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Khan AZ, Badar S, O'Callaghan KM, Zlotkin S, Roth DE. Fecal Iron Measurement in Studies of the Human Intestinal Microbiome. Curr Dev Nutr 2022; 6:nzac143. [PMID: 36475017 PMCID: PMC9718653 DOI: 10.1093/cdn/nzac143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/09/2022] [Accepted: 09/09/2022] [Indexed: 04/22/2024] Open
Abstract
Iron is an essential micronutrient for humans and their intestinal microbiota. Host intestinal cells and iron-dependent bacteria compete for intraluminal iron, so the composition and functions of the gut microbiota may influence iron availability. Studies of the effects of the microbiota or probiotic interventions on host iron absorption may be particularly relevant to settings with high burdens of iron deficiency and gastrointestinal infections, since inflammation reduces iron bioavailability and unabsorbed intraluminal iron may modify the composition of the microbiota. The quantification of stool iron content may serve as an indicator of the amount of intraluminal iron to which the intestinal microbiota is exposed, which is particularly relevant for studies of the effect of iron on the intestinal microbiome, where fecal samples collected for purposes of microbiome characterization can be leveraged for stool iron analysis. However, few studies are available to guide researchers in the selection and implementation of stool iron assays, particularly because cross-comparison of available methods is limited in literature. This review aims to describe the available stool iron quantification methods and highlight their potential application in studies of iron-microbiome relationships, with a focus on pediatric research. MS-based methods offer high sensitivity and precision, but the need for expensive equipment and the high per-sample and maintenance costs may limit their widespread use. Conversely, colorimetric assays offer lower cost, ease of use, and rapid turnaround times but have thus far been optimized primarily for blood-derived matrices rather than stool. Further research efforts are needed to validate and standardize methods for stool iron assessment and to determine if the incorporation of such analyses in human microbiome studies 1) yields insights into the interactions between intestinal microbiota and iron and 2) contributes to the development of interventions that mitigate iron deficiency and promote a healthy microbiome.
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Affiliation(s)
- Afreen Z Khan
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada
- Centre for Global Child Health and SickKids Research Institute, The Hospital for Sick Children, Toronto, Canada
| | - Sayema Badar
- Centre for Global Child Health and SickKids Research Institute, The Hospital for Sick Children, Toronto, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Karen M O'Callaghan
- Centre for Global Child Health and SickKids Research Institute, The Hospital for Sick Children, Toronto, Canada
| | - Stanley Zlotkin
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada
- Centre for Global Child Health and SickKids Research Institute, The Hospital for Sick Children, Toronto, Canada
- Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Daniel E Roth
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada
- Centre for Global Child Health and SickKids Research Institute, The Hospital for Sick Children, Toronto, Canada
- Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Vehapoglu A, Ozgurhan G, Ustabas Kahraman F, Cakın ZE, Sumbul B. Association between Consumption of Cow's Milk and Iron Deficiency Anemia in Children: Are There Roles for Hepcidin-25/Ferroportin? A Case-Control Study. Pediatr Hematol Oncol 2020; 37:676-686. [PMID: 32705943 DOI: 10.1080/08880018.2020.1782547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Systemic iron homeostasis is regulated by the interaction of the peptide hormone, hepcidin and the iron exporter, ferroportin. The objective was to investigate the relationship between the consumption of cow's milk and iron deficiency anemia in children 2-10 years old and its association with the hepcidin-25 and ferroportin concentrations. The study population consisted of 187 prepubescent children of similar ideal body weight (IBW:90-120%); 82 children with iron deficiency anemia (37girls and 45boys; 4.27 ± 0.28 years) and 105 (47girls and 58boys; 4.25 ± 0.34 years) healthy age-sex-matched controls. Serum fasting hepcidin-25/ferroportin concentrations were measured by enzyme immunoassay in all subjects. Mean cow's milk consumption in the anemic group (373 ± 248 mL/d) tended to be higher than that in the control group (320 ± 226 mL/d), but the result was not statistically significant (p = 0.063).The mean hepcidin-25 level was significantly higher in the anemic group (19.5 ± 18.4 ng/mL) than in the healthy controls (11.0 ± 10.7, p < 0.001). The mean ferroportin level was lower in the anemic group (21.04 ± 5.74 ng/mL) than in the healthy controls (22.68 ± 4.77 ng/ml, p = 0.037). Consuming cow's milk was not associated with IDA in prepubertal children, provided that it was adequately supplemented with iron-enriched foods. We observed a significant increase in hepcidin-25 levels and a decrease in ferroportin levels in children with iron deficiency anemia compared with healthy controls. Children who consumed more cow's milk had higher levels of hepcidin-25. Iron deficiency anemia is not a concern when cow's milk is given to children if the complementary foods are rich in iron.
