scholarly journals Iron deficiency in Europe

2001 ◽  
Vol 4 (2b) ◽  
pp. 537-545 ◽  
Author(s):  
Serge Hercberg ◽  
Paul Preziosi ◽  
Pilar Galan
Keyword(s):  
Iron Deficiency ◽  
Iron Absorption ◽  
Blood Donation ◽  
Iron Status ◽  
Dietary Factors ◽  
Iron Nutrition ◽  
Dietary Recommendations ◽  
Iron Stores ◽  
Iron Deficient ◽  
Menstruating Women

AbstractIn Europe, iron deficiency is considered to be one of the main nutritional deficiency disorders affecting large fractions of the population, particularly such physiological groups as children, menstruating women and pregnant women. Some factors such as type of contraception in women, blood donation or minor pathological blood loss (haemorrhoids, gynaecological bleeding,..) considerably increase the difficulty of covering iron needs. Moreover, women, especially adolescents consuming lowenergy diets, vegetarians and vegans are at high risk of iron deficiency.Although there is no evidence that an anbsence of iron stores has any adverse consequences, it does indicate that iron nutrition is borderline, since any further reduction in body iron is associated with a decrease in the level of functional compounds such as haemoglobin.The prevalence of iron-deficient anaemia has slightly decreased in infants and menstruating women. Some positive factors may have contributed to reducing the prevalence of iron-deficiency anaemia in some groups of population: the use of iron-frotified formulas and iron-fortified cereals; the use of oral contraceptives and increased enrichment of iron in several countries; and the use of iron supplements during pregnancy in some European countries.It is possible to prevent and control iron deficiency by counseling individuals and families about sound iron nutrition during infancy and beyond, and about iron supplementation during pregnancy, by screening persons on the basis of their risk for iron deficiency, and by treating and following up persons with presumptive iron deficiency. This may help to reduce manifestations of iron deficiency and thus improve public health. Evidence linking iron status with risk of cardiovascular disease or cancer is unconvincing and does not justify changes in food fortification or medical practice, particularly because the benefits of assuring adequate iron intake during growth and development are well established. But stronger evidence is needed before rejecting the hypothesis that greater iron stores increase the incidence of CVD or cancer. At present, currently available data do not support radical changes in dietary recommendations. They include all means for increasing the content of dietary factors enhancing iron absorption or reducing the content of factors inhibiting iron absorption. Increased knowledge and increased information about factors may be important tools in the prevention of iron deficiency in Europe.

Importance of iron absorption in human health: An overview

2020 ◽  
Vol 16 ◽  
Author(s):  
Satya Prasad Dixit ◽  
Logesh Rajan ◽  
Dhanabal Palaniswamy ◽  
Suresh Kumar Mohankumar
Keyword(s):  
Iron Deficiency ◽  
Human Health ◽  
Genetic Factors ◽  
Iron Absorption ◽  
Iron Status ◽  
Essential Elements ◽  
Iron Bioavailability ◽  
Dietary Factors ◽  
Dietary Recommendations ◽  
Ferritin Concentration

: Iron is one of the essential elements required for human health, as it plays a vital role in a number of metabolic, growth and developmental processes, including erythropoiesis, DNA synthesis, electron transport and others. Iron deficiency is a concern in both developing and developed (industrialized) countries, and in particular young women are highly vulnerable. This review investigates dietary and genetic determinants of iron metabolism in the human body and a possible solution to combat the iron deficiency by exploring via various targets. Hence, this review mainly focuses on the assessment of dietary and genetic factors affecting the iron bioavailability and homeostasis and collates the available information from 2000 to till date from Pubmed. The dietary factors including ascorbic acid an important factor in animal protein foods (meat, fish and poultry) enhance iron absorption whereas the phytic acid, soy protein, calcium and polyphenols have been reported to inhibit iron absorption. However, the effects of these dietary factors on iron absorption do not necessarily translate into an association with iron status and iron stores (serum ferritin concentration). Moreover, the genetic factors influence the absorption of iron involving HFE, TFR2, FPN1 and HAMP in humans. Further research is needed to determine optimal dietary recommendations for both the prevention and treatment of iron deficiency.

