Common Bean Leaves as a Source of Dietary Iron: Functional Test in an Iron-Deficient Rat Model.

Recent findings made by our group indicate that the iron content in Phaseolus vulgaris leaves is at least four times greater than in grains therefore, we evaluated the effect of supplementation with bean leaf (iron content of 275 mg/kg on a dry basis) in iron-deficient rats. Anemia was induced by feeding rats with an iron-deficient diet (IDD) for 11 days and iron-recovery diets were subsequently tested for 14 days using a normal diet, a 10 % bean leaf-supplemented IDD (BLSD) or a ferrous sulfate-supplemented IDD. Decreased levels of leukocytes (64 %), erythrocytes (30 %), lymphocytes (62 %), granulocytes (72 %), hematocrit (34 %), hemoglobin (35 %), and ferritin (34 %) were observed in the iron-deficient rats compared to the control rats. BLSD supplementation showed the highest recovery values relative to those recorded for control rats: leukocytes (40 %), erythrocytes (24 %), lymphocytes (33 %), granulocytes (88 %), hematocrit (17 %), and hemoglobin (18 %), suggesting that common bean leaves could be a good source of bioavailable iron with possible immunomodulatory effects.

Iron deficiency anaemia in reproductive age women attending obstetrics and gynecology outpatient of university health centre in Al-Ahsa, Saudi Arabia.

BACKGROUND: Iron deficiency is the most common nutritional disorder in the world. The aim of this questionnaire based survey study was to determine the prevalence of iron deficiency anemia in reproductive age women, and their relation to variables such as age, marital status, education with those attending obstetrics and gynecology outpatient of King Faisal University Health Centre in Al-Ahsa in eastern region of Kingdom of Saudi Arabia. MATERIALS AND METHODS: This study was conducted for the period of 6 month staring from September 2012 to February 2013. The questionnaire had three sections on personal information: their educational indicators, gynecological clinical history, and hematological indices. RESULTS: The average age was 25.97±7.17 years. According to the gynecological clinical history of the respondents, 15 (48.4%) respondents were pregnant while 16 (51.6%) were not pregnant. There was significant effect of pregnancy status on Hb level. Majority of the anemic respondents 15/17 were married. Moreover 14/17 anemic women were experiencing severe menstrual bleeding, 11/17 respondents were pregnant. 54.8% of respondents were hemoglobin deficient while 77.4% were found to have low Hct. In 87.1 % of the respondents, transferrin saturation was found to be abnormal. CONCLUSION: In this study iron deficiency anemia is quite prevalent in the university community especially among pregnant women. The fetus's and newborn infant's iron status depends on the iron status of the pregnant woman and therefore, iron deficiency in the mother-to-be means that growing fetus probably will be iron deficient as well. Thus iron deficiency anemia during pregnancy in well-educated set up needs more attention by the concerned authorities.

Effects of multimicronutrient home fortification on anemia and growth in Bhutanese refugee children.

BACKGROUND: Anemia remains a significant public health problem in refugee settings. Home fortification with micronutrient powders has been proposed as a feasible option to alleviate micronutrient deficiencies; its efficacy in reducing anemia in children aged 6 to 24 months has been demonstrated in several trials. OBJECTIVE: To evaluate the effectiveness of a large-scale micronutrient powder distribution program in reducing anemia prevalence and promoting growth in refugee children aged 6 to 59 months. METHODS: Four representative cross-sectional surveys were conducted 13 months before and 7, 14, and 26 months after initiation of the supplementation program. Data collected on children aged 6 to 59 months included hemoglobin concentration, anthropometric indicators, morbidity, feeding practices, and information on the micronutrient distribution program. The study had a pre-post design with no control group. RESULTS: The overall prevalence of anemia in children did not change significantly between baseline (43.3%) and endpoint (40.2%). The prevalence of moderate anemia decreased over the same period from 18.9% to 14.4% (p < .05). The levels of severe anemia were negligible (< 1%) in all surveys. The prevalence of stunting decreased significantly from 39.2% at baseline to 23.4% at endpoint (p < .001), a relative decrease of40%. Reported coverage, use, and acceptance of micronutrient supplements remained consistently high throughout the study. CONCLUSIONS: In the absence of a control group, changes in key outcomes should be interpreted with caution. The minor effect on hemoglobin status requires further investigation of underlying causes of anemia in this population. The large positive effect on linear growth may be a significant benefit of supplementation if confirmed by future studies.

Provision of micronutrient powder in response to the Cyclone Sidr emergency in Bangladesh: cross-sectional assessment at the end of the intervention.

