Tolerance and efficacy of intravenous iron saccharate for iron deficiency anemia in children and adolescents receiving long-term parenteral nutrition

The aim of this study was to evaluate the safety and efficacy of intravenous iron saccharate administration in iron-deficient anemic children, under long-term parenteral nutrition, who are unable to tolerate oral iron supplementation or are unresponsive to oral supplementation because of gastrointestinal dysfunction or iron malabsorption. METHODS: Twenty-two infants and children aged 5 months-17 years (median: 38 months) receiving long-term parenteral nutrition and presenting with iron deficiency anemia were included. Total iron to be infused was determined by the formula: total iron (mg) = 0.6 x W (100 - Hb x 100/12) (W: weight, Hb: hemoglobin). Intravenous iron saccharate was given at the hospital. Each patient received a test dose of 25 mg of iron saccharate prior to the initiation of the infusion. Hemoglobin values, reticulocytes count, serum iron, and serum ferritin were determined before iron administration (day 1), as well as 15 and 45 days after iron administration. RESULTS: Tolerance of intravenous iron saccharate was good except in one patient who developed transient exanthema and hypotension after completion of the last iron saccharate infusion. Intravenous iron led to a significative increase in hemoglobin concentration of 2.2 g/dl within 45 days (range: 0.4-4.3 g/dl). CONCLUSION: Intravenous iron supplementation with iron saccharate is an efficient procedure, replenishing iron body stores and significantly increasing the hemoglobin concentration. The possible occurrence of allergic reactions emphasizes the need for close medical supervision.     

Diet and genetic factors associated with iron status in middle-aged women

BACKGROUND: Gene mutations associated with iron overload have been identified. How food and nutrient intakes affect iron status in persons who may be at risk of iron overload because their genetic status is unknown. OBJECTIVE: The objective was to determine the relation between food and nutrient intakes, HFE genotype, and iron status. Foods and nutrients associated with iron stores, with adjustment for gene mutations associated with hemochromatosis, were explored. DESIGN: A prospective cohort of women aged 35-69 y (the UK Women's Cohort Study) provided information on diet through a questionnaire and food diary; 6779 women in the cohort provided cheek cell samples, blood samples, or both, which were genotyped for C282Y and H63D mutations, and 2489 women also had their iron status assessed. Relations between serum ferritin and iron intake were investigated by using multiple linear regression, with adjustment for potential confounders. RESULTS: The strongest dietary association with serum ferritin concentration was a positive association with heme iron and not with nonheme or total iron. Weaker positive associations were seen with red and white meat, and negative associations were seen with total energy and white and brown whole-meal bread, independent of genotype and other potential confounders. The effect of genotype on ferritin concentrations primarily occurred after menopause, at which time a strong interaction between genotype and heme iron intake was observed. Other factors associated with serum ferritin concentrations were age, body mass index, blood donation, menopausal status, and HFE genotype. CONCLUSIONS: Postmenopausal women eating a diet rich in heme iron and who were C282Y homozygotes had the highest serum ferritin concentrations.     

Effect of nutrition education and diet modification in iron depleted preschool children in nurseries in Tehran: a pilot study