scholarly journals Evaluation of the iron status of a population

Blood ◽  
1976 ◽  
Vol 48 (3) ◽  
pp. 449-455 ◽  
Author(s):  
JD Cook ◽  
CA Finch ◽  
NJ Smith
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Red Cell ◽  
Adult Males ◽  
Packed Red Blood Cells ◽  
Iron Deficient ◽  
Menstruating Women ◽  
Prevalence Of Anemia

Abstract The iron status of a population of 1564 subjects living in the northwestern United States was evaluated by measurements of transferrin saturation, red cell protoporphyrin, and serum ferritin. The frequency distribution of these parameters showed no distinct separation between normal and iron-deficient subjects. When only one of these three parameters was abnormal (transferrin saturation below 15%, red cell protoporphyrin above 100 mug/ml packed red blood cells, serum ferritin below 12 ng/ml), the prevalence of anemia was only slightly greater (10.9%) than in the entire sample (8.3%). The prevalence of anemia was increased to 28% in individuals with two or more abnormal parameters, and to 63% when all three parameters were abnormal. As defined by the presence of at least two abnormal parameters, the prevalence of iron deficiency in various populations separated on the basis of age and sex ranged from 3% in adolescent and adult males to 20% in menstruating women. It is concluded that the accuracy of detecting iron deficiency in population surveys can be substantially improved by employing a battery of laboratory measurements of the iron status.

scholarly journals Utility of serum ferritin as a measure of iron deficiency in normal males undergoing repetitive phlebotomy

Blood ◽  
1980 ◽  
Vol 56 (5) ◽  
pp. 786-791 ◽  
Author(s):  
RA Jacob ◽  
HH Sandstead ◽  
LM Klevay ◽  
LK Johnson
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Iron Absorption ◽  
Iron Status ◽  
Normal Male ◽  
Controlled Environment ◽  
Mixed Diet ◽  
Iron Stores ◽  
Normal Males ◽  
Normal Men

Abstract Hematologic indices and iron balance data were obtained on 22 normal male volunteers who were subjected to a mean +/- SD phlebotomy of 164 +/- 34 ml whole blood/mo while living in a controlled environment. Over an average stay of 5 mo, volunteers did not develop anemia, but did display a reduction in iron stores that was quantitated by measurement of serum ferritin and iron balance. The percent saturation of transferrin and the usual erythrocyte parameters did not reflect changes in iron status. Loss of iron, which was calculated from quantitative phlebotomy and iron balance data, showed that a decrease of 1 ng of serum ferritin represented a loss of 4.5 +/- 5.3 mg of iron in 10 men whose initial serum ferritins were greater than 25 ng/ml, and 25.3 +/- 58.8 mg of iron in 7 men whose initial serum ferritins were less than 25 ng/ml. The period required for 3 volunteers who consumed a self-selected mixed diet at home to replace their depleted iron stores to prephlebotomy levels was about 4.5 mo. The sensitivity of serum ferritin as an index of iron stores was affirmed. In addition it was found that normal men who were consuming a mixed diet containing about 15 mg of iron daily and losing blood at a rate of 164 +/- 34 ml/mo did not increase their iron absorption sufficiently to compensate for the iron loss.

scholarly journals Utility of serum ferritin as a measure of iron deficiency in normal males undergoing repetitive phlebotomy

Blood ◽  
1980 ◽  
Vol 56 (5) ◽  
pp. 786-791
Author(s):  
RA Jacob ◽  
HH Sandstead ◽  
LM Klevay ◽  
LK Johnson
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Iron Absorption ◽  
Iron Status ◽  
Normal Male ◽  
Controlled Environment ◽  
Mixed Diet ◽  
Iron Stores ◽  
Normal Males ◽  
Normal Men

