RESUMEN
BACKGROUND: It has been suggested that routine intake of supplements containing iron or combination of iron and folic acid during pregnancy improves maternal health and pregnancy outcomes. OBJECTIVES: To assess the efficacy, effectiveness and safety of routine antenatal daily or intermittent iron supplementation with or without folic acid during pregnancy on the health of mothers and newborns. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (June 2005). Additionally, we contacted relevant organizations for the identification of ongoing and unpublished studies. SELECTION CRITERIA: All randomised or quasi-randomised trials evaluating the effect of routine supplementation with iron or combination of iron and folic acid during pregnancy. DATA COLLECTION AND ANALYSIS: We assessed trials for methodological quality using the standard Cochrane criteria. Two authors independently assessed the trials for inclusion and one author extracted data. We collected information on randomisation method, allocation concealment, blinding and loss to follow up. The primary outcomes included maternal and infant clinical and laboratory outcomes. MAIN RESULTS: Forty trials, involving 12706 women, were included in the review. Overall, the results showed significant heterogeneity across most prespecified outcomes. Heterogeneity could not be explained by standard sensitivity analyses including quality assessment; therefore, all results were analysed assuming random-effects. Very limited information related to clinical maternal and infant outcomes was available in the included trials. The data suggest that daily antenatal iron supplementation increases haemoglobin levels in maternal blood both antenatally and postnatally. It is difficult to quantify this increase due to significant heterogeneity between the studies. Women who receive daily antenatal iron supplementation are less likely to have iron deficiency and iron-deficiency anaemia at term as defined by current cut-off values. Side-effects and haemoconcentration are more common in women who receive daily iron supplementation. No differences were evident between daily and weekly supplementation with regards to gestational anaemia; haemoconcentration during pregnancy appears less frequent with the weekly regimen. The clinical significance of hemoconcentration defined as haemoglobin greater than 130 g/L remains uncertain. AUTHORS' CONCLUSIONS: Further studies are needed to assess the effects of routine antenatal supplementation with iron or a combination of iron and folic acid on clinically important maternal and infant outcomes.
Asunto(s)
Suplementos Dietéticos , Ácido Fólico/administración & dosificación , Hierro/administración & dosificación , Anemia Ferropénica/prevención & control , Femenino , Humanos , Embarazo , Complicaciones Hematológicas del Embarazo/prevención & control , Resultado del Embarazo , Atención Prenatal/métodos , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
OBJECTIVE: To assess relationships between energy, nutrient and food intakes, alcohol consumption, smoking status and body mass index (BMI), and serum concentrations of beta-carotene, alpha-tocopherol, vitamin C, selenium and zinc. METHODS: Data on health status, alcohol consumption, smoking habits, anthropometric data and biochemical measurements were obtained in 1821 women aged 35-60 y and 1307 men aged 45-60 y, participant to the SU.VI.MAX Study. Data on dietary intake were available on a subsample who reported six 24-h dietary records during the first 18 months of the study. RESULTS: Women had higher baseline serum beta-carotene and vitamin C concentrations and lower concentration for serum vitamin E, zinc and selenium than men. In women, younger age was associated with lowered mean concentration of serum beta-carotene, vitamin E and selenium. In men, only differences were observed for serum zinc, which was lower in older men. Current smokers of both sexes had significantly lower concentrations of serum beta-carotene, vitamin C and selenium, and, only in women, of vitamin E, than nonsmokers. Alcohol consumers had lower concentrations of serum beta-carotene and higher selenium concentrations. Serum beta-carotene and vitamin C concentrations were lower in obese subjects. There were positive associations of dietary beta-carotene, vitamin C and E with their serum concentrations. Age, nutrient and alcohol intakes, serum cholesterol, BMI and smoking status explained 15.2% of the variance of serum beta-carotene in men and 13.9% in women, and 10.8 and 10.0% for serum vitamin C, and 26.3 and 28.6% for serum vitamin E, respectively. CONCLUSION: Serum antioxidant nutrient concentrations are primarily influenced by sex, age, obesity, tobacco smoking, alcohol consumption and especially dietary intake of those antioxidant nutrients.
