Long-Term Weekly Iron Supplementation Improves and Sustains Nonpregnant Women's Iron Status as Well or Better than Currently Recommended Short-Term Daily Supplementation1 (original) (raw)
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Nutritional Iron Deficiency: The Role of Oral Iron Supplementation
Current Medicinal Chemistry, 2014
Nutritional iron deficiency represents a relevant health problem mainly in developing countries. Children and pregnant women represent the main target of this disease, and the low amount of bio-available iron mostly depends on plant-based diets. Iron deficiency may have serious consequences, with severe impairment of the immune function leading to infectious diseases. The brain development in embryos and fetuses during gestation can be greatly affected by iron deficiency of the mother with heavy outcomes on the cognition status of children. A better understanding of molecular pathways involved in iron absorption and metabolism are the basis for new strategies for developing a therapy for iron deficiency. Different therapeutic strategies are summarized, and iron fortification appears the best tool.
Reviews, 1996
Background Daily iron supplementation has been traditionally a standard practice for preventing and treating anaemia but its long term use has been limited as it has been associated with adverse side effects such as nausea, constipation and teeth staining. Intermittent iron supplementation has been suggested as an effective and safer alternative to daily iron supplementation for preventing and reducing anaemia at population level, especially in areas where this condition is highly prevalent. Objectives To assess the effects of intermittent oral iron supplementation, alone or in combination with other nutrients, on anaemia and its associated impairments in menstruating women, compared with no intervention, a placebo or daily supplementation.
Alternate strategies for improving iron nutrition: lessons from recent research
British Journal of Nutrition, 2001
Strategies such as dietary diversification and food fortification have yielded significant results in controlling iron deficiency anaemia in developed countries. Reducing the prevalence of iron deficiency anaemia in developing countries is still a matter of importance. The major factors responsible for iron deficiency anaemia in the vulnerable segments of developing countries are reduced intake and poor bioavailability of dietary iron. Dietary diversification and food-based approaches pose considerable challenges before they can be implemented on a wide scale. Anaemia control programmes based on the administration of prophylactic doses of iron and folic acid tablets have been widely implemented. As the programmes were not effective in countries such as India, the dosage of iron was increased. The role of excess iron in causing intestinal oxidative stress has drawn attention to other approaches of iron supplementation. Prophylactic administration of iron along with antioxidants like vitamins E and C or foods rich in these vitamins is one such strategy. To reduce the intestinal oxidative stress, intermittent supplementation of iron is being considered. The potential benefits and shortcomings of these approaches are reviewed.
Oral iron supplementation in iron-deficient women: How much and how often?
Molecular Aspects of Medicine, 2020
Iron deficiency and iron deficiency anemia (IDA) are major public health problems worldwide, especially in young women. Oral iron supplementation can be an effective strategy to treat and prevent IDA, but guidelines vary. Some experts recommend doses of 150-200 mg elemental iron per day, with the dose split through the day. However, recent studies suggest this may not be an optimal regimen. The fraction of iron absorbed from high doses of oral iron is low, and unabsorbed iron can cause gut irritation, inflammation and dysbiosis, and these reduce compliance. In recent studies using serum hepcidin profiles and stable iron isotopes to quantify iron absorption in young women, we have shown that: (a) oral iron doses ≥60 mg in iron-deficient women, and doses ≥100 mg in women with IDA, stimulate an acute increase in hepcidin that persists 24 h after the dose, but subsides by 48 h; (b) therefore, to maximize fractional iron absorption, oral doses ≥60 mg should be given on alternate days; (c) the circadian increase in plasma hepcidin is augmented by a morning iron dose; therefore, iron doses should not be given in the afternoon or evening after a morning dose. If rate of Hb response is important, a pooled analysis of our data done for this review indicates that total iron absorption is also higher if twice the target daily iron dose is given on alternate days. In summary, these studies suggest changing from daily to alternate-day schedules and from divided to morning single doses increases iron absorption and may reduce side effects. Thus, providing morning doses of 60-120 mg iron as a ferrous salt given with ascorbic acid on alternate days may be an optimal oral dosing regimen for women with iron-deficiency and mild IDA.
Heme iron-based dietary intervention for improvement of iron status in young women
Nutrition, 2013
Objective: Conventional iron deficiency treatment with pharmacologic iron doses often causes side effects. Heme iron has high bioavailability and a low capacity to cause gastrointestinal side effects. This study investigated the possibility of using heme iron in the form of blood-based crisp bread as a diet-based treatment program to improve the iron status of women of reproductive age. Methods: In a 12-wk intervention study, 77 women (mean age 24 y) were assigned to one of four groups: blood-based crisp bread (35 mg of iron [Fe], 27 mg of which was heme Fe), iron supplementation consisting of 35 mg of non-heme iron/day (Fe35), iron supplementation consisting of 60 mg of non-heme iron/day (Fe60), and controls (iron-free tablets). Results: Body iron increased significantly in the crisp bread group by a median of 2.7 mg/kg (interquartile range 3.1, n ¼ 18), in the Fe35 group by 2.7 mg/kg (interquartile range 2.8, n ¼ 11), and in the Fe60 group by 4.1 mg/kg (interquartile range 3.6, n ¼ 13), whereas no change was observed in the control group. No statistically significant difference in iron status increase was observed between the crisp bread group compared with the two iron-supplemented groups. Conclusion: Dietary-based treatment containing heme iron has few side effects and can be used efficiently to improve the iron status of women of reproductive age.
