Iron Absorption: Factors, Limitations, and Improvement Methods

The toxicological analysis and assessment of essential elements (Cu, Fe, Mn, Zn) in Food for Special Medical Purposes (FSMP) dedicated to oncological patients available in Polish pharmacies

Foods for Special Medical Purposes (FSMP) for oncology patients, available in pharmacies, play a crucial role in providing nutrition and supplementation. However, the scientific literature lacks comprehensive research on the safety of essential trace elements in these products. This study aimed to assess Cu, Fe, Mn and Zn levels in commonly prescribed FSMPs (n = 23) from Polish pharmacies. Using ICP-MS after microwave-induced digestion (using concentrated nitric acid and hydrogen peroxide), we evaluated element levels. Our research used three approaches: the raw score for Cu, Fe, Mn, and Zn; single intake per serving; and the daily ration, compared with the reference values of the European Food Safety Authority. Discrepancies were found between the actual and declared product compositions, influenced by the route of administration and the recommended intake. Despite variations, all products were considered safe for oncological patients based on current evidence. However, it is recommended to have clear guidelines for FSMPs in cancer care. This pioneering study evaluates the safety and quality of prescription FSMPs for cancer patients from toxicological and nutritional perspectives, highlighting the need for standardised protocols in pharmacy-dispensed FSMPs.

Decoding ferroptosis: Revealing the hidden assassin behind cardiovascular diseases

The discovery of regulatory cell death processes has driven innovation in cardiovascular disease (CVD) therapeutic strategies. Over the past decade, ferroptosis, an iron-dependent form of regulated cell death driven by excessive lipid peroxidation, has been shown to drive the development of multiple CVDs. This review provides insights into the evolution of the concept of ferroptosis, the similarities and differences with traditional modes of programmed cell death (e.g., apoptosis, autophagy, and necrosis), as well as the core regulatory mechanisms of ferroptosis (including cystine/glutamate transporter blockade, imbalance of iron metabolism, and lipid peroxidation). In addition, it provides not only a detailed review of the role of ferroptosis and its therapeutic potential in widely studied CVDs such as coronary atherosclerotic heart disease, myocardial infarction, myocardial ischemia/reperfusion injury, heart failure, cardiomyopathy, and aortic aneurysm but also an overview of the phenomenon and therapeutic perspectives of ferroptosis in lesser-addressed CVDs such as cardiac valvulopathy, pulmonary hypertension, and sickle cell disease. This article aims to integrate this knowledge to provide a comprehensive view of ferroptosis in a wide range of CVDs and to drive innovation and progress in therapeutic strategies in this field.

The Role of Fresh Beef Intake and Mediterranean Diet Adherence during Pregnancy in Maternal and Infant Health Outcomes

Beef is an excellent source of nutrients important for maternal health and fetal development. It is also true that the Mediterranean diet is beneficial for the health of both the mother and offspring; however, the relative value of fresh beef intake within Mediterranean diet patterns during pregnancy is unknown. The objective of this project was two-fold: (1) assess the relationship between beef intake and nutrient intake in a pregnant population; (2) assess the relationship between maternal beef consumption among varying degrees of Mediterranean diet adherence with maternal risk of anemia and infant health outcomes. This is a secondary analysis of an existing cohort of pregnant women (n = 1076) who participated in one of two completed clinical trials examining the effect of a docosahexaenoic acid supplementation on birth and offspring outcomes. Women were enrolled between 12 and 20 weeks of gestation and were followed throughout their pregnancies to collect maternal and infant characteristics, food frequency questionnaires [providing beef intake and Mediterranean diet (MedD) adherence], and supplement intake. Women with the highest fresh beef intake had the highest intake of many micronutrients that are commonly deficient among pregnant women. Fresh beef intake alone was not related to any maternal or infant outcomes. There was a reduced risk of anemia among women with medium to high MedD quality and higher fresh beef intake. Women in the medium MedD group had 31% lower odds of anemia, and women in the high MedD group had 38% lower odds of anemia with every one-ounce increase in fresh beef intake, suggesting that diet quality indices may be misrepresenting the role of fresh beef within a healthy diet. These findings show that beef intake increases micronutrient intake and may be protective against maternal anemia when consumed within a healthy Mediterranean diet pattern.

Legumes and common beans in sustainable diets: nutritional quality, environmental benefits, spread and use in food preparations

In recent decades, scarcity of available resources, population growth and the widening in the consumption of processed foods and of animal origin have made the current food system unsustainable. High-income countries have shifted towards food consumption patterns which is causing an increasingly process of environmental degradation and depletion of natural resources, with the increased incidence of malnutrition due to excess (obesity and non-communicable disease) and due to chronic food deprivation. An urgent challenge is, therefore, to move towards more healthy and sustainable eating choices and reorientating food production and distribution to obtain a human and planetary health benefit. In this regard, legumes represent a less expensive source of nutrients for low-income countries, and a sustainable healthier option than animal-based proteins in developed countries. Although legumes are the basis of many traditional dishes worldwide, and in recent years they have also been used in the formulation of new food products, their consumption is still scarce. Common beans, which are among the most consumed pulses worldwide, have been the focus of many studies to boost their nutritional properties, to find strategies to facilitate cultivation under biotic/abiotic stress, to increase yield, reduce antinutrients contents and rise the micronutrient level. The versatility of beans could be the key for the increase of their consumption, as it allows to include them in a vast range of food preparations, to create new formulations and to reinvent traditional legume-based recipes with optimal nutritional healthy characteristics.

Iron Deficiency Related to Obesity

There is a direct correlation between being overweight and iron deficiency. Physiological changes occur in obese adipose cells that contribute to the development of iron deficiency (ID) and iron deficiency anemia (IDA). These changes disrupt the normal iron metabolic checks and balances. Furthermore, bariatric surgery can lead to long-term ID and IDA. Oral iron supplementation may not be effective for many of these patients. Intravenous iron infusions can significantly increase the quality of life for individuals experiencing this condition but are also associated with potentially serious complications. Adequate knowledge about intravenous (IV) iron administration can greatly increase the safety of this beneficial therapy. This review article explains the relationship between obesity, ID/IDA, bariatric surgery and the safe administration of IV iron.

Relationship between prepregnancy BMI and the concentrations of iron, calcium, and magnesium in serum and hair during the first trimester of pregnancy in women

BACKGROUND

In women of childbearing age, a low dietary supply of iron, calcium, and magnesium is often observed. Minerals deficiency in pregnant women is often associated with abnormal body weight and may impact fetal development disorders. The aim of this study is to determine the relationship between prepregnancy body mass index (BMI) and the dietary intake of iron, calcium and magnesium and their concentrations in serum and hair in pregnant women.

METHOD

The study involved 97 Caucasian/white low-risk pregnant women at 12 weeks of gestation. The analysis of minerals in serum and hair samples was performed using atomic absorption spectrometry. Pre-pregnancy BMI was calculated based on self-reported weight. The study used a validated questionnaire and a 24-h recall nutrition interview, which were analyzed using Aliant software.

RESULTS

It was found that overweight and obese women exhibited higher magnesium concentration in serum, while iron content in serum and hair was markedly lower compared to women with normal body weight. The average total supply of iron was below the recommendation in pregnant women. Moreover, an inverse significant relationship was observed between BMI and iron concentration in hair and serum in the whole population.

CONCLUSION

In conclusion, being overweight or obese before pregnancy is associated with low dietary iron intake and low iron concentration in serum and hair during the first trimester of pregnancy in women.

