An overview of evidence for a causal relation between iron deficiency during development and deficits in cognitive or behavioral function

Nutrition and Metabolism Center, Children's Hospital Oakland Research Institute, Oakland, CA, USA.
American Journal of Clinical Nutrition (Impact Factor: 6.77). 04/2007; 85(4):931-45.
Source: PubMed

ABSTRACT This review, intended for a broad scientific readership, summarizes evidence relevant to whether a causal relation exists between dietary iron deficiency with (ID+A) or without (ID-A) anemia during development and deficits in subsequent cognitive or behavioral performance. An overview of expert opinion and major evidence in humans and animals is provided. Cognitive and behavioral effects observed in humans with ID-A and in animals with ID+/-A are provided in tables. The degree to which 5 conditions of causality are satisfied and whether deleterious effects of ID-A might be expected to occur are discussed. On the basis of the existing literature, our major conclusions are as follows. Although most of the 5 conditions of causality (association, plausible biological mechanisms, dose response, ability to manipulate the effect, and specificity of cause and effect) are partially satisfied in humans, animals, or both, a causal connection has not been clearly established. In animals, deficits in motor activity are consistently associated with severe ID+A, but adverse effects on performance in tests that target cognitive function have not been clearly shown. Resistance to iron treatment was observed in most trials of children <2 y of age with ID+A, but not in older children. Similar observations were made in rodents when ID+A occurred before rather than after weaning. In children >2 y of age and in adolescents with ID-A, evidence suggests cognitive or behavioral deficits; however, the surprisingly small number of studies conducted in either humans or animals prevents a thorough assessment.