In view of the high prevalence of iron deficiency in preschool children and its consequences, this study was carried out to examine the effect of nutrition education and dietary modification on 438 two- to six-year-old nursery school children in Tehran in 1999. Sixty-two children who were judged anemic, iron-depleted, or having low iron stores were randomly allocated to "control," "dietary modification" (consuming one additional citrus fruit after lunch), and "nutrition education" (teaching the mothers proper eating patterns based on the food pyramid) groups. Food habits were surveyed, including 24-hour dietary recall and food frequency, as well as timing of consumption of special items; this survey was carried out for each child before and after intervention. After three months, blood samples were taken from the subjects. The prevalence of anemia, iron depletion, and low iron stores was 11.4, 62.8, and 15.1% respectively, with no significant differences observed in hemoglobin and percent transferrin saturation (%TS) between the groups. Mean+/-SD serum ferritin concentrations in "control," "diet modification," and "nutrition education" groups were 8.9+/-3.1, 9.5+/-3.7, and 6.9+/-2.3 microg/dL. The same figures at the end of intervention were 6.9+/-3.5, 11.2+/-5, and 10.7+/-5.9 microg/dL, respectively. Analysis of variance showed ferritin concentrations to be significantly different, in that there was a reduction in the control and elevation in the nutrition education groups. There was no significant difference in %TS before and after the intervention. During three months of intervention, changes in frequency of fruit and fruit juice intake after the meals in nutrition education and diet modification groups were significantly correlated to serum ferritin alteration. Frequency of fruit juice intake (rich in vitamin C) after meals (at least five times a week) can significantly increase serum ferritin within three months. Therefore, educating mothers of iron-deficient children while increasing the iron stores in children can prevent the recurrence of iron deficiency and result in general child well-being.     

Iron status in Swedish teenage girls: impact of low dietary iron bioavailability

OBJECTIVE: Although it is well known that bioavailability of iron in the diet is important, it has not been fully elucidated in practice. We investigated iron intake and iron absorption in the ordinary diet of free-living individuals in relation to iron status and assessed iron requirements. METHODS: From a total of 1245 adolescent boys and girls included in the G?teborg Adolescence Study of food habits, 28 adolescent girls registered their food intake during 7 d. Iron intake was assessed on the basis of these 7-d dietary records. Iron absorption was calculated using an algorithm including enhancing and inhibiting dietary factors on iron absorption in relation to individual iron status. RESULTS: Available iron intake was 11.5 +/- 2.8 mg/d (mean +/- SD). The proportion of girls with an iron intake below the Nordic nutrition recommendations was 85% (n = 24). Calculated iron absorption was 1.09 +/- 0.59 mg/d (mean +/- SD). Only four girls satisfied their estimated individual iron requirement concerning the absorbed amount of iron. Iron depletion (serum ferritin concentration < or = 15 microg/L) was present in 10 girls (36%), 2 of whom were also anemic (hemoglobin concentration < or = 120 g/L). CONCLUSION: Swedish adolescent girls seemed to have difficulties satisfying their iron requirement in terms of absorbed amount. The data support the view that iron intake and bioavailability of dietary iron is important when evaluating whether iron requirements have been met.     

Non-anemic iron depletion,oral iron supplementation and indices of copper status in college-aged females

OBJECTIVES: Indices of copper status, specifically serum copper and ceruloplasmin concentrations and erythrocyte superoxide dismutase activity, and iron status, including serum ferritin, transferrin receptors, hemoglobin and hematocrit, were studied in 27 college-aged females with adequate iron versus low iron stores. METHODS: Serum copper and ceruloplasmin concentrations, erythrocyte superoxide dismutase activity, serum ferritin, transferrin receptors, hemoglobin and hematocrit were studied in 15 females with non-anemic iron depletion before and after five weeks of iron supplementation and in 12 healthy iron-adequate females aged 19 to 28 years. RESULTS: Mean hemoglobin, hematocrit and ferritin concentrations of the control group (144 +/- 11 g/L, 43 +/- 3% and 38 +/- 15 micro g/L, respectively) were significantly higher than those of the iron depleted group prior to supplementation (134 +/- 9 g/L, 39 +/- 2% and 11 +/- 6 micro g/L, respectively). The serum transferrin receptor to serum ferritin ratio was significantly greater for the iron depleted group prior to supplementation (890 +/- 753) versus the control group (151 +/- 61). Mean serum copper and ceruloplasmin concentrations and erythrocyte superoxide dismutase activity of the iron-adequate control group (20.0 +/- 5.7 micro mol/L, 463 +/- 142 mg/L and 527 +/- 124 U/mL, respectively) were significantly higher than those of the iron depleted group (12.4 +/- 3.8 micro mol/L, 350 +/- 108 mg/L and 353 +/- 186 U/mL, respectively) prior to supplementation. Following iron supplementation, hematocrit and ferritin concentrations of the iron depleted group significantly increased to 42 +/- 3% and 26 +/- 8 micro g/L, respectively. Mean serum transferrin receptor concentrations and the serum transferrin receptor to ferritin ratios significantly decreased in the iron depleted group following supplementation (6.1 +/- 1.6 mg/L to 4.6 +/- 1.5 mg/L and 890 +/- 753 to 198 +/- 114, respectively). Iron supplementation also significantly increased the mean serum copper concentration to 14.2 +/- 5.4 micro mol/L and, in subjects with serum ferritin concentrations 相似文献   

