Iron: deficiencies and requirements

Toxic Elemental Impurities in Herbal Weight Loss Supplements; A Study Using ICP-OES Microwave-Assisted Digestion

The tendency of using weight loss herbal preparations is continuously increasing, especially for the widespread consumption of junk food that is characterized by high calories. Weight loss herbal preparations are considered a type of food supplement product, and, as such, the regulations governing their quality control might be minimal. These products could be locally formulated in any country or internationally imported. Being non-controlled products, the herbal weight-loss products may contain high levels of elemental impurities that might exceed the permissible ranges. Moreover, these products contribute to the total daily intake (TDI) of such elements, which might represent concerns about their potential toxicological danger. In this research, the elemental contents in such products were investigated. The inductively coupled plasma with optical emission spectrometer (ICP-OES) was used to determine the levels of 15 elemental contents, namely, Na, K, Ca, Mg, Al, Cu, Fe, Li, Mn, As, Co, Cr, Cd, Ni and Pb. The results showed that seven micro-elements, namely Cd, Co, Ni, Cr, Pb, Li and Cu, were either not detectable or at a concentration much lower than their tolerable limits. However, all studied macro-elements (Na, K, Ca and Mg), together with Fe, were found at considerable, yet safe levels. On the other hand, Mn, Al and As contents showed perturbing levels in some of the studied products. Finally, a conclusion was highlighted for the necessity for stricter surveillance of such herbal products.

Microextraction procedures for preconcentration of Fe (III) in water and food samples prior to colorimetric detection: a comparative study

Two extraction procedures, namely dispersive liquid-liquid microextraction (DLLME) and dispersive liquid-liquid microextraction based on solidification of floating organic drop (DLLME-SFOD), have been compared for the spectrophotometric determination of Fe (III). In both procedures, Fe (III) was extracted after complexation with gallic acid in the presence of cetyltrimethylammonium bromide (CTAB). Tetrachloroethylene and 1-undecanol were used as extraction solvents in DLLME and DLLME-SFOD, respectively, while acetone was used as dispersing solvents. The effects of various experimental parameters (solution pH, the concentration of ligand and CTAB, as well as nature and amount of extraction and disperser solvents) on the extraction efficiency were investigated. Under optimum conditions, the calibration graphs were linear in the range of 50.0–650.0 and 8.0–800.0 μg L−1 and the detection limits were 15.0 and 5.0 μg L−1 for DLLME and DLLME-SFOD, respectively. The presence of NaCl, up to 1.0% (w/v) did not impact the extraction procedures. The analyte was good tolerated in the presence of most concomitant ions. The procedures were applied for the determination of Fe (III) in standard reference materials and real samples with good recoveries (95.5–99.0%) for DLLME-SFOD while poor recoveries (68.0–82.5%) were obtained when DLLME was applied. The analytical figures of the procedures were comparable with those listed in the literature and it could be concluded that DLLME-SFOD may be considered one of the best tools used for preconcentration of Fe (III), owing to its simplicity, time-saving and the possibility of using in conventional analytical laboratories.

Graphical abstract

Iron deficiency anaemia in pregnancy: A contemporary review

Iron deficiency anaemia is a global health problem, which particularly affects pregnant women. Iron deficiency anaemia during pregnancy is associated with increased maternal and perinatal morbidity and mortality. Maternal iron deficiency may also be associated with neurocognitive deficits in infants. Iron requirements increase during pregnancy and are influenced by hepcidin, the master regulator of iron homeostasis. The enduring global burden of maternal anaemia suggests that currently employed iron supplementation strategies are suboptimal. Recent developments in our understanding of systemic and placental iron homeostasis may improve therapeutic effectiveness by altering the dose and frequency of oral iron. Intravenous iron appears to be a safe treatment to correct maternal anaemia rapidly but research on patient-centred outcomes and cost-effectiveness is needed. Future trials should be adequately powered to assess outcomes relevant to pregnant women.

Antepartum and postpartum anemia: a narrative review

Antepartum anemia impacts over a third of pregnant women globally and is associated with major maternal and perinatal morbidity, including peripartum transfusion, maternal death, maternal infection, preterm birth, and neurodevelopmental disorders among offspring. Postpartum anemia impacts up to 80% of women in low-income and rural populations and up to 50% of women in Europe and the United States, and is associated with postpartum depression, fatigue, impaired cognition, and altered maternal-infant bonding. Iron deficiency is the most common cause of maternal anemia because of insufficient maternal iron stores at the start of pregnancy, increased pregnancy-related iron requirements, and iron losses due to blood loss during parturition. Anemic women should undergo testing for iron deficiency; a serum ferritin cutoff level of 30 μg/L is commonly used to diagnose iron deficiency during pregnancy. The first-line treatment of iron deficiency is oral iron. Intravenous iron is a consideration in the following scenarios: a poor or absent response to oral iron, severe anemia (a hemoglobin concentration <80 g/L), rapid treatment for anemia in the third trimester, women at high risk for major bleeding (such as those with placenta accreta), and women for whom red blood cell transfusion is not an option. Given the high prevalence of antepartum and postpartum anemia, anesthesiologists are advised to partner with other maternal health professionals to develop anemia screening and treatment pathways.

