Determining iron bio-availability with a constant heme iron value

Dietary quality, anaemia prevalence and their associated factors among rural school- going adolescents in Acholi sub -region of Uganda

BACKGROUND

Globally, iron deficiency anaemia is a widespread public health problem affecting vulnerable populations including adolescents. However, over the years, the Uganda Demographic Health Surveys mostly report the status of anaemia for women of reproductive age (15-49 years) and children up to 5 years, leaving out the focus on adolescents. Moreover, high prevalence of anaemia among children below five years could suggest that anaemia still persists at adolescence. Therefore, the study aimed at determining dietary quality, prevalence of anaemia and their associated factors among school-going adolescents.

METHODS

A cross-sectional study involving 341 adolescent boys and girls aged 10-19 years was carried out in two rural schools in Gulu district. Prevalence of anaemia was determined by obtaining blood specimens from a finger prick into a microcuvette and analysed for haemoglobin (Hb) level using Haemoglobin analyser, whereas dietary quality was assessed using the Individual Dietary Diversity Score (IDDS). Socio-economic and demographic data were collected using a semi-structured questionnaire.

RESULTS

The overall prevalence of anaemia was 16.0% (Girls:18.1%; Boys:13.0%), while the mean Hb level was 13.2 ± 1.4 g/dl (Girls 13.0 ± 1.3 g/dl; Boys 13.5 ± 1.6 g/dl). The mean number of food groups consumed among the adolescents was 3.5 ± 2.1 for girls and 3.0 ± 1.8 for boys (p˃0.05). Animal source foods, fruits and vitamin A-rich vegetables, other fruits and vegetables were consumed by adolescent girls more than the boys. Similarly, a higher proportion of adolescent girls than boys consumed iron-rich foods: fish and meat, organ meat and dark green leafy vegetables. Further, all the socio-demographic factors in the study did not predict dietary diversity (p ˃ 0.05). On the other hand, education attainment by parent/guardian and nature of menstruation predicted the prevalence of anaemia amongst adolescents (p < 0.05).

CONCLUSIONS

The prevalence of anaemia was high among adolescents. Coupled with this, there, was low dietary diversity among the adolescents. The level of education of the parent/guardian and nature of the menstrual discharge were significant predictors of anaemia amongst girls. From this study, we recommend interventions by both health and agricultural-related practitioners to strengthen activities in rural schools such as health and nutrition education to create awareness about dietary diversity and promotion of agricultural practices such as school vegetable gardens, orchards poultry production and rearing of small ruminants to support consumption of diverse foods in schools with the view of reducing the burden from iron deficiency anaemia.

Comparison of nutritional profile between plant-based meat analogues and real meat: A review focusing on ingredients, nutrient contents, bioavailability, and health impacts

In order to fully understand the nutritional heterogeneity of plant-based meat analogues and real meat, this review summarized their similarities and differences in terms of ingredients, nutrient contents, bioavailability and health impacts. Plant-based meat analogues have some similarities to real meat. However, plant-based meat analogues are lower in protein, cholesterol and VB12 but higher in dietary fiber, carbohydrates, sugar, salt and various food additives than real meat. Moreover, some nutrients in plant-based meat analogues, such as protein and iron, are less bioavailable. There is insufficient evidence that plant-based meat analogues are healthier, which may be related to the specific attributes of these products such as formulation and degree of processing. As things stand, it is necessary to provide comprehensive nutrition information on plant-based meat products so that consumers can make informed choices based on their nutritional needs.