Rhizosphere metabolic cross-talk from plant-soil-microbe tapping into agricultural sustainability: Current advance and perspectives

Rhizosphere interactions from plant-soil-microbiome occur dynamically all the time in the "black microzone" underground, where we can't see intuitively. Rhizosphere metabolites including root exudates and microbial metabolites act as various chemical signalings involving in rhizosphere interactions, and play vital roles on plant growth, development, disease suppression and resistance to stress conditions as well as proper soil health. Although rhizosphere metabolites are a mixture from plant roots and soil microbes, they often are discussed alone. As a rapid appearance of various omics platforms and analytical methods, it offers possibilities and opportunities for exploring rhizosphere interactions in unprecedented breadth and depth. However, our comprehensive understanding about the fine-tuning mechanisms of rhizosphere interactions mediated by these chemical compounds still remain clear. Thus, this review summarizes recent advances systemically including the features of rhizosphere metabolites and their effects on rhizosphere ecosystem, and looks forward to the future research perspectives, which contributes to facilitating better understanding of biochemical communications belowground and helping identify novel rhizosphere metabolites. We also address challenges for promoting the understanding about the roles of rhizosphere metabolites in different environmental stresses.

Iron homeostasis in older adults: balancing nutritional requirements and health risks

Iron plays a crucial role in many physiological processes, including oxygen transport, bioenergetics, and immune function. Iron is assimilated from food and also recycled from senescent red blood cells. Iron exists in two dietary forms: heme (animal based) and non-heme (mostly plant based). The body uses iron for metabolic purposes, and stores the excess mainly in splenic and hepatic macrophages. Physiologically, iron excretion in humans is inefficient and not highly regulated, so regulation of intestinal absorption maintains iron homeostasis. Iron losses occur at a steady rate via turnover of the intestinal epithelium, blood loss, and exfoliation of dead skin cells, but overall iron homeostasis is tightly controlled at cellular and systemic levels. Aging can have a profound impact on iron homeostasis and induce a dyshomeostasis where iron deficiency or overload (sometimes both simultaneously) can occur, potentially leading to several disorders and pathologies. To maintain physiologically balanced iron levels, reduce risk of disease, and promote healthy aging, it is advisable for older adults to follow recommended daily intake guidelines and periodically assess iron levels. Clinicians can evaluate body iron status using different techniques but selecting an assessment method primarily depends on the condition being examined. This review provides a comprehensive overview of the forms, sources, and metabolism of dietary iron, associated disorders of iron dyshomeostasis, assessment of iron levels in older adults, and nutritional guidelines and strategies to maintain iron balance in older adults.

The Importance and Essentiality of Natural and Synthetic Chelators in Medicine: Increased Prospects for the Effective Treatment of Iron Overload and Iron Deficiency

The supply and control of iron is essential for all cells and vital for many physiological processes. All functions and activities of iron are expressed in conjunction with iron-binding molecules. For example, natural chelators such as transferrin and chelator-iron complexes such as haem play major roles in iron metabolism and human physiology. Similarly, the mainstay treatments of the most common diseases of iron metabolism, namely iron deficiency anaemia and iron overload, involve many iron-chelator complexes and the iron-chelating drugs deferiprone (L1), deferoxamine (DF) and deferasirox. Endogenous chelators such as citric acid and glutathione and exogenous chelators such as ascorbic acid also play important roles in iron metabolism and iron homeostasis. Recent advances in the treatment of iron deficiency anaemia with effective iron complexes such as the ferric iron tri-maltol complex (feraccru or accrufer) and the effective treatment of transfusional iron overload using L1 and L1/DF combinations have decreased associated mortality and morbidity and also improved the quality of life of millions of patients. Many other chelating drugs such as ciclopirox, dexrazoxane and EDTA are used daily by millions of patients in other diseases. Similarly, many other drugs or their metabolites with iron-chelation capacity such as hydroxyurea, tetracyclines, anthracyclines and aspirin, as well as dietary molecules such as gallic acid, caffeic acid, quercetin, ellagic acid, maltol and many other phytochelators, are known to interact with iron and affect iron metabolism and related diseases. Different interactions are also observed in the presence of essential, xenobiotic, diagnostic and theranostic metal ions competing with iron. Clinical trials using L1 in Parkinson's, Alzheimer's and other neurodegenerative diseases, as well as HIV and other infections, cancer, diabetic nephropathy and anaemia of inflammation, highlight the importance of chelation therapy in many other clinical conditions. The proposed use of iron chelators for modulating ferroptosis signifies a new era in the design of new therapeutic chelation strategies in many other diseases. The introduction of artificial intelligence guidance for optimal chelation therapeutic outcomes in personalised medicine is expected to increase further the impact of chelation in medicine, as well as the survival and quality of life of millions of patients with iron metabolic disorders and also other diseases.

Role of Nutrients in Pediatric Non-Dialysis Chronic Kidney Disease: From Pathogenesis to Correct Supplementation

Nutrition management is fundamental for children with chronic kidney disease (CKD). Fluid balance and low-protein and low-sodium diets are the more stressed fields from a nutritional point of view. At the same time, the role of micronutrients is often underestimated. Starting from the causes that could lead to potential micronutrient deficiencies in these patients, this review considers all micronutrients that could be administered in CKD to improve the prognosis of this disease.

Nutritional Support: The Use of Antioxidants in Inflammatory Bowel Disease

The problem of treating inflammatory bowel disease continues to be a topic of great interest for researchers. Despite the complexity surrounding their treatment and strategies to prolong periods of remission, there is a promising exploration of various compounds that have potential in combating inflammation and alleviating symptoms. Selenium, calcium, magnesium, zinc, and iron are among these compounds, offering a glimpse of hope in the treatment of IBD. These essential minerals not only hold the promise of reducing inflammation in these diseases, but also show the potential to enhance immune function and possibly influence the balance of intestinal microflora. By potentially modulating the gut microbiota, they may help support overall immune health. Furthermore, these compounds could play a crucial role in mitigating inflammation and minimising complications in patients with IBD. Furthermore, the protective effect of these compounds against mucosal damage in IBD and the protective effect of calcium itself against osteoporosis in this group of patients are notable.

Towards prolonging ovarian reproductive life: Insights into trace elements homeostasis

Ovarian aging is marked by a reduction in the quantity and quality of ovarian follicles, leading to a decline in female fertility and ovarian endocrine function. While the biological characteristics of ovarian aging are well-established, the exact mechanisms underlying this process remain elusive. Recent studies underscore the vital role of trace elements (TEs) in maintaining ovarian function. Imbalances in TEs can lead to ovarian aging, characterized by reduced enzyme activity, hormonal imbalances, ovulatory disorders, and decreased fertility. A comprehensive understanding of the relationship between systemic and cellular TEs balance and ovarian aging is critical for developing treatments to delay aging and manage age-related conditions. This review consolidates current insights into TEs homeostasis and its impact on ovarian aging, assesses how altered TEs metabolism affects ovarian aging, and suggests future research directions to prolong ovarian reproductive life. These studies are expected to offer novel approaches for mitigating ovarian aging.