Asunto(s)
Antioxidantes/metabolismo , Dieta , Obesidad/sangre , Oligoelementos/sangre , Adulto , Factores de Edad , Consumo de Bebidas Alcohólicas/sangre , Antioxidantes/administración & dosificación , Antioxidantes/análisis , Ácido Ascórbico/administración & dosificación , Ácido Ascórbico/sangre , Análisis Químico de la Sangre , Ingestión de Energía , Femenino , Francia , Humanos , Masculino , Persona de Mediana Edad , Selenio/administración & dosificación , Selenio/sangre , Factores Sexuales , Fumar/sangre , Oligoelementos/administración & dosificación , Oligoelementos/análisis , Vitamina E/administración & dosificación , Vitamina E/sangre , Zinc/administración & dosificación , Zinc/sangre , beta Caroteno/administración & dosificación , beta Caroteno/sangreRESUMEN
To determine the prevalence of anemia, and iron (ID) and vitamin A deficiencies aiming at their prevention, 414 children between 6 and 24 months of age, were randomly selected from the whole province of Chaco. A sociodemographic survey was implemented, and hemoglobin (Hb), plasma ferritin and retinol were measured. Anemia prevalence (Hb < 110 g/L) was 66.4 per cent, without differences between age groups, and included 18 per cent with Hb < 90 g/L. These cases were significantly less in children 6-8 month of age (5.1 per cent) than in the others (approximately equal to 20 per cent) (P: 0.007). Mean Hb was also higher in 6-8 months old children and was associated with lower prevalence of ID (ferritin < 12 micrograms/L) (p < 0.000) but not with age (p = 0.8865). ID already present, however, in 36.6 per cent of children in this age group, reached a prevalence of 72.9 per cent in children older than 18 months. Anemia prevalence was significantly higher in males, in children whose birth weight was < 3000 g, in those who had never taken iron supplements and among the poor, both structural and by income. Retinol values < 20 micrograms/dl occurred only in 5.1 per cent of children. Iron nutrition prior to, during pregnancy and in children during the first 2 years of life must be improved by joining strategies based on community empowerment aimed at improving dietary iron, assuring effective preventive supplementation and promoting the opportune umbilical cord ligation.
Asunto(s)
Humanos , Masculino , Femenino , Lactante , Anemia Ferropénica , Deficiencia de Vitamina A/epidemiología , Hierro/deficiencia , Anemia Ferropénica , Anemia/sangre , Anemia/epidemiología , Anemia/prevención & control , Argentina/epidemiología , Deficiencia de Vitamina A/sangre , Deficiencia de Vitamina A/prevención & control , Ferritinas , Accesibilidad a los Servicios de Salud , Hemoglobinas/análisis , Prevalencia , Factores SocioeconómicosRESUMEN
Aiming at their prevention, to determine the prevalence of gestational iron deficiency and anemia, considering access to health care and associations with social and biological variables in the Province of el Chaco, Argentina. Three hundred and sixty four, randomly selected pregnant women from the whole province participated. Mean Hemoglobin (Hb) +/- SD dropped progressively from 118.4 +/- 11.0 to 112.1 +/- 11.5 g/L (p = 0.015) between the 1st and the 3rd gestational trimesters. Anemia prevalence (Hb < 110 g/L) was 17.4, 26.5 and 35.8 per cent. From the 1st to the 3rd trimesters. Second trimester prevalence was 14.1 per cent using Hb < 105 g/L as recently suggested. The ferritin geometric mean during the progressive gestational trimesters were 28.9; 16.0 and 11.1 micrograms/L. 21.7, 40.5 and 60.5 per cent had ferritins < 12 micrograms/L, and 39.1, 58.9 and 83.2 per cent had ferritins < 20 micrograms/L in these respective trimesters (p < 0.004 between trimesters in both cases). Both iron deficiency and anemia were significantly greater in women with unfinished primary education and with interpregnancy interval < 1 year. Seventy five percent of women had adequate number of antenatal visits but only 23 per cent were taking iron supplements and 10 per cent had stopped taking them. The prevention and correction of gestational iron deficiency and anemia must focus on the preconceptional period (inter-pregnancy spacing and increasing iron intake using all available means) as well as during pregnancy improving adherence to iron supplements by means of motivation of health workers and community.
