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Alternate strategies for improving iron nutrition: lessons from recent research

Published online by Cambridge University Press:  09 March 2007

K. Madhavan Nair*
Affiliation:
Department of Biophysics, National Institute of Nutrition, Indian Council of Medical Research, Jamai Osmania P.O., Hyderabad – 500007, India
*
Corresponding author: Dr K. Madhavan, fax +91 40 7019074, email [email protected]
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Abstract

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Strategies such as dietary diversification and food fortification have yielded significant results in controlling iron deficiency anaemia in developed countries. Reducing the prevalence of iron deficiency anaemia in developing countries is still a matter of importance. The major factors responsible for iron deficiency anaemia in the vulnerable segments of developing countries are reduced intake and poor bioavailability of dietary iron. Dietary diversification and food-based approaches pose considerable challenges before they can be implemented on a wide scale. Anaemia control programmes based on the administration of prophylactic doses of iron and folic acid tablets have been widely implemented. As the programmes were not effective in countries such as India, the dosage of iron was increased. The role of excess iron in causing intestinal oxidative stress has drawn attention to other approaches of iron supplementation. Prophylactic administration of iron along with antioxidants like vitamins E and C or foods rich in these vitamins is one such strategy. To reduce the intestinal oxidative stress, intermittent supplementation of iron is being considered. The potential benefits and shortcomings of these approaches are reviewed.

