Prevalence and approaches to manage iron deficiency anemia (IDA)

Boosting nutritional value: the role of iron fortification in meat and meat products

Iron deficiency is a widespread nutritional problem affecting millions of people globally, leading to various health issues including anemia. Iron fortification of meat and meat products has emerged as an effective strategy to combat this issue. This review explores the process and benefits of iron fortification, focusing on the types of iron compounds suitable for fortification, such as ferrous sulfate and ferric pyrophosphate, their bioavailability, and their impact on the sensory and nutritional qualities of meat products. Technological challenges and solutions, including encapsulation, chelation, and microencapsulation techniques, have been examined to minimize their negative impacts on sensory qualities. This review also discusses the regulatory framework governing iron fortification and consumer acceptance. Analytical methods for determining iron content, such as spectrophotometric and colorimetric detection, are discussed. Although iron-fortified meat products offer health benefits, sensory aspects and consumer acceptance are important considerations. This review provides a comprehensive understanding of the role and significance of iron fortification in meat products as a public health intervention to address iron deficiency.

Improvement of stability and antioxidant capacity of peptide - iron complexes by sonication

In the present study, peptide‑iron complexes derived from Dictyophora rubrovolvata volva (U-VP-Fe) were prepared using ultrasonication. Their structures, interactions, stability and antioxidant activity were systematically characterised. The production conditions optimized by orthogonal tests were as follows: ultrasonic power 90 W, peptide concentration 4 %, mass ratio of peptide/FeCl2 1:1, and pH 4. Under such conditions, the iron binding capacity could reach 66.35 mg/g. Fluorescence spectral analyses revealed that hydrophobic forces dominated the binding to Fe2+, and the binding process was endothermic and spontaneous. Morphological analyses showed that U-VP-Fe featured a dense and smooth surface with significantly improved surface hydrophobicity and particle size. Stability analyses suggested that U-VP-Fe exhibited better resistance to high temperature, pH and gastrointestinal digestion than the hydrothermal control (C-VP-Fe). Antioxidant assays demonstrated that U-VP-Fe presented superior antioxidant capacity than C-VP-Fe. The findings lay the theoretical foundation for applying ultrasound method to produce peptide‑iron complexes as novel iron supplements.

Research progress on the relationship between Helicobacter pylori infection and iron deficiency anemia

Helicobacter pylori (H. pylori) infection affects around half of the global population and is a globally highly prevalent pathogen that is closely linked not only to gastrointestinal diseases such as chronic atrophic gastritis, functional dyspepsia and peptic ulcer but also to the development and progression of a variety of extra-gastrointestinal diseases. Numerous studies have shown the correlation between H. pylori infection and iron-deficiency anemia (IDA). The prevalence of H. pylori infection is higher in individuals with IDA, and the hemoglobin level of patients with IDA can be increased to different degrees or even returned to normal following active H. pylori eradication. However, this conclusion is still controversial. In this paper, a comprehensive literature search was conducted using the PubMed/MEDLINE/Web of Science database, combining the following terms: "Helicobacter pylori," "Helicobacter pylori infection," "iron deficiency anemia," "iron deficiency," "iron absorption," "iron malabsorption," "serum iron," "hemoglobin," "pathogenesis," "mechanism," and "eradication therapy." Through extensive literature searches, the correlation between H. pylori infection and IDA, its potential mechanism, and the efficacy of H. pylori eradication therapy in IDA patients have been comprehensively discussed. We conclude that the majority of existing studies have confirmed the correlation between H. pylori infection and IDA, indicating that patients with H. pylori infection are more likely to develop IDA and that the prevalence of H. pylori infection is higher in individuals with IDA. Compared with iron supplementation alone, combining H. pylori eradication with iron supplementation is more effective in treating IDA, particularly in unexplained or refractory IDA cases. These findings provide valuable insights for clinicians managing patients with unexplained or refractory IDA.

Effect of iron fortification and prebiotics on iron biomarkers in anemic rats

One of the biggest public health problems globally is that of iron deficiency anemia. The present research aimed to determine the effect of prebiotics along with iron fortification on iron biomarkers in female anemic rats as some evidence suggests that prebiotics convert increase the solubility of iron, thereby enhancing its absorption. A total of 126 Sprague Dawley rats were fed with sixteen different types of fortified feed containing prebiotics (Inulin + Galacto Oligosaccharides) and Iron Fortificants (Sodium Ferric Ethylenediaminetetraacetate + Ferrous Sulphate). The duration of the trials was 3 months aimed at determining the effect of iron fortification and prebiotics on different iron biomarkers including Hemoglobin (Hb), Hematocrit, Red Blood Cell (RBC) count, Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin (MCH) and Mean Corpuscular Hemoglobin Concentration (MCHC). The trials resulted in statistically significant improved iron biomarkers among female anemic rats (P-value < 0.05). It was concluded that iron fortification and prebiotics in combination were able to increase the levels of iron biomarkers in female anemic rats.