Asunto(s)
Humanos , Femenino , Embarazo , Adulto , Anemia Ferropénica , Complicaciones Hematológicas del Embarazo/epidemiología , Hierro/deficiencia , Anemia Ferropénica , Argentina/epidemiología , Estudios Transversales , Complicaciones Hematológicas del Embarazo/prevención & control , Ferritinas , Hemoglobinas/análisis , PrevalenciaRESUMEN
BACKGROUND: Reducing the phytate content in grains by genetic manipulation is a novel approach to increasing nonheme-iron absorption from mixed diets. Fractional iron absorption from a genetically modified strain of low-phytate maize (LPM) increased significantly, by 50%. OBJECTIVE: We assessed iron absorption from porridges prepared from the same LPM (lpa-1-1 mutant) and unmodified wild-type maize (WTM), both of which were fortified with either ferrous sulfate or sodium iron EDTA. DESIGN: Porridges providing 3.4 mg Fe were fortified with either ferrous sulfate or sodium iron EDTA to provide an additional 1 mg Fe/serving. In 14 nonanemic women, iron absorption was measured as the amount of radioiron incorporated into red blood cells (extrinsic tag method) 12 d after consumption of the study diets. RESULTS: No significant effect of phytate content on iron absorption was found when porridge was fortified with either sodium iron EDTA or ferrous sulfate. Fractional absorption of iron from WTM porridge fortified with sodium iron EDTA (5.73%) was 3.39 times greater than that from the same porridge fortified with ferrous sulfate (1.69%). Fractional absorption of iron from the sodium iron EDTA-fortified LPM porridge (5.40%) was 2.82 times greater than that from LPM porridge fortified with ferrous sulfate (1.91%) (P<0.0001 for both comparisons, repeated-measures analysis of variance). Thus, the previously identified benefit of LPM was no longer detectable when maize porridge was fortified with additional iron. CONCLUSION: Iron was absorbed more efficiently when the fortificant was sodium iron EDTA rather than ferrous sulfate, regardless of the type of maize.
Asunto(s)
Ácido Edético/farmacocinética , Compuestos Férricos/farmacocinética , Compuestos Ferrosos/farmacocinética , Alimentos Fortificados , Absorción Intestinal , Hierro de la Dieta/farmacocinética , Zea mays/genética , Adulto , Análisis de Varianza , Anemia Ferropénica/prevención & control , Femenino , Humanos , Absorción Intestinal/efectos de los fármacos , Quelantes del Hierro , Ácido Fítico/efectos adversos , Zea mays/metabolismoRESUMEN
The absorption of a commercial brand of small-particle reduced iron was evaluated in 10 normal subjects. For each subject, the hemoglobin incorporation method was used to measure the true absorption of 60 mg of iron from either ferrous sulfate or ferric ammonium citrate. The iron tolerance test (ITT) was also studied for these two compounds and for reduced iron. This procedure consisted of measuring the area under the curve of plasma iron elevations at specified times for 6 hours, or the peak plasma iron, corrected by the plasma iron disappearance rate obtained from measuring plasma iron at specified times for 4 hours after the slow intravenous injection of 0.4 mg of iron as ferric citrate. Only the ITT was used to measure the absorption of 60 mg of reduced iron. Reference dose iron ascorbate absorption was measured in each subject. The absorption of ferric ammonium citrate and reduced iron was expressed as percent of dose and also as absorption percent of that of ferrous sulfate. Mean % geometric "true absorptions" were 39.0 for reference dose, 10.4 for FeSO4 and 2.4 for ferric ammonium citrate. The later was 23% that of FeSO4. By ITT the mean geometric % absorptions were 7.9, 3.7 and 3.2 for FeSO4, ferric ammonium citrate and reduced iron respectively, or 47 and 41% of that of FeSO4. We propose that the true absorption of the commercial brand of reduced iron tested was 20% that of FeSO4 based on the relation between the ITT results of reduced iron and the ITT and true absorption values of ferric ammonium citrate in relation to FeSO4. The use of this method for measuring absorption of unlabeled iron compounds is discussed.