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Affiliation(s)
- Aysel Vehapoglu
- Department of Pediatrics, Bezmialem Vakıf University, Faculty of Medicine, Istanbul, Turkey
| | - Gamze Ozgurhan
- Department of Pediatrics, Süleymaniye Maternity and Children's Training and Research Hospital, Istanbul, Turkey
| | - Feyza Ustabas Kahraman
- Department of Pediatrics, Bezmialem Vakıf University, Faculty of Medicine, Istanbul, Turkey
| | - Zeynep Ebru Cakın
- Department of Pediatrics, Bezmialem Vakıf University, Faculty of Medicine, Istanbul, Turkey
| | - Bilge Sumbul
- Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey
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El Amin Aissiou MY, Assami MK, El Hadi Cherifi M, Djennadi N, Aroua H, Bitam A. Prolonged exclusive lactation and low educational level of mothers as potential risk factors for the occurrence of iron deficiency anemia among young Algerian preschool children living in poor rural area (Djelfa). MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2017. [DOI: 10.3233/mnm-16104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Mohammed Yehya El Amin Aissiou
- Laboratory of Human Nutrition and food Technology of Algiers, High National School of Agronomy of El Harrach, Street of Hassan Badi El Harrach, Algiers, Algeria
| | - Mustapha Kamel Assami
- Laboratory of Human Nutrition and food Technology of Algiers, High National School of Agronomy of El Harrach, Street of Hassan Badi El Harrach, Algiers, Algeria
| | | | | | - Hayet Aroua
- Clinical Laboratory of Larbaa, Larbaa, Blida, Algeria
| | - Arezki Bitam
- Laboratory of Human Nutrition and food Technology of Algiers, High National School of Agronomy of El Harrach, Street of Hassan Badi El Harrach, Algiers, Algeria
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Gibson RS, Heath ALM, Szymlek-Gay EA. Is iron and zinc nutrition a concern for vegetarian infants and young children in industrialized countries? Am J Clin Nutr 2014; 100 Suppl 1:459S-68S. [PMID: 24871479 DOI: 10.3945/ajcn.113.071241] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Well-planned vegetarian diets are considered adequate for all stages of the life cycle, despite limited data on the zinc status of vegetarians during early childhood. The bioavailability of iron and zinc in vegetarian diets is poor because of their higher content of absorption inhibitors such as phytate and polyphenols and the absence of flesh foods. Consequently, children as well as adult vegetarians often have lower serum ferritin concentrations than omnivores, which is indicative of reduced iron stores, despite comparable intakes of total iron; hemoglobin differences are small and rarely associated with anemia. However, data on serum zinc concentrations, the recommended biomarker for identifying population groups at elevated risk of zinc deficiency, are sparse and difficult to interpret because recommended collection and analytic procedures have not always been followed. Existing data indicate no differences in serum zinc or growth between young vegetarian and omnivorous children, although there is some evidence of low serum zinc concentrations in vegetarian adolescents. Some vegetarian immigrants from underprivileged households may be predisposed to iron and zinc deficiency because of nondietary factors such as chronic inflammation, parasitic infections, overweight, and genetic hemoglobin disorders. To reduce the risk of deficiency, the content and bioavailability of iron and zinc should be enhanced in vegetarian diets by consumption of fortified cereals and milk, by consumption of leavened whole grains, by soaking dried legumes before cooking and discarding the soaking water, and by replacing tea and coffee at meals with vitamin C-rich drinks, fruit, or vegetables. Additional recommended practices include using fermented soy foods and sprouting at least some of the legumes consumed. Fortified foods can reduce iron deficiency, but whether they can also reduce zinc deficiency is less certain. Supplements may be necessary for vegetarian children following very restricted vegan diets.
