Efficacy of iron-fortified whole maize flour on iron status of schoolchildren in Kenya: a randomised controlled trial Relationship between vitamin D deficiency, bone remodelling and iron status in iron-deficient young women consuming an iron-fortified food Effect of daily iron supplementation on iron status, cell-mediated immunity, and incidence of infections in 6–36 month old Togolese children Long-Term Dose-Response Condensed Tannin Supplementation Does Not Affect Iron Status or Bioavailability Effect of intravenous iron sucrose in peritoneal dialysis patients who receive erythropoiesis-stimulating agents for anemia: a randomized, controlled trial. Vitamin A and iron status are improved by vitamin A and iron supplementation in pregnant Indonesian women. Low iron status as a factor of increased bone resorption and effects of an iron and vitamin D-fortified skimmed milk on bone remodelling in young Spanish women Response of hemoglobin, serum ferritin, and serum transferrin receptor during iron supplementation in pregnancy: a prospective study. Longitudinal changes of manganese-dependent superoxide dismutase and other indexes of manganese and iron status in women. Iron supplementation improves iron status and reduces morbidity in children with or without upper respiratory tract infections: a randomized controlled study in Colombo, Sri Lanka. A Randomized Controlled Trial in Young Women of the Effects of Consuming Pork Meat or Iron Supplements on Nutritional Status and Feeling of Well-being Redistribution of vitamin A after iron supplementation in Indonesian infants. Weekly iron supplementation is as effective as 5 day per week iron supplementation in Bolivian school children living at high altitude Effect of Zinc on Efficacy of Iron Supplementation in Improving Iron and Zinc Status in Women Effect of eradication of Helicobacter pylori and iron supplementation on the iron status of children with iron deficiency. Iron treatment normalizes cognitive functioning in young women. Effect of improved vitamin A status on response to iron supplementation in Pakistani infants. Iron Supplementation Until 6 Months Protects Marginally Low-Birth-Weight Infants From Iron Deficiency During Their First Year of Life [Intake of an iron-supplemented milk formula as a preventive measure to avoid low iron status in 1-3 year-olds]. Diet and genetic factors associated with iron status in middle-aged women. Role of oral versus IV iron supplementation in the erythropoietic response to rHuEPO: a randomized, placebo-controlled trial. Use of microencapsulated iron(II) fumarate sprinkles to prevent recurrence of anaemia in infants and young children at high risk. Marginal iron deficiency without anemia impairs aerobic adaptation among previously untrained women.
BACKGROUND Sodium iron edetic acid ( NaFeEDTA ) might be a more bioavailable source of iron than electrolytic iron , when added to maize flour . We aim ed to assess the effect , on children 's iron status , of consumption of whole maize flour fortified with iron as NaFeEDTA or electrolytic iron . METHODS 516 children , aged 3 - 8 years , from four schools in Marafa , Kenya , were r and omly assigned to four groups . All were given the same amount of porridge five times a week . The porridge for one group was made from unfortified whole maize flour ; for the other three groups it was fortified with either high-dose NaFeEDTA ( 56 mg/kg ) , low-dose NaFeEDTA ( 28 mg/kg ) , or electrolytic iron ( 56 mg/kg ) . Concentrations of haemoglobin , plasma ferritin , and transferrin receptor were analysed in sample s taken at baseline and at the end of the 5-month intervention . The primary outcome was iron-deficiency anaemia . We analysed data on an intention-to-treat basis . This trial is registered with Clinical Trials.gov , number NCT00386074 . FINDINGS The prevalence of iron-deficiency anaemia in children given unfortified flour was 10 % . Compared with placebo , the prevalence of iron-deficiency anaemia in children given flour fortified with high-dose NaFeEDTA , low-dose NaFeEDTA , and electrolytic iron changed by -89 % ( 95 % CI -97 % to -49 % ) , -48 % ( -77 % to 20 % ) , and 59 % ( -18 % to 209 % ) , respectively . Consumption of high-dose NaFeEDTA improved all measured iron-status indicators . Low-dose NaFeEDTA decreased the prevalence of iron deficiency but did not noticeably change the prevalence of anaemia . Electrolytic iron did not improve any of these iron-status indicators .  