Asunto(s)
Compuestos Férricos/farmacocinética , Compuestos Ferrosos/farmacocinética , Hierro/farmacocinética , Compuestos de Amonio Cuaternario/farmacocinética , Absorción , Adolescente , Adulto , Anciano , Disponibilidad Biológica , Suplementos Dietéticos , Femenino , Ferritinas/sangre , Hemoglobinas/análisis , Hemoglobinas/metabolismo , Humanos , Hierro/administración & dosificación , Hierro/sangre , Radioisótopos de Hierro , Masculino , Persona de Mediana Edad , Tamaño de la Partícula , Recuento Corporal TotalRESUMEN
BACKGROUND: There is a need to determine whether iron absorption from iron amino acid chelates is protected from inhibition by dietary phytate and regulated normally by iron status. OBJECTIVE: The objective of this study was to compare iron absorption from ferrous sulfate, ferrous bisglycinate, and ferric trisglycinate in whole-maize meal; to determine whether iron from ferrous bisglycinate and ferrous sulfate exchanges in the intestinal pool; and to assess iron absorption from ferrous bisglycinate and ferric trisglycinate over a range of iron statuses. DESIGN: In study 1A, 10 iron-sufficient men consumed ferrous sulfate-fortified whole-maize meal porridge equilibrated with (59)Fe-sulfate on day 1 and (55)Fe-bisglycinate on day 2. In study 1B, these volunteers consumed ferrous sulfate-fortified porridge equilibrated with (59)Fe-sulfate and (55)Fe-bisglycinate simultaneously. In studies 2A and 2B, iron absorption from 3 mg Fe as (59)Fe-ascorbate, (55)Fe-bisglycinate, or (59)Fe-trisglycinate in water and in porridge was compared in 23 subjects with a range of iron statuses. Iron absorption was determined from blood radioactivity on day 16. RESULTS: In study 1A, geometric mean iron absorption from ferrous bisglycinate was 6.0% (range: 2.6-13.6%), 4 times higher than that from ferrous sulfate (1. 7%; range: 1.0-3.3%; P < 0.05). In study 1B, absorption from neither source was different from that in study 1A. In studies 2A and 2B, absorption from all sources was strongly inversely related to serum ferritin, with geometric means of 32.5% (iron ascorbate), 9.1% (bisglycinate), and 15.3% (trisglycinate). Iron from ferric trisglycinate was poorly absorbed (2.3%; range: 0.5-9.2%) from maize. CONCLUSION: In whole-maize meal, iron from ferrous bisglycinate is better absorbed than is iron from ferrous sulfate and does not exchange with iron from maize or ferrous sulfate in the intestinal pool. Absorption of iron from bisglycinate and trisglycinate is regulated normally by iron status.
Asunto(s)
Glicina , Quelantes del Hierro , Hierro/farmacocinética , Estado Nutricional , Zea mays , Absorción , Adulto , Femenino , Compuestos Férricos , Ferritinas/sangre , Compuestos Ferrosos , Alimentos Fortificados , Humanos , Radioisótopos de Hierro , Masculino , Análisis de RegresiónRESUMEN
Numerous studies have shown that iron-loaded diets increase markers of lipid peroxidation in rats, but few have addressed the effects of oral iron supplements on these markers. We investigated the effects of daily and intermittent iron supplements on iron and vitamin E status, and lipid peroxidation. Iron supplements were administered in doses equivalent to those often given to pregnant women in the developing world. In Study 1, iron-deficient (D) and iron-normal (N) rats were fed either 0 or 8000 microgram of supplemental iron daily for 21 d. In Study 2, D rats were fed either the same supplements daily or once every 3 d (8 supplements total). Lipid peroxidation was assessed by breath ethane and pentane and by malondialdehyde (MDA) (using GC-MS). In Study 1, daily supplemented N and D rats had liver nonheme iron concentrations that were 1.8- and 2.7-fold higher, respectively, than those in unsupplemented N rats. Breath ethane levels were also higher in supplemented rats (P < 0.05), but MDA (in plasma, liver, kidney) and liver vitamin E did not differ. Unexpectedly, severely D, anemic rats had significant elevations in the levels of breath ethane, liver MDA and kidney MDA. In Study 2, liver iron and breath ethane decreased progressively (P < 0.05) from 1 d to 3 d after the last iron dose in intermittently supplemented rats. We conclude that iron deficiency results in lipid peroxidation, but that its correction with daily iron supplements results in abnormal iron accumulation and increased lipid peroxidation in rats. These effects are mitigated by intermittent iron supplementation.