Type
Research Article
Copyright
Copyright © The Nutrition Society 2001

References

Angeles-Agdeppa, I, Schultink, W, Sastraomidjojo, S, Gross, R & Karyad, D (1997) Weekly micronutrient supplementation to build iron stores in female Indonesian adolescents American Journal of Clinical Nutrition 66, 177183.CrossRefGoogle ScholarPubMed
Baynes, RD & Cook, JD (1996) Current issues of iron deficiency Current Opinion in Hematology 3, 145149.CrossRefGoogle ScholarPubMed
Beaton, G, McCabe, G, Yir, R & Zlotkin, S (1999) Efficacy of intermittent iron supplementation in the control of iron deficiency anaemia in developing countries. Summary of major findings. Report prepared for release at the INACG meeting, March 1999.Google Scholar
Brahmam, GNV, Madhavan, Nair K, Laxmaiah, A, Gal Reddy, Ch, Ranganathan, S, Vishnuvardhana Rao, M, Nadamuni, Naidu A, Vijayaraghavan, K, Sivakumar, B & RM, Geertman (2000) Community trials with iron and iodine fortified salt (double fortified salt). In Proceedings of the 8th World Salt Symposium, pp. 955960. [Geertman, RM, editor]. Amsterdam: Elsevier.Google Scholar
Derman, D, Sayers, M, Lynch, SR, Charlton, RW & Bothwell, TH (1977) Iron absorption from a cereal-based meal containing cane sugar fortified with ascorbic acid British Journal of Nutrition 38, 261269.CrossRefGoogle ScholarPubMed
Fairweather-Tait, SJ, Swindell, TT & Wright, AJA (1985) Further studies in rats on the influence of iron intake on the estimation of bioavailability of Fe British Journal of Nutrition 54, 7986.CrossRefGoogle ScholarPubMed
Hallberg, L, Garby, L, Suwanik, R & Bjorn-Rasmussen, E (1974) Iron absorption from South-East Asian diets American Journal of Clinical Nutrition 27, 826836.CrossRefGoogle Scholar
ICMR Task Force study (1989) Evaluation of the National Nutritional Anaemia Prophylaxis Programme New Delhi: Indian Council of Medical Research.Google Scholar
ICMR Task Force Study (1992) Field supplementation trial in pregnant women with 60 mg, 120 mg and 180 mg of iron with 500 μg folic acid New Delhi: Indian Council of Medical Research.Google Scholar
Liu, XN, Kang, J, Zhao, L & Viteri, FE (1995) Intermittent iron supplementation in Chinese preschool children is efficient and safe Food and Nutrition Bulletin 16, 139146.CrossRefGoogle Scholar
Liu, XN, Yang, WJ, Zhang, H, Ying, YG, Xie, J & Vitteri, FE (1995) Weekly iron supplementation is effective and safe in pregnant women FASEB Journal 9, A5658.Google Scholar
Mac Phail, PA, Patel, RC, Bothwell, TH & Lamparelli, RD (1994) EDTA and the absorption of iron from food American Journal of Clinical Nutrition 59, 644648.Google Scholar
Nadiger, HA, Krishnamachari, KAVR, Nadamuni Naidu, A, Narasinga Rao, BS & Srikantia, SG (1980) The effect of common salt (sodium chloride) fortified with iron to control anaemia: results of a preliminary study British Journal of Nutrition 43, 4551.CrossRefGoogle ScholarPubMed
Nair, KM, Brahmam, GNV, Ranganathan, S, Vijayaraghavan, K, Sivakumar, B & Krishnaswamy, K (1998) Impact evaluation of iron and iodine fortified salt Indian Journal of Medical Research 108, 203211.Google ScholarPubMed
Narasinga, Rao BS (1994) Fortification of salt with iron and iodine to control anemia and goitre. Development of a new formula with good stability and bioavailability of iron and iodine Food and Nutrition Bulletin 15, 3239.Google Scholar
Picciano, MF (1999) Editorial: Iron and folate supplementation: an effective intervention in adolescent females American Journal of Clinical Nutrition 69, 10691070.Google Scholar
Rao, BSN, Vijayasarathy, C & Prabhavathi, T (1983) Iron absorption from habitual diets of Indians studied by extrinsic tag techniques Indian Journal of Medical Research 77, 648657.Google Scholar
Report of the Working Group on Fortification of Salt with Iron (1982) Use of common salt fortified with iron in the control and prevention of anaemia – a collaborative study American Journal of Clinical Nutrition 35, 14421451.CrossRefGoogle Scholar
Ridwan, E, Schultink, W, Dillon, D & Gross, R (1996) Effects of weekly iron supplementation on pregnant Indonesian women are similar to those of daily supplementation American Journal of Clinical Nutrition 63, 884890.CrossRefGoogle ScholarPubMed
Seshadri, S (1997) Nutritional anaemia in South Asia. In Malnutrition in South Asia. A Regional Profile, No. 5 [Gillespie, S, editor]. UNICEF, Regional Office of South Asia.Google Scholar
Slivka, A, Kang, J & Cohen, G (1986) Hydroxyl radicals and the toxicity of oral iron Biochemical Pharmacology 35, 553556.CrossRefGoogle ScholarPubMed
Soni, BL & Sharma, DC (1974) Total and ionizable iron in common Indian cooked foods American Journal of Clinical Nutrition 27, 455457.Google Scholar
Srigiridhar, K & Nair, KM (1997) Protective effects of antioxidant enzymes and GSH in vivo on iron mediated lipid peroxidation in gastrointestinal tract of rat Indian Journal of Biochemistry and Biophysics 34, 402405.Google ScholarPubMed
Srigiridhar, K & Nair, KM (1998) Iron deficient intestine is more susceptible to peroxidative damage during iron supplementation in rats Free Radical Biology and Medicine 25, 660665.Google Scholar
Srigiridhar, K & Nair, KM (2000) Supplementation with α-tocopherol or a combination of α-tocopherol and ascorbic acid protects the gastrointestinal tract of iron deficient rats against iron induced oxidative damage during iron repletion British Journal of Nutrition 83, 165173.CrossRefGoogle Scholar
Steer, P, Alam, AM, Wadsworth, J & Welch, A (1995) Relationship between maternal haemoglobin concentration and birth weight in different ethnic groups British Medical Journal 310, 489491.Google Scholar
Tee, ES, Kandiah, M, Awin, N, Chong, SM, Satgunasingam, N, Kamarudin, L, Milani, S, Dugdale, AE & Veteri, FE (1999) School-administered weekly iron-folate supplements improve haemoglobin and ferritin concentrations in Malaysian adolescent girls American Journal of Clinical Nutrition 69, 12491256.CrossRefGoogle ScholarPubMed
Vasantha, Lakshmi K (1998) Interactions amongst transferrin, ferritin and other iron binding proteins during iron absorption. PhD thesis: Faculty of Science (Biochemistry), Osmania University, Hyderabad, India.Google Scholar
Yip, R (1996) Iron supplementation during pregnancy: is it effective? American Journal of Clinical Nutrition 63, 853855.CrossRefGoogle ScholarPubMed
Zhou, LM, Yang, WW, Hua, JZ, Deng, CQ, Tao, X & Stoltzfus, RJ (1998) Relationship of haemoglobin measured at different times in pregnancy to preterm birth and low birth weight in Shanghai, China American Journal of Epidemiology 148, 9981006.CrossRefGoogle ScholarPubMed