Children who were iron-deficient at baseline benefited more from high-dose and low-dose NaFeEDTA than those with sufficient iron at baseline . INTERPRETATION Consumption of whole maize flour fortified with NaFeEDTA caused modest , dose-dependent improvements in children 's iron status . Fortification with electrolytic iron did not improve their iron status . Therefore , in high-phytate flours , NaFeEDTA is more suitable than electrolytic iron for supplementation of iron in the diet Background Iron and vitamin D deficiencies are two of the most widespread nutritional disorders in the world . Our aim was to know whether the consumption of an iron-fortified fruit juice modifies bone remodelling and the possible influence of baseline vitamin D status on the recovery of iron status in a group of iron-deficient women . Methods  Iron biomarkers , 25-hydroxyvitamin D levels and dietary intake  were measured in 123 iron-deficient menstruating women . A subgroup ( n = 41 ) participated in a r and omised double-blind placebo-controlled study of 16-weeks during winter . They consumed a placebo fruit juice ( P ) or iron-fortified fruit juice ( F ) . Dietary intake , 25-hydroxyvitamin D , parathormone ( PTH ) , bone alkaline phosphatase ( ALP ) , aminoterminal telopeptide of collagen I ( NTX ) and iron biomarkers were determined . Results Ninety-two per cent of the iron-deficient women were vitamin D deficient or insufficient . Transferrin saturation and 25-hydroxyvitamin D were positively correlated . Iron status improved in F , 25-hydroxyvitamin D decreased in F and P , and PTH , ALP and NTX levels were within the normal range and did not vary . Women with 25-hydroxyvitamin D ≥ 50 nmol/L compared with 25-hydroxyvitamin D < 50 nmol/L showed a higher increase in transferrin saturation ( a marker of iron supply to tissues ) during iron recovery . Conclusion The prevalence of vitamin D deficiency or insufficiency is very high in iron-deficient women . The recovery of iron status by consuming an iron-fortified food does not affect 25-hydroxyvitamin D levels ; however , the increase in iron supply to tissues is lower if the women also present vitamin D deficiency . Although bone health does not seem to be affected in this group of women , correction of iron and vitamin D deficiencies should be promoted in young women to improve present and future health Objective : To assess the impact of a daily oral iron supplementation on hematological status , cell-mediated immunity and susceptibility to infections in children living in an environment where iron deficiency , malaria and other infections are frequent . Design : R and omized , double-blind iron supplementation including a placebo group . Setting : A village in Togo , West Africa . Subjects : Of the 229 6–36-month-old children of both sexes recruited , 197 with hemoglobin concentration ≥80 g/l were included and 163 completed the study .Intervention : Children received daily a placebo ( n=79 ) or a dose of 2–3 mg of elemental iron per kg of body weight ( n=84 ) for 3 months . Hematological , nutritional and immune status were assessed at the beginning and at the end of the supplementation period , and 6 months later . Morbidity was recorded throughout the study . Results : Iron supplementation had a significant and positive effect on iron status of children and no impact on the incidence of infections , especially malaria . Its probable effect on immune status was masked by interference of infections and their treatment , which contributed to improve hematological and immune status in both groups . Conclusion : According to the negative consequences of anemia and iron deficiency on global child development , control of iron deficiency by oral iron supplementation in young children has to be conducted , associated with prophylaxis and treatment of malaria and repeated deworming . Sponsorship : Program supported by IRD.European Journal of Clinical Nutrition ( 2000 ) 54 , Abstract Background : Repeated phytic acid consumption leads to iron absorption adaptation but , to the best of our knowledge , the impact of repeated tannin consumption has not yet been established . Salivary proline-rich proteins ( PRPs ) may improve iron absorption by precipitating tannins . Objectives : This study aim ed to determine the effect of long-term , dose-response condensed tannin supplementation on iron bioavailability and status and to assess the effect of salivary proteins on iron bioavailability during prolonged condensed tannin consumption . A secondary objective was to assess astringency as a potential marker for adaptation to tannins and iron bioavailability . Methods : Eleven nonanemic women were enrolled in a double-blind 3-dose crossover trial . Three ( 1.5 , 0.25 , or 0.03 g ) condensed tannin supplements were consumed 3 times/d for 4 wk in r and om order , with 2-wk washouts in between . Meal challenges were employed before and after supplementation to assess iron bioavailability , iron status , salivary PRP changes , and astringency . Results : Tannin supplementation in any dose did not change iron bioavailability at any dose ( P > 0.82 ) from weeks 0 to 4 . Hemoglobin ( P = 0.126 ) and serum ferritin ( P = 0.83 ) were unchanged by tannin dose from weeks 0 to 4 . There were significant correlations among tannin supplementation and iron bioavailability , basic proline-rich proteins ( bPRPs ) ( r = 0.366 , P = 0.003 ) , and cystatin production ( r = 0.27 , P = 0.03 ) . Astringency ratings did not change significantly within or between tannin doses ( P > 0.126 ) , but there were negative relations among bPRP ( r < −0.32 , P < 0.21 ) , cystatin production ( r < −0.2 , P < 0.28 ) , and astringency ratings . Conclusions : Condensed tannin consumption did not affect iron bioavailability or status regardless of the supplementation period in premenopausal nonanemic women . Correlation analyses suggest that bPRPs and cystatins are associated with improved iron bioavailability and that lower ratings of astringency may predict improved iron absorption with repeated tannin consumption Although iron therapy is essential to optimize use of erythropoiesis-stimulating agents ( ESA ) , r and omized , controlled trials have heretofore been unavailable to evaluate reliably the efficacy of intravenous iron as an adjuvant to ESA treatment in peritoneal dialysis ( PD ) patients . In a multicenter trial , patients who had anemia , PD-dependent chronic kidney disease , stable ESA therapy , and a broad range of iron status ( ferritin < or = 500 ng/ml , transferrin saturation < or = 25 % ) were r and omly assigned to receive either 1 g of iron sucrose intravenously in three divided doses ( 300 mg over 1.5 h on days 1 and 15 , 400 mg over 2.5 h on day 29 ) or no supplemental iron . No serious adverse drug events occurred after intravenous iron administration . The primary end point , peak hemoglobin increase , was higher ( 1.3 + /- 1.1 versus 0.7 + /- 1.1 , mean + /- SD ; P = 0.0028 ) , and anemia intervention ( transfusion , increase in ESA dose , or intravenous iron therapy not called for in protocol ) occurred later ( P = 0.0137 ) and less often in intravenous iron-treated patients compared with untreated control subjects ( one of 66 [ 1.3 % ] versus five of 30 [ 16.7 % ] ) . Among patients who did not require intervention , iron-treated patients showed a calculated net ESA dose decrease compared with untreated control subjects . Baseline iron status did not predict responsiveness to intravenous iron therapy . Intravenous iron sucrose is an effective adjunct to ESA therapy in anemic patients with PD-dependent chronic kidney disease and is administered safely as 300 mg over 1.5 h or 400 mg over 2.5 h. Evidence of iron deficiency at baseline is not required to demonstrate intravenous iron efficacy In Indonesia , deficiencies of vitamin A and iron are of public health concern during pregnancy . We sought to determine the effects of vitamin A and iron supplementation on the vitamin A and iron status of pregnant Indonesian women . The women ( n = 27 ) were r and omly assigned to four groups . The modified relative dose response ( MRDR ) test for vitamin A status and hemoglobin , hematocrit and ferritin values were determined at baseline . Thereafter , daily supplements were administered : placebo [ Pl ] ( n = 7 ) , 8.4 micromol vitamin A [ A ] ( n = 7 ) , 1.07 mmol iron [ Fe ] ( n = 5 ) , and 8.4 micromol vitamin A plus 1.07 mmol iron [ A + Fe ] ( n = 8) . Post-treatment tests were performed after 8 wk . The MRDR value was reduced , i.e. , vitamin A status improved , more markedly by the combination of vitamin A and iron than by either nutrient alone ( P = 0.034 ) . The decrease in the MRDR relative to baseline was significant in the A + Fe group ( P = 0.008 ) . Iron status was also significantly improved in these women ( P < 0.05 ) with both iron and vitamin A supplementation . The mechanism of the enhancing effect of iron on the vitamin A-induced reduction in the MRDR is not known Purpose This study aim ed to determine whether there is a relationship between iron status and bone metabolism , and to compare the effects of the consumption , as part of the usual diet , of an iron or iron and vitamin D-fortified skimmed milk on bone remodelling in iron-deficient women . Methods Young healthy iron-deficient or iron-sufficient women ( serum ferritin ≤30 ng/mL or > 30 ng/mL , respectively ) were recruited . Iron-deficient women were assigned to a nutritional intervention consisting of a r and omised , controlled , double-blind , parallel design trial of 16 weeks during winter . They consumed , as part of their usual diet , an iron ( Fe group , n = 54 ) or iron and vitamin D-fortified ( Fe+D group , n = 55 ) flavoured skimmed milk ( iron , 15 mg/day ; vitamin D3 , 5 μg/day , 200 IU ) . The iron-sufficient women followed their usual diet without supplementation ( R group , n = 56 ) . Dietary intake , body weight , iron biomarkers , 25-hydroxyvitamin D ( 25OHD ) , parathyroid hormone ( PTH ) , procollagen-type 1 N-terminal