Methods to assess iron and iodine status

Four methods are recommended for assessment of iodine nutrition: urinary iodine concentration, the goitre rate, and blood concentrations of thyroid stimulating hormone and thyroglobulin. These indicators are complementary, in that urinary iodine is a sensitive indicator of recent iodine intake (days) and thyroglobulin shows an intermediate response (weeks to months), whereas changes in the goitre rate reflect long-term iodine nutrition (months to years). Spot urinary iodine concentrations are highly variable from day-to-day and should not be used to classify iodine status of individuals. International reference criteria for thyroid volume in children have recently been published and can be used for identifying even small goitres using thyroid ultrasound. Recent development of a dried blood spot thyroglobulin assay makes sample collection practical even in remote areas. Thyroid stimulating hormone is a useful indicator of iodine nutrition in the newborn, but not in other age groups. For assessing iron status, haemoglobin measurement alone has low specificity and sensitivity. Serum ferritin remains the best indicator of iron stores in the absence of inflammation. Measures of iron-deficient erythropoiesis include transferrin iron saturation and erythrocyte zinc protoporphyrin, but these often do not distinguish anaemia due to iron deficiency from the anaemia of chronic disease. The serum transferrin receptor is useful in this setting, but the assay requires standardization. In the absence of inflammation, a sensitive method to assess iron status is to combine the use of serum ferritin as a measure of iron stores and the serum transferrin receptor as a measure of tissue iron deficiency.     

Risk of iron overload among middle-aged women

Iron overload, expressed as increased body iron stores, has been recognized as a potential hazard because it promotes the generation of oxygen radicals. We analyzed factors associated with serum ferritin levels (an indicator of body iron stores) among middle-aged women with a high prevalence of nutrient supplement use. Serum ferritin concentrations were determined on automated immunoassay for 487 healthy women with the mean age of 57 years who participated in the New York University Women's Health Study. The mean serum ferritin concentration in postmenopausal women was more than twice that in premenopausal women. Serum ferritin concentrations progressively increased with advancing age, but adjustment for menopausal status considerably weakened this association. Among non-dietary factors, nonwhite ethnicity, obesity and cigarette smoking were positively associated with serum ferritin concentrations. After adjustment for these factors and for menopausal status, serum ferritin levels were positively associated with meat intake and multivitamin use and inversely associated with breakfast cereal consumption. However, none of these lifestyle factors positively associated with serum ferritin levels had a significant impact on serum ferritin levels above 100 ng/ml (approximately equal to median concentration). Our results suggest that iron overload seems unlikely among middle aged women through their diet and nutritional supplements.     

Iron absorption is more closely related to iron status than to daily iron intake in 12- to 48-mo-old children

