Dietary iron intervention using a staple food product for improvement of iron status in female runners

Inorganic nutrients and heavy metals in some wild edible plants consumed by rural communities in Northern Uganda: Implications for human health

For centuries, wild edible plant species have sustained local communities across Africa by supplementing households' diets in seasons of food shortage. Wild edible plants contain inorganic nutrients, which are essential for the proper functioning of organisms. However, their nutritional contents have not been well researched and are generally poorly understood. This study aimed to quantify the levels of inorganic micro-and macronutrients as well as heavy metals (Mg, Ca, K, Fe, Zn, Cd, Hg and Pb) in selected wild edible plants traditionally consumed among the Acholi communities in northern Uganda, and associated health risks of consuming them. The leaves and young stems of 12 wild edible plants, viz: Acalypha rhomboidea, Asystacia gangetica, Crassocephalum sacrobasis, Crotalaria ochroleuca, Heterotis rotundifolia, Hibiscus cannabinus, Hibiscus sp., Hibiscus surattensis, Ipomoea eriocarpa, Maerua angolensis, Senna obtusifolia and Vigna membranacea were air-dried and crushed to powder. The powders were then macerated using aqua regia solution and analyzed in triplicates using the Atomic Absorption Spectrophotometry (AAS). The target hazard quotient (THQ) of Pb was calculated for non-carcinogenic health risks. Mg, Ca, K, Fe, Zn and Pb were detectable in all the wild edible plants sampled. All inorganic nutrients (mg/100gdw), were below the Recommended Daily Allowance (RDA); Mg (9.4 ± 0.19 to 10.4 ± 0.15), Ca (119 ± 5.82 to 1265 ± 14.9), Fe (3.29 ± 0.02 to 11.2 ± 0.09), Zn (0.52 ± 0.02 to 2.36 ± 0.03). Hg and Cd were below detectable limits in all the samples tested. The content of Pb (0.69 ± 0.11 to1.22 ± 0.07) was higher than the CODEX and EU limits of 0.1 ppm (0.001 mg/g) but was below the recommended threshold of 1. The health risk assessment revealed no potential hazards both in children and adults. However, there is a need to study the bioavailability of Pb when the vegetables are consumed due to factors such as indigestion and antinutritional compounds.

The Effect of Teff Seed on Hematological Findings and Anthropometric Measurements

Background

The low incidence of diseases such as celiac, anemia, osteoporosis, and obesity in Ethiopia has aroused interest in the study of teff. The primary objective of this study was to determine the effect of regular consumption of teff seeds on hematological findings and anthropometric measurements in overweight and obese individuals. The secondary objective was to compare these effects of teff seeds with the Mediterranean diet.

Methods

In our study, planned as a cohort study, 28 participants followed the teff seed-containing diet (n=14) and the Mediterranean diet (n=14) for 3 months. To determine nutritional status, a 72-h recall was taken. Anthropometric measurements and hematological findings were recorded at the beginning and end of the study.

Results

There was a significant decrease in fasting blood glucose, cholesterol, LDL, and HDL levels in the teff group (p<0.05). The increase in total protein levels in the teff group was significantly higher than in the Mediterranean diet group (p=0.05). With increased intake of carbohydrates (g) in the teff group, fasting blood glucose levels decreased significantly. There was no significant difference between the two groups regarding anthropometric measurements.

Conclusion

It has been found that the teff seed has no predominance over anthropometric measurements, as compared to the Mediterranean diet, and that it is more effective in improving hematological findings related to obesity. There is a need for more comprehensive studies that also address physical activity, the different types of teff seeds available, and include increased participant numbers.

Millets Can Have a Major Impact on Improving Iron Status, Hemoglobin Level, and in Reducing Iron Deficiency Anemia-A Systematic Review and Meta-Analysis

The prevalence of iron deficiency anemia is highest among low and middle-income countries. Millets, including sorghum, are a traditional staple in many of these countries and are known to be rich in iron. However, a wide variation in the iron composition of millets has been reported, which needs to be understood in consonance with its bioavailability and roles in reducing anemia. This systematic review and meta-analysis were carried out to analyze the scientific evidence on the bioavailability of iron in different types of millets, processing, and the impact of millet-based food on iron status and anemia. The results indicated that iron levels in the millets used to study iron bioavailability (both in vivo and in vitro) and efficacy varied with the type and variety from 2 mg/100 g to 8 mg/100 g. However, not all the efficacy studies indicated the iron levels in the millets. There were 30 research studies, including 22 human interventions and 8 in vitro studies, included in the meta-analysis which all discussed various outcomes such as hemoglobin level, serum ferritin level, and absorbed iron. The studies included finger millet, pearl millet, teff and sorghum, or a mixture of millets. The results of 19 studies conducted on anaemic individuals showed that there was a significant (p < 0.01) increase in hemoglobin levels by 13.2% following regular consumption (21 days to 4.5 years) of millets either as a meal or drink compared with regular diets where there was only 2.7% increase. Seven studies on adolescents showed increases in hemoglobin levels from 10.8 ± 1.4 (moderate anemia) to 12.2 ± 1.5 g/dl (normal). Two studies conducted on humans demonstrated that consumption of a pearl millet-based meal significantly increased the bioavailable iron (p < 0.01), with the percentage of bioavailability being 7.5 ± 1.6, and provided bioavailable iron of 1 ± 0.4 mg. Four studies conducted on humans showed significant increases in ferritin level (p < 0.05) up to 54.7%. Eight in-vitro studies showed that traditional processing methods such as fermentation and germination can improve bioavailable iron significantly (p < 0.01) by 3.4 and 2.2 times and contributed to 143 and 95% of the physiological requirement of women, respectively. Overall, this study showed that millets can reduce iron deficiency anemia.