propeptide ( P1NP ) , and aminoterminal telopeptide of collagen I ( NTx ) were determined . Results Negative correlations were found between baseline log-ferritin and log-NTx ( p < 0.001 ) , and between transferrin and P1NP ( p = 0.002 ) . Serum 25OHD increased ( from 62 ± 21 to 71 ± 21 nmol/L , mean ± SD , p < 0.001 ) while P1NP and NTx decreased in Fe+D during the assay ( p = 0.004 and p < 0.001 , respectively ) . NTx was lower in Fe+D compared to Fe at week 8 ( p < 0.05 ) and was higher in Fe and Fe+D compared to R throughout the assay ( p < 0.01 ) . PTH did not show changes . Conclusions Iron deficiency is related with higher bone resorption in young women . Consumption of a dairy product that supplies 5 μg/day of vitamin D3 reduces bone turnover and increases circulating 25OHD to nearly reach an optimal vitamin D status , defined as 25OHD over 75 OBJECTIVE We evaluated the effect of iron supplementation on biochemical indicators of iron status , namely hemoglobin ( Hb ) , serum ferritin ( SF ) , and serum transferrin receptor ( sTfR ) , during pregnancy . METHODS A prospect i ve study was conducted in 73 pregnant women who received daily supplements of 60 mg of iron and 500 microg of folic acid for 100 d from 19 wk of gestation . The indicators of  iron status ( Hb , SF , and sTfR ) at 19 , 27 , and 35 wk of gestation were analyzed . The response of iron status indicators to iron supplementation was assessed in the cohort and in pregnant women who were anemic ( n = 35 ) and non-anemic ( n = 38 ) at 19 wk . RESULTS All three indicators of iron status during supplementation ( 27 and 35 wk ) were similar to the presupplementation status . The sTfR as an indicator correlated negatively with presupplementation Hb levels ( r = -0.417 ) . Based on sTfR level in iron-adequate pregnant women , a cutoff value of at least 12.0 mg/L was derived to define iron deficiency in pregnancy . When the response was tested in anemic pregnant women , iron supplementation improved mean Hb ( P < 0.05 ) at the end of 35 wk ( 96 + /- 8.8 to 110 + /- 20.2 g/L ) of gestation , with no change in SF . Conversely , non-anemic pregnant women showed a significant increase in SF and a decrease in Hb ( 122 + /- 11.6 to 112 + /- 15.2 g/L ) at 35 wk of gestation . A significant effect of iron intake on sTfR was seen only among iron-deficient anemic women . CONCLUSIONS These observations suggest that , during pregnancy , sTfR responds to iron supplementation when there is iron-deficiency anemia and therefore can be used as an indicator The effect of dietary factors on manganese-dependent superoxide dismutase ( MnSOD ) activity in humans has not been studied . We longitudinally evaluated changes in MnSOD activity and other indices of manganese and iron status in 47 women during a 124-d supplementation study . Subjects received one of four treatments : placebo , 60 mg iron , 15 mg manganese , or both mineral supplements daily . Manganese supplementation result ed in significant increases in lymphocyte MnSOD activity and serum manganese concentrations from baseline values but no changes in urinary manganese excretion or in any indices of iron status . Oral contraceptive use and the stage of the menstrual cycle did not confound the use of lymphocyte MnSOD activity or serum manganese to monitor manganese status , but fat intake affected both indices . This work demonstrated that lymphocyte MnSOD activity can be used with serum manganese concentrations to monitor manganese exposure in humans BACKGROUND Iron deficiency anemia and recurrent infections are common among children of low socioeconomic status . OBJECTIVE The objective was to evaluate the effects of iron supplementation on iron status and morbidity in children with or without infection . DESIGN Children aged 5 - 10 y were recruited for a r and omized , controlled , double-blind study from out patients attending the Children 's Hospital , Colombo , Sri Lanka . Clinical , inflammatory , nutritional , and iron statuses were determined at baseline and after the intervention . Children with a history of recurrent upper respiratory tract infections ( URTIs ) and with laboratory and clinical evidence of a current URTI constituted the infection group ( n = 179 ) , and children without infection constituted the control group ( n = 184 ) . Subjects in both groups were supplemented with ferrous sulfate ( 60 mg Fe ) or placebo once daily for 8 wk . Morbidity from URTIs , the number of gastrointestinal infections , and compliance were recorded every 2 wk . RESULTS The overall prevalence of anemia was 52.6 % . Iron supplementation significantly improved iron status by increasing hemoglobin ( P < 0.001 ) and serum ferritin ( P < 0.001 ) concentrations from baseline values in the children with or without infection . There was no significant improvement in iron