Clinical and Biochemical Profile of Iraqi Local Breed Cows During Pregnancy and Early Lactation

This study was conducted in Al-Alam region, which is located in Salah Al-Din Governorate, on first month pregnant Iraqi local cows (n-10). The follow up extended from the first month of pregnancy up to the end of the first month post-parturition during that some clinical and biochemical parameters were measured in the serum. Blood samples from the jugular vein of cows were collected monthly for the whole period of experiment and divided into four stages: early pregnancy, mid pregnancy, late pregnancy, and early lactation immediately after birth. It was observed that the temperature, respiration rate, and heart rate increased gradually and significantly (P≤0.05) with the progress of pregnancy reaching to its highest value in the last period of pregnancy and decreased after birth. The last trimester of pregnancy and the early lactation were also showed a significant decrease (P≤0.05) of the phosphorus, calcium, iron, and copper concentrations compared to the first and second trimesters of the pregnancy however, significant increases in other biochemical values (P≤0.05) were observed in urea and creatinine concentrations in the last trimester of pregnancy and early lactation. In addition to a significant decrease (P≤0.05) of the ratios of concentrations of glucose, total protein, albumin, and globulin in the last period of pregnancy compared to other periods. The decrease in the value of globulin continued until the early birth period while the study did not show any significant difference in the concentration of bilirubin between durations. Finally, values of the ALT, AST and ALP enzymes showed significant increases (P≤0.05) in their concentrations in the last period of pregnancy. It is concluded that possible changes in the biochemical parameters of the local Iraqi cows’ blood during pregnancy and early lactation are existed

Incorporation of microencapsulated hydrophilic and lipophilic nutrients into foods by using ultrasound as a pre-treatment for drying: A prospective study

The present work proposes using the ultrasound technology to incorporate microencapsulated nutrients during pre-treatments for drying of food products. Both hydrophilic and lipophilic nutrients were evaluated: incorporation of microcapsules of iron (obtained by spray drying using maltodextrin as wall material) and carotenoids (obtained by hot emulsification and solidification using hydrogenated palm oil as wall material). The ultrasound pre-treatment was applied in water and ethanol, where the microcapsules were dispersed, and food samples were immersed. Pumpkin and apple were selected as suitable food material to perform the iron and carotenoid incorporation, respectively. Ultrasound allowed more homogeneous iron incorporation in pumpkin. The iron content increased more than 1000% in pre-treated samples compared to control. In the same manner, carotenoid content increased in about 430% when ultrasound was applied. After drying, the carotenoid content decreased by 65% in control samples. However, better carotenoid retention was obtained after drying in ultrasound processed samples. The results show that pre-treatment with ultrasound can be used to incorporate nutrients into the food matrix, increasing not only the incorporated quantity but also promoting their preservation. Nevertheless, future studies must be performed to determine the nutrient bioavailability and bioaccessibility.

Synthesis and Characterization of an Antioxidative Galactomannan⁻Iron(III) Complex from Sesbania Seed

Galactomannan, a water-soluble polymer in the cell wall of leguminous plants, has been proven to possess anticancer and antioxidative activity. In this work, galactomannan with different molecular weights (GM-40 and GM-65) was obtained from Sesbania seeds and synthesized into galactomannan–iron(III) complexes, which are termed as GM-40-Fe and GM-65-Fe, respectively. These galactomannan–iron(III) complexes are intended to function as organic iron supplements to treat iron deficiency with the added benefit of antioxidative activity. The prepared galactomannan–iron(III) complexes were characterized for chemical composition, morphology, antioxidant capacity, and bioavailability in vitro. The results showed that galactomannan–iron(III) complexes could be produced with iron contents as high as 65.4 mg/g. Antioxidant assays indicated that both GM-40-Fe and GM-65-Fe exhibited antioxidant activities for scavenging radicals in vitro. The iron release/bioavailability assays showed that the iron was easily released into artificial gastric and intestinal juices, resulting in iron release rates of 88–94% over 300 min. These results suggest that galactomannan–iron(III) complexes synthesized from Sesbania seed polysaccharides are capable of being administered as organic iron supplements to patients with iron deficiency.