Pulse Probiotic Superfood as Iron Status Improvement Agent in Active Women-A Review

Active women or women of reproductive age (15–49 years old) have a high risk of suffering from anaemia. Anaemia is not solely caused by iron deficiency, however, the approaches to improve iron status in both cases are greatly related. Improving the iron status of active women can be done by dietary intervention with functional food. This review aims to provide insights about the functional food role to increase iron absorption in active women and the potency of pulse probiotic superfood development in dry matrices. Results showed that the beneficial effect of iron status is significantly improved by the synergic work between probiotic and prebiotic. Furthermore, chickpeas and lentils are good sources of prebiotic and the consumption of pulses are related with 21st century people’s intention to eat healthy food. There are wide possibilities to develop functional food products incorporated with probiotics to improve iron status in active woman.

Patterns of Dietary Iron Intake, Iron Status, and Predictors of Haemoglobin Levels among Early Adolescents in a Rural Ghanaian District

Introduction

Early adolescents are vulnerable to anaemia due to lean body mass and menarche. The study assessed patterns of dietary iron intake, iron status, and predictors of anaemia among early adolescents.

Method

One hundred and thirty-seven early adolescents were randomly selected in a rural district in Ghana. Multiple-pass 24-hour recall, iron food frequency questionnaire consisting of 27 food items, and semistructured questionnaire were administered. Variables include sociodemographics, dietary factors, and laboratory investigation including haemoglobin, ferritin, and C-reactive protein examination. Statistical Package for the Social Sciences (SPSS) software was used to calculate odds ratio and perform Mann–Whitney U test, chi-square (X²) test, exploratory factor analysis, and partial correlation (r) tests.

Results

Participants had mean age of 11.5 years. Three iron dietary patterns explaining 28.7% of the total variance were identified: iron dietary pattern 1 (11%) composed of iron-rich, iron-enhancing, and iron-inhibiting foods; iron dietary pattern 2 (9.9%) comprised of iron-rich, iron-enhancing, and non-iron-inhibiting foods; and iron dietary pattern 3 (7.1%) consisting of stinging nettle, iron-inhibiting foods, non-iron-enhancing foods, non-cocoyam leaves, and non-turkey berries. Meal skipping (X² = 5.7, p < 0.05), times of eating a day (X² = 12.6, p < 0.05), and guardian educational status (X² = 6.7, p < 0.05) significantly affected dietary iron intake. Anaemia was associated with meal skipping (β = 0.367, p > 0.05), snacking (β = 0.484, p > 0.05), and junior high school (JHS) education (β = 0.544, p > 0.05). Partial correlation showed statistically significant relationship between iron dietary pattern 1 and dietary iron (r = −0.234, p < 0.01), iron dietary pattern 2 and dietary iron (r = -0.198, p < 0.05), iron dietary pattern 2 and vitamin C (r = -0.201, p < 0.05), and haemoglobin and ferritin (r = −0.178, p < 0.05).

Conclusion

Meal skipping, guardian educational status, and number of times of eating a day were significantly associated with dietary iron intake. Meal skipping, snacking, and adolescents with JHS education were positively associated with anaemia.

The Effect of Lactobacillus plantarum 299v on Iron Status and Physical Performance in Female Iron-Deficient Athletes: A Randomized Controlled Trial