Few studies have evaluated iron absorption in small children after the first year of life. Our objectives were to examine the relations among iron intake, iron absorption, and iron status in a group of healthy children. We studied 28 children, ages 12 to 48 mo, after a 7-d home adaptation to a diet representative of their usual daily mineral intake. A multi-tracer stable isotope study was performed to assess iron absorption both from a meal ((58)Fe) and from a reference iron dose ((57)Fe) given with ascorbic acid without a meal. Iron intake was 6.9 +/- 2.4 mg, approximately the 35th percentile of typical U.S. intakes. Absorption of (58)Fe was related to serum ferritin (r(2) = 0.319, P = 0.0018) and more so to reference dose iron absorption (r(2) = 0.653, P < 0.0001). Iron absorption was negatively correlated with zinc intake (r(2) = 0.090, P = 0.0049) but was not correlated with iron intake (P = 0.20). However, zinc intake was not correlated with measures of iron status, including reference dose iron absorption and serum ferritin (r(2) < 0.1, P > 0.25). Total absorbed iron was similar to needs estimated by the Institute of Medicine. We conclude that iron absorption in young children is more closely related to iron status than to iron intake. Reference dose iron absorption may be superior to serum ferritin as a surrogate measure for iron status in this age group. Although zinc intake may affect iron absorption from a meal, it does not appear to have a detectable effect on overall iron status in otherwise well-nourished children.     

Effect of germination of finger millet on nutritional value of foods and effect of food supplement on nutrition and anaemia status in Tanzanian children

Inadequate dietary intake, often combined with an infection can lead to malnutrition that often manifest as growth failure or deficiency of essentials nutrients including iron leading to iron deficiency anaemia. In an effort to investigate diet in relation to nutrition status of children, diet and dietary intake were investigated in rural Tanzania. The effect of germination of finger millet based food recipe on its nutritional value was evaluated. The food consisted of finger millet flour, kidney beans, ground peanuts and dried mangoes at predetermined proportions of 75:10:10:5 respectively. Dietary habits of young children were investigated and effects of a fortified food supplement and the cereal based recipe on nutrition status of children were investigated. The two diets were then supplemented to children for 6 months and changes on anaemia and anthropometrical indices of children were evaluated at follow up periods. To assess anaemia and iron status, haemoglobin (Hb), haematocrit (Hct), erythrocyte protoporphyrin (EP) and serum ferritin (SF); and weights and heights were measured to assess growth. A significant improvement in nutrient density was noted in processed cereals. Bioavailability of iron in cereal based diet increased from 0.75 +/- 18 to 1.25 +/- 41 mg/100 g (P = 008), viscosity was significantly raised by 12% and phytate concentration was reduced from 4.5 +/- 0.5 to 4.1 +/- 0.5 mg/g (P = 0.03). Significantly lower intake of iron was observed in schoolchildren with Hb < 11.5 g/dl) compared to those who were normal. Total iron intake was 22+/- 7 and 27 +/- 13 mg/day, respectively (P < 0.05). There was a significant correlation between iron intake and serum ferritin (r = 0.233, P < 0.05). After six months of supplementing children with the fortified beverage a significantly larger increase in haemoglobin concentration was shown in the fortified group than in the non-fortified group (a difference of 6.2 versus 3.2 g/dl respectively). Supplementing infants with the germinated cereal based food supplement showed a general improvement on Hb status and growth that was not significantly different to that in the control group (P > 0.05). In conclusion, consumption of foods with low iron bioavailability is a major cause of anaemia. Germination improves the nutritional value of foods however there is need to fortify such processed foods for infant feeding.     

Calcium intake is weakly but consistently negatively associated with iron status in girls and women in six European countries