Thermosensitive Chitosan Hydrogels: A Potential Strategy for Prolonged Iron Dextran Parenteral Supplementation

Iron deficiency anemia (IDA) presents a global health challenge, impacting crucial development stages in humans and other mammals. Pigs, having physiological and metabolic similarities with humans, are a valuable model for studying and preventing anemia. Commonly, a commercial iron dextran formulation (CIDF) with iron dextran particles (IDPs) is intramuscularly administered for IDA prevention in pigs, yet its rapid metabolism limits preventive efficacy. This study aimed to develop and evaluate chitosan thermosensitive hydrogels (CTHs) as a novel parenteral iron supplementation strategy, promoting IDPs' prolonged release and mitigating their rapid metabolism. These CTHs, loaded with IDPs (0.1, 0.2, and 0.4 g of theoretical iron/g of chitosan), were characterized for IM iron supplementation. Exhibiting thermosensitivity, these formulations facilitated IM injection at ~4 °C, and its significant increasing viscosity at 25-37 °C physically entrapped the IDPs within the chitosan's hydrophobic gel without chemical bonding. In vitro studies showed CIDF released all the iron in 6 h, while CTH0.4 had a 40% release in 72 h, mainly through Fickian diffusion. The controlled release of CTHs was attributed to the physical entrapment of IDPs within the CTHs' gel, which acts as a diffusion barrier. CTHs would be an effective hydrogel prototype for prolonged-release parenteral iron supplementation.

Plant-based Diet and Iron Deficiency Anemia in Sundanese Adolescent Girls at Islamic Boarding Schools in Indonesia

BACKGROUND

Adolescent girls are at risk for iron deficiency anemia (IDA) due to the higher demand of iron for growth and the loss of blood during menstruation. Consumption of foods containing iron that have higher bioavailability can reduce the risk of IDA although diets that are largely plant-based, like those consumed by many Sundanese people, may not contain sufficient bioavailable iron. Here, we investigated the correlation between plant-based diets and IDA in adolescent Sundanese girls who were students at Islamic boarding schools in Indonesia.

METHODS

A total of 176 girls from seven Islamic boarding schools in Tasikmalaya were recruited. Nutritional intake data were obtained using 24-hr dietary recall. Blood samples were analyzed with a Sysmex-XNL instrument to measure several parameters including hemoglobin, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC).

RESULTS

The prevalence of IDA in the study population was 22.2%. Iron intake was 6.59 mg/day, which was lower than the recommended amount. The molar ratio of phytic acid to iron and vitamin C to iron was 8.72 and 0.03, respectively. There was a correlation between heme iron and both hemoglobin (p=0.009) and hematocrit (p=0.018). Iron from meat, fish, and poultry was correlated with hemoglobin (p=0.009) and hematocrit (p=0.011).

CONCLUSION

The Sundanese plant-based diet did not affect the IDA status. Instead, IDA was associated with consumption of less animal-based foods that have iron with higher bioavailability. Increased access to an animal-based menu at the school cafeteria could be an approach to prevent IDA in students at Islamic boarding schools in Indonesia.

Biomarkers and Fatty Fish Intake: A Randomized Controlled Trial in Norwegian Preschool Children

BACKGROUND

Biomarkers such as omega-3 (n-3) PUFAs, urinary iodine concentration (UIC), 1-methylhistidine (1-MH), and trimethylamine N-oxide (TMAO) have been associated with fish intake in observational studies, but data from children in randomized controlled trials are limited.

OBJECTIVES

The objective of this exploratory analysis was to investigate the effects of fatty fish intake compared with meat intake on various biomarkers in preschool children.

METHODS

We randomly allocated (1:1) 232 children, aged 4 to 6 y, from 13 kindergartens. The children received lunch meals of either fatty fish (herring/mackerel) or meat (chicken/lamb/beef) 3 times a week for 16 wk. We analyzed 86 biomarkers in plasma (n = 207), serum (n = 195), RBCs (n = 211), urine (n = 200), and hair samples (n = 210). We measured the effects of the intervention on the normalized biomarker concentrations in linear mixed-effect regression models taking the clustering within the kindergartens into account. The results are presented as standardized effect sizes.

RESULTS

We found significant effects of the intervention on the following biomarkers: RBC EPA (20:5n-3), 0.61 (95% CI: 0.36, 0.86); DHA (22:6n-3), 0.43 (95% CI: 0.21, 0.66); total n-3 PUFAs, 0.41 (95% CI: 0.20, 0.64); n-3/n-6 ratio, 0.48 (95% CI: 0.24, 0.71); adrenic acid (22:4n-6, -0.65 (95% CI: -0.91, -0.40), arachidonic acid (20:4n-6), -0.54 (95% CI: -0.79, -0.28); total n-6 PUFAs, -0.31 (95% CI: -0.56, -0.06); UIC, 0.32 (95% CI: 0.052, 0.59); hair mercury, 0.83 (95% CI: 0.05, 1.05); and plasma 1-MH, -0.35 (95% CI: -0.61, -0.094).

