The Effects of Iron Deficiency on the Gut Microbiota in Women of Childbearing Age

Low-Iron Diet-Induced Fatty Liver Development Is Microbiota Dependent and Exacerbated by Loss of the Mitochondrial Iron Importer Mitoferrin2

Iron deficiency is the number one nutritional problem worldwide. Iron uptake is regulated at the intestine and is highly influenced by the gut microbiome. Blood from the intestines drains directly into the liver, informing iron status and gut microbiota status. Changes in either iron or the microbiome are tightly correlated with the development of metabolic dysfunction-associated steatotic liver disease (MASLD). To investigate the underlying mechanisms of the development of MASLD that connect altered iron metabolism and gut microbiota, we compared specific pathogen free (SPF) or germ-free (GF) mice, fed a normal or low-iron diet. SPF mice on a low-iron diet showed reduced serum triglycerides and MASLD. In contrast, GF low-iron diet-fed mice showed increased serum triglycerides and did not develop hepatic steatosis. SPF mice showed significant changes in liver lipid metabolism and increased insulin resistance that was dependent upon the presence of the gut microbiota. We report that total body loss of mitochondrial iron importer Mitoferrin2 (Mfrn2-/-) exacerbated the development of MASLD on a low-iron diet with significant lipid metabolism alterations. Our study demonstrates a clear contribution of the gut microbiome, dietary iron, and Mfrn2 in the development of MASLD and metabolic syndrome.

Micronutrient (iron, selenium, vitamin D) supplementation and the gut microbiome

PURPOSE OF REVIEW

Deficiencies in micronutrients persist as widespread global challenges, where supplementation remains a crucial therapeutic approach. This review aims to elucidate the intricate relationships between micronutrient supplementation - specifically iron, selenium (Se), and vitamin D (Vit D) - and gut microbiota composition, investigating their collective impact on host health and disease susceptibility.

RECENT FINDINGS

Maintaining balanced iron levels is essential for gut microbiota equilibrium and host health, as both iron deficiency and excess disrupt gut bacterial balance, affecting colon health. Se supplementation can restore and improve the gut microbial balance, influencing health outcomes not only in the gut but also in areas such as neuroprotection in the brain, testicular health, and metabolic syndrome. Clinical and experimental models demonstrate that Vit D modulates the gut microbiome, enhancing anti-inflammatory effects, supporting metabolic health, and potentially reducing the risk of gut-related behavioral changes and diseases.

SUMMARY

Findings of this review emphasize that balanced iron levels are essential for maintaining a healthy gut microbiota composition and underscore the beneficial effects of Se and Vit D in modulating the gut microbiome. The interactions between micronutrients and the gut microbiome are complex but may have a broad spectrum of health outcomes.

The association of infant and mother gut microbiomes with development of allergic diseases in children: a systematic review

OBJECTIVE

It is believed that gut microbiota alteration leads to both intestinal and non-intestinal diseases in children. Since infants inherit maternal microbiota during pregnancy and lactation, recent studies suggest that changes in maternal microbiota can cause immune disorders as well. This systematic review was designed to assess the association between the child and mother's gut microbiome and allergy development in childhood.

DATA SOURCES

In this systematic review, international databases including PubMed, Scopus, and ISI/WOS were searched until January 2023 to identify relevant studies.

STUDY SELECTIONS

Observational studies that analyzed infant or maternal stool microbiome and their association with allergy development in children were included in this study. Data extraction and quality assessment of the included studies were independently conducted by two researchers.

RESULTS

Of the 1694 papers evaluated, 21 studies examined neonate gut microbiome by analyzing stool samples and six studies examined maternal gut microbiota. A total of 5319 participants were included in this study. Asthma followed by eczema and dermatitis were the most common allergy disorders among children. Urbanization caused a lack of diversity in the bacterial microbiota as well as lower levels of Bifidobacterium and Lachnospira associated with a higher risk of allergy. In contrast, higher levels of Roseburia and Flavonifractor were associated with lower allergy risk.