Several studies indicate that intake of calcium can inhibit iron absorption especially when taken simultaneously. In the CALEUR study, a cross-sectional study among girls (mean 13.5 y) and young women (mean 22.0 y) in six European countries, the association between calcium intake and iron status was studied. In 1,080 girls and 524 women, detailed information on calcium intake was collected by means of a 3-d food record, and serum ferritin, serum iron, serum transferrin and transferrin saturation were measured as indicators of iron status. The mean levels of serum iron, ferritin and transferrin were 15.8 +/- 6.1 mmol/L, 34.5 +/- 19.1 microg/L and 3. 47 +/- 0.47 g/L, respectively, in girls and 16.9 +/- 7.5 mmol/L, 40. 2 +/- 30.5 and microg/L, 3.59 +/- 0.60 g/L, respectively, in women. A consistent inverse association between calcium intake and serum ferritin was found, after adjusting the linear regression model for iron intake, age, menarche, protein, tea and vitamin C intake and country, irrespective of whether calcium was ingested simultaneously with iron. The adjusted overall regression coefficients for girls and women were -0.57 +/- 0.20 and -1.36 +/- 0.46 per 100 mg/d increase in calcium intake, respectively. Only in girls, transferrin saturation as a measure for short-term iron status was inversely associated with calcium intake (adjusted overall coefficient -0.18 +/- 0.08). However, analysis per country separately showed no consistency. We conclude that dietary calcium intake is weakly inversely associated with blood iron status, irrespective of whether calcium was ingested simultaneously with iron.     

Determinants of iron status in Malaysian adolescents from a rural community

Iron deficiency anaemia is the most common micronutrient deficiency worldwide. The prevalence of anaemia in the developing countries is three to four times higher than that in the developed countries. The iron status was assessed in 199 apparently healthy male and female adolescents aged 12-19 years living in a fishing community in Sabah, Malaysia. Data on socio-economic characteristics, lifestyles, anthropometry measurements, iron status, and dietary intake were gathered. Dietary intake of energy, iron, and most nutrients (with the exception of protein and vitamin C) were below the recommended levels for Malaysian adolescents. Three-quarters of the iron was derived from plant foods. The mean haemoglobin value for the male was 13.9 +/- 1.3 g/dl with 9.5% having less than 12 g/dl, while the respective figures for the female were 12.4 +/- 1.6 g/dl and 28.6%. The mean serum ferritin concentrations for male and female adolescents were 21.5 and 15.4 microg/l, respectively; with 25.7% of the males and 49.5% of the females having deficient levels of ferritin. Dietary intake of total energy and iron, and gender were found to be independent determinants of serum ferritin and haemoglobin levels, accounting for over 40% of the variations for each of these iron indicators. In males, but not in females, the intake of dietary protein and iron, and physical activity were also found to be significant determinants of serum ferritin. The age of subjects and household size were significant determinants of haemoglobin levels for male subjects, but not for female subjects. The findings indicate the importance of adequate intake of energy and dietary iron for improving the iron status of adolescents.     

Factors related to iron nutrition of adolescent females

Serum ferritin was measured in 144 adolescent females (ages 11.5–16.5 years) to evaluate iron status. Two years later, 96 of these girls were reexamined and changes in ferritin values of individuals were determined. Initial concentrations of ferritin and changes were related to dietary and other variables. Girls with ferritin concentrations classed as deficient were leaner and consumed more calcium and less vitamin C than those with adequate stores. Although it was not shown to affect initial ferritin values, iron intake was related to the change in ferritin during two years. Girls who maintained ferritin levels within 15% of original values consumed a mean of 13.1±1.1 (SE) mg iron. Those showing more than 15% decrease in ferritin concentration consumed 11.2±0.6 mg, significantly less than the 15.8 ±1.3 mg reported by girls whose ferritin values increased.     