status in the children who received placebo . In both the infection group and the control group , the mean number of URTI episodes and the total number of days sick with an URTI during the period of intervention were significantly lower ( P < 0.005 and P < 0.001 , respectively ) in the children who received iron supplements than in those who received placebo . CONCLUSION Iron supplementation significantly improves iron status and reduces morbidity from URTIs in children with or without infection Objectives : Limited information is available on the role of pork meat in influencing iron status . The aim of this study was to determine the effect of consuming pork meat as compared to iron supplementation on nutritional status and feeling of well-being . Methods : Young women were r and omly assigned to a control diet ( CG ) , a pork-containing diet ( PG ) , or a control diet with iron supplementation ( SG ) for 12 weeks . Sixty-five women aged 24.6 ± 4.4 years ( mean ± SD ) completed the trial . Results : Serum ferritin concentrations were increased significantly ( p = 0.001 ) in participants assigned to the SG as compared with the other groups , as assessed by repeated- measures analysis of variance . At week 12 , hemoglobin concentrations were significantly higher in PG and SG as compared with CG . Plasma zinc concentrations at the end of the intervention were similar to baseline concentrations for individuals in the CG and PG but were decreased significantly ( p < 0.05 ) in SG . Plasma- , erythrocyte-folate , and serum vitamin B6 and B12 concentrations were not significantly affected by the intervention , although the concentrations of vitamins B6 and B12 tended to increase in PG . Well-being , as measured using the Health Survey Short Form ( SF-36 ) and its 8 multi-item scales , showed significant improvement in vitality in SG ( p < 0.05 ) and bodily pain in PG ( p < 0.05 ) . No significant relationships were observed between these health concept scores and biomarkers of nutritional status . Conclusions : Consumption of pork meat by young women maintains hemoglobin levels to the same extent as low-dose iron supplementation and enhances the components of well-being , mainly their perception of bodily pain BACKGROUND Deficiencies of iron and vitamin A are prevalent worldwide . Single-micronutrient supplementation is widely used to combat these deficiencies . However , micronutrient deficiencies often occur concurrently , and there are many interactions between micronutrients . OBJECTIVE This study investigated interactions among 3 important micronutrients -- iron , vitamin A , and zinc -- when they are given as supplements . DESIGN In a r and omized , double-blind , placebo-controlled supplementation trial , 387 Indonesian infants aged 4 mo were supplemented 5 d/wk for 6 mo with 10 mg Fe , 10 mg Zn , 2.4 mg beta-carotene , 10 mg each of Fe and Zn , 10 mg Zn + 2.4 mg beta-carotene , or placebo . Complete data on micronutrient status , including hemoglobin , ferritin , retinol , zinc , and the modified relative dose response ( a measure of liver retinol stores ) , were available from 256 infants at the end of the study . RESULTS Iron-supplemented infants had significantly lower plasma retinol concentrations and a significantly higher prevalence of vitamin A deficiency , as defined by a plasma retinol concentration < 0.70 micromol/L , than did the non-supplemented infants . In contrast , the modified relative dose response of the iron-supplemented infants indicated greater liver stores of vitamin A.  Iron supplementation improved iron status , and zinc supplementation improved zinc status , but beta-carotene supplementation did not significantly improve vitamin A status . CONCLUSIONS In this study , iron supplementation in infants with marginal vitamin A status led to lower plasma vitamin A concentrations and simultaneously to greater vitamin A liver stores . This implies a redistribution of retinol after iron supplementation , which might induce vitamin A deficiency . Therefore , iron supplementation in infants should be accompanied by measures to improve vitamin A status Objective : To compare the efficacy of a daily and a weekly iron supplementation on the hematological status of anemic children living at high altitude . Design : Double blind iron supplementation trial including a placebo control group . Setting : A socioeconomically disadvantaged district of La Paz , Bolivia ( altitude of 4000 m ) . Subjects : Anemic ( hemoglobin concentration≤144 g/L ) , 3.3–8.3 y old children of both sexes . Intervention : Children received a placebo ( n=57 ) or a dose of 3–4 mg of elemental iron per kg body weight ( FeSO4 tablets ) 1 d per week ( n=58 ) or 5 d per week ( n=58 ) for 16 weeks . Results : Hemoglobin and zinc erythrocyte protoporphyrin concentrations improved significantly in