Development strategy of non-GMO organism for increased hemoproteins in Corynebacterium glutamicum: a growth-acceleration-targeted evolution

Heme, found in hemoproteins, is a valuable source of iron, an essential mineral. The need for an alternative hemoprotein source has emerged due to the inherent risks of large-scale livestock farming and animal proteins. Corynebacterium glutamicum, regarded for Qualified Presumption of Safety or Generally Recognized as Safe, can biosynthesize hemoproteins. C. glutamicum single-cell protein (SCP) can be a valuable alternative hemoprotein for supplying heme iron without adversely affecting blood fat levels. We constructed the chemostat culture system to increase hemoprotein content in C. glutamicum SCP. Through adaptive evolution, hemoprotein levels could be naturally increased to address oxidative stress resulting from enhanced growth rate. In addition, we used several specific plasmids containing growth-accelerating genes and the hemA promoter to expedite the evolutionary process. Following chemostat culture for 15 days, the plasmid in selected descendants was cured. The evolved strains showed improved specific growth rates from 0.59 h-1 to 0.62 h-1, 20% enhanced resistance to oxidative stress, and increased heme concentration from 12.95 µg/g-DCW to 14.22-15.24 µg/g-DCW. Notably, the putative peptidyl-tRNA hydrolase-based evolved strain manifested the most significant increase (30%) of hemoproteins. This is the first report presenting the potential of a growth-acceleration-targeted evolution (GATE) strategy for developing non-GMO industrial strains with increased bio-product productivity.

Development of a Predictive Model for Iron Levels in Bovine Muscle Tissue Using Hair as a Predictor

The assessment of iron levels in cattle muscle tissue is crucial for livestock management because it influences both animal health and meat quality, key factors in sustainable development. This study aimed to develop an optimal model for noninvasively predicting the iron content in Hereford cattle muscle tissue, contributing to a comprehensive understanding of the animals' elemental status. The research involved the atomic absorption analysis of muscle tissue and hair samples from cattle. A regression model was constructed using the least squares method to identify the most effective approach. These findings have ecological applications, aiding in evaluating environmental health and establishing acceptable iron thresholds for animals. The proposed mathematical model utilizing biomarkers (levels of Mg, K, Fe, Al, Cr in hair) will allow for the assessment of iron levels in cattle muscle tissue throughout the period of productive use, with the possibility of adjustment and tracking the changes in elemental status over time. The utilization of the developed method will enable the diagnosis of animal elementosis and assessment of the iron level burden. Subsequently, this will allow for the improvement of the qualitative characteristics of the final product. Thus, the obtained data contribute to fundamental knowledge regarding the content and variability of iron levels in the muscle tissue of cattle.

Creating a Framework for Treating Autoimmune Gastritis-The Case for Replacing Lost Acid

Autoimmune gastritis (AIG) is characterized by the destruction of gastric parietal cells, resulting in hypochlorhydria and eventual achlorhydria, as oxyntic glands in the corpus are destroyed and become atrophic. The permanent loss of gastric acid has many impacts-both theoretical and documented. The most concerning of these are hypergastrinemia and increased N-nitroso compounds, both of which increase the risk of gastric cancers. While known deficiencies of B12 and iron are often replaced in AIG, acid is not. Moreover, patients with AIG are often prescribed acid suppression for a stomach that is decidedly no longer acidic, worsening the sequelae of gastric atrophy. Betaine hydrochloride (BHCL) is a short-acting acidifying agent, available over the counter in capsule form. Mealtime acid supplementation has an historic basis and could ameliorate many AIG-related gastrointestinal symptoms. Theoretically, acidification could also reduce the potential for hypergastrinemia and the production of N-nitroso compounds, consequently reducing the risk of gastric cancers. Supplemental vitamin C may also help in preventing gastric N-nitroso formation, regardless of the gastric pH. This narrative review describes the functions of gastric acid in gastrointestinal and immune health, documents the effects of hypochlorhydria in AIG, and proposes potential options for safely re-establishing the acid milieu of the stomach for patients with AIG.

The role and impact of abnormal vitamin levels in autism spectrum disorders

The prevalence of autism spectrum disorder (ASD), a neurodevelopmental disorder with a predominance of social behavioral disorders, has increased dramatically in various countries in recent decades. The interplay between genetic and environmental factors is believed to underlie ASD pathogenesis. Recent analyses have shown that abnormal vitamin levels in early life are associated with an increased risk of autism. As essential substances for growth and development, vitamins have been shown to have significant benefits for the nervous and immune systems. However, it is unknown whether certain vitamin types influence the emergence or manifestation of ASD symptoms. Several studies have focused on vitamin levels in children with autism, and neurotypical children have provided different insights into the types of vitamins and their intake. Here, we review the mechanisms and significance of several vitamins (A, B, C, D, E, and K) that are closely associated with the development of ASD in order to prevent, mitigate, and treat ASD. Efforts have been made to discover and develop new indicators for nutritional assessment of children with ASD to play a greater role in the early detection of ASD and therapeutic remission after diagnosis.

Unraveling the Role of Maternal Serum Ferritin Levels in Preterm Delivery: A Comprehensive Review

Preterm delivery remains a critical global health concern, with numerous adverse consequences for both neonate and healthcare systems. Understanding the relationship between maternal ferritin levels, as a marker of iron status, and the risk of preterm birth is the focal point of this comprehensive review. We provide insights into the multifaceted nature of this connection, highlighting factors that influence maternal ferritin levels, including dietary intake, genetic and physiological variations, comorbidities, and iron supplementation. While evidence suggests an association between low maternal ferritin levels and preterm birth, causality remains elusive, necessitating further research with robust study designs. The potential mechanisms linking maternal iron status to preterm birth, such as inflammation, infection, and oxidative stress, are explored, underscoring the need for in-depth investigations. This comprehensive review emphasizes the clinical importance of assessing and monitoring maternal ferritin levels in prenatal care and advocates for public health initiatives to raise awareness and provide targeted interventions, particularly in high-risk populations. As we strive to address these unanswered questions and embark on innovative research directions, the aim is to ultimately enhance our understanding of the complex relationship between maternal iron status and preterm birth, leading to improved maternal and child health outcomes.

In vitro and in vivo genotoxicity evaluation of ALP1018, a nanomineral food supplement

The use of nano-based dietary supplements is increasing around the world, as nanotechnology can help enhance nutrient bioavailability. ALP1018 is a newly developed iron-zinc complex supplement designed as a nanoformulation to improve the efficacy of iron and zinc supplementation. However, safety concerns have been raised, as there is no clear evaluation of ALP1018 toxicity. The goal of this study was to determine the potential mutagenicity and genotoxicity of ALP1018 through three standard screenings: the Ames test, which evaluates bacterial reverse mutations; the in vitro test of chromosomal aberration in Chinese hamster lung cells; and the in vivo micronucleus assay using ICR mice. ALP1018 showed no mutagenic effect, as no increase was observed in the presence or absence of metabolic activation (S9 mix) in revertant colonies on all the bacterial strains used in the Ames test. No structural chromosomal abnormalities were observed in the presence or absence of the S9 mix in mammalian cells used in the chromosomal aberration assay. In the micronucleus test, the frequency of micronucleated polychromatic erythrocytes was not significantly increased in mouse bone marrow cells. Based on these findings, we can conclude that ALP1018 is safe to use and has no mutagenic or genotoxic potential.