CONCLUSIONS

Of the 86 biomarkers, the strongest effect of fatty fish intake was on n-3 PUFAs, UIC, hair mercury, and plasma 1-MH. We observed no or limited effects on biomarkers related to micronutrient status, inflammation, or essential amino acid, choline oxidation, and tryptophan pathways.The trial was registered at clinicaltrials.gov (NCT02331667).

Bioconservation of iron and enhancement of antioxidant and antibacterial properties of chicken gizzard protein hydrolysate fermented by Pediococcus acidilactici ATTC 8042

BACKGROUND

The poultry industry is one of the fastest growing sectors, and it generates considerable quantities of chicken gizzards (CG) every day. However, due to their hard texture and high microbial load, and due to cultural beliefs, they are not preferred by consumers. Chicken gizzards are a substantial source of proteins, iron, and other nutrients, which can be used effectively to produce nutraceuticals, rich in peptides (antioxidants and antibacterial), bio-iron, essential free amino acids, and fatty acids vital for human health.

RESULTS

Lactic acid fermentation of CG by Pediococcus acidilactici ATTC 8042 increased the antioxidant activity of 2,2-diphenyl-1-picrylhydrazyl (DPPH), azino-bis (3-ethylbenzothiaziline-6-sulphonic acid) (ABTS), and ferric reducing antioxidant power (FRAP) by up to 26 times compared with unfermented CG (P < 0.05). The amount of hydrolysis and solvents (ethanol and water) used for extracting protein hydrolysates significantly affected the antioxidant properties. Moreover, fermented CG showed a negligible reduction in bio-iron (2-3%) compared with heat-processed CG (85 °C for 15 min), in which bio-iron was reduced by up to 20.3% (P < 0.05). The presence of unsaturated fatty acids such as C20:4 and C22:4 n-6 indicated a low level of lipid oxidation.

CONCLUSION

Fermented CG, with its reasonably high antioxidant and antibacterial activity, together with a substantial amount of bio-iron and other nutritional components can serve as a functional food or feed additive to reduce oxidative stress and to treat iron deficiency. © 2020 Society of Chemical Industry.

Iron supplementation and iron-fortified foods: a review

About one-third of the world population is suffering from iron deficiency. Delivery of iron through diet is a practical, economical, and sustainable approach. Clinical studies have shown that the consumption of iron-fortified foods is one of the most effective methods for the prevention of iron deficiency. However, supplementing iron through diet can cause undesirable side-effects. Thus, it is essential to develop new iron-rich ingredients, iron-fortified products with high bioavailability, better stability, and lower cost. It is also essential to develop newer processing technologies for more effective fortification. This review compared the iron supplementation strategies used to treat the highly iron-deficient population and the general public. We also reviewed the efficacy of functional (iron-rich) ingredients that can be incorporated into food materials to produce iron-fortified foods. The most commonly available foods, such as cereals, bakery products, dairy products, beverages, and condiments are still the best vehicles for iron fortification and delivery.Scope of reviewThe manuscript aims at providing a comprehensive review of the latest publications that cover three aspects: administration routes for iron supplementation, iron-rich ingredients used for iron supplementation, and iron-fortified foods.