Novel Flaxseed Gum Nanocomposites Are Slow Release Iron Supplements

Nanocomposites, based on iron salts and soluble flaxseed gum (FG), were prepared as potential treatments of iron deficiency anemia (IDA). FG was extracted, characterized, and formulated into iron-loading nanocomposites via ion-exchange against FeCl₃, Fe₂(SO₄)₃, FeCl₂, and FeSO₄·7H₂O. FG-iron nanocomposites preparation condition was optimized, and physicochemical properties of the nanocomposites were investigated. In vitro release kinetics of iron in simulated gastric fluid (SGF) was also evaluated. FG heteropolysaccharide, consisting of rhamnose (33.73%), arabinose (24.35%), xylose (14.23%), glucose (4.54%), and galactose (23.15%) monosaccharides, linked together via varieties of glycosidic bonds, was a good recipient for both ferric and ferrous irons under screened conditions (i.e., 80 °C, 2 h, I/G = 1:2). Iron loaded contents in the nanocomposites prepared from FG-FeCl₃, FG-Fe₂(SO₄)₃, FG-FeCl₂, and FG-FeSO₄·7H₂O were 25.51%, 10.36%, 5.83%, and 22.83%, respectively. Iron in these nanocomposites was mostly in a bound state, especially in FG-FeCl₃, due to chelation forming bonds between iron and polysaccharide hydroxyl or carboxyl groups and formed stable polysaccharide-iron crystal network structures. Free iron ions were effectively removed by ethanol treatments. Because of chelation, the nanocomposites delayed iron release in SGF and the release kinetics were consistent with Korsmeyer-Peppas model. This indicates that such complexes might reduce side effects of free iron in human stomach. Altogether, this study indicates that these synthetic FG-iron nanocomposites might be developed as novel iron supplements for iron deficiency, in which FG-FeCl₃ is considered as the best option.

A novel low molecular weight Enteromorpha polysaccharide-iron (III) complex and its effect on rats with iron deficiency anemia (IDA)

Iron deficiency anemia (IDA) is a common nutritional disease that affects normal erythropoiesis. Traditional iron supplements usually cause gastrointestinal irritation. In this study, a novel low-molecular-weight polysaccharide from Enteromorpha prolifera (LPE) was prepared by oxidation degradation, and LPE-iron (III) complex was synthesized and characterized. The molecular weight of LPE-iron (III) complex was 21.25kDa, and iron content was 25%. The therapeutic effects of LPE-iron (III) complex on IDA were investigated in rats. The hematological indices and organ coefficients of the rats were analyzed. Results showed a dose-dependent relationship, and a prior intragastric administration of LPE-iron (III) complex (2mg Fe/kg body weight) exhibited considerable effect when compared with the positive control. Therefore, LPE-iron (III) complex could be exploited as a new iron fortifier.

The variation of macro- and micro-minerals of tissues in diabetic and non-diabetic rats

This study determined the levels of Ca, Mg, Fe, Zn, Cu, and Na in various tissues samples (liver, brain, kidney, intestines, muscle and hair) of diabetic and non-diabetic rats by flame atomic absorption spectroscopy, in order to assess the role of element levels during T2DM. The ratios of Ca/Mg, Zn/Cu, Ca/Zn, and Mg/Zn in diabetic and non-diabetic rat tissues were also calculated. The determined element levels were further subjected to a student-t test statistical analysis and multiple-linear-regression in order to evaluate similarities, differences, and an inter-element association in tissues of diabetic and non-diabetic rats. The results of the study showed high variability in element levels and Ca/Mg Zn/Cu Mg/Zn Ca/Zn ratios in the tissues of diabetic and non-diabetic rats, but are tissue- and element-dependent, suggesting differences in the accumulation of the elements in tissues of diabetics and non-diabetics. The obtained significant differences in the levels of elements and Ca/Mg Zn/Cu Mg/Zn Ca/Zn ratios in several tissues of diabetic and non-diabetic rats in this study suggest that the investigated elements play considerable roles in the T2DM disease process. Strong inter-element associations (R²≥0.9) were observed for some elements in tissues of diabetic and non-diabetics rats. However, poor inter-elemental associations were obtained for some elements in the tissues of diabetic and non-diabetic rats.

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.

Relationship of polychlorinated biphenyls (PCBs) with parasitism, iron homeostasis, and other health outcomes: Results from a cross-sectional study on recently arrived African immigrants

Polychlorinated biphenyls (PCBs) are toxic and persistent chemicals produced between 1930s and 1980s, which accumulate in humans and wildlife. Although a decreasing trend of PCB levels in humans has been described in developed countries, mainly as a consequence of strict regulations and remediation plans, an inverse trend has been recently reported in people from developing countries. We had the opportunity of sampling a series of African immigrants recently arrived to the Spanish archipelago of the Canary Islands, in which high levels of PCBs have been described, and we studied the relationships between their level of contamination and health status. A total of 570 subjects who underwent a complete medical examination and a face-to-face interview were recruited for this study. Hematological and biochemical parameters (blood and urine) were determined in all participants. Serology for the diagnostic of infectious diseases was also performed, and direct identification of parasites was performed in feces, urine or blood samples when appropriate. It is remarkable that up to 26.0% of the population had intestinal parasites, and we found an inverse relationship between PCB levels and parasitism and parasitic diseases: median values of PCBs were lower in parasitized subjects than in subjects without parasites in stool (237.6ng/g fat vs. 154.4ng/g fat for marker PCBs, p=0.015) and median values of dioxin-like PCBs were lower in subjects carrying pathogen parasites than among subjects showing non-pathogen parasites in stool (0.0 ng/g fat vs. 13.1ng/g fat, respectively; p=0.001). Although this inverse association had been described in some vertebrates this is the first study reporting such an association in humans. Furthermore, it has been also recently described that PCBs may disrupt iron metabolism, and we found a direct relationship between serum iron and total PCBs burden (r=0.231, p=0.025), suggesting that PCBs, although at subclinical level, could play a role on iron homeostasis. Although the role of PCBs in parasitism and in the iron metabolism needs future research, our findings may help to understand the adverse health outcomes associated to environmental exposure to PCBs and they might be used in exposed populations as indicators of subtle effects due to environmental insult.