Adequacy and Distribution Equity of Nutrition Supplies across China

Procuring food enriched with diverse nutrients is pivotal for maintaining a robust immune system. However, the food system is now unprecedentedly globalized and faces challenges arising from climate change, pandemics, and political unrest. This study aims to illuminate the gap in exploring the adequacy and distribution equity of nutrition supplies in response to potential trade fluctuations and restrictions on agrifood within China's local agriculture endowments. Also, it seeks to identify the role of trade in contributing to these indices. Accordingly, we analyzed the distribution of nutrients in agrifood categories from production to consumption and assessed the adequacy and distribution equity of corresponding available nutrition supply from the local food provision system in terms of meeting residents' nutritional requirements, across China, and compared with those in the practical market. The local self-supply system showed that 12 out of 31 provinces have difficulty achieving an iron supply with 11% to 108% deficiencies. Except for iron, 52% (folate)-90% (vitamin B12) of agricultural output was available for diet provisioning nationwide. While food trade emerges as a crucial factor in enhancing secure and equitable nutrition supply, risks associated with micronutrient deficiencies necessitate careful consideration in current global circumstances. Our analysis explored a regional pool of nutrient information in supplements to the conventional food profile in China and could implicate better knowledge toward healthier food supplies and tailored improvements for achieving a resilient nutrition supply.

Ferrous-sucrose complex supplementation regulates maternal plasma metabolism and the fecal microbiota composition and improves neonatal immunity and placental glucose transportation by activating the EGF/PI3K/AKT signaling pathways in sows

Pregnancy is a dynamic state involving rapid physiological changes in metabolism, affecting the health and development of the offspring. During pregnancy, the placenta constitutes a physical and immunological barrier to provide fetal nutrition through the maternal blood and prevent the exposure of the fetus to dangerous signals. Metabolic changes in the plasma, the fecal microbiota profile, and functional regulation in the placenta were studied in sows supplied with a ferrous-sucrose complex (FeSuc) from late gestation to parturition. The results revealed that maternal FeSuc supplementation enhanced arginine and proline metabolism, glutathione metabolism, with increased glutamic acid, beta-D-glucosamine, L-proline, 1-butylamine, and succinic acid and reduced sphingosine and chenodeoxycholic acid sulfate levels in the plasma. Moreover, significantly increased abundances of Christensenellaceae_R-7_group, Prevotellaceae_NK3B31_group, and Lachnospiraceae_NK4B4_group were detected in the feces of sows from the FeSuc group (P < 0.05). Spearman's correlation analysis indicated that Prevotellaceae_NK3B31_group abundances were positively correlated with glutamic acid, indoxyl sulfate, acetyl-DL-leucine, and beta-D-glucosamine, while Christensenellaceae_R-7_group was positively correlated with beta-D-glucosamine. Furthermore, maternal FeSuc supplementation significantly increased neonatal glucose (P < 0.01) and iron (P < 0.01) in the neonatal serum, significantly increased IL-10 and TGF-β1 levels in the neonatal liver (P < 0.01) and jejunum (P < 0.05), promoted the transcription of immune molecules in the placenta, and significantly increased the protein expressions of EGF (P < 0.05), PI3K (P < 0.01), p-PI3K (P < 0.001), p-AKT (P < 0.01), and glucose transporter 1 (GLUT1) (P < 0.001) in the placenta. The current study demonstrated that FeSuc supplementation regulated maternal metabolism processes by altering the fecal microbial composition and improved neonatal immunity and placental glucose transportation by activating the EGF/PI3K/AKT signaling pathways in sows.

Awareness and practices in preventing maternal iron deficiency among pregnant women living in urban slum areas in Makassar City, Indonesia

BACKGROUND

During pregnancy, the body requires more complex nutritional intake. Therefore, problems with fulfilling nutrition during pregnancy occur often. One of the most common nutritional problems in pregnancy is iron deficiency anemia, the most widespread micronutrient problem and the most difficult to overcome worldwide. This study aimed to determine awareness and prevention behavior associated with the incidence of iron deficiency in pregnant women living in urban slum areas.

MATERIALS AND METHODS

This was a cross-sectional study. The data collection used KoboToolbox, an Android-based tool. Iron status was examined by serum ferritin level assay using ELISA at the Microbiology Laboratory Unit of Hasanuddin University Hospital.

RESULTS

The prevalence of pregnant women who experienced iron deficiency was 78%. The logistic regression analysis showed that poor awareness (AOR = 3.03, CI 95% 1.26-7.29, P = 0.013) and practices in taking iron enhancers (AOR = 2.85, CI 95% 1.18-6.92, P = 0.020) became the main factors associated with iron deficiency among pregnant women.

CONCLUSIONS

Poor awareness and practices regarding consuming iron enhancers increased the risk of iron deficiency among pregnant women living in urban slum areas. Iron deficiency is a major health concern for pregnant women, especially those living in slum settlements, which must be addressed. A more optimal healthcare system for pregnant women may reduce the incidence of iron anemia in pregnancy by improving health promotion and optimizing healthcare services.

Modulation of the Gut Microbiota by Nutrition and Its Relationship to Epigenetics

The intestinal microbiota is a community of microorganisms inhabiting the human intestines, potentially influencing both physiological and pathophysiological processes in the human body. Existing evidence suggests that nutrients can influence the modulation of the gut microbiota. However, there is still limited evidence regarding the effects of vitamin and mineral supplementation on the human gut microbiota through epigenetic modification. It is plausible that maintaining an adequate dietary intake of vitamin D, iron, fibre, zinc and magnesium may have a beneficial effect on alleviating inflammation in the body, reducing oxidative stress, and improving the condition of the intestinal microbiota through various epigenetic mechanisms. Moreover, epigenetics involves alterations in the phenotype of a cell without changing its fundamental DNA sequence. It appears that the modulation of the microbiota by various nutrients may lead to epigenetic regulation. The correlations between microbiota and epigenetics are potentially interdependent. Therefore, the primary objective of this review is to identify the complex relationships between diet, gut microbiota, and epigenetic regulation. These interactions could play a crucial role in systemic health.

Impairment of Nutritional Status and Quality of Life Following Minimal-Invasive Esophagectomy-A Prospective Cohort Analysis

Minimal-invasive resection of the esophagus for esophageal cancer has led to a relevant decrease in postoperative morbidity. Postoperatively, patients still suffer from surgical and adjuvant therapy-related symptoms impairing nutrition and quality of life. The aim of this study was to evaluate the nutritional status and associated symptoms six months after esophagectomy. Patients who attended follow-up examination six months after minimal-invasive esophagectomy were included. Blood and fecal tests, quality of life surveys (QLQ-C30 and QLQ-OG25) and nutritional risk screening (NRS) were performed. Twenty-four patients participated. The mean weight loss was 11 kg. A significant decrease in vitamin B12 (737 to 467 pg/mL; p = 0.033), ferritin (302 to 126 ng/mL; p = 0.012) and haptoglobin (227 to 152 mg/dL; p = 0.025) was found. In total, 47% of the patients had an impaired pancreatic function (fecal elastase < 500 µg/g). Physical (72 to 58; p = 0.034) and social functioning (67 to 40; p = 0.022) was significantly diminished, while self-reported global health status remained stable (52 to 54). The number of patients screened and found to be in need of nutritional support according to NRS score decreased slightly (59% to 52%). After MIE, patients should be meticulously monitored for nutritional status after surgery.

The Multifaceted Roles of Bovine Lactoferrin: Molecular Structure, Isolation Methods, Analytical Characteristics, and Biological Properties

Bovine lactoferrin (bLF) is widely known as an iron-binding glycoprotein from the transferrin family. The bLF molecule exhibits a broad spectrum of biological activity, including iron delivery, antimicrobial, antiviral, immunomodulatory, antioxidant, antitumor, and prebiotic functions, thereby making it one of the most valuable representatives for biomedical applications. Remarkably, LF functionality might completely differ in dependence on the iron saturation state and glycosylation patterns. Recently, a violently growing demand for bLF production has been observed, mostly for infant formulas, dietary supplements, and functional food formulations. Unfortunately, one of the reasons that inhibit the development of the bLF market and widespread protein implementation is related to its negligible amount in both major sources─colostrum and mature milk. This study provides a comprehensive overview of the significance of bLF research by delineating the key structural characteristics of the protein and elucidating their impact on its physicochemical and biological properties. Progress in the development of optimal isolation techniques for bLF is critically assessed, alongside the challenges that arise during its production. Furthermore, this paper presents a curated list of the most relevant instrumental techniques for the characterization of bLF. Lastly, it discusses the prospective applications and future directions for bLF-based formulations, highlighting their potential in various fields.