Assessing and managing iron deficiency anemia in sickle cell disease: Insights from a systematic review and meta-analysis

ABSTRACT

Sickle cell disease (SCD) is prevalent in Sub-Saharan Africa, the Middle East, and parts of India, where it is often complicated by iron deficiency anemia (IDA). Untreated IDA exacerbates SCD symptoms, reducing quality of life (QOL) and increasing morbidity and mortality. Diagnosis typically depends on ferritin levels, which can be unreliable due to inflammation associated with SCD's altered red cell morphology and chronic hemolysis. This systematic review and meta-analysis explores the interplay between IDA and SCD, focusing on diagnostic criteria for effective management. We conducted a thorough search of PubMed and EMBASE, leading to the selection of 14 studies following PRISMA guidelines. The review protocol was registered in PROSPERO (CRD42023462914). Data extraction, quality assessments, and heterogeneity checks were rigorously performed. Out of 3188 articles, 14 studies met the inclusion criteria, covering 763 SCD cases with 118 instances of IDA. The meta-analysis found an IDA prevalence of 6% (95% CI: 1%-20%) among SCD patients, with high heterogeneity (I 2 = 88.8%). Sensitivity analysis adjusted for publication bias indicated an 8% prevalence (95% CI: 4%-19%) with reduced heterogeneity (I 2 = 19.5%). Subgroup analysis revealed a lower prevalence of IDA in pregnant women (0.01%; 95% CI: 0.00%-0.92%) compared to non-pregnant individuals (7%; 95% CI: 2%-22%). The study highlights significant regional variability in IDA prevalence among SCD patients, emphasizing the importance of early diagnosis and targeted management to improve patient outcomes and QOL.

Dietary quality, anaemia prevalence and their associated factors among rural school- going adolescents in Acholi sub -region of Uganda

BACKGROUND

Globally, iron deficiency anaemia is a widespread public health problem affecting vulnerable populations including adolescents. However, over the years, the Uganda Demographic Health Surveys mostly report the status of anaemia for women of reproductive age (15-49 years) and children up to 5 years, leaving out the focus on adolescents. Moreover, high prevalence of anaemia among children below five years could suggest that anaemia still persists at adolescence. Therefore, the study aimed at determining dietary quality, prevalence of anaemia and their associated factors among school-going adolescents.

METHODS

A cross-sectional study involving 341 adolescent boys and girls aged 10-19 years was carried out in two rural schools in Gulu district. Prevalence of anaemia was determined by obtaining blood specimens from a finger prick into a microcuvette and analysed for haemoglobin (Hb) level using Haemoglobin analyser, whereas dietary quality was assessed using the Individual Dietary Diversity Score (IDDS). Socio-economic and demographic data were collected using a semi-structured questionnaire.

RESULTS

The overall prevalence of anaemia was 16.0% (Girls:18.1%; Boys:13.0%), while the mean Hb level was 13.2 ± 1.4 g/dl (Girls 13.0 ± 1.3 g/dl; Boys 13.5 ± 1.6 g/dl). The mean number of food groups consumed among the adolescents was 3.5 ± 2.1 for girls and 3.0 ± 1.8 for boys (p˃0.05). Animal source foods, fruits and vitamin A-rich vegetables, other fruits and vegetables were consumed by adolescent girls more than the boys. Similarly, a higher proportion of adolescent girls than boys consumed iron-rich foods: fish and meat, organ meat and dark green leafy vegetables. Further, all the socio-demographic factors in the study did not predict dietary diversity (p ˃ 0.05). On the other hand, education attainment by parent/guardian and nature of menstruation predicted the prevalence of anaemia amongst adolescents (p < 0.05).

CONCLUSIONS

The prevalence of anaemia was high among adolescents. Coupled with this, there, was low dietary diversity among the adolescents. The level of education of the parent/guardian and nature of the menstrual discharge were significant predictors of anaemia amongst girls. From this study, we recommend interventions by both health and agricultural-related practitioners to strengthen activities in rural schools such as health and nutrition education to create awareness about dietary diversity and promotion of agricultural practices such as school vegetable gardens, orchards poultry production and rearing of small ruminants to support consumption of diverse foods in schools with the view of reducing the burden from iron deficiency anaemia.