Critical reviews in food science and nutrition, 2018
This meta-analysis compared the effects of dietary intervention versus iron supplementation on biochemical parameters related to the iron nutritional status in humans. The PubMed, CENTRAL, LILACS, SCIELO, OPENGREY.EU and ClinicalTrials.gov databases were searched for randomized clinical trials that assigned individuals to a dietary intervention or to an iron supplementation regimen, for 12 weeks or more. The primary outcome was the hemoglobin concentration, and secondary outcomes were ferritin, RDW, mean corpuscular volume, soluble transferrin receptor, total iron binding capacity, serum iron, and transferrin saturation. From the 6095 records identified, twelve studies were included, six with children, five with adolescents/adults, and one with pregnant women. In the subgroup of studies that included anemic/iron deficient children, supplementation significantly increased the hemoglobin concentration (weighted mean difference (WMD): 3.19 g/L [95% CI: 1.31, 5.07]) and induced a signif...
Nutritional Needs and Dietary Modifications in Woman- Iron Deficiency
2020
In developing and underdeveloped countries, anemia exists in terms of food insecurity, where meeting overall energy needs and dietary diversity continues to be the major challenge. In India, women of reproductive age are undernourished which results in the premature birth of child, miscarriages, and even later in life changes of increasing risk of diabetes, hypertension, and obesity. Iron deficiency among the males also imparts a socio-economic burden of the country. Millions in India depends on rice and wheat to fill their stomachs, but those staple foods lack important vitamins and minerals. India is the latest country to enter the realm of biofortification. Therefore, there has been a need to explore the strategies to ensure the biofortification management to finally prove a boon for the food security. The study was carried out to provide some of the information needed for an effective & sustainable program to control anemia in women.
Background: Patients with hemochromatosis are instructed to avoid taking supplemental iron. Whether supplemental iron intakes lead to higher iron status among healthy persons remains less clear. Objective: The objective was to ascertain whether supplemental iron intakes are associated with increases in iron transport (transferrin saturation) and stores (serum ferritin) among US adults aged ͧ19 y. Design: We analyzed data for 5948 adults from whom a fasting serum sample was collected during the third National Health and Nutrition Examination Survey. We used multivariable linear regression and analysis of variance to assess the association of supplemental iron intake with iron transport and stores among men (aged 19 -30 y or 30 y) and women (nonpregnant premenopausal or postmenopausal); multiple comparison tests were also performed. Results: Healthy adults who took supplements containing average daily amounts of iron at ͨ3 times the recommended dietary allowance (RDA) did not have significantly higher iron transport or stores than did those who did not take supplements. In younger men, the intake of 32 mg Fe/d (4҂ RDA) was associated with mean transport iron concentrations that were significantly higher than those in persons who took 0 to ͨ24 mg Fe/d. In older men, the intake of 32 mg Fe/d (4҂ RDA) was associated with mean iron stores that were significantly higher than those in persons who took 0 to ͨ 24 mg Fe/d; a similar result was observed in postmenopausal women, but it was of borderline statistical significance. Conclusion: Supplement users should be made aware of the amount of iron necessary to satisfy dietary requirements and informed of the possible influence that excess iron intake can have on body iron stores and health.
Development, prevention and treatment of iron deficiency in women
Nutrition Research, 1998
Research to date has not been able to adequately describe the relative impact of dietary and lifestyle variables on iron status. While total iron intake appears unrelated to iron status, bio-available dietary iron should correlate with iron stores, after adjustment for iron losses. Therefore, the objective of this study was to examine dietary and lifestyle variables that are important in the determination of iron status for Australian women of child-bearing age. Serum ferritin was measured in 52 iron-deficient and 24 iron-replete women. Dietary data were collected using seven-day weighed food records and bio-available dietary iron calculations were performed using the algorithms developed by Monsen et al., Monsen and Balintfy, and Tseng et al. Self-reported data on demographic characteristics, parity, breastfeeding, oral contraceptive pill, intrauterine device and hormone replacement therapy use, menstruation, smoking, alcohol intake, exercise, dieting, vitamin and mineral supplement use and blood donation were collected. Multiple linear regression was used to examine dietary and lifestyle factors associated with serum ferritin. Current oral contraceptive pill use and alcohol intake were positively associated (P = 0.01 and P = 0.001 respectively) and phytate intake was negatively associated (P = 0.05) with serum ferritin. Total iron, haem iron and bioavailable dietary iron intakes were not associated with iron stores. Bio-available dietary iron estimates were well below the recommended intakes for menstruating women, suggesting possible problems with either the algorithms or the assumptions built into the current Australian recommended dietary intakes. Further work to accurately determine bio-available dietary iron estimates for Australian women is needed. (Aust J Nutr Diet 2001;58:107-113)