Cefiderocol-associated brown chromaturia

Cefiderocol is a novel siderophore cephalosporin antibiotic. In the present case report, a woman in her 70s presented with a 1-week history of altered mental status and progressive purulent discharge from a non-healing diabetic foot ulcer on her right heel. MRI of the right foot revealed chronic osteomyelitis of the calcaneum. Surgical debridement was performed, and the tissue cultures grew extensively drug resistant (XDR) Pseudomonas aeruginosa, XDR Acinetobacter baumannii and Enterococcus faecalis The patient received ampicillin-sulbactam and cefiderocol. The antibiotic treatment course was complicated by brown urine discolouration. Investigations were unrevealing for haemoglobinuria, myoglobinuria and bilirubinuria. A side effect from cefiderocol was suspected and subsequently discontinued. Her urine colour returned to its normal colour within 3 days of discontinuation of cefiderocol.

The potential for the use of leghemoglobin and plant ferritin as sources of iron

Iron is an essential component for the body, but it is also a major cause for the development of many diseases such as cancer, cardiovascular diseases, and autoimmune diseases. It has been suggested that a diet rich in meat products, especially red meat and highly processed products, constitute a nutritional model that increases the risk of developing. In this context, it is indicated that people on an elimination diet (vegetarians and vegans) may be at risk of deficiencies in iron, because this micronutrient is found mainly in foods of animal origin and has lower bioavailability in plant foods. This article reviews the knowledge on the use of leghemoglobin and plant ferritin as sources of iron and discusses their potential for use in vegetarian and vegan diets.

Nutritional Modulation of Hepcidin in the Treatment of Various Anemic States

Twenty years after its discovery, hepcidin is still considered the main regulator of iron homeostasis in humans. The increase in hepcidin expression drastically blocks the flow of iron, which can come from one's diet, from iron stores, and from erythrophagocytosis. Many anemic conditions are caused by non-physiologic increases in hepcidin. The sequestration of iron in the intestine and in other tissues poses worrying premises in view of discoveries about the mechanisms of ferroptosis. The nutritional treatment of these anemic states cannot ignore the nutritional modulation of hepcidin, in addition to the bioavailability of iron. This work aims to describe and summarize the few findings about the role of hepcidin in anemic diseases and ferroptosis, as well as the modulation of hepcidin levels by diet and nutrients.

Factors affecting iron absorption and the role of fortification in enhancing iron levels

Iron is an important micronutrient required for a number of biological processes including oxygen transport, cellular respiration, the synthesis of nucleic acids and the activity of key enzymes. The World Health Organization has recognised iron deficiency as the most common nutritional deficiency globally and as a major determinant of anaemia. Iron deficiency anaemia affects 40% of all children between the ages of 6 and 59 months, 37% of mothers who are pregnant and 30% of women between the ages of 15 and 49 years worldwide. Dietary iron exists in two main forms known as haem iron and non-haem iron. Haem iron is obtained from animal sources such as meat and shows higher bioavailability than non-haem iron, which can be obtained from both plant and animal sources. Different components in food can enhance or inhibit iron absorption from the diet. Components such as meat proteins and organic acids increase iron absorption, while phytate, calcium and polyphenols reduce iron absorption. Iron levels in the body are tightly regulated since both iron overload and iron deficiency can exert harmful effects on human health. Iron is stored mainly as haemoglobin and as iron bound to proteins such as ferritin and hemosiderin. Iron deficiency affects individuals at increased risk due to factors such as age, pregnancy, menstruation and various diseases. Different solutions for iron deficiency are applied at individual and community levels. Iron supplements and intravenous iron can be used to treat individuals with iron deficiency, while various types of iron-fortified foods and biofortified crops can be employed for larger communities. Foods such as rice, flour and biscuits have been used to prepare fortified iron products. However, it is important to ensure the fortification process does not exert significant negative effects on organoleptic properties and the shelf life of the food product.

Effect of replacing inorganic iron with iron-rich microbial preparations on growth performance, serum parameters and iron metabolism of weaned piglets

This study aimed to investigate the effects of replacing of dietary inorganic iron with iron-rich Lactobacillus plantarum and iron-rich Candida utilis on the growth performance, serum parameters, immune function and iron metabolism of weaned piglets. Fifty-four 28-day-old healthy Duroc × Landrace × Yorkshire castrated male weanling piglets of similar body weight were randomly and equally divided into three groups. The piglets were kept in three pens per group, with six pigs in each pen. The dietary treatments were (1) a basal diet + ferrous sulfate preparation containing 120 mg/kg iron (CON); (2) a basal diet + iron-rich Candida utilis preparation containing 120 mg/kg iron (CUI); and (3) a basal diet + iron-rich Lactobacillus plantarum preparation containing 120 mg/kg iron (LPI). The entire feeding trial lasted for 28 days, after which blood, viscera, and intestinal mucosa were collected. The results showed no significant difference in growth parameters and organ indices of the heart, liver, spleen, lung, and kidney of weaned piglets when treated with CUI and LPI compared with the CON group (P > 0.05). However, CUI and LPI significantly reduced the serum contents of AST, ALP, and LDH (P < 0.05). Serum ALT content was significantly lower in the LPI treatment compared to the CON group (P < 0.05). Compared to CON, CUI significantly increased the contents of serum IgG and IL-4 (P < 0.05), and CUI significantly decreased the content of IL-2. LPI significantly increased the contents of serum IgA, IgG, IgM and IL-4 (P < 0.05), while LPI significant decreased the levels of IL-1β, IL-2, IL-6, IL-8, and TNF-α compared to CON (P < 0.05). CUI led to a significant increase in ceruloplasmin activity and TIBC (P < 0.05). LPI significantly increased the contents of serum Fe and ferritin, and increased the serum ceruloplasmin activity and TIBC compared to CON (P < 0.05). Furthermore, CUI resulted in a significant increase in the relative mRNA expression of FPN1 and DMT1 in the jejunal mucosa (P < 0.05). LPI significantly increased the relative mRNA expression of TF, FPN1, and DMT1 in the jejunal mucosa (P < 0.05). Based on these results, the replacement of dietary inorganic iron with an iron-rich microbial supplement could improve immune function, iron absorption and storage in piglets.

How to Increase the Nutritional Quality of Stinging Nettle Through Controlled Plant Nutrition§

Research background

As food production faces major challenges, modern agricultural practices are increasingly focused on conserving resources, reducing negative environmental impacts and sustainably producing food with a high content of health-promoting phytochemicals. During production, many factors can affect the quality and chemical composition of a final food product. Proper selection of cultivating conditions, especially a balanced nutrition, can significantly increase nutritional value and result in foods with strong biological and functional properties. Stinging nettle is a rich source of minerals, vitamins, pigments, phenols and other bioactive compounds and can be consumed as a green leafy vegetable with beneficial effects on human health. Therefore, the aim of this study is to determine the nutritional quality and antioxidant capacity of stinging nettle leaves under the influence of different nutrient solution (NS) treatments and three harvest cycles.