Hematologic indices and iron balance data were obtained on 22 normal male volunteers who were subjected to a mean +/- SD phlebotomy of 164 +/- 34 ml whole blood/mo while living in a controlled environment. Over an average stay of 5 mo, volunteers did not develop anemia, but did display a reduction in iron stores that was quantitated by measurement of serum ferritin and iron balance. The percent saturation of transferrin and the usual erythrocyte parameters did not reflect changes in iron status. Loss of iron, which was calculated from quantitative phlebotomy and iron balance data, showed that a decrease of 1 ng of serum ferritin represented a loss of 4.5 +/- 5.3 mg of iron in 10 men whose initial serum ferritins were greater than 25 ng/ml, and 25.3 +/- 58.8 mg of iron in 7 men whose initial serum ferritins were less than 25 ng/ml. The period required for 3 volunteers who consumed a self-selected mixed diet at home to replace their depleted iron stores to prephlebotomy levels was about 4.5 mo. The sensitivity of serum ferritin as an index of iron stores was affirmed. In addition it was found that normal men who were consuming a mixed diet containing about 15 mg of iron daily and losing blood at a rate of 164 +/- 34 ml/mo did not increase their iron absorption sufficiently to compensate for the iron loss.

The TMPRSS6 Ala736 Val Polymorphism Is Associated With Decreased Hemoglobin and Iron Status In Females Undergoing Repeated Phlebotomy

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 787-787 ◽  
Author(s):  
Alan E. Mast ◽  
John C Langer ◽  
Walter Bialkowski ◽  
Simone Glynn ◽  
Tzong-Hae Lee ◽  
...  
Keyword(s):  
Blood Donors ◽  
Iron Absorption ◽  
Blood Donation ◽  
Iron Status ◽  
Dietary Iron ◽  
Body Iron ◽  
Iron Stores ◽  
First Time ◽  
Average Body ◽  
Average Hemoglobin

Abstract Background Iron depletion and deferral for low hemoglobin occur rapidly in some donors while others can repeatedly donate without deferral. This variation may be partly explained by significant genetic differences that affect regulation of dietary iron absorption and/or hemoglobin level following blood donation. Previous studies have found that the C282Y and H63D hemochromatosis mutations do not improve dietary iron absorption following donation. TMPRSS6 is a membrane-associated serine protease that degrades hemojuvelin, thereby decreasing hepcidin production with consequent increase in dietary iron absorption. Its physiological importance is best demonstrated by the development of iron resistant iron deficiency anemia in those with TMPRSS6 mutations. A common TMPRSS6 polymorphism, A736V (rs855791), is associated with lower hemoglobin, MCV and transferrin saturation. Its correlation with iron status and hemoglobin production was examined in blood donors undergoing repeated phlebotomy. Methods Three sample sets from blood donors with well-characterized demographics, blood donation history, hemoglobin and iron parameters enrolled in the approximately 2-year longitudinal Retrovirus Epidemiology Donor Study-II (REDS-II) Iron Status Evaluation Study (RISE) were selected from the NHLBI BioLINCC repository: (Set 1) a random sample of 200 male and 200 female first-time donors and donors reactivated at study enrollment (no donations for 2 years); (Set 2) 114 first-time females who became “frequent” donors by donating at least 4 times in a 2-year period; and (Set 3) 33 repeat male donors, who were deferred for low hemoglobin during the study. Genetic testing for the TMPRSS6 A736V polymorphism was performed on donors in all 3 sets. Variation of hemoglobin and iron status among genotypes, adjusted for donor age, weight, race/ethnicity, number of donations in the previous 12 months and length of time between donations, was assessed using linear models. Results Genotypic frequencies in Set 1 were 40% AA, 42% A/V and 18% VV. The prevalence was not statistically different in the other two sets of donors, although there was a trend for higher prevalence of VV (30%) in Set 3. Hemoglobin, log-transformed ferritin and body iron stores (calculated based on ferritin and soluble transferring receptor) varied among TMPRSS6 genotypes in females but not in males. For females, average hemoglobin was 0.75 and 0.53 g/dL higher in AA (p<0.0001) and A/V (p=0.0057) than in VV. Average ferritin was 75% and 53% higher in AA (p=0.0024) and A/V (p=0.022) than in VV. Average body iron stores were 2.2 mg/kg and 1.8 mg/kg higher in AA (p=0.0045) and AV (p=0.022) than in VV. For males, average hemoglobin was only 0.13 g/dL higher in AA (p=0.47) and 0.035 g/dL lower in A/V (p=0.83) than in VV. Average ferritin was only 15% higher in AA (p=0.46) and was 8% lower in A/V (p=0.83) than in VV. Average body iron stores were 0.84 mg/kg higher in AA (p=0.10) and 0.15 mg/kg lower in A/V (p=0.75) than in VV. Due to the differences found in females, the longitudinal models were repeated using Set 2 subjects, which confirmed a significant association of the TMPRSS6 polymorphism with hemoglobin in females; 0.50 and 0.35 g/dL higher in AA (p<0.0037) and A/V (p=0.0255) than in VV. However, trends for effects on ferritin and body iron stores did not reach significance. Plasma hepcidin values were also available for Set 2 subjects, but significant differences among TMPRSS6 genotypes were not found. Conclusions The A736V TMPRSS6 polymorphism is associated with significant differences in hemoglobin and iron status of first-time female blood donors after undergoing iron loss from repeated phlebotomy. The apparent difference between males and females in variation among genotypes may be the result of greater baseline iron depletion in females rather than a gender difference per se. This is the first demonstration of an association between a common polymorphism of iron metabolism and altered individual responses to blood donation. The findings are consistent with a model in which the TMPRSS6 genotypes differ in proteolytic activity towards hemojuvelin, thereby altering hepcidin production and dietary iron absorption in otherwise healthy, but iron depleted individuals. Disclosures: Mast: Novo Nordisk: Honoraria, Research Funding.