BACKGROUND: Micronutrient powder has been endorsed as an effective means to improve the micronutrient status of emergency-affected populations. OBJECTIVE: To document the experience and findings of a cross-sectional assessment of the micronutrient powder program implemented as part of the emergency response to Cyclone Sidr. METHODS: Micronutrient powder was distributed to 100,714 children under 5 years of age and 59,439 pregnant or lactating women severely affected by Cyclone Sidr in Bangladesh. A cross-sectional assessment, including hemoglobin and anthropometric measurements, was conducted after the completion of the micronutrient powder program among children under 5 years of age, lactating mothers, and postmenarcheal adolescent girls in the intervention area. Comparison groups for each, drawn from the control area, which had not received micronutrient powder, were assessed at the same time. RESULTS: The prevalence of anemia among children under 5 years of age was approximately 80% in both areas. Among children in the intervention area, those who consumed at least 75% of the micronutrient powder sachets had a lower prevalence of stunting than those who consumed less than 75% of the sachets (40% vs. 52%, p < .05). Among lactating mothers in the intervention area, the prevalence rates of thinness and anemia were lower among those who consumed at least 75% of the sachets than among those who consumed less than 75% of the sachets (thinness, 31% vs. 46%, p < .05; anemia, 50% vs. 61%, p = .07). For adolescent girls in the intervention and control areas, none of whom had received micronutrient powder, the prevalence rates of anemia were 52% and 45%, respectively (p = .05). CONCLUSIONS: Micronutrient powder may reduce anemia among lactating mothers, when the compliance rate is high. Anemia prevalence prior to micronutrient powder distribution had not been investigated and could have been higher among children and lactating mothers in the intervention than in the control area, resulting in the negation of the potential positive impact of micronutrient powder on anemia.

Relationship of the availability of micronutrient powder with iron status and hemoglobin among women and children in the Kakuma Refugee Camp, Kenya.

BACKGROUND: Micronutrient powder is a potential strategy to improve iron status and reduce anemia in refugee populations. OBJECTIVE: To evaluate the effect of the availability of home fortification with a micronutrient powder containing 2.5 mg of sodium iron ethylenediaminetetraacetate (NaFeEDTA) on iron status and hemoglobin in women and children in the Kakuma Refugee Camp in northwest Kenya. METHODS: Hemoglobin and soluble transferrin receptor were measured in 410 children 6 to 59 months of age and 458 women of childbearing age at baseline (just before micronutrient powder was distributed, along with the regular food ration) and at midline (6 months) and endline (13 months)follow-up visits. RESULTS: At the baseline, midline, and endline visits, respectively, the mean (+/- SE) hemoglobin concentration in women was 121.4 +/- 0.8, 120.8 +/- 0.9, and 120.6 +/- 1.0 g/L (p = .42); the prevalence of anemia (hemoglobin < 120 g/L) was 42.6%, 41.3%, and 41.7% (p = .92); and the mean soluble transferrin receptor concentration was 24.1 +/- 0.5, 20.7 +/- 0.7, and 20.8 +/- 0.7 nmol/L (p = .0006). In children, the mean hemoglobin concentration was 105.7 +/- 0.6, 109.0 30322 1.5, and 105.5 +/- 0.3 g/L (p = .95), respectively; the prevalence of anemia (hemoglobin < 110 g/L) was 55.5%, 52.3%, and 59.8% (p = .26); and the mean soluble transferrin receptor concentration was 36.1 +/- 0.7, 29.5 +/- 1.9, and 28.4 +/- 3.2 nmol/L (p = .02), in models that were adjusted for age using least squares means regression. CONCLUSIONS: In children and in women of childbearing age, the availability of micronutrient powder was associated with a small improvement in iron status but no significant change in hemoglobin in this refugee camp setting.

Is biliopancreatic diversion with duodenal switch indicated for patients with body mass index <50 kg/m2?

BACKGROUND: Biliopancreatic diversion with duodenal switch (DS) has been the standard surgical approach for the treatment of morbidly obese patients at our institution since the early 1990 s. The published data, however, have shown the use of the DS to be limited to the treatment of super-morbidly obese patients (body mass index [BMI] ≥ 50 kg/m(2)). The aim of the present study was to present our long-term results with the DS in patients with an initial BMI of <50 kg/m(2). METHODS: This was a retrospective study of all patients with a BMI <50 kg/m(2) who had undergone DS from June 1992 to May 2005. The data are reported as the mean ± standard deviation. RESULTS: The data from 810 consecutive patients, with a mean initial BMI of 44.2 ± 3.6 kg/m(2), were reviewed. The mean follow-up was 103 ± 49 months. Major perioperative complications occurred in 5.8% of patients, including 5 deaths (.6%). The initial excess weight loss was 76% ± 22%, and the excess weight loss was >50% in 89% of patients. Malnutrition required readmission in 4.3% and surgical revision in 1.5%. The prevalence of severe albumin deficiency (<30 g/L) was 1.1%, hemoglobin deficiency (<100 g/L), 1.6%, iron deficiency (<4 mmol/L) 2.1%, and calcium deficiency (<2 g/L) 3%. The percentage of patients "very satisfied" with the global result was 91%, and 37% would have preferred to lose more weight. CONCLUSION: These results showed that in non super-obese patients, DS was very efficient in terms of weight loss and patient satisfaction. This was associated with a 1.5% risk of revision for malnutrition. However, nutritional deficiencies required frequent readjustment of supplements, particularly for calcium, vitamin A, and vitamin D.

