In this representative cross-sectional study, we found that both overweight/obesity and central obesity were inversely associated with anemia. The result was consistent with studies from Peru, Egypt, and the US, but not with a Mexican study [4, 5]. The level of iron and vitamin C intake may partly explain the discrepancy. In our study, average iron intake ranged from 20 to 24 mg/d, which is in line with the Adequate Intake of 20 mg/d for Chinese women . Although obese/overweight women had a higher intake of iron than underweight women, the average intake of underweight women was still adequate. In contrast, in the Mexican population iron intake was reported to be in the range of 8–9 mg/d . Intake of vitamin C, the most potent enhancer of non-heme iron absorption, was present in sufficient amounts in the diets of Chinese women (60 mg/d), whereas vitamin C intake in Mexican women was low (30 mg/d). It may be that the Chinese diet conveys enough absorbable iron to lower the risk of anemia in contrast to the Mexican diet . Although overweight or obesity in the population may not decrease red-cell survival or impair erythropoiesis, obesity might still result in hypoferremia through hepcidin or other mediators .
Waist circumference reflects intra-abdominal fat mass, and is related to cardiovascular diseases in adults . Limited studies have assessed the relationship between central obesity and anemia. Gillum et al.  reported a positive association between waist-hip-ratio and serum ferritin. In our study, women with central obesity were less likely to have anemia, consistent with the results with overall obesity.
The main limitation of our study is that we used anemia as an indicator which only represents a part of the complex assessment of iron status. Therefore, we cannot truly distinguish anemia of chronic disease and anemia caused by iron deficiency.
In conclusion, in this study we found an inverse association between overweight/obesity, central obesity and anemia in Chinese women from Jiangsu Province. Our study contributes to the existing knowledge base on the complex association between adiposity and anemia. Inclusion of multiple iron and inflammation markers in future studies could possibly unravel the true meaning of our findings.