Prenatal Iron Deficiency in Guinea Pigs Increases Locomotor Activity but Does Not Influence Learning and Memory

The objective of the current study was to determine whether prenatal iron deficiency induced during gestation in guinea pigs affected locomotor activity and learning and memory processes in the progeny. Dams were fed either iron-deficient anemic or iron-sufficient diets throughout gestation and lactation. After weaning, all pups were fed an iron-sufficient diet. On postnatal day 24 and 40, the pups’ locomotor activity was observed within an open-field test, and from postnatal day 25 to 40, their learning and memory processes were assessed within a Morris Water Maze. The behavioural and cognitive tests revealed that the iron deficient pup group had increased locomotor activity, but solely on postnatal day 40, and that there were no group differences in the Morris Water Maze. In the general discussion, we propose that prenatal iron deficiency induces an increase in nervousness due to anxiety in the progeny, which, in the current study, resulted in an increase of locomotor activity.

Effect of iron supplementation on the expression of hypoxia-inducible factor and antioxidant status in rats exposed to high-altitude hypoxia environment

Iron and oxygen are essential substance for cellular activity in body tissues. Hypoxia-inducible factors (HIFs) can respond to available oxygen changes in the cellular environment and regulate the transcription of a series of target genes. The study was conducted to investigate the effects of iron supplementation on the expression of hypoxia-inducible factor-1 alpha (HIF-1α) and antioxidant status in rats exposed to high-altitude hypoxia environment. Forty rats were divided into control (CON), hypobaric hypoxia (HH), and hypobaric hypoxia plus ferrous sulfate (FeSO4) (9.93 mg/kg body weight (BW)/day) (HFS) and hypobaric hypoxia plus iron glycinate chelate (Fe-Gly) (11.76 mg/kg BW/day) (HFG) groups. Results showed that Fe-Gly effectively alleviated weight loss and intestinal mucosa damage induced by hypobaric hypoxia, whereas FeSO4 aggravated hypobaric hypoxia-induced weight loss, liver enlargement, spleen atrophy, and intestinal damage. Iron supplementation decreased liver superoxide dismutase (T-SOD) and catalase (CAT) activity (P < 0.01) and increased iron concentration in the liver compared to HH group (P < 0.001). Moreover, Fe-Gly upregulated liver transferrin expression in messenger RNA (mRNA) level (P < 0.05) and downregulated serum erythropoietin (EPO) concentration (P < 0.01) and liver HIF-1α expression level (P < 0.05 in mRNA level; P < 0.001 in protein level) compared to HH group. The study indicated that FeSO4 supplementation at high altitudes aggravated the oxidative damage of tissues and organs that could be mediated through production of malondialdehyde (MDA) and inhibition antioxidant enzyme activities. Fe-Gly can protect hypobaric hypoxia-induced tissues injury. Moreover, iron supplementation at high altitudes affected HIF-1α-mediated regulating expression of targeting genes such as EPO and transferrin. The study highlights that iron supplementation under hypobaric hypoxia environment has possible limitation, and efficient supplementation form and dosage need careful consideration.

Hepcidin and iron homeostasis during pregnancy

Hepcidin is the master regulator of systemic iron bioavailability in humans. This review examines primary research articles that assessed hepcidin during pregnancy and postpartum and report its relationship to maternal and infant iron status and birth outcomes; areas for future research are also discussed. A systematic search of the databases Medline and Cumulative Index to Nursing and Allied Health returned 16 primary research articles including 10 human and six animal studies. Collectively, the results indicate that hepcidin is lower during pregnancy than in a non-pregnant state, presumably to ensure greater iron bioavailability to the mother and fetus. Pregnant women with undetectable serum hepcidin transferred a greater quantity of maternally ingested iron to their fetus compared to women with detectable hepcidin, indicating that maternal hepcidin in part determines the iron bioavailability to the fetus. However, inflammatory states, including preeclampsia, malaria infection, and obesity were associated with higher hepcidin during pregnancy compared to healthy controls, suggesting that maternal and fetal iron bioavailability could be compromised in such conditions. Future studies should examine the relative contribution of maternal versus fetal hepcidin to the control of placental iron transfer as well as optimizing maternal and fetal iron bioavailability in pregnancies complicated by inflammation.