Comparison of different dietary levels of iron and zinc for the enrichment of eggs in laying hens

Zinc (Zn) and iron (Fe) are necessary for structural and metabolic functions of the body like, immune competence, physical growth, reproductive function, and neurobehavioral development. The deficiency of micronutrients is a severe public health distress in nearly all developing countries which leads to the syndrome of malnutrition mostly in children and women. The present study was conducted to compare the effect of different levels of Fe and Zn on feed intake (FI), feed conversion ratio (FCR), daily egg production, and Fe and Zn depositions in the egg yolk of laying hens. For this purpose, 80 commercial laying birds were allocated into four groups consisting of four replicates each (n = 5). The basal ration was provided to the control group (C) while three different levels (100, 200, and 300 mg/kg diet/element) of Fe and Zn (1:1) were provided to the FZ100, FZ200, and FZ300 groups, respectively. Overall FI, hen day egg production, and FCR were not affected (p > 0.05). The Fe and Zn content in egg yolk were significantly increased in the FZ300 group after 4 weeks of supplementation. The cost per egg produced in response to different levels of Fe and Zn supplementation was not affected however a numerical increase in cost/egg was found in the FZ300 group. In conclusion, Fe and Zn supplementation (300 mg/kg diet/element) significantly enhanced the egg Fe and Zn contents without adversely affecting production parameters including FI, egg production, and FCR of laying hens.

Prospects of iron solubilizing Bacillus species for improving growth and iron in maize (Zea mays L.) under axenic conditions

Iron (Fe) deficiency in calcareous soils is a significant agricultural challenge, affecting crop productivity and nutritional quality. This study aimed to isolate, characterize, and evaluate Fe solubilizing rhizobacterial isolates from maize rhizosphere in calcareous soils as potential biofertilizers. Forty bacterial isolates coded as SG1, SG2, …, SG40 were isolated and screened for siderophore production, with ten showing significant Fe solubilizing capabilities. These isolates were further assessed for phosphate solubilization and exopolysaccharides production. The selected bacterial isolates were also screened under axenic conditions for their ability to improve maize growth. The isolates SG8, SG13, SG24, SG30 and SG33 significantly enhanced growth parameters of maize. Notably, SG30 showed highest increment in shoot length (58%), root length (54%), root fresh and dry biomass (67% and 76%), SPAD value (67%), relative water contents (69%), root surface area (61%), and Fe concentration in shoots (79%) as compared to control. The biochemical characterization of these strains showed that all these strains have capability to solubilize insoluble phosphorus, produce indole-3-acetic acid (IAA), and ammonia with catalase, urease and protease activity. Molecular identification through 16s rRNA gene sequencing confirmed high similarity (99.7-100%) of the selected isolates to various Bacillus species, including B. pyramidoids, B. firmicutes, and B. cereus. The study provides a strong base for developing eco-friendly, cost-effective biofertilizers to address Fe deficiency in crops and promote sustainable agriculture.

A smartphone-based sensor for detection of iron and potassium in food and beverage samples

A novel approach for simultaneous detection of iron and potassium via a smartphone-based potentiometric method is proposed in this study. The screen printed electrodes were modified with carbon black nanomaterial and ion selective membrane including zinc (II) phtalocyanine as the ionophore. The developed Fe3+-selective electrode and K+-selective electrode exhibited detection limits of 1.0 × 10-6 M and 1.0 × 10-5 M for Fe3+ and K+ ions, respectively. The electrodes were used to simultaneously detect Fe3+ and K+ ions in apple juice, skim milk, soybean and coconut water samples with recovery values between 90%-100.5%, and validated against inductively coupled plasma-optical emission spectrometry. Due to the advantageous characteristics of the sensors and the portability of Near Field Communication potentiometer supported with a smartphone application, the proposed method offers sensitive and selective detection of iron and potassium ions in food and beverage samples at the point of need.

The levels, single and multiple health risk assessment of 23 metals in enteral nutrition formulas

Enteral nutrition formulas are products that provide macro and micronutrients to patients who cannot receive their nutrition orally. In this study, the levels of 23 metals known to have potential health risks were determined by inductively coupled plasma mass spectrometry in a total of 28 enteral nutrition formula. Metal exposure was calculated according to three different daily energy intake scenarios (Scenario 1 = 50% oral nutrition + 50% enteral nutrition formula, Scenario 2 = 25% oral nutrition + 75% enteral nutrition formula and Scenario 3 = 100% enteral nutrition formula) and evaluated in terms of non-carcinogenic health risks. The mean levels of Fe, Co, Ni, Cu, Zn, Mo, Se, Li, Be, V, As, Sr, Ag, Cd, Sb, Ba, La, Hg and Pb in the samples analyzed were determined 12,000 ± 3300, 64 ± 1.6, 10 ± 13, 1300 ± 400, 8500 ± 2500, 75 ± 30, 61 ± 21, 0.34 ± 0.36, 0.05 ± 0.08, 7.3 ± 2, 1.6 ± 0.6, 457 ± 166, 0.02 ± 0.1, 0.14 ± 0.12, 0.01 ± 0.1, 74 ± 103, 0.63 ± 0.4, 0.05 ± 0.03 and 0.14 ± 0.7 μg/L. These metals were considered safe in terms of non-carcinogenic health risks when analyzed individually. However, when the target hazard quotient values of all metals were evaluated together, hazard index values were higher than the reference value of 1, for both men and women, indicating potential health risks.