Estimation of Iron Content and Its Contribution in Iron-Fortified Food Products Consumed by School Children in Sri Lanka

Iron fortification is an effective strategy that can be implemented to ensure supply and intake of iron for the public at large. Even though iron-fortified foods are widely available in the Sri Lankan market, the quantification of iron in those foods is not under the regulations of the food authorities in Sri Lanka. Therefore, this study aims to quantify the concentration of iron in selected iron-fortified foods available in the local market and determine their contribution to the recommended daily allowances (RDA) per serving. The iron content in most popular powdered milk, biscuits, and breakfast cereals among the children of 15-16 years in Horana Divisional Secretariat was analyzed using atomic absorption spectroscopy, and its contribution to RDA was calculated. The average iron values of iron-fortified milk powder (IFMP), iron-fortified biscuit (IFB), and iron-fortified breakfast cereals (IFBC) were found to be 18.08 ± 9.53, 7.88 ± 0.07, and 17.78 ± 7.47 mg/100 g, respectively. The average estimated daily intake (EDI) per serving of IFMP, IFB, and IFBC was 3.61 ± 1.75, 2.13 ± 0.06, and 5.60 ± 1.45 mg, respectively. The highest contribution to the RDA can be obtained by a single serving of IFBC. Only less than half of the tested products have compatible iron levels with their labeled information. Iron-fortified foods which were studied have a high amount of iron, and they can make from 5% to 35% contribution to RDAs in young children, adolescents, and adults even by a single serving.

Iron Content of Some Popular Cooked Foods Consumed by the Rural School Children in Sri Lanka

Iron is an important micronutrient that can be found in different food sources in varying quantities. Iron deficiency is common in populations consuming cereal-based diets with little or no animal-derived food products. Rice is the staple for Sri Lankans, which may not provide sufficient bioavailable iron. Sri Lankan food composition table does not contain data on iron in home-cooked foods. Aim of the present study was to determine the iron content in commonly consumed home-cooked foods (rice, vegetables, green leaves, pulses, fish, etc.) by children aged 15-16 years. The study was carried out in eight schools at the Divisional Secretariat, Horana. The average iron values of cooked rice, vegetables, green leaves, pulses, and fish were 23.29 ± 14.46, 19.34 ± 9.90, 29.56 ± 13.64, 45.16 ± 22.28, and 46.72 ± 14.53 mg/kg, respectively. A serving of cooked red raw rice (rathu kekulu) provided the highest Estimated Daily Intake (EDI) of iron. The total EDI per serving for all categories was 6.39 ± 1.06 mg, contributing to the recommended daily allowance (RDA) of 42.62% of girls and 58.12% of boys as defined by the United States Department of Agriculture. Meanwhile, based on the Sri Lankan RDA, dietary iron contribution per serving ranges from 16.39% to 17.76% in girls and 16.39% to 21.31% in boys in the 15-16 years age category. Therefore, these home-cooked foods which were prepared using local recipes have high iron content and can replenish a major proportion of recommended quotidian values for iron intake.

Evaluating the efficacy of a ferrous-ion-chelating peptide from Alaska pollock frame for the improvement of iron nutritional status in rats

This study aimed to investigate the effects of ferrous-ion-chelating peptides from Alaska pollock frames (APFP-Fe) on iron deficiency in anaemic rats. We hydrolysed the Alaska pollock frames to obtain a peptide with an average molecular weight of 822 Da. The bioavailability of APFP-Fe was tested using animal experiments. Wistar rats were randomly divided into six groups: an iron deficiency control group, a normal control group, and iron deficiency groups treated with ferrous sulfate (FeSO₄) or low-, medium-, or high-dose APFP-Fe. Rats in the iron deficiency groups were fed an iron-deficient diet to establish the iron deficiency anaemia (IDA) model. After the model was established, different iron supplements were given to rats once per day via intragastric administration for 21 days. The results showed that APFP-Fe had restorative effects, returning the body weight, weight gain, height, and haematological parameters in IDA rats to normal levels. In addition, compared with FeSO₄, APFP-Fe promoted significant weight gain and effectively improved haemoglobin, serum iron and transferrin levels, and recovery of the capacity of iron binding with transferrin, especially at the medium and high doses. These findings suggest that APFP-Fe is an effective source of iron for improving the iron nutritional status in IDA rats and shows promise as a new source of iron supplementation.