The Nutritional Facts of Bamboo Shoots and Their Usage as Important Traditional Foods of Northeast India

Bamboo shoots are considered as one of the useful health foods because of their rich contents of proteins, carbohydrates, vitamins, fibres, and minerals and very low fat. Though bamboo shoots provide lots of health benefits, their consumption is confined mostly to Southeast Asian and East Asian countries. The acceptability of bamboo shoots as popular vegetable crop is very less due to their high pungent smell and bitter acidic taste. The use of bamboo as food in India is mainly restricted to Northeastern part of the country where they form an indispensable part of several traditional speciality dishes. The different ethnic communities take fresh or fermented bamboo shoot as one of most preferred traditional food items. Some of the important bamboo based traditional foods are ushoi, soibum, rep, mesu, eup, ekhung, hirring, and so forth. Bamboo shoots should be properly processed before they are consumed as freshly harvested shoots have high content of toxic cyanogenic glycosides which may pose serious health problems. The prospect of bamboo shoot industry in Northeast India is bright due to its rich genetic resources of bamboos. However, habitat destruction and extensive use of bamboos for food, handicraft, and construction purposes have resulted in severe depletion of natural bamboo resources. This review stresses upon the high nutritive values and health benefits of bamboo shoots and their usage as important traditional foods in Northeast India. The bamboo market potential of the region and use of in vitro plant micropropagation methods as effective means of bamboo conservation are also emphasized in this paper.

Iron deficiency is associated with food insecurity in pregnant females in the United States: National Health and Nutrition Examination Survey 1999-2010

Food-insecure pregnant females may be at greater risk of iron deficiency (ID) because nutrition needs increase and more resources are needed to secure food during pregnancy. This may result in a higher risk of infant low birth weight and possibly cognitive impairment in the neonate. The relationships of food insecurity and poverty income ratio (PIR) with iron intake and ID among pregnant females in the United States were investigated using National Health and Nutrition Examination Survey 1999-2010 data (n=1,045). Food security status was classified using the US Food Security Survey Module. One 24-hour dietary recall and a 30-day supplement recall were used to assess iron intake. Ferritin, soluble transferrin receptor, or total body iron classified ID. Difference of supplement intake prevalence, difference in mean iron intake, and association of ID and food security status or PIR were assessed using χ(2) analysis, Student t test, and logistic regression analysis (adjusted for age, race, survey year, PIR/food security status, education, parity, trimester, smoking, C-reactive protein level, and health insurance coverage), respectively. Mean dietary iron intake was similar among groups. Mean supplemental and total iron intake were lower, whereas odds of ID, classified by ferritin status, were 2.90 times higher for food-insecure pregnant females compared with food-secure pregnant females. Other indicators of ID were not associated with food security status. PIR was not associated with iron intake or ID. Food insecurity status may be a better indicator compared with income status to identify populations at whom to direct interventions aimed at improving access and education regarding iron-rich foods and supplements.

Association between maternal iron supplementation during pregnancy and risk of celiac disease in children

BACKGROUND & AIMS

The aim of our study was to determine whether the use of iron supplements during pregnancy affects the risk for celiac disease in children.

METHODS

We assessed data from the prospective Norwegian Mother and Child cohort study, in which individuals with celiac disease were identified by answers on questionnaires and linkage to the Norwegian Patient Register. Complete data were available for 78,846 children (mean age 5.9 years, range 2-12 years); 314 children were identified with celiac disease. Questionnaires were given to pregnant women to collect information on use of iron-containing supplements, diet, anemia, and levels of hemoglobin.

RESULTS

Celiac disease was diagnosed in 4.65 of 1000 children whose mothers took iron supplements while they were pregnant, compared with 3.15 of 1000 children whose mothers did not. After adjusting for children's age, sex, and age of gluten introduction, and the presence of celiac disease in mothers, iron supplementation during pregnancy remained significantly associated with celiac disease in children (odds ratio [OR], 1.33; 95% confidence interval [CI], 1.05-1.68; P = .019). However, celiac disease was not associated with the mothers' intake of iron from foods (adjusted OR, 1.00; 95% CI, 0.97-1.03). Anemia before or during the early stages of pregnancy was not significantly associated with the risk of celiac disease in children (adjusted OR, 1.24; 95% CI, 0.84-2.00; P = .24). The use of iron supplements during pregnancy remained significantly associated with celiac disease in children after adjusting for children who were given iron supplements before 18 months of age, which itself was associated with celiac disease.

CONCLUSIONS

In a prospective Norwegian Mother and Child cohort study, we found an increased risk of celiac disease in children whose mothers used iron supplements during pregnancy; this association does not appear to arise from maternal anemia.

Gold-deferrioxamine nanometric interface for selective recognition of Fe(III) using square wave voltammetry and electrochemical impedance spectroscopy methods

Deferrioxamine, a bacterial hydroxamic siderophore having high binding affinity for Fe(III), is used in its immobilized form, as self-assembled monolayer on Au, for accumulation and recognition of Fe(III) from the solution phase. The accumulated Fe(III) is detected via both active mode based on faradaic reduction current of Fe(III), and inactive mode based on impedimetric effect of accumulated Fe(III) against redox reaction of a suitable probe. Appropriate electrochemical techniques, square wave voltammetry and electrochemical impedance spectroscopy, are used for the transduction of analytical signals obtained by this sensor. Then, the parameters influencing the sensor response are optimized. In the best conditions, a linear response, from 1.0×10(-10) to 1.0×10(-7)M Fe(III) in logarithmic scale with a detection limit of 2.0×10(-11)M, and mean relative standard deviation of 1.7% for n=4 is observed. The results show that the sensor can be used for determination of Fe(III) in the presence of various inorganic ions and biological species. Validity of the method and applicability of the sensor are successfully tested by determination of Fe(III) in various real samples including plant tissue (corn leaves), industrial alloy (Ferrotitanium), and pharmaceutical samples (Venofer(®) ampoule, Ironorm(®) capsule, and V.M. Protein(®) powder).