CONCLUSIONS

This systematic review shows that gut microbiota may be associated with allergy development. Further studies are required to provide a definitive answer.

Nutrition in chronic inflammatory conditions: Bypassing the mucosal block for micronutrients

Nutritional Immunity is one of the most ancient innate immune responses, during which the body can restrict nutrients availability to pathogens and restricts their uptake by the gut mucosa (mucosal block). Though this can be a beneficial strategy during infection, it also is associated with non-communicable diseases-where the pathogen is missing; leading to increased morbidity and mortality as micronutritional uptake and distribution in the body is hindered. Here, we discuss the acute immune response in respect to nutrients, the opposing nutritional demands of regulatory and inflammatory cells and particularly focus on some nutrients linked with inflammation such as iron, vitamins A, Bs, C, and other antioxidants. We propose that while the absorption of certain micronutrients is hindered during inflammation, the dietary lymph path remains available. As such, several clinical trials investigated the role of the lymphatic system during protein absorption, following a ketogenic diet and an increased intake of antioxidants, vitamins, and minerals, in reducing inflammation and ameliorating disease.

Comprehensive insight into the alterations in the gut microbiome and the intestinal barrier as a consequence of iron deficiency anaemia

BACKGROUND

Iron deficiency is the top leading cause of anaemia, whose treatment has been shown to deteriorate gut health. However, a comprehensive analysis of the intestinal barrier and the gut microbiome during IDA have not been performed to date. This study aims to delve further into the analysis of these two aspects, which will mean a step forward minimising the negative impact of iron supplements on intestinal health.

METHODS

IDA was experimentally induced in an animal model. Shotgun sequencing was used to analyse the gut microbiome in the colonic region, while the intestinal barrier was studied through histological analyses, mRNA sequencing (RNA-Seq), qPCR and immunofluorescence. Determinations of lipopolysaccharide (LPS) and bacteria-specific immunoglobulins were performed to assess microbial translocation.

RESULTS

Microbial metabolism in the colon shifted towards an increased production of certain amino acids, short chain fatty acids and nucleotides, with Clostridium species being enriched during IDA. Structural alterations of the colonic epithelium were shown by histological analysis. RNA-Seq revealed a downregulation of extracellular matrix-associated genes and proteins and an overall underdeveloped epithelium. Increased levels of serum LPS and an increased immune response against dysbiotic bacteria support an impairment in the integrity of the gut barrier during IDA.

CONCLUSIONS

IDA negatively impacts the gut microbiome and the intestinal barrier, triggering an increased microbial translocation. This study emphasizes the deterioration of gut health during IDA and the fact that it should be addressed when treating the disease.

Tragacanth gum-based nano-nutraceuticals synthesis by encapsulation of beetroot juice and Ocimum basilicum leaves for micronutrient deficient population

Micronutrient deficiencies, such as iron, folic acid, and vitamins C and D, are currently prevalent due to inadequate consumption of natural food sources, namely raw vegetables and fruits. This deficiency is compounded by the growing reliance on synthetic nutraceuticals and processed food, which exhibit poor absorbency within the gastrointestinal tract. Scientific studies consistently indicate that naturally prepared whole foods are superior in terms of nutrient absorption compared to processed and synthetic supplements. To address this issue, we utilized FDA-approved tragacanth gum (TG) in the synthesis of nano-nutraceuticals by encapsulating beetroot juice and ball-milled sweet basil (Ocimum basilicum). TG, in its micro or macro form, possesses the remarkable ability to form hydrogels capable of absorbing water up to 50 times its weight. However, the hydrogel-forming property diminishes when TG is reduced to the nanoscale. We effectively exploited these properties to facilitate the synthesis of nano-nutraceuticals. The procedure involved encapsulating beetroot juice and sweet basil nanopowder using TG hydrogel, followed by freeze-drying. Subsequently, the freeze-dried encapsulated TG composite was subjected to ball-milling to achieve the desired nano-nutraceuticals. These nano-nutraceuticals naturally contain essential nutrients such as iron, folic acid, ascorbic acid, chlorophyll, niacin, and sugars, without the need for chemical processing or preservatives.