Asunto(s)
Dieta , Deficiencias de Hierro , Hierro/farmacología , Peroxidación de Lípido/efectos de los fármacos , Animales , Peso Corporal/efectos de los fármacos , Pruebas Respiratorias , Relación Dosis-Respuesta a Droga , Esquema de Medicación , Etano/química , Cromatografía de Gases y Espectrometría de Masas , Hierro/administración & dosificación , Riñón/metabolismo , Hígado/metabolismo , Masculino , Malondialdehído/sangre , Malondialdehído/química , Estado Nutricional , Ratas , Ratas Sprague-Dawley , Vitamina E/sangreRESUMEN
Numerous studies in animals and humans provide evidence that ethane and pentane in expired air are useful markers of in vivo lipid peroxidation. The measurement of breath hydrocarbons, being noninvasive, is well suited for routine use in research and clinical settings. However, the lack of standardized methods for collecting, processing, and analyzing expired air has resulted in the use of a wide variety of different methods that have yielded highly disparate results among investigators. This review outlines the methods that we have developed and validated for measuring ethane and pentane in expired air from rats and humans. We describe the advantages of these methods, their performance, as well as potential errors that can be introduced during sample collection, concentration, and analysis. A main source of error involves contamination with ambient-air ethane and pentane, the concentrations of which are usually much greater and more variable than those in expired air. Thus, it appears that the effective removal of ambient-air hydrocarbons from the subject's lungs before collection is an important step in standardizing the collection procedure. Also discussed is whether ethane or pentane is a better marker of in vivo lipid peroxidation.
Asunto(s)
Pruebas Respiratorias , Etano/análisis , Peroxidación de Lípido , Pentanos/análisis , Animales , Biomarcadores/análisis , Humanos , Ratas , Reproducibilidad de los Resultados , RespiraciónRESUMEN
This 7-mo double-blind study compared the efficacy of two iron supplementation schemes in improving iron nutrition among 116 healthy fertile-age women. They were randomly distributed in three groups, receiving: Group 1, iron + folate (60 mg and 250 microg, respectively) daily for 3 mo (currently recommended scheme), and folate (250 microg) weekly the subsequent 4 mo. Group 2, folate daily, and 60 mg iron only once weekly for 3 mo, and then weekly iron + folate for 4 mo. Group 3, folate daily for 3 mo and then weekly for 4 mo. At baseline, 16% had depleted stores (plasma ferritin <15 microg/L) and 16% had hemoglobin levels <125 g/L. Eight percent had hemoglobin levels <120 g/L. In Group 1 hemoglobin and ferritin increased at 3 mo but returned to near basal conditions after 4 mo of weekly folate. In Group 2, hemoglobin and ferritin increased progressively throughout the 7 mo but mostly after 3 mo. Group 3 did not change. Side effects were highest with daily iron. Weekly iron supplementation over 7 mo (30 doses) improved and sustained iron nutrition at least as effectively and was better tolerated than 90 daily iron supplements consumed during 3 mo.