Experimental approach

The experiment was conducted in a floating hydroponic system in which treatments with different nutrient solutions were applied and three harvest cycles were carried out. After each harvest, the following treatments were applied: treatment 1 - depletion of nutrient solution by adding water, treatment 2 - supplementation of nutrient solution by adding initial nutrient solution and treatment 3 - correction of nutrient solution by adding nutrients. Among the bioactive compounds, minerals, ascorbic acid, phenols and photosynthetic pigments content, as well as antioxidant capacity were analysed spectrophotometrically, while individual phenols were determined by liquid chromatography.

Results and conclusions

Different nutrition solution treatments and the number of harvest cycles had a significant effect on the content of the analysed bioactive compounds. The highest mass fraction (on fresh mass basis) of total phenols expressed as gallic acid equivalents (377.04 mg/100 g), total flavonoids expressed as catechol equivalents (279.54 mg/100 g), ascorbic acid (112.37 mg/100 g) and pigments (total chlorophylls 1.84, and total carotenoids 0.36 mg/g) as well as the highest antioxidant capacity expressed as Trolox equivalents (35.47 µmol/g) were recorded in the samples supplemented with nutrient solution (treatment NS2) and analysed after the third harvest.

Novelty and scientific contribution

This is the first time that stinging nettle leaves have been produced in a floating hydroponic system by controlled plant nutrition. We have set this type of nutritional manipulation with multiple harvest cycles as an innovative technique for the production of novel food with improved nutritional value that can be consumed as green leafy vegetables.

Harnessing the power of nutritional antioxidants against adrenal hormone imbalance-associated oxidative stress

Oxidative stress, resulting from dysregulation in the secretion of adrenal hormones, represents a major concern in human health. The present review comprehensively examines various categories of endocrine dysregulation within the adrenal glands, encompassing glucocorticoids, mineralocorticoids, and androgens. Additionally, a comprehensive account of adrenal hormone disorders, including adrenal insufficiency, Cushing's syndrome, and adrenal tumors, is presented, with particular emphasis on their intricate association with oxidative stress. The review also delves into an examination of various nutritional antioxidants, namely vitamin C, vitamin E, carotenoids, selenium, zinc, polyphenols, coenzyme Q10, and probiotics, and elucidates their role in mitigating the adverse effects of oxidative stress arising from imbalances in adrenal hormone levels. In conclusion, harnessing the power of nutritional antioxidants has the potential to help with oxidative stress caused by an imbalance in adrenal hormones. This could lead to new research and therapeutic interventions.

Recent Developments in Metallic Degradable Micromotors for Biomedical and Environmental Remediation Applications

Synthetic micromotor has gained substantial attention in biomedicine and environmental remediation. Metal-based degradable micromotor composed of magnesium (Mg), zinc (Zn), and iron (Fe) have promise due to their nontoxic fuel-free propulsion, favorable biocompatibility, and safe excretion of degradation products Recent advances in degradable metallic micromotor have shown their fast movement in complex biological media, efficient cargo delivery and favorable biocompatibility. A noteworthy number of degradable metal-based micromotors employ bubble propulsion, utilizing water as fuel to generate hydrogen bubbles. This novel feature has projected degradable metallic micromotors for active in vivo drug delivery applications. In addition, understanding the degradation mechanism of these micromotors is also a key parameter for their design and performance. Its propulsion efficiency and life span govern the overall performance of a degradable metallic micromotor. Here we review the design and recent advancements of metallic degradable micromotors. Furthermore, we describe the controlled degradation, efficient in vivo drug delivery, and built-in acid neutralization capabilities of degradable micromotors with versatile biomedical applications. Moreover, we discuss micromotors' efficacy in detecting and destroying environmental pollutants. Finally, we address the limitations and future research directions of degradable metallic micromotors.

An Update on Drug-Nutrient Interactions and Dental Decay in Older Adults

In recent decades, the global demographic landscape has undergone a discernible shift that has been characterised by a progressive increase in the proportion of elderly individuals, indicative of an enduring global inclination toward extended lifespans. The aging process, accompanied by physiological changes and dietary patterns, contributes to detrimental deviations in micronutrient consumption. This vulnerable aging population faces heightened risks, including dental caries, due to structural and functional modifications resulting from insufficient nutritional sustenance. Factors such as physiological changes, inadequate nutrition, and the prevalence of multiple chronic pathologies leading to polypharmacy contribute to the challenge of maintaining an optimal nutritional status. This scenario increases the likelihood of drug interactions, both between medications and with nutrients and the microbiome, triggering complications such as dental decay and other pathologies. Since the drug industry is evolving and new types of food, supplements, and nutrients are being designed, there is a need for further research on the mechanisms by which drugs interfere with certain nutrients that affect homeostasis, exemplified by the prevalence of caries in the mouths of older adults. Infectious diseases, among them dental caries, exert serious impacts on the health and overall quality of life of the elderly demographic. This comprehensive review endeavours to elucidate the intricate interplay among drugs, nutrients, the microbiome, and the oral cavity environment, with the overarching objective of mitigating the potential hazards posed to both the general health and dental well-being of older adults. By scrutinising and optimising these multifaceted interactions, this examination aims to proactively minimise the susceptibility of the elderly population to a spectrum of health-related issues and the consequences associated with dental decay.

Iron Homeostasis in Azotobacter vinelandii

Iron is an essential nutrient for all life forms. Specialized mechanisms exist in bacteria to ensure iron uptake and its delivery to key enzymes within the cell, while preventing toxicity. Iron uptake and exchange networks must adapt to the different environmental conditions, particularly those that require the biosynthesis of multiple iron proteins, such as nitrogen fixation. In this review, we outline the mechanisms that the model diazotrophic bacterium Azotobacter vinelandii uses to ensure iron nutrition and how it adapts Fe metabolism to diazotrophic growth.

The Chains of Ferroptosis Interact in the Whole Progression of Atherosclerosis

Atherosclerosis (AS), a category of cardiovascular disease (CVD) that can cause other more severe disabilities, increasingly jeopardizes human health. Owing to its imperceptible and chronic symptoms, it is hard to determine the pathogenesis and precise therapeutics for AS. A novel type of programmed cell death called ferroptosis was discovered in recent years that is distinctively different from other traditional cell death pathways in morphological and biochemical aspects. Characterized by iron overload, redox disequilibrium, and accumulation of lipid hydroperoxides (L-OOH), ferroptosis influences endothelial cells, vascular smooth muscle cells (VSMCs), and macrophages, as well as inflammation, partaking in the pathology of many cardiovascular diseases such as atherosclerosis, stroke, ischemia-reperfusion injury, and heart failure. The mechanisms behind ferroptosis are so sophisticated and interwoven that many molecules involved in this procedure are unknown. This review systematically depicts the initiation and modulation of ferroptosis and summarizes the contribution of ferroptosis to AS, which may open a feasible approach for target treatment in the alleviation of AS progression.

Native Potato Starch and Tara Gum as Polymeric Matrices to Obtain Iron-Loaded Microcapsules from Ovine and Bovine Erythrocytes

Iron deficiency leads to ferropenic anemia in humans. This study aimed to encapsulate iron-rich ovine and bovine erythrocytes using tara gum and native potato starch as matrices. Solutions containing 20% erythrocytes and different proportions of encapsulants (5, 10, and 20%) were used, followed by spray drying at 120 and 140 °C. Iron content in erythrocytes ranged between 2.24 and 2.52 mg of Fe/g; microcapsules ranged from 1.54 to 2.02 mg of Fe/g. Yields varied from 50.55 to 63.40%, and temperature and encapsulant proportion affected moisture and water activity. Various red hues, sizes, and shapes were observed in the microcapsules. SEM-EDS analysis revealed the surface presence of iron in microcapsules with openings on their exterior, along with a negative zeta potential. Thermal and infrared analyses confirmed core encapsulation within the matrices. Iron release varied between 92.30 and 93.13% at 120 min. Finally, the most effective treatments were those with higher encapsulant percentages and dried at elevated temperatures, which could enable their utilization in functional food fortification to combat anemia in developing countries.