Pharmacokinetics of pulmonary manganese absorption: evidence for increased susceptibility to manganese loading in iron-deficient rats

2005 ◽  
Vol 288 (5) ◽  
pp. L887-L893 ◽  
Author(s):  
Elizabeth Heilig ◽  
Ramon Molina ◽  
Thomas Donaghey ◽  
Joseph D. Brain ◽  
Marianne Wessling-Resnick
Keyword(s):  
Iron Deficiency ◽  
Iron Absorption ◽  
Iron Status ◽  
Mrna Levels ◽  
Blood Clearance ◽  
Divalent Metal Transporter 1 ◽  
Divalent Metal Transporter ◽  
Pulmonary Uptake ◽  
Iron Deficient ◽  
Metal Absorption

High levels of airborne manganese can be neurotoxic, yet little is known about absorption of this metal via the lungs. Intestinal manganese uptake is upregulated by iron deficiency and is thought to be mediated by divalent metal transporter 1 (DMT1), an iron-regulated factor known to play a role in dietary iron absorption. To better characterize metal absorption from the lungs to the blood and test whether iron deficiency may modify this process, the pharmacokinetics of pulmonary manganese and iron absorption by control and iron-deficient rats were compared. Levels of DMT1 expression in the lungs were determined to explore potential changes induced by iron deficiency that might alter metal absorption. The pharmacokinetic curves for intratracheally instilled54Mn and59Fe were significantly different, suggesting that pulmonary uptake of the two metals involves different mechanisms. Intratracheally instilled iron-deficient rats had significantly higher blood54Mn levels, whereas blood59Fe levels were significantly reduced compared with controls. The same trend was observed when radioisotopes were delivered by intravenous injection, indicating that iron-deficient rats have altered blood clearance of manganese. In situ analysis revealed the presence of DMT1 transcripts in airway epithelium; however, mRNA levels did not change in iron deficiency. Although lung DMT1 levels and metal absorption did not appear to be influenced by iron deficiency, the differences in blood clearance of instilled manganese identified by this study support the idea that iron status can influence the potential toxicity of this metal.

scholarly journals Evaluation of the iron status of a population

Blood ◽  
1976 ◽  
Vol 48 (3) ◽  
pp. 449-455 ◽  
Author(s):  
JD Cook ◽  
CA Finch ◽  
NJ Smith
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Red Cell ◽  
Adult Males ◽  
Packed Red Blood Cells ◽  
Iron Deficient ◽  
Menstruating Women ◽  
Prevalence Of Anemia

