Iron deficiency anemia prevention

Iron deficiency For the prevention and treatment of iron deficiency and iron deficiency anemias. 

The only clinical indication for the use of iron preparations is the treatment or prevention of iron deficiency anemia. Iron deficiency is commonly seen in populations with increased iron... 

Methods for the depolymerization of dextran to uniform fractions of lower molecular weight have led to the use of two dextran fractions that are suitable for parenteral administration.13,30 In the United States, a dextran fraction of MW 70,000 is used as a blood-volume expander. Clinical dextran is used to restore blood volume in the treatment of patients who have either lost considerable amounts of blood or are in shock. A dextran fraction of MW 40,000 is used to improve the flow in capillaries, to prevent or treat vascular occlusion, and to perfuse organs artifically. B-512(F) dextran is completely metabolized141 in man when fractions are administered parentally. Various dextran fractions have been used to prepare numerous derivatives,29 such as the sulfates, and 0-(2-diethylaminoethyl) (DEAE)-dextran, and complexes with various metals. Dextran sulfates have anticoagulant,340 antilipemic,340 and anti-ulcer341 activity. A soluble, iron-dextran complex342 of MW 5000 is used to alleviate iron-deficiency anemia, and a calcium complex332 alleviates hypocalcemia of cattle. 

Iron deficiency anemia occurs mainly in infants, children, and fertile women. For this reason, a variety of foods, including infant formula and infant cereals, is fortified with iron. Ferrous sulfate is a form of iron that is most readily absorbed by the gut, but when added to dry cereals it can promote their spoilage and rancidity. For this reason, dry cereals are fortified with elemental iron particles, ferric pyrophosphate, or ferrous fumarate (Davidsson et ah, 1997). Ascorbic add may also be added to the cereal to enhance iron absorption. To view some of the numbers, infant cereals may contain 75 mg iron/kg cereal (1.3 mmol iron/kg), 1 mmol phytic acid/kg, and 2.6 mmol ascorbic acid/kg (Davidsson et cd., 1997). Although phytic acid impairs iron absorption, the added ascorbate serves to prevent this effect. An alternate method for preventing phytate from impairing iron absorption is to treat the food with the enzyme phytase. A parent interested in enhancing a child s iron absorption can easily feed a child some orange juice, but it would not be practical to pretreat the child s cereal with phytase. A typical availability of ferrous sulfate in infants is about 3-5% (with no ascorbate), and 6-10% (with ascorbate). Ascorbate is effective when present in a twofold molar excess over the iron. 

Iron deficiency anemia is commonly found in both affluent and economically deprived populations. In prevention of this nutritional deficiency disease, both increase in dietary iron and increase in the availability of this dietary iron for population groups at risk should be concurrently addressed. This is a problem for which the solution lies primarily not with the medical community but rather with the providers of food in agriculture and food industry. 

The demand for folate is increased in people with thalassemia because of a more rapid cell turnover due to ineffective erythropoiesis. Where this demand cannot be met, a megaloblastic anemia may be superimposed on the thalassemia (R14, G8). This may be difficult to recognize because the abnormal synthesis of the globin moiety of hemoglobin may prevent the development of characteristic megaloblasts. A similar situation may occur in iron-deficiency anemia where characteristic megaloblasts will not develop until... 

The average dose for the treatment of iron-deficiency anemia is about 200 mg of iron/day (2—3 mg/kg/day), given in three equal doses of 65 mg. Children weighing 15—30 kg can take half the average adult dose, while small children and infants can tolerate relatively large doses of iron (e.g., 5 mg/kg). The dose used is a compromise between the desired therapeutic action and the adverse effects. Prophylaxis and mild nutritional iron deficiency may be managed with modest doses. When the object is the prevention of iron deficiency in pregnant women, for example, doses of 15—30 mg of iron/day are adequate to meet the 3-6 mg daily requirement of the last 2 trimesters. 

Iodine is an essential component of thyroid hormone either low or high intake may lead to thyroid disease. Currently, intake of seaweed, a low-calorie food containing sufficient calcium, potassium, iron and vegetable fibers, has been recommended for the prevention of ischemic heart diseases, cerebrovascular diseases, dys-hpidemia, diabetes mellitus, hypertension, metabofic syndrome and obesity, as well as for osteoporosis and iron-deficiency anemia (Mizukami et ai, 1993). Besides, salt has been iodized, and as a result, iodine intake has increased throughout the world (Zhao et ai, 1998). 