supplemented groups but not in the placebo group . Changes in hemoglobin during the study were not significantly different between supplemented groups ( weekly group : 15.2±6.9 g/L and daily group : 18.6±11.1 g/L ) but were different from the placebo group ( 0.5±7.1 g/L , P<0.001 ) . At the end of the supplementation period , the hemoglobin distribution was Gaussian , and similar in both supplemented groups . Adjusting for the initial hemoglobin concentration , final hemoglobin and its changes were similar in both supplemented groups . Conclusion : Weekly iron supplementation is as efficacious as daily iron supplementation in improving iron status and correcting moderate iron deficiency anemia in Bolivian school children living at high altitude . Sponsorship : Program supported in part by ORSTROM , the French Ministry of Foreign Affairs and the National Secretary 's Office of Health , Bolivia Iron and zinc may interact in micronutrient supplements and thereby decrease efficacy . We investigated interactive effects of combined zinc and iron supplementation in a r and omized controlled trial conducted in 459 Guatemalan women . Four groups were supplemented for 12 weeks : ( 1 ) weekly iron and folic acid ( IFA ) ; ( 2 ) weekly IFA and 30 mg zinc ; ( 3 ) daily IFA ; ( 4 ) daily IFA and 15 mg zinc . Effects were assessed by generalized linear regression . Baseline hemoglobin ( Hb ) concentration was 137.4 ± 15.5 g/L , 13 % were anemic and 54 % had zinc deficiency . Hb cconcentrations were similar by supplement type , but Hb concentrations improved significantly in anemic women at baseline ( increase of 21.8 g/L ) . Mean percentage changes in serum ferritin were significantly higher in daily compared to weekly supplemented groups ( 86 % versus 32 % ) . The addition of zinc to IFA supplements had no significant impact on iron or zinc status . In conclusion , adding zinc to IFA supplements did not modify efficacy on iron status or improve zinc status , but daily supplementation was more efficacious than weekly in improving iron stores BACKGROUND AND AIMS We undertook this study to evaluate the effect of Helicobacter pylori eradication and iron supplementation on the iron nutritional status in children with iron deficiency . METHODS Seven hundred and one children from four public schools in Mexico City were screened to evaluate their iron status . Of them , 72 children with iron deficiency or with anemia were included in this study and were tested for H. pylori infection . Those infected were given eradication treatment and were r and omly assigned to daily supplementation for 3 months with ferrous sulfate or placebo . Noninfected children received ferrous sulfate . At the end of the interventions , blood sample s were drawn to evaluate their effects on the nutritional status of iron . RESULTS Thirty eight children with iron deficiency or anemia were infected by H. pylori at baseline . The eradication rate was 86.8 % . Children in whom H. pylori eradication was achieved showed an increase of 0.37g/dL ( 95 % CI -0.02 , 0.75 ) on the hemoglobin mean concentration compared to the noninfected children . Children who achieved H. pylori eradication and received ferrous sulfate supplementation showed an increase of 0.47g/dL ( 95 % CI 0.01 - 0.93 ) on the hemoglobin mean concentration compared to the noninfected children who received iron supplementation . Noninfected children supplemented with ferrous sulfate showed an increase in ferritin concentration of 11.26 ng/mL ( 95 % CI 1.86 - 20.65 ) compared to those who were given the placebo . CONCLUSIONS Our results suggest that the eradication of H. pylori plus iron supplementation increases the pool of functional iron .  Iron supplementation increases the storage of iron in school-age children with iron deficiency BACKGROUND Evidence suggests that brain iron deficiency at any time in life may disrupt metabolic processes and subsequently change cognitive and behavioral functioning . Women of reproductive age are among those most vulnerable to iron deficiency and may be at high risk for cognitive alterations due to iron deficiency . OBJECTIVE We aim ed to examine the relation between iron status and cognitive abilities in young women . DESIGN A blinded , placebo-controlled , stratified intervention study was conducted in women aged 18 - 35 y of varied iron status who were r and omly assigned to receive iron supplements or a placebo .  