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    • "In 2002, iron deficiency anemia (IDA) was considered to be among the most important contributing factors to the global burden of anemia [WHO, 2002]. In a recent review of the prevalence of iron deficiency anemia in the United States, 9% of toddlers and up to 11% of adolescent girls were iron deficient [McCann and Ames, 2007] The highest prevalence is found in Africa (47.5%) and in South-East Asia (35.7%). It is 17.8% in Americans [ WHO, 2008], 14% in the residents of United Arab Emirates; 11% in Egyptians; and 40% in the Syrian Arab Republic and Oman among women of child-bearing age [Al-Buhairan et al., 2001; Al-Quaiz 2001; Djazayery 2001; Bagchi 2004]. "
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    ABSTRACT: Iron deficiency is the most common nutritional disorder in the world. The aim of this questionnaire based survey study was to determine the prevalence of iron deficiency anemia in reproductive age women, and their relation to variables such as age, marital status, education with those attending obstetrics and gynecology outpatient of King Faisal University Health Centre in Al-Ahsa in eastern region of Kingdom of Saudi Arabia. This study was conducted for the period of 6 month staring from September 2012 to February 2013. The questionnaire had three sections on personal information: their educational indicators, gynecological clinical history, and hematological indices. The average age was 25.97±7.17 years. According to the gynecological clinical history of the respondents, 15 (48.4%) respondents were pregnant while 16 (51.6%) were not pregnant. There was significant effect of pregnancy status on Hb level. Majority of the anemic respondents 15/17 were married. Moreover 14/17 anemic women were experiencing severe menstrual bleeding, 11/17 respondents were pregnant. 54.8% of respondents were hemoglobin deficient while 77.4% were found to have low Hct. In 87.1 % of the respondents, transferrin saturation was found to be abnormal. In this study iron deficiency anemia is quite prevalent in the university community especially among pregnant women. The fetus's and newborn infant's iron status depends on the iron status of the pregnant woman and therefore, iron deficiency in the mother-to-be means that growing fetus probably will be iron deficient as well. Thus iron deficiency anemia during pregnancy in well-educated set up needs more attention by the concerned authorities.
    African Journal of Traditional, Complementary and Alternative Medicines 07/2014; 11(2):339-42. DOI:10.4314/ajtcam.v11i2.19 · 0.56 Impact Factor
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    • "There is considerable evidence about the important role of iron in cognitive, behavioral, and motor development (Beard 2001). It is a component of many enzymes involved in neurotransmitter synthesis, and in iron deficiency (ID), due to decreased activity of associated enzymes, monoamine neurotransmitter systems may be affected (McCann and Ames 2007). A decrease in brain iron concentration is accompanied by changes in serotonergic and dopaminergic systems, in cortical fiber conduction, and myelogenesis (Erikson et al. 2001). "
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    ABSTRACT: Association between Autism and Iron Deficiency in Autistic Children Al Ali S MSN, Alkaissi A PhD, Russo S PhD Faculty of Higher Studies Nursing and Midwifery Department An-Najah National University, Nablus-Palestine Background: Iron has an important role in cognitive, behavioral, and motor development. A high prevalence of iron deficiency (ID) has been reported in children with autism. Aim: is to investigate the association between autism and iron deficiency in autistic children in the northern West Bank and to identify food selectivity. Participant and Methods: 90 children with an age range of 3 to 13 years participated in a case control study distributed into study group and two control groups. Thirty children diagnosed with autism according to DSM-IV and ICD-10criteria served as a study group, 30 children with mental disorders other than autism served as a control group, and 30 typically developing children (normal children) taken from the public functioned as a second control group. Results: ID was detected in 20% (N = 6/30) of autistic children based on Serum ferritin level (SF< 10µ/l), compared with 0% for the two control groups (p= 0.0001). And iron deficiency anemia was 13.3% (4\30) for autistic group. It was found also that the frequency of low iron intake in these children was associated with feeding difficulties and food selectivity; there was a significant difference between children in the autistic group who chose foods with a red color as a favorite 23% (7/30) compared to the other two control groups: 0%, respectively (p= 0.0001). Conclusion: There is an association between autism, iron deficiency and anemia. Low levels of serum ferritin in autistic children might be a sign of iron deficiency and an early precursor of iron deficiency anemia. These findings suggest that food selectivity is more common in children with autism than in typically developing children. These findings suggest that ferritin levels should be measured in children with autism as a part of routine investigation. Keywords: Child, Autism, Mental disorder, typically developing children, Iron deficiency, Iron deficiency anemia, Ferritin.
    Middle Eastern Nurses & Partners Uniting in Human Caring, Aquaba, Jordan; 02/2014
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    • "In particular, data from the UK suggest that a large proportion of adolescent girls have iron intakes below the lowest reference nutrient intake [43] and the HELENA study assessing iron status in European adolescents biochemically, found a higher percentage of adolescent girls than boys to be iron depleted [44]. Iron deficiency can lead to short term health effects such as physical and mental tiredness and inability to concentrate [36], which can affect daily life and school performance, but can also result in long term effects on cognitive function [45], and thus is a public health concern. "
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    ABSTRACT: A balanced diet is fundamental for healthy growth and development of children. The aim of this study was to document and evaluate the dietary intake of Cypriot children aged 6-18 years (y) against recommendations, and to determine whether maternal education and children's weight status are associated with adherence to recommendations. The dietary intake of a random sample of 1414 Cypriot children was assessed using a 3-day food diary. Adherence to recommendations was estimated and the association of their mother's education and their own weight status on adherence were explored. A large percentage of children consumed less than the minimum of 45%en of carbohydrate (18.4%-66.5% in different age groups) and exceeded the recommended intakes of total fat (42.4%-83.8%), saturated fatty acids (90.4%-97.1%) and protein (65.2%-82.7%), while almost all (94.7%-100%) failed to meet the recommended fibre intake. Additionally, a large proportion of children (27.0%-59.0%) consumed >300 mg/day cholesterol and exceeded the upper limit of sodium (47.5%-78.5%). In children aged 9.0-13.9y, there was a high prevalence of inadequacy for magnesium (85.0%-89.9%), in girls aged 14.0-18.9y, of Vitamin A (25.3%),Vitamin B6 (21.0%) and iron (25.3%) and in boys of the same group, of Vitamin A (35.8%). Children whose mother was more educated were more likely to consume >15%en from protein, Odds Ratio (OR) 1.85 (95% CI:1.13-3.03) for mothers with tertiary education and exceed the consumption of 300 mg/day cholesterol (OR 2.13 (95% CI:1.29-3.50) and OR 1.84 (95% CI:1.09-3.09) for mothers with secondary and tertiary education respectively). Children whose mothers were more educated, were less likely to have Vitamin B1 (p<0.05) and Vitamin B6 intakes below the EAR (p < 0.05 for secondary school and p < 0.001 for College/University) and iron intake below the AI (p < 0.001). Overweight/obese children were more likely to consume >15%en protein (OR 1.85 (95% CI:1.26-2.71) and have a < Adequate Intake of calcium (OR 1.85 (95% CI:1.11-3.06). Cypriot children consume a low quality diet. Maternal education and children's' own weight status are associated with children's adherence to recommendations. Public health policies need to be evaluated to improve dietary quality and reduce disease burden.
    BMC Public Health 01/2014; 14(1):13. DOI:10.1186/1471-2458-14-13 · 2.26 Impact Factor
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