Dietary iron and iron deficiency anemia among adolescent girls from Benin

BACKGROUND: Iron deficiency anemia affects a large number of women in developing countries, especially during childbearing years. Few studies determined the association between estimated absorbable iron intakes and iron deficiency. METHODS: The association between dietary iron intake and iron status was studied in 100 adolescent girls aged 14-16 years from Benin. Fifty adolescents were boarding at the school, while 50 lived at home. Biochemical indices of iron status included: hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration, serum iron, total iron-binding capacity and % transferrin saturation. Dietary intakes were obtained by two 24-hour recalls and absorbable iron intakes were estimated using Monsen's model. The probability approach was used to estimate inadequacy in iron intake. RESULTS: While 73% of adolescents met the recommendations for dietary iron intake, only 27% had estimated absorbable iron intake above the average requirement for absorbed iron. Non-heme iron represented 97.2% of the total iron intake. Forty three percent of subjects were anemic (hemoglobin<120 g/l). Iron deficiency defined by a four-model index based on > or =2 abnormal values in the four independent indicators of iron status used (serum iron, total iron-binding capacity, mean corpuscular volume, mean corpuscular hemoglobin concentration) was present in 14% of the subjects, while 13% had iron deficiency anaemia (hemoglobin<120 g/l+four-model index). Using a multiple regression analysis, total absorbable iron intakes (including iron supplements) were highly and positively associated with hemoglobin and hematocrit concentrations (P=0.000001 and P=0.00007 respectively). CONCLUSION: In this group of adolescents, total absorbable iron intakes were related to iron deficiency. Efforts should be made to increase the heme iron content of the diet and the bioavailability of non-heme iron by promoting affordable local foods rich in iron and promoters of iron absorption (Vitamin C and meat, poultry and fish factor).     

Oxidative stress in older patients with iron deficiency anaemia

We propose that oxidative damage may play a role in the pathogenesis of iron deficiency anaemia (IDA). Participants were selected from Basic Attention Ambulatory from North of Rio Grande do Sul, Brazil. All subjects were older than 65 years — 17 patients with IDA and primary hypertension and 18 patients with primary hypertension (control group) were included in the present study. We measured antioxidant defenses including superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), and total glutathione (GSH) by spectrophotometric assays. We also determined protein oxidative damage in haemolysate and plasma by carbonyl assay. We characterized the lipid peroxidation by malondialdehyde (MDA) accumulation. The results show that IDA patients had significantly higher CAT and SOD levels than controls. GPx activity was not different between the groups. Oxidative protein damage was noted in the plasma but not in the haemolysate. A significantly enhanced production of MDA was observed in the serum of IDA patients, as an indication of increased level of auto-oxidizable lipids under oxidative stress. These results support the idea that patients with IDA are subjected to chronic oxidative stress. Therefore it is important that IDA in older persons receives adequate attention in clinical practice and is not considered simply a part of normal aging.     

Dietary treatment of iron deficiency in women of childbearing age.

BACKGROUND: The Australian Iron Status Advisory Panel advocates dietary intervention as the first treatment option for mild iron deficiency [serum ferritin (SF) = 10-15 microg/L]. However, there appear to be no studies on the efficacy of dietary treatment for iron deficiency. OBJECTIVE: We compared the effects of iron supplementation and of a high-iron diet on serum ferritin (SF) and hemoglobin in iron-deficient women of childbearing age. DESIGN: Forty-four iron-deficient women (SF <15 microg/L or SF = 15-20 microg/L plus serum iron <10 micromol/L and total-iron-binding capacity >68 micromol/L) and 22 iron-replete women (hemoglobin > or =120 g/L and SF >20 microg/L) matched for age and parity categories were enrolled and completed 7-d weighed food records at baseline. The iron-deficient women were randomly allocated to receive iron supplementation (105 mg/d; supplement group) or a high-iron diet (recommended intake of absorbable iron: 2.25 mg/d; diet group) for 12 wk. Hematologic and dietary assessments were repeated at the end of the intervention and again after a 6-mo follow-up. RESULTS: Mean SF in the supplement group increased from 9.0 +/- 3.9 microg/L at baseline to 24.8 +/- 10.0 microg/L after the intervention and remained stable during follow-up (24.2 +/- 9.8 microg/L), whereas the diet group had smaller increases during the intervention (8.9 +/- 3.1 to 11.0 +/- 5.9 microg/L) but continued to improve during follow-up (to 15.2 +/- 9.5 microg/L). Mean hemoglobin tended to improve in both intervention groups, but the change was only significant in the supplement group. CONCLUSIONS: In iron-deficient women of childbearing age, a high-iron diet produced smaller increases in SF than did iron supplementation but resulted in continued improvements in iron status during a 6-mo. follow-up.     

The potential pitfall of attributing iron deficiency anaemia to ulceration in a Barrett's oesophagus.

We report a 58-year-old man with recurrent ulceration in a Barrett's oesophagus whose iron-deficiency anaemia was in fact due to a caecal carcinoma. Recent reports suggest an association between these two disorders. A Barrett's oesophagus should not be blamed for iron deficiency unless neoplasms of the colon have been excluded.