The Association Between Vitamin B1 Deficiency and Anemia Among Elderly Patients at a Rural Hospital in Japan: A Cross-Sectional Study

Background and objective Vitamin B1 deficiency can cause a variety of abnormalities in the neuropsychiatric, cardiovascular, and other systems. This condition can be rapidly corrected and prevented from progressing to irreversible sequelae through vitamin B1 supplementation. Therefore, early detection of and intervention in vitamin B1 deficiency are essential. We have previously demonstrated an association between vitamin B1 deficiency and appetite loss in hospitalized older adult patients in rural Japan. This study aimed to examine the additional predictors of vitamin B1 deficiency in patients with appetite loss and other symptoms suggestive of vitamin B1 deficiency. Material and methods This cross-sectional study involved 519 patients admitted to a rural hospital between April 2020 and March 2022. Data on vitamin B1 levels, age, sex, BMI, albumin levels, functional independence measure (FIM), hemoglobin levels, Charlson Comorbidity Index (CCI), and medications were collected from electronic medical records. Vitamin B1 deficiency was defined as serum vitamin B1 level <20 µg/dL. Data were analyzed using the Mann-Whitney U test, Student's t-test, and chi-square test, followed by multivariate logistic regression to examine the predictors of vitamin B1 deficiency. Results A total of 113 patients (21.5%) were found to be vitamin B1-deficient. Multivariate logistic regression showed that anemia was significantly associated with vitamin B1 deficiency [adjusted odds ratio (AOR): 1.71, 95% confidence interval (CI): 1.07-2.73, p<0.05]. Conclusion Based on our findings, anemia is significantly associated with vitamin B1 deficiency in hospitalized Japanese patients living in rural areas. Therefore, physicians should be mindful of the possibility of vitamin B1 deficiency in hospitalized patients with anemia.

Ascorbic acid intake during pregnancy

The continuing global increase in allergic conditions and diseases in children is now a serious public health and scientific issue. Amongst other concerns is the maternal antenatal diet as intake of essential nutrients. Even small deficits in essential vitamin C can permanently impair the developing brain for example. In this article, we first review ascorbic acid deficiency in different organs of both mother and foetus. However, major emphasis is on the importance of vitamin C in foetal immunity with studies showing an inverse relationship between maternal intake of fresh fruit and vegetables and allergic conditions in childhood, inter alia. Other review results are included.

Ultraprocessed plant-based foods: Designing the next generation of healthy and sustainable alternatives to animal-based foods

Numerous examples of next-generation plant-based foods, such as meat, seafood, egg, and dairy analogs, are commercially available. These products are usually designed to have physicochemical properties, sensory attributes, and functional behaviors that match those of the animal-sourced products they are designed to replace. However, there has been concern about the potential negative impacts of these foods on human nutrition and health. In particular, many of these products have been criticized for being ultraprocessed foods that contain numerous ingredients and are manufactured using harsh processing operations. In this article, the concept of ultraprocessed foods is introduced and its relevance to describe the properties of next-generation plant-based foods is discussed. Most commercial plant-based meat, seafood, egg, and dairy analogs currently available do fall into this category, and so can be classified as ultraprocessed plant-based (UPB) foods. The nutrient content, digestibility, bioavailability, and gut microbiome effects of UPB foods are compared to those of animal-based foods, and the potential consequences of any differences on human health are discussed. Some commercial UPB foods would not be considered healthy based on their nutrient profiles, especially those plant-based cheeses that contain low levels of protein and high levels of fat, starch, and salt. However, it is argued that UPB foods can be designed to have good nutritional profiles and beneficial health effects. Finally, areas where further research are still needed to create a more healthy and sustainable food supply are discussed.

The Ferritin, Hepcidin and Cytokines Link in the Diagnoses of Iron Deficiency Anaemia during Pregnancy: A Review

Following a diagnosis of iron deficiency anaemia in pregnancy, iron supplements are prescribed using UK guidelines; however, despite this, the condition remains highly prevalent, affecting up to 30% of pregnant women in the UK. According to the World Health Organisation, it globally accounts for 45% in the most vulnerable groups of pregnant women and infants (<5 years old). Recently, the efficacy of iron replacement therapy and the effectiveness of current standard testing of iron parameters have been reviewed in order to evaluate whether a more accurate diagnosis can be made using alternative and/or supplementary markers. Furthermore, many questions remain about the mechanisms involved in iron metabolism during pregnancy. The most recent studies have shed more light on serum hepcidin and raised questions on the significance of pregnancy related inflammatory markers including cytokines in iron deficiency anaemia. However, research into this is still scarce, and this review aims to contribute to further understanding and elucidating these areas.

Bioavailability Assessment of an Iron Formulation Using Differentiated Human Intestinal Caco-2 Cells

In recent years, there has been growing interest in exploring alternative and innovative delivery systems to improve the efficacy of iron supplements, satisfying iron needs and lowering side effects. To address this issue, this study aimed at demonstrating the advantages of Ferro Supremo formulation (composed of encapsulated iron, vitamins, and micronutrients), in terms of capacity to improve iron intestinal absorption, in comparison with standard FeSO4. Hence, differentiated Caco-2 cells have been used for assessing the in vitro bioavailability and safety of FS and FeSO4. MTT experiments demonstrated that both FS and FeSO4 are not able to impair the viability of Caco-2 cells. Furthermore, the quantitative and qualitative analysis, conducted by atomic absorption spectrometry and fluorescence determinations, revealed that FS can enter, accumulate in the cytoplasm, and be transported by intestinal cells four times more efficiently than FeSO4. Our findings indicate that this formulation can be considered a valuable and efficiently good choice as food supplements for improving iron deficiency.

Reversible severe pulmonary hypertension and right heart failure with cardiogenic shock due to scurvy: a case report

Background

The systemic complications of vitamin C deficiency, otherwise known as scurvy, have been well-documented in history. Few case reports have documented severe cardiopulmonary complications such as right heart failure (RHF) and pulmonary hypertension (PH).

Case summary

A 25-year-old female presented to the hospital with two weeks of progressive fatigue, dyspnoea, myalgias, and arthralgias. She was admitted for symptomatic anaemia requiring transfusion. Her symptoms persisted and she developed severe PH and RHF, complicated by cardiogenic shock and multiple episodes of cardiac arrest. She was found to have severe vitamin C deficiency secondary to a severely self-restricted diet. After repletion of vitamin C, the patient had complete resolution of RHF and PH.

Discussion

This case adds to the sparse literature documenting severe cardiopulmonary complications of vitamin C deficiency. We believe that this is the first adult case of scurvy causing RHF and PH leading to cardiogenic shock and episodes of cardiac arrest. There are multiple hypotheses on the pathogenesis of scurvy-associated PH and RHF, including overactivation of hypoxia-inducible transcription factors and deficiency of vitamin C's vasodilatory effect that acts through increased nitric oxide production in endothelial cells. When recognized, early vitamin C repletion may prevent severe cardiopulmonary complications of scurvy.