The iron status of a population of 1564 subjects living in the northwestern United States was evaluated by measurements of transferrin saturation, red cell protoporphyrin, and serum ferritin. The frequency distribution of these parameters showed no distinct separation between normal and iron-deficient subjects. When only one of these three parameters was abnormal (transferrin saturation below 15%, red cell protoporphyrin above 100 mug/ml packed red blood cells, serum ferritin below 12 ng/ml), the prevalence of anemia was only slightly greater (10.9%) than in the entire sample (8.3%). The prevalence of anemia was increased to 28% in individuals with two or more abnormal parameters, and to 63% when all three parameters were abnormal. As defined by the presence of at least two abnormal parameters, the prevalence of iron deficiency in various populations separated on the basis of age and sex ranged from 3% in adolescent and adult males to 20% in menstruating women. It is concluded that the accuracy of detecting iron deficiency in population surveys can be substantially improved by employing a battery of laboratory measurements of the iron status.

Proton Pump Inhibitor Use and the Ability to Replete Iron Stores

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 1039-1039
Author(s):  
Alina M Huang ◽  
Christine M Ho ◽  
John L. Reagan ◽  
Eric Winer
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Proton Pump ◽  
Iron Absorption ◽  
Oral Iron ◽  
Deficiency Anemia ◽  
Care Clinic ◽  
Iron Stores ◽  
Iron Deficient ◽  
Iron Replacement

Abstract Abstract 1039 Background: Oral iron absorption occurs in the duodenum and requires increased gastric acidity to allow iron to remain in the more soluble, ferrous form. Many patients with iron deficiency anemia who require oral iron repletion are on proton pump inhibitors (PPIs) for management of various conditions that require acid suppression for treatment. In vitro studies suggest that inhibition of gastric acid secretion decreases the bioavailability of iron. In patients with established iron deficiency anemia who are on PPIs, there is a paucity of data regarding the efficacy of iron replacement with concomitant PPI use. Sharma et al. published a case report on 2 patients who were iron deficient and on PPI therapy (Sharma et. al. Southern Medical Journal 2004). Their findings showed that discontinuation of the PPI resulted in improvement of iron deficiency anemia on the same dose of oral iron replacement. Additionally, Hutchinson et al. demonstrated that in individuals with hereditary hemachromatosis, those on PPIs had a significant reduction in phlebotomy requirements needed to keep serum ferritin ∼50μg (Hutchinson et. al. Gut 2007). We conducted a retrospective study to assess whether a difference exists in terms of iron repletion between patients on a PPI versus those not on a PPI. Methods: Patients were selected from the medical primary care clinic from charts dating January 2000 until January 2009. Included patients were adults older than 18 years of age, a diagnosis of iron deficiency based on ferritin < 30 with at least one follow up ferritin value, and recipients of oral iron replacement. Excluded patients were those with chronic active bleeding and anemia of chronic disease. Indices examined include iron (Fe), total iron binding capacity (TIBC), ferritin, transferrin saturation, hemoglobin (Hb), hematocrit (Hct), and mean corpuscular volume (MCV). The primary endpoint of interest is repletion of iron stores defined by ferritin > 30. Those who were able to replete their iron stores are termed “responders” and those who were not are termed “nonresponders”. Results: Forty-five patients have been identified who have met the above criteria. Of these patients, 14 were on a PPI and 31 were not on a PPI. Of the patients not on a PPI, 38.7% responded to oral iron. Of the patients on a PPI, 50.0% responded to oral iron. The average initial and final values of indices of interest were compared between the groups (Table 1). Discussion: Our data suggests that patients both on and off PPIs show the ability to replete their iron stores. Furthermore, it appears that a slightly greater percentage of patients on a PPI compared with those not on a PPI are able to replete their iron stores, though the numbers remain small. Most importantly, these findings challenge the commonly held belief that PPI use impairs oral iron absorption. A prospective study is warranted to further confirm these observational data. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Consumption of a Double-Fortified Salt Affects Perceptual, Attentional, and Mnemonic Functioning in Women in a Randomized Controlled Trial in India