Asunto(s)
Hierro/administración & dosificación , Estado Nutricional , Adolescente , Adulto , Análisis de Varianza , Dieta , Método Doble Ciego , Esquema de Medicación , Femenino , Ferritinas/sangre , Hemoglobinas/efectos de los fármacos , Humanos , Protoporfirinas/sangre , Factores de TiempoRESUMEN
We describe a method for the collection of expired air and further document the performance of our analytical technique that is used to measure ethane and pentane simultaneously. Four minutes of breathing hydrocarbon-free air before collection effectively removed high concentrations of residual ambient ethane and pentane from the lungs, with washout times up to 30 min resulting in no further reductions in breath hydrocarbons. Mean (+/-SE) exhalation rates (pmol/kg b.wt./min) in 11 subjects were 2.4 +/- 0.6 for ethane and 1.5 +/- 1.3 for pentane. Total intraindividual variability in exhalation rates (as percent coefficient of variation, %CV), measured from 4 subjects on at least 6 different days, was greater for pentane (44% CV) than for ethane (29% CV). Analytical variability contributed 6% to the total %CV. Advantages of the method are described, and reasons for the large variability in values reported in the literature are discussed.
Asunto(s)
Pruebas Respiratorias/métodos , Etano/análisis , Pentanos/análisis , Adulto , Anciano , Pruebas Respiratorias/instrumentación , Calibración , Cromatografía de Gases , Femenino , Humanos , Masculino , Persona de Mediana Edad , Respiración , Sensibilidad y Especificidad , TemperaturaRESUMEN
BACKGROUND: Iron deficiency and its consequent anemia constitute the commonest micronutrient deficiency in the world. OBJECTIVE: We investigated whether long-term, weekly iron-folate supplements administered at school would improve hemoglobin and ferritin concentrations in adolescent girls, including those with mild-to-moderate anemia and hemoglobin concentrations indicating borderline anemia. DESIGN: Subjects were 266 girls with hemoglobin concentrations of 80-119.9 g/L (group A) and 358 girls with hemoglobin concentrations of 120-130 g/L (group B) who were otherwise healthy. Two hundred sixty-six girls in group A and 268 girls in group B were randomly assigned to receive either 60 or 120 mg Fe plus 3.5 mg folic acid weekly for 22 wk. Ninety of the girls in group B were randomly assigned to receive only 5 mg folic acid weekly. Capillary hemoglobin and plasma ferritin were measured at baseline and after 12 and 22 wk of supplementation. RESULTS: By the end of the study, 2% of the girls had dropped out and > 96% had taken > or = 20 of the 22 tablets; side effects were minimal. Mean plasma ferritin increased significantly in all iron-supplemented groups, independently of initial hemoglobin values and iron doses. Ferritin concentrations decreased in the girls supplemented with folic acid only. As expected, hemoglobin responses to iron were higher in group A than in group B and increases were positively correlated with initial plasma ferritin. Hemoglobin failed to respond to folate supplementation if initial plasma ferritin concentrations were low. Mean hemoglobin increased significantly and consistently in relation to the length of treatment. CONCLUSION: Long-term, weekly iron-folate supplementation was found to be a practical, safe, effective, and inexpensive method for improving iron nutrition in adolescent schoolgirls.
Asunto(s)
Anemia Ferropénica/tratamiento farmacológico , Ferritinas/sangre , Ácido Fólico/uso terapéutico , Hematínicos/uso terapéutico , Hemoglobinas/análisis , Hierro/uso terapéutico , Adolescente , Análisis de Varianza , Anemia Ferropénica/sangre , Anemia Ferropénica/clasificación , Capilares , Combinación de Medicamentos , Femenino , Ácido Fólico/administración & dosificación , Hematínicos/administración & dosificación , Humanos , Hierro/administración & dosificación , Malasia , Cooperación del Paciente , Instituciones AcadémicasRESUMEN
Iron supplementation is a public health strategy designed for the prevention of iron deficiency and its consecutive anemia. It should be targeted, safe, flexible, long term and ideally, community based under the supervision of the health sector. It must be differentiated from iron therapy, even though, in the intermediate and long term it corrects mild-moderate deficiency of iron and ferropenic anemia. It should complement other measures for the control of iron deficiency. A summary of results comparing daily and intermittent iron supplementation (every 3-days in rats, and weekly in humans) is presented, including studies in an animal model, human supplementary-iron absorption studies, clinical research and field studies. It is concluded that intermittent iron supplementation is efficacious and, that in the long term it achieves an increase in iron reserves while avoiding sustained oxidative stress caused by current practices of excess daily iron supplementation, particularly in the developing world. The stage is set for long-term weekly iron supplementation programs in large population groups to determine its sustainability and effectiveness.