Physicochemical characterization and determination of trace metals in different edible fats and oils in Bangladesh: Nexus to human health

The study assessed the quality of four different edible fats and oils using standard analytical techniques. The presence of potentially toxic elements was determined using atomic absorption spectrometry. This study reveals that edible oils function admirably in terms of physical traits such as moisture content, boiling point, melting point, density, and specific gravity. Some edible fats and oils exceeded the standard limit of moisture, acid value, and peroxide value and these values were found in the range of 0.120-0.760 %, 0.220-2.45 mg KOH/g, and 1.23-21.7 meq/kg respectively. The iodine value for fats showed satisfactory results but for oils observed lower than the standard value varied from 68.2 to 104 g/100 g. The results of saponification value for most of the oils and fats were found satisfactory but others were lower than recommended limits and detected results were in the range of 167-224 mg KOH/g. Trace metals viz. Fe, Mn, Ni, Pb, Cd, Cu, and Co were measured in all samples and the concentration ranged from 0.070 to 47.0, 0.120-2.44, 0.540-27.1, 0.030-1.87, 0.010-4.63 and 0.060-8.39 ppm for iron, manganese, nickel, lead, copper, and cobalt respectively. The study found high levels of Fe, Mn, Ni, Cu, and Co in edible fats and oils in Bangladesh. No Cd was found, and Pb was not present in over half of the samples, which included the majority of mustard oils. The levels of Fe and Ni were higher than advised, but there was no discernible toxicological danger from Cd or Pb. The results of the health risk assessment indicated that there was no risk to children's health and possible hazards to adults' health.

Frequency of Anemia/IDA and Associated Risk Factors Among Working Women of a Medical Center in Tehran, Iran: A Cross-Sectional Study

Introduction

The study aimed to examine anemia prevalence and risk factors in employed women at a medical center compared to unemployed women from a charity center, with anemia defined as hemoglobin <120 g/L and iron deficiency as serum ferritin <30 ng/mL or serum iron <10 mcg/dL.

Material and Methods

This cross-sectional study included 651 employed, non-pregnant randomly selected women aged 20-67 years. Participants completed questionnaires on sociodemographic, nutritional, and obstetrical characteristics. Blood indicators such as hemoglobin, serum ferritin, iron, and TIBC were measured.

Results

Out of 651 participants, 395 (60.7%) had anemia/IDA (Hb <120 g/L, ferritin <30 ng/mL, or iron <10mcg/dL), comprising 308 (47.3%) having IDA and 215 (33%) having anemia. Younger age (<40 years) and menorrhagia were individually associated with 1.84- and 2.79- times increased risk of developing anemia in the studied population, respectively. A higher number of shifts and lack of vegetable consumption were found to be significantly prevalent in the anemic group. The prevalence of anemia/IDA among hospital staff and referred women was 60.7% and 43.1%, respectively.

Conclusions

The study emphasized the influence of employment on the prevalence of anemia/IDA among hospital staff compared to unemployed women.

Non-invasive Hemoglobin Screening for Detection of Postpartum Anemia

Introduction

Postpartum period is a critical period for a woman, where the body of the woman is in healing stage. In this situation, there arises the risk for developing anemia, if proper diet is not maintained. So, it is necessary to routinely determine the hemoglobin levels during this period to avoid chances of developing anemia and assist in early diagnosis.

Methodology

A cross-sectional study was carried out at the maternity ward of Kalinga Institute of Medical Sciences Hospital, Bhubaneswar. The study was conducted for a period of 5-6 months by received approval from the concerned institutional committee. The study involved women participants having age above 18 years and who had recently undergone delivery. Written informed consent was taken from all the participants prior to their enrolment for this study.

Results

A total of 670 women were involved in this study and more than 50% of the women were found to be affected by anemia. A Pearson's correlation of 0.87 was observed with sensitivity of 95.69% and specificity of 67.06% between the hematology analyzer and non-invasive EzeCheck device in determining anemia.

