scholarly journals Complementary Feeding and Iron Status: “The Unbearable Lightness of Being” Infants

Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4201
Author(s):  
Vito Leonardo Miniello ◽  
Maria Carmen Verga ◽  
Andrea Miniello ◽  
Cristina Di Mauro ◽  
Lucia Diaferio ◽  
...  

The complementary feeding (CF) period that takes place between 6 and 24 months of age is of key importance for nutritional and developmental reasons during the transition from exclusively feeding on milk to family meals. In 2021, a multidisciplinary panel of experts from four Italian scientific pediatric societies elaborated a consensus document on CF, focusing in particular on healthy term infants. The aim was to provide healthcare providers with useful guidelines for clinical practice. Complementary feeding is also the time window when iron deficiency (ID) and iron deficiency anemia (IDA) are most prevalent. Thus, it is appropriate to address the problem of iron deficiency through nutritional interventions. Adequate iron intake during the first two years is critical since rapid growth in that period increases iron requirements per kilogram more than at any other developmental stage. Complementary foods should be introduced at around six months of age, taking into account infant iron status.

Author(s):  
Joanna Gajewska ◽  
Jadwiga Ambroszkiewicz ◽  
Witold Klemarczyk ◽  
Ewa Głąb-Jabłońska ◽  
Halina Weker ◽  
...  

Iron metabolism may be disrupted in obesity, therefore, the present study assessed the iron status, especially ferroportin and hepcidin concentrations, as well as associations between the ferroportin-hepcidin axis and other iron markers in prepubertal obese children. The following were determined: serum ferroportin, hepcidin, ferritin, soluble transferrin receptor (sTfR), iron concentrations and values of hematological parameters as well as the daily dietary intake in 40 obese and 40 normal-weight children. The ferroportin/hepcidin and ferritin/hepcidin ratios were almost two-fold lower in obese children (p = 0.001; p = 0.026, respectively). Similar iron concentrations (13.2 vs. 15.2 µmol/L, p = 0.324), the sTfR/ferritin index (0.033 vs. 0.041, p = 0.384) and values of hematological parameters were found in obese and control groups, respectively. Iron daily intake in the obese children examined was consistent with recommendations. In this group, the ferroportin/hepcidin ratio positively correlated with energy intake (p = 0.012), dietary iron (p = 0.003) and vitamin B12 (p = 0.024). In the multivariate regression model an association between the ferroportin/hepcidin ratio and the sTfR/ferritin index in obese children (β = 0.399, p = 0.017) was found. These associations did not exist in the controls. The results obtained suggest that in obese children with sufficient iron intake, the altered ferroportin-hepcidin axis may occur without signs of iron deficiency or iron deficiency anemia. The role of other micronutrients, besides dietary iron, may also be considered in the iron status of these children.


2010 ◽  
Vol 80 (45) ◽  
pp. 263-270 ◽  
Author(s):  
Ana C. Cepeda-Lopez ◽  
Isabelle Aeberli ◽  
Michael B. Zimmermann

Increasing obesity is a major global health concern while at the same time iron-deficiency anemia remains common worldwide. Although these two conditions represent opposite ends of the spectrum of over- and under-nutrition, they appear to be linked: overweight individuals are at higher risk of iron deficiency than normal-weight individuals. Potential explanations for this association include dilutional hypoferremia, poor dietary iron intake, increased iron requirements, and/or impaired iron absorption in obese individuals. Recent evidence suggests obesity-related inflammation may play a central role through its regulation of hepcidin. Hepcidin levels are higher in obese individuals and are linked to subclinical inflammation; this may reduce iron absorption and blunt the effects of iron fortification. Thus, low iron status in overweight individuals may result from a combination of nutritional (reduced absorption) and functional (increased sequestration) iron deficiency. In this review, we focus on subclinical inflammation in obesity, and its effect on hepcidin levels, as the most plausible explanation for the link between iron deficiency and obesity.


2012 ◽  
Vol 52 (4) ◽  
pp. 223
Author(s):  
Olga Rasiyanti Siregar ◽  
Bugis Lubis ◽  
Muara Lubis ◽  
Bidasari Lubis ◽  
Guslihan Dasa Tjipta