Influence of different nano/micro-carriers on the bioavailability of iron: Focus on in vitro-in vivo studies

Anemia resulting from iron (Fe) deficiency is a global public health problem. The deficiency of Fe is usually due to insufficient dietary intake of iron, interaction of Fe with other food components, and thus low bioaccessibility/bioavailability. Fe encapsulation has the potential to tackle some major challenges in iron fortification of foods. Various nano/micro-carriers have been developed for encapsulation of Fe, including emulsions, liposomes, hydrogels, and spray-dried microcapsules. They could reduce the interactions of Fe with food components, increase iron tolerance and intestinal uptake, and decrease adverse effects. This article review covers the factors affecting the bioavailability of Fe along with emerging carriers that can be used as a solution of this issue. The application of Fe-loaded carriers in food supplements and products is also described. The advantages and limitations associated with the delivery efficiency of each carrier for Fe are highlighted.

Designing healthier plant-based foods: Fortification, digestion, and bioavailability

Many consumers are incorporating more plant-based foods into their diets as a result of concerns about the environmental, ethical, and health impacts of animal sourced foods like meat, seafood, egg, and dairy products. Foods derived from animals negatively impact the environment by increasing greenhouse gas emissions, land use, water use, pollution, deforestation, and biodiversity loss. The livestock industry confines and slaughters billions of livestock animals each year. There are concerns about the negative impacts of some animal sourced foods, such as red meat and processed meat, on human health. The livestock industry is a major user of antibiotics, which is leading to a rise in the resistance of several pathogenic microorganisms to antibiotics. It is often assumed that a plant-based diet is healthier than one containing more animal sourced foods, but this is not necessarily the case. Eating more fresh fruits, vegetables, nuts, and whole grain cereals has been linked to improved health outcomes but it is unclear whether next-generation plant-based foods, such as meat, seafood, egg, and dairy analogs are healthier than the products they are designed to replace. Many of these new products are highly processed foods that contain high levels of saturated fat, sugar, starch, and salt, and low levels of micronutrients, nutraceuticals, and dietary fibers. Moreover, they are often rapidly digested in the gastrointestinal tract because processing disrupts plant tissues and releases the macronutrients. Consequently, it is important to formulate plant-based foods to reduce the levels of nutrients linked to adverse health effects and increase the levels linked to beneficial health effects. Moreover, it is important to design the food matrix so that the macronutrients are not digested and absorbed too quickly, but the micronutrients are highly bioavailable. In this article, we discuss how next-generation plant-based foods can be made healthier by controlling their nutrient profile, digestibility, and bioavailability.

Novel plant-based meat alternatives: Implications and opportunities for consumer nutrition and health

Against the backdrop of the global protein transition needed to remain within planetary boundaries, there is an influx of plant-based meat alternatives that seek to approximate the texture, flavor and/or nutrient profiles of conventional animal meat. These novel plant-based meat alternatives, enabled by advances in food technology, can be fundamentally different from the whole-plant foods from which they are derived. One of the reasons is the necessity to use food additives on various occasions, since consumers' acceptance of plant-based meat products primarily depends on the organoleptic properties. Consequently, a high degree of heterogeneity in formulation and nutritional profiles exists both within and between product categories of plant-based meat alternatives with unknown effects on several aspects of human health. This is further complicated by the differences in digestibility and bioavailability between proteins from animal and plant sources, which have a profound impact on colonic fermentation, nutritional adequacy and potential health effects. On the other hand, emerging strategies provide opportunities to develop affordable, delicious and nutritious plant-based meat alternatives that align with consumer interests.

Nutritional studies in patients with β-thalassemia major: A short review

BACKGROUND

Patients with β-thalassemia major (BTM) had variable prevalence of undernutrition and abnormal body composition.  Methods: We performed an electronic search in PubMed, Scopus, Research gate, and Web of Sciences to evaluate the prevalence of nutritional disorders in patients with BTM worldwide in relation to their body composition and possible etiological factors. In addition, we reviewed the published nutritional intervention studies.  Results: 22 studies on the prevalence of undernutrition (12 countries) and 23 nutritional intervention studies were analyzed.  Undernutrition occurred in a considerable number of patients but varied greatly among different countries (from 5.2% to 70%). The lower middle income (LMI) countries (India, Pakistan, Iran, Egypt) had higher prevalence, while (high -middle and high income (Turkey, Greece, North America, USA, Canada) had lower prevalence.  Even in patients with normal BMI, abnormalities of body composition are common with decreased muscle mass, lean-body mass, and bone mineral density. 65% to 75% of them had lower energy intake with low levels of circulating nutrients, minerals (zinc, selenium, and copper), and vitamins (D, E) versus controls. Increased macro and micronutrient requirements decreased absorption and /or increased loss or excretion are etiologic factors. Undernutrition was associated with short stature and lower quality of life (QOL). High prevalence of endocrinopathies, poor transfusion regimen (tissue hypoxia), improper chelation, and lack of maternal education, represented important risk factors in the production of poor growth in weight and stature.

CONCLUSIONS

Timely detection of undernutrition in patients with BTM and proper nutritional intervention could prevent growth delay and comorbidities.

Dietary Intake of Pregnant Women with and without Inflammatory Bowel Disease in the United States

BACKGROUND

Pregnancy is a vulnerable time where the lives of mother and baby are affected by diet, especially high-risk pregnancies in women with inflammatory bowel disease (IBD). Limited research has examined diet during pregnancy with IBD.

AIMS

Describe and compare the diet quality of pregnant women with and without IBD, and examine associations between dietary intake and guidelines during pregnancy.

METHODS

Three 24 h recalls were utilized to assess the diets of pregnant women with IBD (n = 88) and without IBD (n = 82) during 27-29 weeks of gestation. A customized frequency questionnaire was also administered to measure pre- and probiotic foods.

RESULTS

Zinc intake (p = 0.02), animal protein (g) (p = 0.03), and ounce equivalents of whole grains (p = 0.03) were significantly higher in the healthy control (HC) group than the IBD group. Nutrients of concern with no significant differences between groups included iron (3% IBD and 2% HC met the goals), saturated fat (only 1% of both groups met the goals), choline (23% IBD and 21% HC met the goals), magnesium (38% IBD and 35% HC met the goals), calcium (48% IBD and 60% HC met the goals), and water intake (49% IBD and 48% HC met the goals).

CONCLUSIONS

Most pregnant women in this cohort fell short of the dietary nutrients recommended in pregnancy, especially concerning for women with IBD.

Trivalent metal ion sensor enabled bioimaging and quantification of vaccine-deposited Al3+ in lysosomes

Extracellular metallic debris is deposited into the well-known 'recycle bins' of the cells named lysosomes. The accumulation of unwanted metal ions can cause dysfunction of hydrolyzing enzymes and membrane rupturing. Thus, herein, we synthesized rhodamine-acetophenone/benzaldehyde derivatives for the detection of trivalent metal ions in aqueous media. In solution, the synthesized probes exhibited a 'turn-on' colorimetric and fluorometric response upon complexation with trivalent metal ions (M³⁺). Mechanistically, M³⁺ chelation enables the appearance of a new emission band at approximately 550 nm, which verifies the disruption of the closed ring and the restoration of conjugation on the xanthene core in rhodamine 6G derivatives. Exclusive localization of the biocompatible probes at the lysosomal compartment favored the quantification of deposited Al³⁺. Moreover, the novelty of the work lies in the detection of Al³⁺ deposited in the lysosome that originated from hepatitis B vaccines, which shows their efficiency for near future in vivo applications.