Conclusion

Women often neglect their health situations and always prioritize their family's wellbeing and health over their own. This avoidance results in the development of a chronic disease which in the long run becomes difficult to be cured. So, in such situations, it is necessary to inculcate certain routine tests for the women during their healing period (such as postpartum stage) to keep an eye on their health status. Use of non-invasive devices can help in achieving this in a painless and much effective manner with instant reporting of the results.

Harnessing the Power of a Novel Triple Chelate Complex in Fermented Probiotic Dairy Products: A Promising Solution for Combating Iron Deficiency Anemia

This study discovered and examined novel triple chelate complexes involving iron, ascorbic acid, and essential amino acids (AsA-Fe-AmA triple chelate complexes) for the first time. The mechanism of complex formation was studied using FTIR spectroscopy and quantum chemical modeling. The produced complexes were shown to be suitable for fortifying food items with a pH of 3-7 that have not been exposed to heat treatment at temperatures over 75 °C for more than 15 min. Thus, it can be said that the concentration for milk fortification should be 0.005 mol/L or less. In vivo experiments in rats models revealed that the synthesized complexes increased serum iron levels after a single application to reference values within 24 h of oral administration. The iron level increased by 14.0 mmol/L at 2 mL dose of the complex. This fact makes it possible to consider the use of developed complexes and developed fermented dairy products for the prevention of iron deficiency and iron deficiency anemia. Research on the effect of discovered compounds on the physicochemical and organoleptic qualities of milk was conducted. Furthermore, iron ascorbate threoninate, iron ascorbate methioninate, iron ascorbate lysinate, and iron ascorbate tryptophanate all had a beneficial effect on Lacticaseibacillus rhamnosus at concentrations as low as 0.0005 mol/L, which is significant for milk fermentation. A study of fermented milk products revealed that the most effective AsA-Fe-AmA triple chelate complex is iron ascorbate lysinate, which might be further investigated as a viable molecule for dietary fortification in iron deficiency anemia. It was found that fortified fermented milk products had a titratable acidity of 67 ± 1°T, pH of 4.38 ± 0.05, and a viscosity of 2018 ± 142 Pa·s.

The origin of ferritin reference intervals: a systematic review

Iron deficiency is a highly prevalent condition, which contributes to unnecessary morbidity, mortality, and health inequity. A serum ferritin concentration of less than 30 μg/L has a high specificity and sensitivity for diagnosing iron deficiency in adults, but the laboratory reported lower limit of normal (LLN) is typically lower. These LLNs might not be rooted in rigorous scientific evidence and might be contributing to structural underdiagnosis of iron deficiency. A systematic review was done per systematic reviews and meta-analysis guidelines with the use of medical literature databases from inception of each database to Nov 30, 2021, to identify studies that determined ferritin reference intervals in healthy adults and grey literature search for the five most common ferritin assays (registration number CRD42022268844). The objectives were to systematically summarise the ferritin reference intervals and to do a methodological quality assessment of the included studies. 2306 studies were screened and 61 full texts were included. 37 studies were eligible for analysis of the ferritin LLN in the general population. The population the sample was comprised of was a total of 21 882 females and 23 650 males participants. The ferritin LLN was a median of 8 μg/L (IQR 5-15) and mean of 9 μg/L (SD 11) in females and a median of 25 μg/L (IQR 16-44) and mean of 25 μg/L (SD 29) in males. 30 (49%) of 61 studies did not explicitly screen for patients at risk of iron deficiency, and 32 (52%) did not refer to a reference interval establishment guideline (eg, guideline recommended by Clinical and Laboratory Standards Institute). The five most used commercial ferritin laboratory assays reported reference intervals with a median LLN of 11 (IQR 9-12) and mean of 9 μg/L (SD 4) for females and median of 22 (IQR 22-24) and mean of 23 μg/L (SD 4) for males. In the literature, serum ferritin reference intervals in healthy adults consistently report a LLN of less than 30 μg/L. Data driving these ferritin reference intervals are at high risk of bias, given no exclusion of individuals at risk for iron deficiency in the presumed normal population sample and no adherence to reference interval establishment standards. We suggest the use of evidence-based laboratory clinical decision limits to diagnose iron deficiency.

Iron Status, Thyroid Dysfunction, and Iron Deficiency Anemia: A Two-Sample Mendelian Randomization Study

INTRODUCTION

Given the clinical association between thyroid dysfunction and iron deficiency anemia (IDA), as well as their shared association with iron status, this study aimed to investigate the causal relationship between iron status and thyroid dysfunction, while also examining the risk of IDA in relation to thyroid dysfunction.