Background Iron deficiency childhood is a concern due to its potentially detrimental effectson development, some of which may be irreversible even after irontreatment. Delayed cord clamping may prevent IDA by increasingan infant's iron reserve at birth.Objective We aimed to evaluate the effect of delayed umbilicalcord clamping at birth on the iron status in newborns at age 24hours of life.Methods This randomized, single􀁒blind study was conducted fromMarch to May 2009, at two general hospitals in Medan, NorthSumatera Province. Eligible newborn infants were randomlyassigned to one of two groups: early cord clamping (Eee)performed 15 seconds after delivery or delayed cord clamping(DeC) performed 2 minutes after delivery. Infants were placed ontheir mothers' abdomens before the umbilical cords were clamped.Hematologic status was determined from umbilical cord blood.Results Sixty􀁒three subjects were included in our study, consistingof31 infants in the Eee group and 32 infants in the Dec group.We found that mean neonatal hemoglobin level was higher inthe Dec group than in the Eee group ( 18.4 g% and 16.2 g%,respectively, P=O.OOOl). Also, mean ferritin level was higher inthe Dec group than in the Eee group (556 mg/dL and 329 mg/dL, respectively, p=o.o 15). Other hematological status indicators,including mean hematocrit and mean corpuscular volume (MeV)level, were also higher in the Dec group. However, mean redblood cell levels were not significantly groups. Nor was there a significant level between the Dec and Eee groups.Concl usion Dela y ed cord c l a m p i n g m a y improve ironstatus and prevent IDA in term infants. [Paediatr Indones.2012;52:223-8].


Nutrients ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 139 ◽  
Author(s):  
Chiao-Ming Chen ◽  
Shu-Ci Mu ◽  
Chun-Kuang Shih ◽  
Yi-Ling Chen ◽  
Li-Yi Tsai ◽  
...  

Iron deficiency (ID) and iron deficiency anemia (IDA) typically occur in developing countries. Notably, ID and IDA can affect an infant’s emotion, cognition, and development. Breast milk is considered the best food for infants. However, recent studies have indicated that breastfeeding for more than six months increases the risk of ID. This study investigated the prevalence of ID and IDA, as well as the association between feeding type and iron nutritional status in northern Taiwan. A cross-sectional study was conducted on infants who returned to the well-baby clinic for routine examination from October 2012 to January 2014. Overall, 509 infants aged 1–12 months completed the iron nutritional status analysis, anthropometric measurement, and dietary intake assessment, including milk and complementary foods. The results revealed that 49 (10%) and 21 (4%) infants in their first year of life had ID and IDA, respectively, based on the World Health Organization criteria. Breastfed infants had a higher prevalence rate of ID and IDA than mixed-fed and formula-fed infants (p < 0.001). Regarding biomarkers of iron status, plasma hemoglobin (Hb), ferritin, and transferrin saturation (%) levels were significantly lower in ID and IDA groups. The prevalence of ID and IDA were 3.7% and 2.7%, respectively, in infants under six months of age, but increased to 20.4% and 6.6%, respectively, in infants above six months of age. The healthy group had a higher total iron intake than ID and IDA groups, mainly derived from infant formula. The total dietary iron intake was positively correlated with infants’ Hb levels. Compared with formula-fed infants, the logistic regression revealed that the odds ratio for ID was 2.157 (95% confidence interval [CI]: 1.369–3.399) and that for IDA was 4.196 (95% CI: 1.780–9.887) among breastfed infants (p < 0.001) after adjusted for all confounding factors (including gestational week, birthweight, sex, body weight percentile, body length percentile, age of infants, mothers’ BMI, gestational weight gain, education level, and hemoglobin level before delivery). In conclusion, our results determined that breastfeeding was associated with an increased the prevalence of ID and/or IDA, especially in infants above six months. This suggests that mothers who prolonged breastfeed after six months could provide high-quality iron-rich foods to reduce the prevalence of ID and IDA.


Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 2045 ◽  
Author(s):  
Mota ◽  
Tounian ◽  
Guillou ◽  
Pierre ◽  
Membré

: Dietary iron deficiency (ID) is the first nutritional deficiency in the world, in terms of disability adjusted life years (DALY). This nutritional deficiency may lead to anemia, especially among children, adolescents, and adult women. The aim of this study was to build an original probabilistic model to quantitatively assess the ID, the iron deficiency anemia (IDA) and the subsequent health burden in France expressed in DALY, per age class and gender. The model considered the distribution of absorbed iron intake, the iron requirement distribution established by the European Food Safety Authority and the iron status in France. Uncertainty due to lack of data and variability due to biological diversity were taken into account and separated using a second-order Monte Carlo procedure. A total of 1290 (95% CI = 1230–1350) IDA cases corresponding to 16 (95% CI = 11–20) DALY were estimated per 100,000 individuals per year. The major contributors to IDA burden were menstruating females aged from 25 to 44 years old. Then, a consumption scenario was built with ground beef as intake, an increase in red meat consumption to 100 g/d would not eliminate entirely the IDA burden. The quantitative methodology applied here for France could be reused for other populations.


