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Loechl CU, Datta-Mitra A, Fenlason L, Green R, Hackl L, Itzkowitz L, Koso-Thomas M, Moorthy D, Owino VO, Pachón H, Stoffel N, Zimmerman MB, Raiten DJ. Approaches to Address the Anemia Challenge. J Nutr 2023; 153 Suppl 1:S42-S59. [PMID: 37714779 PMCID: PMC10797550 DOI: 10.1016/j.tjnut.2023.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 07/21/2023] [Accepted: 07/31/2023] [Indexed: 09/17/2023] Open
Abstract
Anemia is a multifactorial condition; approaches to address it must recognize that the causal factors represent an ecology consisting of internal (biology, genetics, and health) and external (social/behavioral/demographic and physical) environments. In this paper, we present an approach for selecting interventions, followed by a description of key issues related to the multiple available interventions for prevention and reduction of anemia. We address interventions for anemia using the following 2 main categories: 1) those that address nutrients alone, and, 2) those that address nonnutritional causes of anemia. The emphasis will be on interventions of public health relevance, but we also consider the clinical context. We also focus on interventions at different stages of the life course, with a particular focus on women of reproductive age and preschool-age children, and present evidence on various factors to consider when selecting an intervention-inflammation, genetic mutations, nutrient delivery, bioavailability, and safety. Each section on an intervention domain concludes with a brief discussion of key research areas.
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Affiliation(s)
- Cornelia U Loechl
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Ananya Datta-Mitra
- Department of Pathology and Laboratory Medicine, University of California, Davis, Davis, CA, United States
| | - Lindy Fenlason
- Bureau for Global Health, USAID, Washington, DC, United States
| | - Ralph Green
- Department of Pathology and Laboratory Medicine, University of California, Davis, Davis, CA, United States
| | - Laura Hackl
- USAID Advancing Nutrition, John Snow Inc., Arlington, VA, United States
| | - Laura Itzkowitz
- Bureau for Global Health, USAID, Washington, DC, United States
| | - Marion Koso-Thomas
- Eunice Kennedy Shriver National Institute of Child Health and Development, National Institutes of Health, Bethesda, MD, Unites States
| | - Denish Moorthy
- USAID Advancing Nutrition, John Snow Inc., Arlington, VA, United States.
| | | | - Helena Pachón
- Food Fortification Initiative, Emory University, Atlanta, GA, United States
| | - Nicole Stoffel
- Laboratory of Human Nutrition, Department of Health Sciences and Technology, ETH Zurich, Zu¨rich, Switzerland; MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Michael B Zimmerman
- MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Daniel J Raiten
- Eunice Kennedy Shriver National Institute of Child Health and Development, National Institutes of Health, Bethesda, MD, Unites States
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Moscheo C, Licciardello M, Samperi P, La Spina M, Di Cataldo A, Russo G. New Insights into Iron Deficiency Anemia in Children: A Practical Review. Metabolites 2022; 12:metabo12040289. [PMID: 35448476 PMCID: PMC9029079 DOI: 10.3390/metabo12040289] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 03/18/2022] [Accepted: 03/23/2022] [Indexed: 12/25/2022] Open
Abstract
Iron deficiency anemia (IDA) is the most frequent hematological disorder in children, with an incidence in industrialized countries of 20.1% between 0 and 4 years of age and 5.9% between 5 and 14 years (39 and 48.1% in developing countries). Although IDA has been recognized for a long time, there are still uncovered issues and room for improving the management of this condition. New frontiers regarding its diagnosis and therapeutic options emerge every day; recently, innovative formulations of iron have been launched, both for oral and parenteral administration, with the aim of offering treatment schedules with higher efficacy and lower toxicity. As a matter of fact, glycinate and liposomal preparations, while maintaining a satisfying efficacy profile, have significantly fewer side effects, in comparison to the traditional elemental iron salts; parenteral iron, usually considered a second-choice therapy reserved to selected cases, may evolve further, as a consequence of the production of molecules with an interesting clinical profile such as ferrocarboxymaltose, which is already available for adolescents aged >14 years. The present article reports the clinically relevant latest insights regarding IDA in children and offers a practical guide to help pediatricians, particularly to choose the most appropriate prevention and therapy strategies.
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Affiliation(s)
- Carla Moscheo
- Pediatric Unit, Azienda Ospedaliero Universitaria Policlinico “Rodolico-San Marco”, viale Carlo Azeglio Ciampi n.1, 95121 Catania, Italy;
| | - Maria Licciardello
- Pediatric Onco-Hematology Unit, Azienda Ospedaliero Universitaria Policlinico “Rodolico-San Marco”, via Santa Sofia n.78, 95123 Catania, Italy; (M.L.); (P.S.); (M.L.S.)
| | - Piera Samperi
- Pediatric Onco-Hematology Unit, Azienda Ospedaliero Universitaria Policlinico “Rodolico-San Marco”, via Santa Sofia n.78, 95123 Catania, Italy; (M.L.); (P.S.); (M.L.S.)
| | - Milena La Spina
- Pediatric Onco-Hematology Unit, Azienda Ospedaliero Universitaria Policlinico “Rodolico-San Marco”, via Santa Sofia n.78, 95123 Catania, Italy; (M.L.); (P.S.); (M.L.S.)
| | - Andrea Di Cataldo
- Pediatric Onco-Hematology Unit, Azienda Ospedaliero Universitaria Policlinico “Rodolico-San Marco”, via Santa Sofia n.78, 95123 Catania, Italy; (M.L.); (P.S.); (M.L.S.)
- Department of Clinical and Experimental Medicine, University of Catania, via Santa Sofia 89, 95123 Catania, Italy
- Correspondence: (A.D.C.); (G.R.)
| | - Giovanna Russo
- Pediatric Onco-Hematology Unit, Azienda Ospedaliero Universitaria Policlinico “Rodolico-San Marco”, via Santa Sofia n.78, 95123 Catania, Italy; (M.L.); (P.S.); (M.L.S.)
- Department of Clinical and Experimental Medicine, University of Catania, via Santa Sofia 89, 95123 Catania, Italy
- Correspondence: (A.D.C.); (G.R.)
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