METHODS

A two-sample mendelian randomization (MR) study was conducted to identify the causal relationship of iron status on thyroid dysfunction, as well as thyroid dysfunction on IDA. Large-scale European population-based genome-wide association study databases were utilized (Genetics of Iron Status consortium, ThyroidOmics consortium, FinnGen consortium, and UK Biobank). Inverse variance-weighted (IVW) was used as the main analysis. In addition, we used weighted median and MR-Egger to enhance the robustness. Sensitivity analysis was conducted to evaluate the robustness of MR results.

RESULTS

The IVW estimates did not reveal any significant causal relationship between serum iron status markers and thyroid dysfunction. However, a significant causal relationship was observed between hypothyroidism and IDA (odds ratio [OR] = 1.101, 95% confidence interval [CI] = 1.048-1.157, p < 0.001). Repeated analyses also demonstrated a similar trend (OR = 1.023, 95% CI = 1.011-1.035, p < 0.001). Sensitivity analysis supported that the MR estimates were robust.

CONCLUSION

In our MR study, an upregulation of the hypothyroidism-associated gene was found to be significantly associated with an elevated risk of IDA in the European population. These findings may offer novel therapeutic insights for clinicians managing patients with hypothyroidism, IDA, or their comorbidities.

Knowledge and practices in preventing nutritional anaemia of the urban poor adolescents in Kuala Lumpur, Malaysia

Background: Anaemia has been identified as a major public health problem that affects both developed and developing countries, including Malaysia. To prevent anaemia, knowledge is a key parameter for changing attitudes and practices. Aim: This present study aims to determine the association of knowledge and practices in preventing nutritional anaemia with anaemia status of urban poor adolescents in Kuala Lumpur, Malaysia. Methods: A total of 209 urban poor adolescents (50.7% males and 49.3% females) aged 10 to 17 years old were recruited from eight low-cost flats (People Housing Programme) in Kuala Lumpur, Malaysia. A self-administered questionnaire was used to assess the sociodemographic characteristics, knowledge and practices in preventing nutritional anaemia. Anaemia status from the haemoglobin level concentration was determined using HemoCue® 201  +  hemoglobinometer. Results: The prevalence of anaemia among urban poor adolescents was 58.4%, particularly prevalent among females (p < 0.001) and household size of six and above (p  =  0.036). Only 29.2% and 10.0% of them were found to have good levels of knowledge and practices in preventing nutritional anaemia, respectively. Adolescents with high knowledge level tended to be anaemic as compared to poor knowledge level (AOR(95% CI)  =  2.20 (1.02, 5.61), p < 0.05) after adjusting for sex, household size and monthly household income. Conclusion: Findings showed high prevalence of anaemia and low levels of knowledge and practices of nutritional anaemia prevention among the urban poor adolescents. Nutrition education and intervention are needed to improve the anaemia status of the urban poor adolescents.

Iron deficiency anemia status in Iranian pregnant women and children: an umbrella systematic review and meta-analysis

BACKGROUND

Iron deficiency anemia (IDA) is a global health challenge, especially affecting females and children. We aimed to conduct an umbrella systematic review of available evidence on IDA's prevalence in Iranian pregnant women and children.

METHODS

We searched the Web of Science, Science Direct, PubMed, Scopus, and Google Scholar databases for articles published by April 2023. Meta-analyses investigating the status of IDA in Iran were included. The findings of seven meta-analyses comprising 189,627 pregnant women with a mean age of 26 and 5,890 children under six years old were included in this study. The methodological quality of each study was evaluated with the Assessment of Multiple Systematic Reviews (AMSTAR2) instrument.

RESULTS

We estimated the prevalence of IDA at 15.71% in pregnant women and 19.91% in young children. According to our subgroup analysis of pregnant women, IDA's prevalence in urban and rural regions was 16.32% and 12.75%; in the eastern, western, central, southern, and northern regions of Iran, it was estimated at 17.8%, 7.97%, 19.97%, 13.45%, and 17.82%, respectively.

CONCLUSION

IDA is common in young children and pregnant females and is a significant public health concern in Iran. The present umbrella review results estimated that Iran is in the mild level of IDA prevalence based on WHO classification. However, due to sanctions and high inflation in Iran, the prevalence of anemia is expected to increase in recent years. Multi-sectoral efforts are required to improve the iron status of these populations and reduce the burden of IDA in the country.

