Nutritional iron deficiency. Lancet

Wageningen University, Wageningen, Gelderland, Netherlands
The Lancet (Impact Factor: 45.22). 09/2007; 370(9586):511-20. DOI: 10.1016/S0140-6736(07)61235-5
Source: PubMed


Iron deficiency is one of the leading risk factors for disability and death worldwide, affecting an estimated 2 billion people. Nutritional iron deficiency arises when physiological requirements cannot be met by iron absorption from diet. Dietary iron bioavailability is low in populations consuming monotonous plant-based diets. The high prevalence of iron deficiency in the developing world has substantial health and economic costs, including poor pregnancy outcome, impaired school performance, and decreased productivity. Recent studies have reported how the body regulates iron absorption and metabolism in response to changing iron status by upregulation or downregulation of key intestinal and hepatic proteins. Targeted iron supplementation, iron fortification of foods, or both, can control iron deficiency in populations. Although technical challenges limit the amount of bioavailable iron compounds that can be used in food fortification, studies show that iron fortification can be an effective strategy against nutritional iron deficiency. Specific laboratory measures of iron status should be used to assess the need for fortification and to monitor these interventions. Selective plant breeding and genetic engineering are promising new approaches to improve dietary iron nutritional quality.

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    • "Our findings further support that iron deficiency is the most common cause for anemia in Nepalese children as indicated by poor iron status indicators in anemic children. Besides the lack of adequate iron in diet, other chronic conditions like hook worm infestation , malaria and genetic factors also contribute to high prevalence of anemia in developing countries[18].The data is expressed as mean ± SD except for UIE and TSH (expressed as median with IQR). P value was calculated at 95 % confidence interval "
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    ABSTRACT: Background Deficiencies of iodine and iron may have adverse effect on thyroid function. This study was undertaken to investigate the association between iron status and thyroid function in Nepalese children living in hilly regions. Methods A cross-sectional study was conducted among 227 school children aged 6–12 years living in hilly regions of eastern Nepal. Urine and blood samples were analyzed for urinary iodine concentration, free thyroxine, free triiodothyronine, thyroid stimulating hormone, hemoglobin, serum iron and total iron binding capacity, and percentage transferrin saturation was calculated. Results The cohort comprised euthyroid (80.6 %, n = 183), overt hypothyroid (1.3 %, n = 3), subclinical hypothyroid (16.3 %, n = 37) and subclinical hyperthyroid (1.8 %, n = 4) children respectively. About 35.2 % (n = 80) children were anemic, 43.6 % (n = 99) were iron deficient and 19.8 % (n = 45) had urinary iodine excretion < 100 μg/L. Hypothyroidism (overt and subclinical) was common in anemic and iron deficient children. The relative risk of having hypothyroidism (overt and subclinical) in anemic and iron deficient children was 5.513 (95 % CI: 2.844−10.685, p < 0.001) and 1.939 (95 % CI: 1.091-3.449, p = 0.023) respectively as compared to non-anemic and iron sufficient children. Thyroid stimulating hormone had significant negative correlation with hemoglobin (r = −0.337, p < 0.001) and transferrin saturation (r = −0.204, p = 0.002). Conclusions Thyroid dysfunction, iron deficiency and anemia are common among Nepalese children. In this cohort, anemic and iron deficient children had poor thyroid function.
    Full-text · Article · Dec 2016 · Thyroid Research
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    • "Iron deficiency anaemia is the most common nutritional disorder prevalent both in developed and developing countries particularly in pregnant women of developing countries (WHO, 2001). This is due to iron deficit intake of diet that could not meet the increased iron demand for the developing foetus (Zimmermann and Hurrell, 2007). According to World Health Organization (WHO, 2001) around 2 billion people who count approximately 30% of the world population is anaemic; pregnant women contributes approximately 41.8% of this anaemic polulation (De Benoist et al., 2008). "
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    ABSTRACT: Anaemia during pregnancy is most commonly observed and highly prevalent in South-East Asia. Various effective programmes have been laid down for its management, mainly daily supplementation of iron folic acid (IFA) tablets. Following the same, standard obstetrical practice has included the IFA supplementation without requiring the determination of iron deficiency. In this study, a total of 120 primigravida (N=60; non-anaemic (Hb > 11 g/dl) and N=60 anaemic (Hb = 8-11 g/ dl)) were selected amongst those attending the Antenatal Clinic in Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India. They were supplemented with daily and weekly IFA tablets till six weeks postpartum. Corresponding changes in haemoglobin level on advance of pregnancy, side effects and compliance associated with daily and weekly IFA supplementation and its associations with iron status markers were studied. The inflammatory markers were also estimated. The statistical significance level (p <0.05) between the groups were assessed by applying unpaired t-test using SPSS (version 16.0). The obtained results publicized the salutary role of daily IFA supplementation in improving the haemoglobin level and iron status markers in anaemic pregnant women though the levels could not reached up to the non-anaemic haemoglobin levels. However, weekly IFA supplementation seems to be a better approach in non-anaemic pregnant women where almost comparable results were obtained in terms of haematological parameters, gestation length and birth weight.
    Full-text · Article · Sep 2015 · Saudi Journal of Biological Sciences
    • "Food fortification is generally recognised as a good strategy to counteract this nutritional deficiency; there is a large body of evidence indicating its efficacy, and it is regarded as the most costeffective long-term strategy (Baltussen, Knai, & Sharan, 2004; Zimmermann & Hurrell, 2007). For an iron fortification programme to be effective, it is essential that the form of iron selected be highly bioavailable. "
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    ABSTRACT: Fortification of food products with iron is a common strategy to prevent or overcome iron deficiency. However, any form of iron is a pro-oxidant and its addition will cause off-flavours and reduce a product's shelf life. A highly bioavailable heme iron ingredient was selected to fortify a chocolate cream used to fill sandwich-type cookies. Two different strategies were assessed for avoiding the heme iron catalytic effect on lipid oxidation: ascorbyl palmitate addition and co-spray-drying of heme iron with calcium caseinate. Oxidation development and sensory acceptability were monitored in the cookies over one-year of storage at room temperature in the dark. The addition of ascorbyl palmitate provided protection against oxidation and loss of tocopherols and tocotrienols during the preparation of cookies. In general, ascorbyl palmitate, either alone or in combination with the co-spray-dried heme iron, prevented primary oxidation and hexanal formation during storage. The combination of both strategies resulted in cookies that were acceptable from a sensory point of view after 1 year of storage.
    No preview · Article · Sep 2015 · Food Chemistry
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