Asunto(s)
Anemia Ferropénica/prevención & control , Suplementos Dietéticos , Deficiencias de Hierro , Hierro de la Dieta/administración & dosificación , Anemia Ferropénica/dietoterapia , Animales , Niño , Modelos Animales de Enfermedad , Femenino , Humanos , Masculino , Embarazo , RatasRESUMEN
BACKGROUND: Genetically modified, low-phytic acid strains of maize were developed to enhance mineral absorption, but have not been tested previously in humans. OBJECTIVES: We evaluated the mineral and phytic acid contents of a low-phytic acid "flint" maize (LPM, the lpa-1-1 mutant) and its parent, wild-type strain (WTM) and measured iron absorption from tortillas prepared with each type of maize and from a reference dose of ferrous ascorbate. DESIGN: Proximate composition and mineral and phytic acid contents were measured by standard techniques. Iron absorption from tortillas was evaluated by using the extrinsic tag method and was measured as the incorporation of radiolabeled iron into the red blood cells of 14 nonanemic men 2 wk after intake. RESULTS: The phytic acid content of LPM was 3.48 mg/g, approximately 35% of the phytic acid content of WTM; concentrations of macronutrients and most minerals were not significantly different between strains. Iron absorption results were adjusted to 40% absorption of ferrous ascorbate. Iron absorption was 49% greater from LPM (8.2% of intake) than from WTM (5.5% of intake) tortillas (P < 0.001, repeated-measures analysis of variance). CONCLUSION: Consumption of genetically modified, low-phytic acid strains of maize may improve iron absorption in human populations that consume maize-based diets.
Asunto(s)
Hierro/farmacocinética , Ácido Fítico/farmacología , Zea mays/genética , Adulto , Análisis de Varianza , Manipulación de Alimentos , Humanos , Fosfatos de Inositol/análisis , Absorción Intestinal/efectos de los fármacos , Deficiencias de Hierro , Masculino , Ácido Fítico/administración & dosificación , Ácido Fítico/análisis , Zea mays/químicaRESUMEN
Iron deficiency (ID), defined as an insufficient supply of iron to the cells of the body after iron reserves have been exhausted, is the most prevalent single nutritional deficiency, affecting over 2,000 million people, mostly in the developing world. Infants, small children, adolescents and pregnant and fertile-age women are most vulnerable. Only about 50% of people with ID develop iron deficiency anemia (IDA), since this is a late manifestation of chronic ID. Based on the average daily iron requirement and on the rate of iron reutilization from red cell hemoglobin destruction, it can be estimated that after iron stores have been depleted, it takes about 4 months of ID erythropoiesis for adult women to have a drop in hemoglobin concentration [Hb] of 10 g/l, if the iron intake is only 70% of requirement. IDA can be defined by a [Hb] below an appropriate cut-off point for age, sex, physiological condition and altitude above sea level, or by a [Hb] increment of more than 10 g/l to the administration of adequate doses of iron. More than 85% of the nutritional anemias are IDA alone, or of iron combined with folate or other nutrient deficiencies.