2017 ◽  
Vol 147 (12) ◽  
pp. 2297-2308 ◽  
Author(s):  
Michael J Wenger ◽  
Laura E Murray-Kolb ◽  
Julie EH Nevins ◽  
Sudha Venkatramanan ◽  
Gregory A Reinhart ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Status ◽  
Controlled Trial ◽  
Reproductive Age ◽  
Deficiency Anemia ◽  
Control Group ◽  
Attention And Memory ◽  
Double Blind ◽  
Iron Deficient ◽  
Mnemonic Function

Abstract Background: Iron deficiency and iron deficiency anemia have been shown to have negative effects on aspects of perception, attention, and memory. Objective: The purpose of this investigation was to assess the extent to which increases in dietary iron consumption are related to improvements in behavioral measures of perceptual, attentional, and mnemonic function. Methods: Women were selected from a randomized, double-blind, controlled food-fortification trial involving ad libitum consumption of either a double-fortified salt (DFS) containing 47 mg potassium iodate/kg and 3.3 mg microencapsulated ferrous fumarate/g (1.1 mg elemental Fe/g) or a control iodized salt. Participants' blood iron status (primary outcomes) and cognitive functioning (secondary outcomes) were assessed at baseline and after 10 mo at endline. The study was performed on a tea plantation in the Darjeeling district of India. Participants (n = 126; 66% iron deficient and 49% anemic at baseline) were otherwise healthy women of reproductive age, 18–55 y. Results: Significant improvements were documented for iron status and for perceptual, attentional, and mnemonic function in the DFS group (percentage of variance accounted for: 16.5%) compared with the control group. In addition, the amount of change in perceptual and cognitive performance was significantly (P < 0.05) related to the amount of change in blood iron markers (mean percentage of variance accounted for: 16.0%) and baseline concentrations of blood iron markers (mean percentage of variance accounted for: 25.0%). Overall, there was evidence that the strongest effects of change in iron status were obtained for perceptual and low-level attentional function. Conclusion: DFS produced measurable and significant improvements in the perceptual, attentional, and mnemonic performance of Indian female tea pickers of reproductive age. This trial was registered at clinicaltrials.gov as NCT01032005.

The influence of high-altitude living on body iron

Blood ◽  
2005 ◽  
Vol 106 (4) ◽  
pp. 1441-1446 ◽  
Author(s):  
James D. Cook ◽  
Erick Boy ◽  
Carol Flowers ◽  
Maria del Carmen Daroca
Keyword(s):  
Standard Error ◽  
Transferrin Receptor ◽  
Quantitative Assessment ◽  
Iron Status ◽  
Dietary Iron ◽  
Body Iron ◽  
Iron Stores ◽  
Iron Deficient ◽  
Iron Based ◽  
Maternal Iron

Abstract The quantitative assessment of body iron based on measurements of the serum ferritin and transferrin receptor was used to examine iron status in 800 Bolivian mothers and one of their children younger than 5 years. The survey included populations living at altitudes between 156 to 3750 m. Body iron stores in the mothers averaged 3.88 ± 4.31 mg/kg (mean ± 1 SD) and 1.72 ± 4.53 mg/kg in children. No consistent effect of altitude on body iron was detected in children but body iron stores of 2.77 ± 0.70 mg/kg (mean ± 2 standard error [SE]) in women living above 3000 m was reduced by one-third compared with women living at lower altitudes (P &lt; .001). One half of the children younger than 2 years were iron deficient, but iron stores then increased linearly to approach values in their mothers by 4 years of age. When body iron in mothers was compared with that of their children, a striking correlation was observed over the entire spectrum of maternal iron status (r = 0.61, P &lt; .001). This finding could provide the strongest evidence to date of the importance of dietary iron as a determinant of iron status in vulnerable segments of a population. (Blood. 2005;106:1441-1446)

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