Fermented Goat's Milk Contributes to the Recovery of Iron Deficiency Anemia via Modulation of the Gut Microbiome

Iron deficiency anemia (IDA) is a global public health concern affecting 1.6 billion people worldwide. The administration of iron supplements during the treatment of IDA adversely affects the intestinal barrier function and the composition and functionality of the intestinal microbiome, both of which are already altered during IDA. For this reason, it is of great interest to develop nutritional strategies aimed at alleviating these gut alterations associated with IDA and its treatment. In this sense, fermented goat's milk (FGM) was studied due to its nutritional quality. Our findings showed that in anemic animals the consumption of a FGM-based diet, compared to a standard diet, had positive modulatory effects on the intestinal microbiome. FGM-based diet restored intestinal dysbiosis, the intestinal barrier functionality, and bacterial translocation, contributing to a more efficient recovery of IDA. Therefore, FGM is a useful nutritional tool to ease intestinal alterations occurring during IDA and during its treatment.

The Prevalence of Anemia in Working Women

INTRODUCTION

Anemia can be defined as a reduction in the amount of hemoglobin (Hb) in red blood cells (RBCs). It is becoming a growing socioeconomic issue. It is important to identify the causes of anemia and educate people about its symptoms. This can aid in the early identification and diagnosis of anemia, thereby preventing the disease's complications. The complications of anemia include the risk of low birth weight, prematurity, prenatal and neonatal mortality, and maternal mortality.

OBJECTIVE

The objective of the study is to investigate the factors contributing to anemia among working-class women employed in government or private sectors located in Karachi, Pakistan. By identifying the causes and risk factors of anemia, participants can be counseled to adopt a healthier lifestyle, a well-balanced diet, and activities that may eliminate the causes of anemia, further preventing the incidence of anemia. The objectives of the study are specific, measurable, achievable, realistic, and time-bound (SMART). The study was conducted from November 2019 to August 2021 despite facing COVID-19-related restrictions. The sample size fit the inclusion criteria, and the objectives were accomplished successfully with adequate resources.

METHODOLOGY

The cross-sectional study was conducted after receiving clearance from institutions and consent from participants. A total of 180 participants provided consent after receiving a thorough explanation of the study, and they had the right to refuse to participate. In respect of confidentiality, the participants were not required to provide their names, as they were not included in our data analysis. The inclusion criteria included women of the working class, aged 18-45 years, working a minimum of four to five hours per week, and employed in government or private sectors located in Karachi, Pakistan. The exclusion criteria included women with bleeding or hematological disorders, a history of surgery in the last 12 months, pregnancy, or systemic disease. Data collection was divided into two sections: section one (questionnaire) and section two (investigations). The questionnaire was given to each participant via Google Forms and was filled out before section two of data collection, which included blood tests via a finger prick to measure hemoglobin with a Veri-Q Multi Meter hemoglobin monitoring system (manufactured by Q-line BIOTECH, New Delhi, India).

RESULTS

The mean Hb was 11.15 ± 1.29 mg/dl (n = 180). The study revealed that 58.3% of the participants had a normal hemoglobin concentration according to the WHO anemia classification, while 41.7% were anemic. Overall, the prevalence of anemia was 41.7%, and the majority (56%) of the participants had mild anemia.

CONCLUSION

The majority of the participants had mild anemia. Education on anemia and its symptoms, eating habits, occupational status, and stress-related factors can affect the hemoglobin concentration in RBCs. A diet low in meat, leafy vegetables, and fruit leads to anemia. Despite knowledge of anemia and its symptoms, non-medical professionals, especially young adults, had a higher prevalence of anemia than medical professionals, although the difference was minor.