Asunto(s)
Anemia Ferropénica/dietoterapia , Suplementos Dietéticos , Deficiencias de Hierro , Hierro de la Dieta/uso terapéutico , Adulto , Anemia Ferropénica/prevención & control , Preescolar , Monitoreo de Drogas , Eritropoyesis , Femenino , Deficiencia de Ácido Fólico/sangre , Deficiencia de Ácido Fólico/prevención & control , Hemoglobinas/metabolismo , Humanos , Lactante , Recién Nacido , Hierro/sangre , Hierro de la Dieta/administración & dosificación , Masculino , Embarazo , Factores de RiesgoRESUMEN
Iron supplementation, mostly with a therapeutic orientation, has been a key strategy for the short-term control of iron deficiency and ferropenic anemia. It has been used almost exclusively in antenatal clinics, but in spite of its confirmed efficacy in supervised trials, it has proven ineffective in practice in most developing countries. Poor effectiveness has been attributed to various factors including insufficient dose and time of supplementation and poor adherence. These problems have led to the administration of high iron doses, which have proven equally ineffective in practice. This paper introduces four concepts: (1) that iron supplementation targeted to pregnant women should cover the full reproductive cycle, from prepregnancy to at least the end of lactation instead of only the pregnant women; (2) that entering pregnancy with iron deficiency contributes to the failure of antenatal iron supplementation and that prepregnancy iron reserves increase the effectiveness of antenatal supplementation; (3) that medium- to long-term weekly ingestion of proper iron-folate supplements, with a preventive aim and directed to all risk groups, should be community based rather than health service based but supervised by the latter (in this sense, preventive supplementation is equal to targeted iron fortification); and (4) that preventive supplementation, based on weekly dosing, has proven efficacious. Problem-oriented research to evaluate the sustainability and medium- to long-term efficacy of these concepts is called for. The bases for the concepts and suggestions are summarized in this paper.
Asunto(s)
Anemia Ferropénica/prevención & control , Deficiencias de Hierro , Hierro de la Dieta/uso terapéutico , Absorción , Adolescente , Adulto , Anemia Ferropénica/dietoterapia , Anemia Ferropénica/epidemiología , Animales , Niño , Preescolar , Ensayos Clínicos como Asunto , Países en Desarrollo , Relación Dosis-Respuesta a Droga , Femenino , Ferritinas/sangre , Alimentos Fortificados , Hemoglobinas/análisis , Humanos , Lactante , Hierro/sangre , Hierro de la Dieta/administración & dosificación , Hierro de la Dieta/farmacocinética , Masculino , Embarazo , Factores de Riesgo , Organización Mundial de la SaludRESUMEN
The simultaneous measurement of 59Fe and 55Fe in whole blood by liquid scintillation counting by the Eakins and Brown (EB) method is extensively used in iron absorption studies. The EB method requires many steps which increase the chances of error and decrease its sensitivity. We describe two modifications to the above method consisting of microwave digestion and column purification of iron. This "New Method" (NM) is simpler and more precise, and sensitive than the EB method. Counting efficiencies with the NM are similar for 59Fe (75%) as with the EB method but are better for 55Fe (29% for NM vs 22%), and cross counting from 59Fe into the 55Fe window is lower with the NM (3.7-4.5%) than with the EB method (10-12%). For the NM, recoveries of radioactive blood samples, in relation to processed standards ranged from 100 to 103% for 59Fe and 101 to 113% for 55Fe. For the EB method, recoveries ranged from 94 to 99% for 59Fe and from 88 to 93% for 55Fe. Even with very low counts, average intrarun CV with the NM was lower than 5.4% for either isotope, while it was as high as 10.0% for 55Fe with the EB method.
Asunto(s)
Radioisótopos de Hierro/análisis , Conteo por Cintilación , Animales , Cromatografía por Intercambio Iónico , Humanos , Radioisótopos de Hierro/sangre , Radioisótopos de Hierro/aislamiento & purificación , Microondas , Sensibilidad y EspecificidadRESUMEN
The measurement of ethane and pentane in breath offers a sensitive and noninvasive means to assess in vivo lipid peroxidation in animals and humans. However, numerous technical obstacles inherent in collecting and concentrating air-breath samples have limited the wider application of these measurements for the assessment of in vivo lipid peroxidation. We have developed a relatively simple, inexpensive, rapid, and reliable method to collect, concentrate, and measure breath ethane and total-body pentane from rats. This method, which concentrates alkanes from 4 liters of collected air-breath on adsorbant cooled to -174 degrees C, was found to be superior to similar cryofocusing techniques at -130 degrees C, which fail to effectively trap highly volatile ethane from large volumes of air. We found ethane evolves predominantly through breath, whereas a significant amount of pentane evolves from sources other than breath. Mean evolution rate for ethane was 1.08 pmol/100 g body wt/min. Pentane evolution rates displayed more inter-rat and day-to-day variability with a mean of 0.52 pmol/100 g body wt/min. We also found that excreted rat feces exude large amounts of ethane and pentane.