Interpretation of Signs, Symptoms, and Laboratory Tests Treatment and Prevention of Iron-Deficiency Anemia... 

TREATMENT AND PREVENTION OF IRON-DEFICIENCY ANEMIA. Once anemia has been diagnosed, the patient should be given some form of supplemental iron since treatment consisting only of additional dietary iron takes a long time to cure anemia. 

Anemia is defined by abnormally low circulating hemoglobin concentrations. A variety of etiologies exist for anemia, including dietary deficiencies of folate or vitamin B12 (pernicious or macrocytic anemia), infections and inflammatory states (anemia of chronic disease), and conditions that result in insufficient production of red blood cells (aplastic anemia) or excessive destruction of red blood cells (hemolytic anemia). However, worldwide, the most prevalent form of anemia is that of iron deficiency, which causes anemia characterized by hypochromic and normo- or microcytic red blood cells. Iron deficiency anemia remains a health problem in both the developed and the developing world. This article discusses the metabolism of iron the assessment of iron deficiency iron requirements across the life span and the consequences, prevention, and treatment of iron deficiency and iron deficiency anemia. 

Interventions Prevention and Treatment of Iron Deficiency Anemia... 

Table 2 Guidelines for iron supplementation to prevent iron deficiency anemia ...

Adapted with permission from Stoltzfus RJ and Dreyfuss ML (1998) Guidelines for the Use of Iron Supplements to Prevent and Treat Iron Deficiency Anemia. Washington, DC International Nutritional Anemia Consultative Group. 

Infancy Iron supplementation in infants is sometimes advised to prevent iron deficiency, even in populations with a relatively low prevalence of iron-deficiency anemia. The US Institute of Medicine, for example, recommends iron drops for exclusively breast-fed infants between 4 and 6 months of age. There is ample evidence from well-designed and controlled studies to show that iron supplementation in infancy significantly improves hemoglobin and ferritin levels, and studies are currently investigating the impact of iron supplementation on dimensions of cognitive development. The benefits and risks of infant iron supplementation, however, remain... 

Taken together, the available evidence su ests that iron supplements should be taken daily to treat iron-deficiency anemia, especially in pregnant women. Weekly supplementation may offer a more feasible preventive strategy, particularly if it reduces costs, improves compliance, and reduces side-effects however, more information is needed to assess the relative effectiveness of daily versus weekly supplementation under program conditions. 

Sublethal effects in birds are similar to those in other species and include growth retardation, anemia, renal effects, and testicular damage (Hammons et al. 1978 Di Giulio et al. 1984 Blus et al. 1993). However, harmful damage effects were observed at higher concentrations when compared to aquatic biota. For example, Japanese quail (Coturnix japonica) fed 75 mg Cd/kg diet developed bone marrow hypoplasia, anemia, and hypertrophy of both heart ventricles at 6 weeks (Richardson et al. 1974). In zinc-deficient diets, effects were especially pronounced and included all of the signs mentioned plus testicular hypoplasia. A similar pattern was evident in cadmium-stressed quail on an iron-deficient diet. In all tests, 1% ascorbic acid in the diet prevented cadmium-induced effects in Japanese quail (Richardson et al. 1974). In studies with Japanese quail at environmentally relevant concentrations of 10 pg Cd/kg B W daily (for 4 days, administered per os), absorbed cadmium was transported in blood in a form that enhanced deposition in the kidney less than 0.7% of the total administered dose was recovered from liver plus kidneys plus duodenum (Scheuhammer 1988). 

There is a possibility that some milk constituents regulate the absorption of ions in the intestine. In studying manganese metabolism we turned to the low iron content in milk. Iron has received great attention in pediatric nutrition. The concern has been to prevent the anemia caused by iron deficiency earlier often found in childhood. Wide milk consumption by infants and young children makes this food an attractive vehicle for iron fortification. Iron-enriched proprietary milk substitutes can adequately prevent the anemia common to infants who subsist largely on low-iron mother s or cow s milk (53). 

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