2021 ◽  
pp. 1-21
Author(s):  
Celeste Tsz Hei Cheung ◽  
Anna M Rangan ◽  
Iris Mei Ying Tse ◽  
Wai Hung Sit ◽  
Jimmy Chun Yu Louie

Abstract Objectives To examine the potential effect on iron intake of 7-8 month-old infants if pre-packaged baby foods (PBFs) were used as the sole source of complementary foods. Design: Based on the 7-day recommended feeding plan for 7-8-month-old infants in Hong Kong (moderate iron-fortified rice cereal with home-cooked meals), 24 modelling scenarios were created which comprised of two milk use modes (breastmilk vs. infant formula); three modes of rice cereal use (no rice cereal; non-iron-fortified rice cereal; iron-fortified rice cereal); and four baby foods usage modes (home-cooked meals; low-iron PBFs only; high-iron PBFs only; mixed PBFs). The PBFs were randomly selected in each of the models and substituted the original meals/snacks. The average daily iron intakes of the modelled meal plans were compared against the Chinese estimated average requirement (EAR) and recommended nutrient intake (RNI) for iron. Setting: Modelling study. Participants: N/A. Results: In general, the infant-formula-based complementary feeding pattern (CFP) had higher average daily iron intake when compared with breastmilk-based CFP. The iron intake of all scenarios under the breastmilk-based CFP were below the RNI and EAR, except for the fortified rice cereal meal plans with high-iron or mixed PBFs. For infant-formula-based CFP, the iron intakes were close to or above the RNI regardless of types of PBF or rice cereal used. Conclusions: The inclusion of fortified rice cereal was important in maintaining adequate iron intake for infants, especially for breastfed infants. The replacement of home-cooked meals by low-iron PBFs could potentially put infants at risk of iron deficiency.


Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2340
Author(s):  
Jordie A. J. Fischer ◽  
Carolina S. Sasai ◽  
Crystal D. Karakochuk

Oral contraceptive use has been associated with decreased menstrual blood losses; thus, can independently reduce the risk of anemia and iron deficiency in women. Manufacturers have recently started to include supplemental iron in the non-hormonal placebo tablets of some contraceptives. The aims of this narrative review are: (i) to describe the relationship between oral contraceptive use and both anemia and iron status in women; (ii) to describe the current formulations of iron-containing oral contraceptives (ICOC) available on the market; and (iii) to systematically review the existing literature on the effect of ICOC on biomarkers of anemia and iron status in women. We discovered 21 brands of ICOC, most commonly including 25 mg elemental iron as ferrous fumarate, for seven days, per monthly tablet package. Our search identified one randomized trial evaluating the effectiveness of ICOC use compared to two non-ICOC on increasing hemoglobin (Hb) and iron status biomarker concentrations in women; whereafter 12 months of contraception use, there were no significant differences in Hb concentration nor markers of iron status between the groups. ICOC has the potential to be a cost-effective solution to address both family planning needs and iron deficiency anemia. Yet, more rigorous trials evaluating the effectiveness of ICOC on improving markers of anemia and iron deficiency, as well as investigating the safety of its consumption among iron-replete populations, are warranted.


2017 ◽  
Vol 147 (12) ◽  
pp. 2297-2308 ◽  
Author(s):  
Michael J Wenger ◽  
Laura E Murray-Kolb ◽  
Julie EH Nevins ◽  
Sudha Venkatramanan ◽  
Gregory A Reinhart ◽  
...  

Abstract Background: Iron deficiency and iron deficiency anemia have been shown to have negative effects on aspects of perception, attention, and memory. Objective: The purpose of this investigation was to assess the extent to which increases in dietary iron consumption are related to improvements in behavioral measures of perceptual, attentional, and mnemonic function. Methods: Women were selected from a randomized, double-blind, controlled food-fortification trial involving ad libitum consumption of either a double-fortified salt (DFS) containing 47 mg potassium iodate/kg and 3.3 mg microencapsulated ferrous fumarate/g (1.1 mg elemental Fe/g) or a control iodized salt. Participants' blood iron status (primary outcomes) and cognitive functioning (secondary outcomes) were assessed at baseline and after 10 mo at endline. The study was performed on a tea plantation in the Darjeeling district of India. Participants (n = 126; 66% iron deficient and 49% anemic at baseline) were otherwise healthy women of reproductive age, 18–55 y. Results: Significant improvements were documented for iron status and for perceptual, attentional, and mnemonic function in the DFS group (percentage of variance accounted for: 16.5%) compared with the control group. In addition, the amount of change in perceptual and cognitive performance was significantly (P < 0.05) related to the amount of change in blood iron markers (mean percentage of variance accounted for: 16.0%) and baseline concentrations of blood iron markers (mean percentage of variance accounted for: 25.0%). Overall, there was evidence that the strongest effects of change in iron status were obtained for perceptual and low-level attentional function. Conclusion: DFS produced measurable and significant improvements in the perceptual, attentional, and mnemonic performance of Indian female tea pickers of reproductive age. This trial was registered at clinicaltrials.gov as NCT01032005.


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