Anemia, iron, and HIV: decoding the interconnected pathways: A review

This review delves into the intricate relationship between anemia, iron metabolism, and human immunodeficiency virus (HIV), aiming to unravel the interconnected pathways that contribute to the complex interplay between these 3 entities. A systematic exploration of relevant literature was conducted, encompassing studies examining the association between anemia, iron status, and HIV infection. Both clinical and preclinical investigations were analyzed to elucidate the underlying mechanisms linking these components. Chronic inflammation, a hallmark of HIV infection, disrupts iron homeostasis, impacting erythropoiesis and contributing to anemia. Direct viral effects on bone marrow function further compound red blood cell deficiencies. Antiretroviral therapy, while essential for managing HIV, introduces potential complications, including medication-induced anemia. Dysregulation of iron levels in different tissues adds complexity to the intricate network of interactions. Effective management of anemia in HIV necessitates a multifaceted approach. Optimization of antiretroviral therapy, treatment of opportunistic infections, and targeted nutritional interventions, including iron supplementation, are integral components. However, challenges persist in understanding the specific molecular mechanisms governing these interconnected pathways. Decoding the interconnected pathways of anemia, iron metabolism, and HIV is imperative for enhancing the holistic care of individuals with HIV/AIDS. A nuanced understanding of these relationships will inform the development of more precise interventions, optimizing the management of anemia in this population. Future research endeavors should focus on elucidating the intricate molecular mechanisms, paving the way for innovative therapeutic strategies in the context of HIV-associated anemia.

Evolving trends and burden of iron deficiency among children, 1990-2019: a systematic analysis for the global burden of disease study 2019

Objectives

We aimed to provide a timely, comprehensive, and reliable assessment of the burden of iron deficiency (ID) in children between 1990 and 2019 at the global, regional, and national levels to inform policymakers in developing locally appropriate health policies.

Methods

Data related to ID among children younger than 15 years old were analyzed by sex, age, year, socio-demographic index (SDI), and location according to the Global Burden of Disease Study 2019 (GBD 2019). Age-standardized rates were used to compare the burden between different regions and countries. Furthermore, the Joinpoint regression model was used to assess temporal trends from 1990 to 2019.

Results

In 2019, the number of prevalent cases and disability-adjusted life years (DALYs) for ID in children were 391,491,699 and 13,620,231, respectively. The global age-standardized prevalence and DALY rates for childhood ID in 2019 were 20,146.35 (95% confidence interval: 19,407.85 to 20,888.54) and 698.90 (466.54 to 1015.31) per 100,000, respectively. Over the past 30 years, the global prevalence of ID among children has been highest in low-SDI regions, particularly in Western Sub-Saharan Africa, South Asia, and Eastern Sub-Saharan Africa. Since 1990, the prevalence and DALY of ID in children have been declining in most geographic regions. Nationally, Ecuador, China, and Chile have shown the most significant decreases in prevalence. The greatest decline in age-standardized DALY rate was observed in Ecuador, while Burkina Faso experienced the highest increase. Bhutan had the highest prevalence and DALY rates in 2019. On the age level, the prevalence was relatively higher among the <5 years age group. At the gender dimension, the prevalence of ID in children overall was more pronounced in girls than in boys, as was the case for DALY.

Conclusion

Although the burden of ID in children has been declining, this disease remains a major public health problem, especially in countries with low SDI. Children younger than 5 years of age are an important group for whom targeted measures are needed to reduce the burden of ID.

Collagenous gastritis in children: A national cohort

BACKGROUND

Collagen gastritis is a rare disease that manifests in children mainly as isolated gastric involvement associated with martial deficiency anemia. There are no recommendations for the management and follow-up of these patients. We aimed to describe the clinical data, endoscopic findings, and treatments deployed in France's children with collagenous gastritis.

METHODS

All French pediatric gastroenterology centers and pediatric centers for rare digestive diseases (Centres de Maladies Rares Digestives) were contacted to collect cases of collagenous gastritis, defined on gastric biopsies and diagnosed before 18 years of age.

RESULTS

A total of 12 cases diagnosed (4 males and 8 females) between 1995 and 2022 could be analyzed. The median age at diagnosis was 12.5 years (7-15.2). The most frequent clinical presentation was abdominal pain (6/11) and/or nonspecific symptomatology attributed to anemia (8/10). Anemia was present in all children (11/11; Hb 2.8-9.1 g/dL). Nodular gastritis was present in 10 patients (antrum: 2; fundus: 4; in antrum and fundus: 4). All patients had a basement membrane thickening (from 19 to 100 μm). The treatments received were PPI (11), oral or intravenous martial supplementation (12), budesonide (1), and prednisone (1). Martial supplementation improved anemia in all cases. At discontinuation, nine of 10 patients had a recurrence of anemia.

CONCLUSION

Collagenous gastritis is an exceptional condition, clinically manifested in children as abdominal pain and iron deficiency anemia probably of hemorrhagic origin. Patients require long-term follow-up and monitoring of their disease to describe the risk of progression better.