Effect of oxidative stress on membrane proteins in thalassemia and iron deficiency anemia

OBJECTIVE

To evaluate the effect of oxidative stress on membrane proteins according to relationship between malondialdehyde (MDA) levels and membrane protein ratios in different two patient groups.

METHODS

Fifty-seven healthy control cases that had no symptoms of inherited blood diseases, 50 diagnosed β-thalassemic patients, and 30 patients with iron deficiency anemia were enrolled. Erythrocyte membrane samples were prepared according to Dodge method and proteins were separated using 8.3% SDS-PAGE. Gels were stained with Coomassie Brillant Blue, then fraction quantities were determined by dansitometric method. MDA levels were measured by thiobarbituric acid method in plasma. One-way ANOVA test was used to compare parameters between groups.

RESULTS

Significant difference in protein deficiency rates for spectrin and band 4.2 in group I, band 6 in group II and band 3 in group I and II when compared with control group (group III) were found. The significant difference between group I and II wasn't determined in spite of the fact that MDA levels of patients were different from the control group statistically.

CONCLUSIONS

Any significant relationship statistically was not found. This consequence may be due to priority removal of oxidatively injured cells from the circulation in thalassemic patients and therefore, significant increase wasn't determined in the concentration of MDA.

UK guidelines on the management of iron deficiency in pregnancy

Iron deficiency is the most common deficiency state in the world, affecting more than 2 billion people globally. Although it is particularly prevalent in less-developed countries, it remains a significant problem in the developed world, even where other forms of malnutrition have already been almost eliminated. Effective management is needed to prevent adverse maternal and pregnancy outcomes, including the need for red cell transfusion. The objective of this guideline is to provide healthcare professionals with clear and simple recommendations for the diagnosis, treatment and prevention of iron deficiency in pregnancy and the postpartum period. This is the first such guideline in the UK and may be applicable to other developed countries. Public health measures, such as helminth control and iron fortification of foods, which can be important to developing countries, are not considered here. The guidance may not be appropriate to all patients and individual patient circumstances may dictate an alternative approach.

Beliefs, attitudes and behaviours of pregnant women in Bali

OBJECTIVE

To explore beliefs, attitudes and behaviours of pregnant women in Bali, Indonesia.

DESIGN

Descriptive qualitative study using in-depth interviews.

SETTING

Community health-care centre in South Kuta, Bali, Indonesia.

PARTICIPANTS

18 Pregnant women aged 20-35 years.

FINDINGS

Insights into beliefs and attitudes regarding pregnancy emerged from the analysis. Participants believed that some foods should or should not be eaten by pregnant women. They believed that vegetables are better than meat during pregnancy. Strong beliefs about traditional herbal remedies also emerged. Complex beliefs on locus of control were also expressed by the majority of the respondents regarding who was responsible for the health and well-being of their infant. Women maintained that they themselves, health-care professionals, nature and God were all responsible for the health of their infant. In addition, some respondents acknowledged the crucial role of the family for support and advice during pregnancy.

IMPLICATIONS FOR PRACTICE

Interventions to improve the quality of antenatal care and pregnancy outcomes in Indonesia should consider these beliefs and attitudes. Counselling by health-care workers, for example, might explicitly seek women's complex beliefs on locus of control, and views on preferences for traditional remedies and food, especially low meat intake. Involvement of husbands and other family members during pregnancy and birth should also be encouraged and re-inforced by health promotion programmes. Community and religious leaders should be engaged to support key messages.

Reduction of cutaneous photosensitivity by application of ointment containing ferrous or cobaltous ions concomitant with the use of topical protoporphyrin IX precursors

BACKGROUND

5-Aminolevulinic acid (ALA) or its methyl ester mediated photodynamic therapy (PDT) is the most widely practiced form of PDT in dermatology. One of the advantages of topical PDT is that undesirable photosensitization lasts only for 24-48 h. However, patients are still sensitive in the areas where the cream has been applied, and are advised to avoid exposure to the sun and other light sources for at least 40 h after ALA-PDT. Therefore, the main aim of this work is to improve post-treatment procedures for increasing patient's comfort. The present study was carried out to investigate clearance of protoporphyrin IX (PpIX) in the presence of metal ions in the cream applied on healthy skin of mice in vivo.

METHODS

The photosensitizer PpIX was induced in normal mouse skin by topical application of ALA. Fluorescence spectroscopy was used to study porphyrin kinetics.