Iron is an essential micronutrient for oxygen transport and mitochondrial metabolism and is critical for physical performance. Compromised iron stores are more commonly found among athletes, and females are especially at risk. Iron deficiency is generally treated using oral iron supplements. However, only a small proportion of ingested iron is absorbed, necessitating higher intakes, which may result in adverse side effects, reduced compliance, and inefficient repletion of iron stores. The probiotic strain Lactobacillus plantarum 299v (Lp299v) significantly increases intestinal iron absorption in meal studies. The present study was conducted to explore the effects of 20 mg of iron with or without Lp299v on iron status, mood state, and physical performance. Fifty-three healthy non-anemic female athletes with low iron stores (ferritin < 30 μg/L) were randomized, and 39 completed the study. Intake of Lp299v with iron for four weeks increased ferritin levels more than iron alone (13.6 vs. 8.2 µg/L), but the difference between the groups was not significant (p = 0.056). The mean reticulocyte hemoglobin content increased after intake of Lp299v compared to control (1.5 vs. 0.82 pg) after 12 weeks, but the difference between the group was not significant (p = 0.083). The Profile of Mood States (POMS) questionnaire showed increased vigor with Lp299v vs. iron alone after 12 weeks (3.5 vs. 0.1, p = 0.015). No conclusive effects on physical performance were observed. In conclusion, Lp299v, together with 20 mg of iron, could result in a more substantial and rapid improvement in iron status and improved vigor compared to 20 mg of iron alone. A larger clinical trial is needed to further explore these findings as well as the impact of Lp299v on physical performance.

Teff consumption and anemia in pregnant Ethiopian women: a case-control study

PURPOSE

Teff, an iron-rich staple grain in Ethiopia, is consumed mainly in the form of teff injera (TI). Studies on the association of TI consumption with anemia are limited. We aimed to determine the association of frequencies of TI consumption with anemia, in Addis Ababa, Ethiopia.

METHODS

We conducted a hospital-based case-control study involving 592 pregnant women: 187 anemic cases, and 405 non-anemic controls. TI consumption was assessed by a food frequency questionnaire (FFQ). Multiple logistic regression, adjusted for dietary and non-dietary covariates, was performed to determine the relation of TI consumption to anemia status.

RESULTS

We found that a decrease in frequency of TI consumption was significantly associated with an increase in the likelihood of anemia (p-trend = 0.009). Compared with everyday TI consumption, the adjusted odds ratios (AORs) of anemia associated with the other frequencies of teff consumption were 1.50 [95% confidence interval (CI) 0.71, 3.23; p = 0.285] for every other day, 2.13 (95% CI 1.03, 4.41; p = 0.04) for 1-2 times a week, and 3.17 (95% CI 1.62, 6.22; p < 0.001) for once in 2 weeks.

CONCLUSIONS

Teff consumption was associated with reduced odds of anemia in pregnant women. Further studies are warranted, including determining the feasibility and effectiveness of TI use for anemia prevention.

REGISTRATION

The study was registered as https://clinicaltrials.gov/ct2/show/NCT03251664 .

Simple sugar supplementation abrogates exercise-induced increase in hepcidin in young men

Background

At present many young people experience too much body iron accumulation. The reason of this phenomenon is not clear. There is accumulating evidences that not proper diet and lack of exercise could be a main contributing factors. This investigation assessed the effects of a diet rich in simple sugars (glucose or fructose) on exercise-induced hepcidin which is hormone regulating iron metabolism.

Methods

A group of physically active young men completed an incremental exercise test before and after a 3-day diet supplemented with fructose (4 g/kg BM) or glucose (4 g/kg BM). After a 1-week break, they crossed over to the alternate mode for the subsequent 3-days period. Venous blood samples were collected before and after 1 h exercise and were analysed for serum hepcidin, IL-6, CRP, iron, and ferritin. The physiological response to exercise was also determined.

Results

The concentration of hepcidin increased 1 h after exercise for the baseline test (p < 0.05), whereas no changes in hepcidin were observed in men whose diet was supplemented with fructose or glucose. Blood IL-6 increased significantly after exercise only in subjects supplemented with fructose. Changes in hepcidin did not correlate with shifts in serum IL-6.

Conclusions

These data suggest that protective effects of exercise on excess iron accumulation in human body which is mediated by hepcidin can be abrogated by high sugar consumption which is typical for contemporary people.

Iron and the female athlete: a review of dietary treatment methods for improving iron status and exercise performance

Iron is a functional component of oxygen transport and energy production in humans and therefore is a critically important micronutrient for sport and exercise performance. Athletes, particularly female athletes participating in endurance sport, are at increased risk of compromised iron status due to heightened iron losses through menstruation and exercise-induced mechanisms associated with endurance activity. Conventionally oral iron supplementation is used in prevention or/and treatment of iron deficiency. However, this approach has been criticised because of the side effects and increased risk of iron toxicity associated with the use of supplements. Thus, more recently there has been a growing interest in using dietary modification rather than the use of supplements to improve iron status of athletes. Dietary iron treatment methods include the prescription of an iron-rich diet, or/and haem iron-based diet, dietary advice counselling and inclusion of novel iron-rich products into the daily diet. Although studies using dietary modification are still scarce, current literature suggests that dietary iron interventions can assist in maintaining iron status in female athletes, especially during intensive training and competition. Future research should focus on the most efficient method(s) of dietary modification for improvement of iron status and whether these approaches can have a favourable impact on sports and exercise performance.