Avaliação do acompanhamento de gestantes com hemoglobina baixa em uma unidade básica de saúde do estado de São Paulo / Evaluation of pregnant women with monitoring of hemoglobin in a low-basic health unit of the state of São Paulo

The group of pregnant women is one of the most sensitive to anemia and they have the deleterious consequences resulting therefrom. This research aims to demonstrate the importance of making during the prenatal examinations required including complete blood count, along with the kinetics of iron. In normal pregnancy there is expansion of plasma volume of up to 40-60% and red cell mass of 20-40%, with the sixth to seventh month. Pan American Health indicate that 42% of pregnant women in Brazil would be anemic. Usually pregnant women anemia is caused by increased demand for iron, and the strategy to combat iron deficiency and iron deficiency anemia is well established, consisting briefly on the following: change in eating habits, diagnosis and treatment of causes of loss blood, infection control that contribute to anemia, food fortification and supplementation with iron salts. This study aims to evaluate the management of pregnant women with low hemoglobin in the basic health unit investigated, and verify the effectiveness of the procedures adopted by that institution to reverse the above mentioned. This was a cross-sectional study with secondary data. The data showed that the prevalence of anemia increased the hemoglobin concentration decreased with the evolution of pregnancy.

Effect of supplementation on haemoglobin and serum retinol levels and nutritional status of school children of northern India.

Supplementation study was carried out in 66 children of 10-12 years of age for a period of about 4 months. On the basis of blood analysis, 33 children were taken as deficient having low level of both Hb (<10 g/dl) and serum retinol (< 20 microg/dl). Similar number of children (33) were selected as control purposively who had Hb > 10 g/dl and serum retinol > 20 microg/dl. Average daily consumption of cereals, pulses, vegetables, fruits, milk and milk products, fats and oils, and sugar and jaggery was below the recommended dietary intake in control as well as deficient subjects, however, control children consumed more when compared to deficient children. Among nutrients the daily mean intake of energy, protein, iron, n-carotene and vitamin C were found lower than RDA in deficient subjects as compared to control subjects. Feeding of 100 g/day of cauliflower leaves powder supplements i.e. biscuits and shakarpara improved the Hb, serum retinol, height, weight and nutritional status in deficient subjects. The increase in Hb, serum retinol, weight and height in supplemented group was 14.61, 33.27, 4.48 and 7.06%, respectively. Initially, 27.27% children had normal nutritional status in deficient group, but after supplementation this value was increased to 42.42%. Higher percentage of children having deficiency signs of vitamin A (6.06%), iron (66.67%), B-complex vitamin (9.09%), and symptoms of protein-energy-malnutrition (72.73%) was observed in deficient subjects as compared to control subjects.

Low ferritin levels indicate the need for iron supplementation: strategy to minimize iron-depletion in regular blood donors.

Iron deficiency is a common problem in regular blood donors which can be prevented by timely iron supplementation. Consequently, these donors should be supplied with oral iron in good time. We evaluated the need to use ferritin rather than or in addition to haemoglobin to screen iron deficiency in blood donors. To this end, serum ferritin was measured routinely every 10th donation in 632 long-term and 171 first-time donors. Furthermore, donors with ferritin < 15 microg L-1 were supplemented with iron. The supplementation efficiency was assessed by follow-up haemoglobin levels over the course of five donations in blood donors with high donation frequency. Our results showed that ferritin decreases after 10 donations and with the increase of donation frequency. In 26% of regular donors, ferritin levels were < 15 microg L-1 and 12% of them were anaemic due to low haemoglobin. After iron supplementation, haemoglobin was raised rapidly in donors with initially low haemoglobin, and thus donor deferment was never indicated. In conclusion, regular ferritin measurement is a useful indicator for iron depletion in blood donors. Our data suggested the usefulness of ferritin screening in first-time donors and regular donors with low haemoglobin levels within the normal range.