RESULTS

Topical application of ferrous, cobalt or zinc sulphate significantly diminished the fluorescence of PpIX in mouse skin. These results show that the clearance kinetics of PpIX observed after exogenous application of ALA are determined by the conversion of PpIX into haem, and not by the clearance of PpIX from the body.

CONCLUSIONS

Application of a vehicle containing ferrous or cobalt sulphate after PDT might be an approach in clinical practice for the reduction of cutaneous photosensitivity and elimination of undesirable photoreactions in skin and lesions.

Hormonal contraceptive practices in young Australian women (≤ 25 years) and their possible impact on menstrual frequency and iron requirements

OBJECTIVES

To investigate the hormonal contraceptive practices of female university students aged ≤ 25 years, their menstrual bleeding frequency, and interest in contraceptive regimens that reduce menstrual frequency or duration.

STUDY DESIGN

A 20-item questionnaire was distributed to female students at Griffith University, Gold Coast campus. This included questions relating to: demographics, menstrual bleeding frequency, current contraceptive practices, and interest in future oral contraceptive regimens that reduce menstrual bleeding frequency and duration.

MAIN OUTCOME MEASURES

Determination of hormonal contraceptive practices and menstrual bleeding frequency undertaken by the sample population.

RESULTS

Eight hundred and fifty one participants completed the questionnaire, ~ 2/3rds of respondents are currently using a hormonal contraceptive (66% of all respondents), with the oral contraceptive pill (OCP) being most common. Most women (73%) reported monthly menstruation, although 16% indicated that they sometimes missed their monthly period, with bleeding every two months. Of all OCP users, approximately 2/3rds have skipped their monthly period at some time, the most common reasons being for convenience (89%). Approximately 70% of respondents were interested in OCP regimens that reduced frequency or duration of menstruation.

CONCLUSION

OCP use is popular amongst Australian university women, with many being interested in the concept of using the OCP to delay menstruation. Given this interest and the availability of hormonal contraceptives that reduce menstrual frequency and duration, assessing the impact of reduced menstrual blood loss on iron stores may be warranted.

Irontophoresis: transdermal delivery of iron by iontophoresis

Transdermal delivery of iron can overcome the GI side effects and the discomfort associated with parenteral administration. Slow and prolonged transdermal delivery of iron would also avoid potential oversaturation of transferrin and overcome accumulation of free iron in the systemic circulation. Ferric pyrophosphate (FPP) has been demonstrated to be safe for systemic administration. Passive transdermal delivery of FPP is poor due to the impermeable skin barrier. Irontophoresis was developed for transdermal delivery of FPP. The predictability and programmability of the technique was assessed in vitro across the hairless rat skin. Following Irontophoresis for 6 h in hairless rats, the total serum iron concentration increased from 182.36 +/- 39.93 microg/dL to 317.56 +/- 28.33 microg/dL and the transferrin saturation increased from 44.6% +/- 2.2% to 60.8% +/- 6.7%. Irontophoresis based iron therapy could be relatively more patient compliant, safe and effective treatment for iron deficiency anemia condition.

Maternal iron deficiency alters essential fatty acid and eicosanoid metabolism and increases locomotion in adult guinea pig offspring

Iron deficiency (ID) is the most prevalent worldwide nutritional deficiency. Groups at risk of developing ID anemia are infants and pregnant women, even in industrialized countries. Our goal in this study was to evaluate the long-term consequences of maternal ID on the offspring's fatty acid and eicosanoid metabolism, behavior, and spatial memory. Female guinea pigs consumed iron-sufficient (IS) and -deficient (ID) diets for 14 d before mating and throughout pregnancy and lactation. Dietary iron restriction resulted in ID in pregnant females. On postnatal d 9, all offspring (ID and IS) were weaned to the IS diet and at 42 d, all offspring were iron replete. Locomotion was tested in pups on postnatal d 24 and 40 and spatial memory from d 25 to 40. Pups from the ID group were significantly more active in the open field at both times of testing, whereas spatial memory, tested in a Morris water maze, was comparable in both groups. On postnatal d 42, liver, RBC, and brain fatty acid composition were measured. Dihomogammalinolenic [20:3(n-6)], docosapentaenoic [22:5(n-3)], and docosahexaenoic [22:6(n-3)] acid contents were significantly higher in brain phospholipids of offspring born to ID dams. Prostaglandin E(2) and F(2alpha) concentrations were also significantly higher in brains of offspring born to ID dams. This demonstrates that moderate ID during gestation and lactation results in alterations of brain fatty acid and eicosanoid metabolism and perturbation in behavior in adult offspring.

Maternal iron deficiency and its effect on essential fatty acid and eicosanoid metabolism and spatial memory in the guinea pig offspring

Iron deficiency is prevalent among infants and pregnant women in industrialized country. The goal of this study was to evaluate the impact of moderate maternal iron deficiency on the offspring's fatty acid and eicosanoid metabolism and spatial memory in guinea pigs. An iron-sufficient (IS) or iron-deficient (ID) diet was fed 14 days before mating and throughout pregnancy and lactation. The pups were tested for spatial memory on post-natal days 4-7. On post-natal day 9, the biochemical analysis included the pup's brain fatty acid profiles, prostaglandin (PGE(2) and PGF(2alpha)) concentrations and cyclooxygenase II protein levels. Spatial memory and indices of eicosanoid metabolism were comparable in both dietary groups. However, n-3 fatty acids were significantly higher (p<0.05) in brain of pups from the ID group. The data suggest that maternal iron deficiency results in a modification of the fatty acid profile of the offspring's brain that is not associated with any spatial memory deficits during early development.

