: Modern iron treatments like Ferric Carboxymaltose (FCM) offer higher doses with fewer gastrointestinal side effects than traditional oral supplements, potentially improving adherence among patients.
Address Underlying Conditions: Healthcare professionals need to address contributing medical issues like uterine myomas in women and chronic kidney disease in the elderly.

Conclusion: A Nuanced Health Challenge

While Japan is a global leader in longevity, the prevalence of anemia, particularly among its women and elderly, highlights a nuanced public health challenge. The root causes are complex, involving a shift away from traditional, iron-rich diets, cultural trends emphasizing thinness, and the health complications of a rapidly aging population. Effective strategies must involve promoting healthier dietary habits, increasing targeted screening for at-risk groups, and utilizing modern medical treatments. By taking these steps, Japan can continue to improve its already high standard of public health and address this often-overlooked nutritional issue.

Key Takeaways

Higher Prevalence: Anemia is more common in Japan than in many other developed countries.
Women at Higher Risk: Japanese women, especially those of reproductive age, have disproportionately high rates of anemia due to decreased iron intake and menstrual blood loss.
Aging Population Vulnerability: The elderly face an increased anemia burden linked to age-related illnesses, especially chronic kidney disease.
Dietary Iron Decline: A shift towards more Westernized diets has significantly reduced average iron intake across the population since 1975.
Cultural Factors: A cultural desire for thinness among young women often leads to restrictive dieting and low BMI, exacerbating iron deficiency.
Targeted Interventions Needed: Public health strategies must focus on nutritional education, early screening, and improved treatment options for at-risk demographics.

Frequently Asked Questions

While Japan has a high overall life expectancy, anemia is a surprisingly common public health issue, with a higher prevalence compared to many other developed nations. The problem is particularly concentrated among specific demographics like women and the elderly.

Japanese women are more susceptible to anemia due to factors including menstrual blood loss and a lower average iron intake from dietary changes. The cultural ideal of thinness can also lead to restrictive eating patterns and low BMI, compounding the issue.

Dietary iron deficiency remains the leading cause of most anemia cases in Japan. This is primarily attributed to a national shift in eating habits over several decades, which has significantly reduced the population's daily iron intake.

Yes, Japan's aging population has led to a shift in the anemia burden towards older age groups. Age-related conditions, especially chronic kidney disease, are significant and growing causes of anemia in the elderly.

Over the past 50 years, the Japanese diet has shifted from a traditional, balanced style rich in certain iron sources to a more Westernized diet high in fat. This change is linked to a major decrease in the average daily iron intake.

Standard treatment for iron deficiency anemia often involves oral iron supplements. More modern treatments, such as intravenous iron preparations like ferric carboxymaltose, are also available for cases where oral supplements are not tolerated or ineffective.

Public health efforts and research continue to monitor and address nutritional deficiencies. Initiatives like the National Health and Nutrition Survey track trends, and medical advancements introduce better treatment options, though targeted interventions for at-risk groups are still emphasized.