北京山区学龄儿童铁营养状况及亚临床铁缺乏的干预效果

目的　调查北京山区学龄儿童机体铁营养状况、亚临床铁缺乏 (SID)患病率及观察采用乙二胺四乙酸钠铁 (NaFeEDTA)间断补充与早期铁干预效果。方法　对北京市房山山区 7～ 13岁学龄儿童 10 12名进行膳食调查、膳食频率调查与体内铁生化指标检测 ,依现行标准筛检贮存铁减少(IDs)、红细胞生成缺铁 (IDE)和缺铁性贫血 (IDA)儿童共 2 6 7名 ,给予口服NaFeEDTA胶囊 ( 6 0mgFe/粒 ) ,每次 1粒 ,IDs与IDE儿童 ,每周 1次 ;IDA儿童每周 3次 ,连续 9周。重复测定体内铁生化指标 ,并与干预前进行比较。结果　各年龄组儿童能量、蛋白质、铁和维生素C平均每日摄入量均达到推荐的膳食营养素摄入量 ,但膳食铁构成中血红素铁所占比例较低 ;该人群血液铁生化指标检测平均值 :血清铁蛋白含量为 ( 5 0 83± 33 0 9) μg/L ,红细胞游离原卟啉 (FEP)含量为 ( 489 44± 2 19 6 1) μg/L ,FEP/血红蛋白 (Hb)比值为 ( 3 83± 1 96 ) ,Hb含量为 ( 130 5 7± 10 82 )g/L ;总铁缺乏 (IDs+IDE +IDA)儿童检出率为 2 6 5 %,其中IDs占 15 5 %,IDE占 7 1%,IDA占 3 9%,SID占缺铁总人数的 85 4%,为IDA儿童的 5 8倍。进行铁干预后 ,体内各项铁指标显著提高并恢复至正常水平。结论　SID是值得重视的隐匿人群 ,采取早期鉴定、干预与综合     

补充铁剂对上海育龄妇女缺铁性贫血改善效果研究

目的了解缺铁性贫血育龄妇女补充铁剂的效果,探讨维持育龄妇女正常铁营养状况的总铁摄入量。方法招募贫血的育龄妇女74名,年龄21～45岁,按血红蛋白随机分成干预组和对照组,每日分别口服一包铁营养包(主要成分为焦磷酸铁和富马酸亚铁,含铁元素8mg)和安慰剂,连续服用6个月观察效果。干预前、3个月及6个月后两组均进行缺铁性贫血相关指标检查、膳食频率调查及24 h膳食回顾调查。结果干预6个月后干预组血红蛋白和血清铁蛋白均显著高于对照组(P<0.01),干预组和对照组血红蛋白值达标人数分别为15人(44.1%)和5人(14.3%),P<0.01;血清铁蛋白达标人数分别为11人(35.5%)和4人(12.1%),P<0.05。膳食铁的平均摄入量为14.0mg/d。总铁摄入量(膳食铁加补充的铁)与血红蛋白值的改变呈正相关(r=0.57,P﹤0.01)。膳食纤维摄入多和月经量多则是危险因素(P<0.05)。结论连续6个月每日补充8mg铁能有效改善育龄妇女缺铁性贫血,育龄妇女每日摄入23.2mg铁可维持正常铁储存状况。     

Dietary intake and iron status of Australian vegetarian women.

BACKGROUND: Despite the possible overall health benefits of a vegetarian diet, there is concern that some vegetarians and infrequent meat eaters, particularly females, may have inadequate iron status because of low or no heme-iron intakes. OBJECTIVE: The objective was to investigate the nutritional intake and iron status of vegetarian women. DESIGN: The nutritional intakes of 50 free-living vegetarian women aged 18-45 y and 24 age-matched omnivorous control women were assessed by using 12-d weighed dietary records. Iron status was assessed by measuring hemoglobin and serum ferritin concentrations. RESULTS: There was no significant difference between mean (+/-SD) daily iron intakes of vegetarians and omnivores (10.7 +/- 4.4 and 9.9 +/- 2.9 mg, respectively), although heme-iron intakes were low in the vegetarians. Vegetarians had significantly lower intakes of protein (P < 0.01), saturated fat (P < 0.01), and cholesterol (P < 0.001), and significantly higher intakes of dietary fiber (P < 0.001) and vitamin C (P < 0.05). Mean serum ferritin concentrations were significantly lower (P = 0.025) in vegetarians (25.0 +/- 16.2 microg/L) than in omnivores (45.5 +/- 42.5 microg/L). However, similar numbers of vegetarians (18%) and omnivores (13%) had serum ferritin concentrations <12 microg/L, which is a value often used as an indicator of low iron stores. Hemoglobin concentrations were not significantly different. CONCLUSION: It is important that both vegetarian and omnivorous women maintain an adequate iron status and follow dietary practices that enhance iron absorption.     