Cognition was assessed by using 8  cognitive performance tasks  ( from Detterman 's Cognitive Abilities Test ) at baseline ( n = 149 ) and after 16 wk of treatment ( n = 113 ) . RESULTS At baseline , the iron-sufficient women ( n = 42 ) performed better on cognitive tasks ( P = 0.011 ) and completed them faster ( P = 0.038 ) than did the women with iron deficiency anemia ( n = 34 ) . Factors representing performance accuracy and the time needed to complete the tasks by the iron-deficient but nonanemic women ( n = 73 ) were intermediate between the 2 extremes of iron status . After treatment , a significant improvement in serum ferritin was associated with a 5 - 7-fold improvement in cognitive performance , whereas a significant improvement in hemoglobin was related to improved speed in completing the cognitive tasks . CONCLUSIONS Iron status is a significant factor in cognitive performance in women of reproductive age . Severity of anemia primarily affects processing speed , and severity of iron deficiency affects accuracy of cognitive function over a broad range of tasks . Thus , the effects of iron deficiency on cognition are not limited to the developing brain We report an apparently protective effect of vitamin A in infants who received iron supplements ( 15 mg/d ) for 3 mo . Those receiving iron showed increases in hemoglobin ( 8 g/L ) , ferritin ( 3.7 micrograms/L ) , and the acute-phase protein alpha 1-antichymotrypsin ( ACT ; 0.06 g/L ) . In both the placebo and iron-supplemented groups there were increases in plasma retinol , lutein , alpha-tocopherol , immunoglobulin A , and immunoglobulin G. The improvement in vitamin A status could only have been from a seasonal increase in dietary sources of vitamin A , eg , breast milk and early weaning foods , and there were no obvious effects on iron utilization ( hemoglobin concentrations ) . However , in the infants receiving iron , those whose retinol concentrations increased also showed reductions in ACT , ferritin , immunoglobulin A , and immunoglobulin M.  Vitamin A is well known for its antiinfective properties and we suggest that these observations illustrate the importance of even small increases in dietary vitamin A or differences in vitamin A status in reducing the potentially toxic effects of iron supplements  in persons in developing countries . These conclusions should now be confirmed with an intervention study to show that the benefits of vitamin A on iron status are due to reduced levels of infection Objectives : Low-birth-weight ( LBW ) infants ( < 2500 g ) have an increased risk of iron deficiency ( ID ) during their first 6 months of life . The optimal dose and duration of iron supplementation to LBW infants are , however , unknown . The objective of the present study was to investigate the long-term effect on iron status and growth in marginally LBW ( 2000–2500 g ) infants , of iron supplements given until 6 months of life . Methods : In a r and omized controlled trial , 285 healthy marginally LBW infants received  0 , 1 , or 2 mg · kg−1 · day−1 of iron supplements from 6 weeks to 6 months of age . At 12 months and 3.5 years of life we measured length , weight , head circumference , and indicators of iron status ( hemoglobin , ferritin , mean corpuscular volume , and transferrin saturation ) and assessed the prevalence of iron depletion , functional ID , and ID anemia . Results : At 12 months of age , there was a significant difference in ferritin between the groups ( P = 0.006 ) . Furthermore , there was a significant difference in the prevalence of iron depletion ( 23.7 % , 10.6 % , and 6.8 % , respectively , in the placebo , 1-mg , and 2-mg groups , P = 0.009 ) and similar nonsignificant trends for functional ID and ID anemia . At 3.5 years of life there were no significant differences in iron status and the mean prevalence of iron depletion was 3.2 % . Anthropometric data were not affected by the intervention . Conclusions : Iron supplements with 2 mg · kg−1 · day−1 until 6 months of life effectively reduces the risk of ID during the first 12 months of life and is an effective intervention for preventing early ID in marginally LBW infants OBJECTIVE Low iron status is a well known risk factor for iron deficiency anemia in infants and young children . The aim of the present study was to evaluate the influence of an iron-fortified toddler formula on iron status in 1 - 3 year-olds . PATIENTS AND METHODS Thirty-three healthy infants and young children were assigned to two groups that received 500 mL/day of and iron-fortified toddler formula or 500 mL/day of unmodified cow 's milk for 4 months . Allocation was r and om and double-blind . Daily dietary intake was calculated by dietary evaluation , and iron nutritional status was assessed ( hemoglobin , hematocrit , mean corpuscular volume , mean corpuscular hemoglobin , mean corpuscular hemoglobin concentration , serum iron , ferritin , and transferrin ) . RESULTS At enrollment , no anemia was found in either group , although hemoglobin concentration and hematocrit were significantly lower in the toddler formula group than in the unmodified cow 's milk group . However , these differences disappeared at the end of the intervention period . After 4 months , the