Biofortification of Crops to Fight Anemia: Role of Vacuolar Iron Transporters

Plant-based foods provide all the crucial nutrients for human health. Among these, iron (Fe) is one of the essential micronutrients for plants and humans. A lack of Fe is a major limiting factor affecting crop quality, production, and human health. There are people who suffer from various health problems due to the low intake of Fe in their plant-based foods. Anemia has become a serious public health issue due to Fe deficiency. Enhancing Fe content in the edible part of food crops is a major thrust area for scientists worldwide. Recent progress in nutrient transporters has provided an opportunity to resolve Fe deficiency or nutritional problems in plants and humans. Understanding the structure, function, and regulation of Fe transporters is essential to address Fe deficiency in plants and to improve Fe content in staple food crops. In this review, we summarized the role of Fe transporter family members in the uptake, cellular and intercellular movement, and long-distance transport of Fe in plants. We draw insights into the role of vacuolar membrane transporters in the crop for Fe biofortification. We also provide structural and functional insights into cereal crops' vacuolar iron transporters (VITs). This review will help highlight the importance of VITs for improving the Fe biofortification of crops and alleviating Fe deficiency in humans.

Iron deficiency in women: ways to reduce prevalence

Iron deficiency states (IDSs) are common disorders at the nexus of various fields. The etiology and pathogenesis of IDSs have been well studied in recent decades, but their prevalence is still high. The highest incidence of IDSs is reported in women of reproductive age. The timely correction of iron deficiency improves women's quality of life and reduces pregnancy complications and infant morbidity. To achieve and maintain the improvement, caution in risk groups, early diagnosis, physiology-based therapy, and follow-up are necessary. Iron sulfate agents are well known as an effective way to treat iron deficiency anemia. However, the high rate of previously reported side effects posed significant challenges to the complete course of therapy. The development of a new molecule with prolonged iron release minimizes the complications of therapy, providing new prospects for iron deficiency treatment. The combination of folic acid to iron sulfate in one tablet simplifies prevention regimens and therapy for pregnant women and those planning to become pregnant and reduces the time to improve.

Prevalence, knowledge, and related factor of anemia among school-going adolescent girls in a remote area of western Rajasthan

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Iron deficiency anaemia: pathophysiology, assessment, practical management

The WHO has recognised iron deficiency anaemia (IDA) as the most common nutritional deficiency in the world, with 30% of the population being affected with this condition. Although the most common causes of IDA are gastrointestinal bleeding and menstruation in women, decreased dietary iron and decreased iron absorption are also culpable causes. Patients with IDA should be treated with the aim of replenishing iron stores and returning the haemoglobin to a normal level. This has shown to improve quality of life, morbidity, prognosis in chronic disease and outcomes in pregnancy. Iron deficiency occurs in many chronic inflammatory conditions, including congestive cardiac failure, chronic kidney disease and inflammatory bowel disease. This article will provide an updated overview on diagnosis and management of IDA in patients with chronic conditions, preoperative and in pregnancy. We will discuss the benefits and limitations of oral versus intravenous iron replacement in each cohort, with an overview on cost analysis between the different iron formulations currently on the market.

Microbial-Assisted Wheat Iron Biofortification Using Endophytic Bacillus altitudinis WR10

Microbial-assisted biofortification attracted much attention recently due to its sustainable and eco-friendly nature for improving nutrient content in wheat. An endophytic strain Bacillus altitudinis WR10, which showed sophistical regulation of iron (Fe) homeostasis in wheat seedlings, inspired us to test its potential for enhancing Fe biofortification in wheat grain. In this study, assays in vitro indicated that WR10 has versatile plant growth-promoting (PGP) traits and bioinformatic analysis predicted its non-pathogenicity. Two inoculation methods, namely, seed soaking and soil spraying, with 10⁷ cfu/ml WR10 cells were applied once before sowing of wheat (Triticum aestivum L. cv. Zhoumai 36) in the field. After wheat maturation, evaluation of yield and nutrients showed a significant increase in the mean number of kernels per spike (KPS) and the content of total nitrogen (N), potassium (K), and Fe in grains. At the grain filling stage, the abundance of Bacillus spp. and the content of N, K, and Fe in the root, the stem, and the leaf were also increased in nearly all tissues, except Fe in the stem and the leaf. Further correlation analysis revealed a positive relationship between the total abundance of Bacillus spp. and the content of N, K, and Fe in grains. Seed staining confirmed the enhanced accumulation of Fe, especially in the embryo and the endosperm. Finally, using a hydroponic coculture model, qPCR quantification indicated effective colonization, internalization, translocation, and replication of strain WR10 in wheat within 48 h. Collectively, strain WR10 assisted successful Fe biofortification in wheat in the field, laying a foundation for further large-scale investigation of its applicability and effectiveness.