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Affiliation(s)
- Rosalind S Gibson
- From the Department of Human Nutrition, University of Otago, Dunedin, New Zealand (RSG and A-LMH); and the Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia (EAS-G)
| | - Anne-Louise M Heath
- From the Department of Human Nutrition, University of Otago, Dunedin, New Zealand (RSG and A-LMH); and the Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia (EAS-G)
| | - Ewa A Szymlek-Gay
- From the Department of Human Nutrition, University of Otago, Dunedin, New Zealand (RSG and A-LMH); and the Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia (EAS-G)
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Rady HI, Samir H, Tomerak R, Gaafar M. Occult blood in stool in exclusively formula fed infants versus exclusively breast fed infants in the first six months of life. EGYPTIAN PEDIATRIC ASSOCIATION GAZETTE 2014. [DOI: 10.1016/j.epag.2013.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Iron status of one-year-olds and association with breast milk, cow's milk or formula in late infancy. Eur J Nutr 2012; 52:1661-8. [PMID: 23212531 DOI: 10.1007/s00394-012-0472-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Accepted: 11/21/2012] [Indexed: 01/14/2023]
Abstract
PURPOSE Studies on iron status in infancy and early childhood have shown contradicting results concerning prolonged breast-feeding and cow's milk intake. The aim of the present study was to investigate associations between iron status among one-year-olds and feeding, with focus on the type of milk. METHODS Randomly selected healthy infants were prospectively investigated until 1 year of age in two cohorts born 1995-1996 (n = 114) and 2005 (n = 140). Information on birth data, feeding and growth until 12 months and iron status at 12 months was collected. Data from the two cohorts were pooled and the infants categorized into three groups according to their predominant milk consumption at 9 months of age, that is, breast milk, cow's milk or follow-on formula. RESULTS The prevalence of iron deficiency was highest in the cow's milk group and lowest in the follow-on formula group. According to a linear model, adjusted for gender, birth weight and exclusive breast-feeding duration, cow's milk consumption was negatively associated with serum ferritin (SF) and formula positively, but breast milk not. Predicted SF (μg/l) = 11.652(intercept) - 5.362(boy) + 0.005 × birth weight (g) + 2.826(exclusively breastfed ≥ 4 months) + 0.027 × formula (ml) - 0.022 × cow's milk (ml) + 0.005 × breast milk (ml). Correction for other dietary factors did not change these results. CONCLUSION In this pooled analysis, cow's milk intake in late infancy associated negatively, and follow-on formula positively, with iron status. Prolonged partial breast-feeding does not seem to be of importance for iron status. Fortified food seems to improve iron status in late infancy.
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Elalfy MS, Hamdy AM, Abdel Maksoud SS, Abdel Megeed RI. Pattern of milk feeding and family size as risk factors for iron deficiency anemia among poor Egyptian infants 6 to 24 months old. Nutr Res 2012; 32:93-9. [DOI: 10.1016/j.nutres.2011.12.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Revised: 12/14/2011] [Accepted: 12/30/2011] [Indexed: 11/08/2022]
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Dror DK, Allen LH. The Importance of Milk and other Animal-Source Foods for Children in Low-Income Countries. Food Nutr Bull 2011; 32:227-43. [DOI: 10.1177/156482651103200307] [Citation(s) in RCA: 167] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Milk and other animal-source foods are concentrated dietary sources of macro- and micronutrients. Despite a global increase in milk production and consumption over the past decades, milk and other animal-source foods are often lacking in the diets of children in developing countries. Objective To evaluate the importance of milk and other animal-source food intake in promoting the growth, development, and health of children in low-income countries. Methods Original research articles describing observational and intervention studies with unfortified milk, fortified milk, and other animal-source foods in children were identified by searching the PubMed database. Results Consumption of milk and other animal-source foods by undernourished children improves anthropometric indices and cognitive function and reduces the prevalence of biochemical and functional nutritional deficiencies, reducing morbidity and mortality. Unfortified and fortified milk used in supplementation trials has been well tolerated and widely accepted by parents and children. Conclusions To improve the dietary quality of children in low-income countries and further the effort to eradicate extreme poverty and hunger in accordance with the United Nations Millennium Development Goals, additional research is necessary to identify and implement programs and policy supporting increased intake of milk and other animal-source foods.
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