Periconceptional iron and folate status is inadequate among married, nulliparous women in rural Bangladesh

Recent evidence suggests that poor fetal growth is associated with preconception anemia and first trimester iron deficiency. Periconceptional iron and folate supplementation may improve the effectiveness of iron supplementation programs during pregnancy by treating preexisting anemia, building iron stores, and reducing risk of neural tube defects. Our objective in this study was to describe the iron and folate status of married, nulliparous women in rural Bangladesh from March to May 2007. Of 272 women, 37% were anemic (hemoglobin <120 g/L), 13% were folate deficient (plasma folate <or=10 nmol/L), 15% were iron deficient (plasma ferritin <12 microg/L or tranferrin receptor >4.4 mg/L), 11% were iron deficient and anemic, and 81% were estimated to have <500 mg of iron stores. Risk of anemia was 4 times greater among nonstudents than students (95% CI: 1.23, 14.69), twice as likely among women with a previous miscarriage compared with those who had never been pregnant (95% CI: 1.04, 5.47), and 6 times greater among iron-deficient compared to iron-replete women (95% CI: 2.76, 11.81). Adolescents (<or=19 y) had lower mean plasma ferritin concentration (38.3 +/- SD vs. 49.1 +/- SD microg/L; P = 0.004) and body iron stores [3.4 +/- 5.2 mg/kg vs. 4.3 +/- 5.6 mg/kg (0.06 +/- 0.09 mmol/kg vs. 0.08 +/- 0.10 mmol/kg); P = 0.006] compared with adults. An unacceptably high percentage of nulliparous women in rural Bangladesh have inadequate iron and folate status. As they enter pregnancy, more than one-third will be anemic, >80% will have inadequate iron stores, and more than one-tenth will be folate deficient. Further research is needed on risk factors of poor nutritional status before the start of a woman's childbearing years.

Association between consumption of black tea and iron status in adult Africans in the North West Province: the THUSA study

The association between black tea consumption and iron status was investigated in a sample of African adults participating in the cross-sectional THUSA (Transition and Health during Urbanization of South Africans) study in the North West Province, South Africa. Data were analysed from 1605 apparently healthy adults aged 15–65 years by demographic and FFQ, anthropometric measurements and biochemical analyses. The main outcome measures were Hb and serum ferritin concentrations. No associations were seen between black tea consumption and concentrations of serum ferritin (menP = 0·059; womenP = 0·49) or Hb (menP = 0·33; womenP = 0·49). Logistic regression showed that tea consumption did not significantly increase risk for iron deficiency (men: OR 1·36; 95 % CI 0·99, 1·87; women: OR 0·98; 95 % CI 0·84, 1·13) nor for iron deficiency anaemia (men: OR 1·28; 95 % CI 0·84, 1·96; women: OR 0·93; 95 % CI 0·78, 1·11). Prevalence of iron deficiency and iron deficiency anaemia was especially high in women: 21·6 and 14·6 %, respectively. However, the likelihood of iron deficiency and iron deficiency anaemia was not significantly explained by tea consumption in sub-populations which were assumed to be at risk for iron deficiency. Regression of serum ferritin levels on tea consumption in women ≤ 40 years, adults with a daily iron intake ≤ 5·80 mg and adults with ferritin levels ≤ 26·60 μg/l, respectively, showedPvalues in the range of 0·28–0·88. Our findings demonstrate that iron deficiency and iron deficiency anaemia is not significantly explained by black tea consumption in a black adult population in South Africa. Tea intake was also not shown to be related to iron status in several sub-populations at risk for iron deficiency.

Inulin–iron complexes: A potential treatment of iron deficiency anaemia

The aim of this work was that to synthesize macromolecular derivatives based on inulin able to complex iron and useful in the treatment of iron deficiency anaemia. Carboxylated or thiolated/carboxylated inulin derivatives were obtained by single or double step reactions, respectively. The first one was obtained by reaction of inulin (INU) with succinic anhydride (SA) alone obtaining INU-SA derivative; the second one was obtained by the reaction of INU with succinic anhydride and subsequent reaction of INU-SA with cysteine; both derivatives were treated with ferric chloride in order to obtain the INU-SA-Fe(III) and INU-SA-Cys-Fe(III) complexes. Both complexes showed an excellent biodegradability in the presence of inulinase and pronounced mucoadhesion properties; in particular, thiolated derivative INU-SA-Cys showed greater mucoadhesive properties than polyacrylic acid chosen, as a positive reference polymer, and a good iron release profile in condition mimicking the intestinal tract. These results suggest the potential employment of such systems in the oral treatment of iron deficiency anaemia or as supplement of iron in foods.