Influence of surgical stress and parenteral nutrition on serum leptin concentration

Experimental studies suggest that leptin may be an important metabolic signal for energy regulation. AIM: To assess whether surgical stress produces changes in serum leptin concentration and to investigate and compare the effect of total parenteral nutrition and hypocaloric parenteral nutrition on serum leptin levels. PATIENTS AND METHODS: Twenty-two surgical patients (11 male and 11 female) in need of parenteral nutrition were recruited. Parenteral nutrition was always initiated 24 h after surgical procedure. Group I (n=15) received total parenteral nutrition, while Group II (n=7) were treated with hypocaloric parenteral nutrition. Serum leptin concentration was determined before surgical procedure (day -1), after surgery and before parenteral nutrition was started (day +1), and after 5 days of treatment with parenteral nutrition (day +6). RESULTS: A tendency to increase serum leptin levels was observed after surgical procedure (6.0+/-1.9 vs 9.9+/-2.7 ng/ml;P= 0.07). After starting parenteral nutrition no significant changes on serum leptin concentrations were found in both groups, but a trend to raise serum leptin was observed in Group I (6.2+/-1.7 vs 8.3+/-2.7 ng/ml) whereas a trend to decrease serum leptin was detected in Group II (4.6+/-2.5 vs 1.6+/-0.5 ng/ml). On day +6 an increase of serum leptin and insulin levels was observed in Group I in comparison with Group II (8.3+/-2.7 vs 1.6+/-0.5 ng/ml;P< 0.05 and 58+/-41 vs 12+/-15 microU/l;P< 0.05 respectively). Finally, a positive correlation at day +6 between insulin and serum leptin levels was observed (r= 0.66;P< 0.01). CONCLUSIONS: a) Surgical stress is associated to an increase of serum leptin concentrations; b) Total and hypocaloric parenteral nutrition produces quite different effects on serum leptin levels that could be related to distinct insulin response.     

Tea consumption and iron status

OBJECTIVE: To give an overview of the association between tea consumption and iron status. METHODS: A PUBMED search was performed (up to June 2001) for all publications containing the words: tea and ferritin, h(a)emoglobin, iron status or an(a)emia. Sixteen studies were evaluated in groups with high (infants, children and premenopausal women) or low prevalence of iron deficiency (men and the elderly). RESULTS AND DISCUSSION: Of the 16 studies reviewed, six included infants and children, six premenopausal women, two men and two the elderly. In study groups with high prevalence of iron deficiency, tea consumption was inversely associated with serum ferritin and/or haemoglobin. The association disappeared when adjusting for confounding (dietary) factors, except for one study including 40% of iron deficient women. In groups with low prevalence of iron deficiency, tea consumption was not inversely associated with serum ferritin and/or haemoglobin. In those at risk for iron overload, such as middle-aged men, tea consumption may lower serum ferritin concentrations as reported in one study. This finding awaits further confirmation. CONCLUSION: This overview shows that tea consumption does not influence iron status in Western populations in which most people have adequate iron stores as determined by serum ferritin concentrations. Only in populations of individuals with marginal iron status does there seem to be a negative association between tea consumption and iron status.     

Iron status and pregnancy in a northern Canadian population: relationship to diet and iron supplementation.