Dietary Iron Bioavailability: Agreement between Estimation Methods and Association with Serum Ferritin Concentrations in Women of Childbearing Age

Predictive iron bioavailability (FeBio) methods aimed at evaluating the association between diet and body iron have been proposed, but few studies explored their validity and practical usefulness in epidemiological studies. In this cross-sectional study involving 127 women (18–42 years) with presumably steady-state body iron balance, correlations were checked among various FeBio estimates (probabilistic approach and meal-based and diet-based algorithms) and serum ferritin (SF) concentrations. Iron deficiency was defined as SF < 15 µg/L. Pearson correlation, Friedman test, and linear regression were employed. Iron intake and prevalence of iron deficiency were 10.9 mg/day and 12.6%. Algorithm estimates were strongly correlated (0.69≤ r ≥0.85; p < 0.001), although diet-based models (8.5–8.9%) diverged from meal-based models (11.6–12.8%; p < 0.001). Still, all algorithms underestimated the probabilistic approach (17.2%). No significant association was found between SF and FeBio from Monsen (1978), Reddy (2000), and Armah (2013) algorithms. Nevertheless, there was a 30–37% difference in SF concentrations between women stratified at extreme tertiles of FeBio from Hallberg and Hulthén (2000) and Collings’ (2013) models. The results demonstrate discordance of FeBio from probabilistic approach and algorithm methods while suggesting two models with best performances to rank individuals according to their bioavailable iron intakes.

Mechanisms Linking Colorectal Cancer to the Consumption of (Processed) Red Meat: A Review

Colorectal cancer (CRC) is the third most commonly diagnosed cancer in the world. The vast majority of CRC cases have been linked to environmental causes rather than to heritable genetic changes. Over the last decades, epidemiological evidence linking the consumption of red and, more convincingly, of processed red meat to CRC has accumulated. In parallel, hypotheses on carcinogenic mechanisms underlying an association between CRC and the intake of red and processed red meat have been proposed and investigated in biological studies. The hypotheses that have received most attention until now include (1) the presence of polycyclic aromatic hydrocarbons and heterocyclic aromatic amines, two groups of compounds recognized as carcinogenic, (2) the enhancing effect of (nitrosyl)heme on the formation of carcinogenic N-nitroso compounds and lipid peroxidation. However, none of these hypotheses completely explains the link between red and processed red meat intake and the CRC risk. Consequently, scientists have proposed additional mechanisms or refined their hypotheses. This review first briefly summarizes the development of CRC followed by an in-depth overview and critical discussion of the different potential carcinogenic mechanisms underlying the increased CRC risk associated with the consumption of red and processed red meat.

Iron in red meat-friend or foe

In developed countries, due to high content and bioavailability, red and processed meats are the main sources of iron in the diet. Adequate intake of this nutrient is essential for the proper development and functioning of the human body, and its deficiencies are associated mainly with the occurrence of anemia, which is one of the most widespread nutritional problems in the world. However, excessive intake of iron can be detrimental to health. Studies have shown that high consumption of red meat and its products, and thereby iron, particularly in the form of heme, increases the risk of non-communicable diseases, including cancers, type II diabetes and cardiovascular disease. Due to the high nutritional value, the presence of red meat in the diet is preferable, but according to World Cancer Research Fund International its consumption should not exceed 500g per week. Furthermore, there are several potential ways to suppress the toxic effects of heme iron in the diet.

Measurement of haem and total iron in fish, shrimp and prawn using ICP-MS: Implications for dietary iron intake calculations

Twenty-five species of fish, shrimp and prawn from local markets in Bangladesh were analysed for concentrations of total Fe, haem Fe and non-haem Fe by ICP-MS. Total Fe and non-haem Fe concentrations were measured in nitric acid-digested samples and haem Fe was extracted using acidified 80% acetone for 60 min. Total Fe concentrations ranged from 0.55-14.43 mg/100 g FW, and haem Fe% ranged from 18%-93% of total Fe. Repeat extractions with 80% acetone recovered additional haem Fe, suggesting that previous measurement by this technique may have underestimated haem Fe content. Calculation of Fe balance (summing Fe in acetone extracts and Fe in the residue after haem Fe extraction) was not significantly different from total Fe, indicating the two processes recovered the different forms of Fe with similar effectiveness.