To determine the extent of iron deficiency, the prognostic value of prenatal ferritin levels and the desirability of prenatal iron supplementation in the western Canadian arctic, dietary iron intake was determined in 171 women and ferritin levels determined in 121 women during pregnancy, 79 at delivery and 77 postnatally, as well as in 65 of their infants at birth and 74 postnatally. Iron deficiency (ferritin < 15 ng/ml) was present in 34% of women during the first two trimesters, 25% (20/79) at delivery and in 51.7% (15/29) of mothers and 31% (9/29) of infants beyond four months after delivery. Maternal follow-up ferritin levels correlated poorly with dietary iron intake but well with prenatal ferritin levels, which appeared to be good predictors of the effectiveness of supplementation. Mean infant follow-up ferritin levels were 105.6 +/- 115.2 ng/ml with, and 46.7 +/- 63.5 without maternal prenatal supplementation (p = 0.03); maternal, 45.5 +/- 40.9 ng/ml with, and 12.8 +/- 9.2 without (p < 0.001). Measurement of prenatal ferritin levels to determine risk of iron deficiency and routine prenatal iron supplementation are recommended.     

Poor iron status is more prevalent in Hispanic than in non-Hispanic white older adults in Massachusetts

Iron status and dietary correlates of iron status have not been well described in Hispanic older adults of Caribbean origin. The aim of this study was to evaluate iron status and describe dietary components and correlates of iron status in Hispanic older adults and in a neighborhood-based comparison group of non-Hispanic white older adults. Six hundred four Hispanic and non-Hispanic white adults (59-91 y of age) from the Massachusetts Hispanic Elders Study were included in the analysis. We examined physiological markers of iron status as well as dietary factors in relation to iron status. Dietary intake was assessed by FFQ. Our results revealed that Hispanics had significantly lower geometric mean serum ferritin (74.1 microg/L vs. 100 microg/L; P<0.001), lower hemoglobin concentrations (137+/-13 vs. 140+/-12 g/L; P<0.01), higher prevalence of anemia (11.5 vs. 7.3%; P<0.05), and suboptimal hemoglobin concentrations (<125 g/L) for this age group (21.4 vs. 13.3%; P<0.05). Iron deficiency anemia was higher (7.2% vs. 2.3%; P<0.05) in Hispanic women. Hispanics had lower mean intakes of total iron, vitamin C, supplemental vitamin C, and total calcium than did non-Hispanic whites. After adjusting for age, sex, BMI, alcohol use, smoking, total energy intake, inflammation, diabetes, and liver disease, intake of heme iron from red meat was positively associated and dietary calcium was negatively associated with serum ferritin. This population of Hispanic older adults was significantly more likely than their non-Hispanic white neighbors to suffer from anemia and poor iron status, particularly among women. Cultural variation in dietary patterns may influence iron availability and body iron stores and contribute to an increased risk for iron deficiency anemia among some Hispanic older adults.     

Nutrition and immunological status in long-term follow up of children with short bowel syndrome

BACKGROUND: Little is known about the long-term evolution, nutrition status, growth, and eventual deficiencies of patients with short bowel syndrome (SBS) adapted to oral feeding after parenteral nutrition (PN). Because there are not absolute criteria for weaning from parenteral or enteral nutrition to oral feeding, new nutrient deficiencies may develop. Subtle nutrition deficits could induce subclinical immune deficiencies; therefore, we studied long-term growth, nutrition status, and the state of the immune system in 10 patients with SBS after weaning PN for at least 2 years. METHODS: Ten children with SBS (3-12 years old; mean, 7.4 years) who had not received PN for at least 2 years were studied. Anthropometric measurements, hemoglobin values, and indicators of iron, zinc, copper, folate and vitamin B(12) nutrition status were evaluated, along with immunoglobulins, lymphocyte subpopulations, and polymorphonuclear candidicidal activity. RESULTS: Weight-for-height was normal in 8 children; height-for-age was low in 5 children whose SBS was established early in life. Fat body mass was also low in 5 subjects. Four children presented macrocytosis, 2 with anemia. Low serum levels of vitamin B(12) (1 child), folates (4 children), and ferritin (2 children) were observed. Diminished candidicidal activity (4 children) was the only remarkable immunological abnormality. Conclusion: Many biologic and growth deficiencies are frequently seen in patients with SBS, even in children adapted to enteral feeding. This finding and the existence of previously unreported decreased candidicidal activity in some patients with SBS deserve long-term clinical and biologic follow up.