toddler formula group showed significantly higher serum ferritin and lower serum transferrin concentrations than the cow 's milk group . CONCLUSION Intake of iron-supplemented toddler formula for 4 months in 1 - 3 year-olds is more effective in maintaining iron nutritional status than cow 's milk BACKGROUND Gene mutations associated with iron overload have been identified . How food and nutrient intakes affect iron status in persons who may be at risk of iron overload because their genetic status is unknown . OBJECTIVE The objective was to determine the relation between food and nutrient intakes , HFE genotype , and iron status . Foods and nutrients associated with iron stores , with adjustment for gene mutations associated with hemochromatosis , were explored . DESIGN A prospect i ve cohort of women aged 35 - 69 y ( the UK Women 's Cohort Study ) provided information on diet through a question naire and food diary ;  6779 women in the cohort provided cheek cell sample s , blood sample s , or both , which were genotyped for C282Y and H63D mutations , and 2489 women also had their iron status assessed . Relations between serum ferritin and iron intake were investigated by using multiple linear regression , with adjustment for potential confounders . RESULTS The strongest dietary association with serum ferritin concentration was a positive association with heme iron and not with nonheme or total iron . Weaker positive associations were seen with red and white meat , and negative associations were seen with total energy and white and brown whole-meal bread , independent of genotype and other potential confounders . The effect of genotype on ferritin concentrations primarily occurred after menopause , at which time a strong interaction between genotype and heme iron intake was observed . Other factors associated with serum ferritin concentrations were age , body mass index , blood donation , menopausal status , and HFE genotype . CONCLUSIONS Postmenopausal women eating a diet rich in heme iron and who were C282Y homozygotes had the highest serum ferritin concentrations BACKGROUND Preoperative treatment with rHuEPO ( epoetin alfa : EPREX , Janssen-Cilag ; or PROCRIT , Ortho Biotech ) in conjunction with iron supplementation increases the erythropoietic response in elective orthopedic surgery patients , but it is not known whether the magnitude of this response is dependent on the route of iron administration . STUDY DESIGN AND METHODS Non-iron-deficient patients undergoing elective orthopedic surgery ( N = 110 ) with baseline Hb > or = 10 to < or = 13 g per dL were r and omly assigned to receive either epoetin alfa ( 600 IU/kg ) plus IV iron ( n = 29 ) or oral iron ( n = 29 ) or placebo plus IV iron ( n = 25 ) or oral iron ( n = 27 ) in this 14-day study . RBC production , Hb , Hct , reticulocytes , iron status , and adverse events were monitored throughout the study . RESULTS Epoetin alfa treatment plus either oral or IV iron supplementation significantly increased total RBC production , Hb , Hct , and reticulocytes over the values seen with the respective placebo treatments ( p = 0.0001 ) . There were no differences between the epoetin alfa treatment groups . Placebo treatment plus oral or IV iron supplementation was not associated with increases in hematologic values . There were no differences in the incidence of adverse events among the treatment groups . CONCLUSION There was a comparable erythropoietic response to epoetin alfa , irrespective of the route of iron administration . The route of iron administration , therefore , does not modulate the erythropoietic response to epoetin alfa in patients who are not iron deficient . Safety and convenience benefits may be gained by adopting oral iron supplementation in this patient subset OBJECTIVE To compare the effectiveness of microencapsulated iron(II ) fumarate sprinkles ( with and without vitamin A ) , iron(II ) sulfate drops , and placebo sprinkles in preventing recurrence of anaemia and to determine the long-term haematological outcomes in children at high risk of recurrence of anaemia 12 months after the end of supplementation . METHODS A prospect i ve , r and omized , placebo-controlled design was used to study 437 Ghanaian children aged 8 - 20 months who were not anaemic ( haemoglobin > or = 100 g/l ) . Four groups were given microencapsulated iron(II ) fumarate sprinkles , microencapsulated iron(II ) fumarate sprinkles with vitamin A , iron(II ) sulfate drops or placebo sprinkles daily for six months . Primary outcome measures were change in haemoglobin and anaemic status at baseline and study end . Non-anaemic children at the end of the supplementation period were reassessed 12 months after supplementation ended . FINDINGS Overall , 324 children completed the supplementation period . Among the four groups , no significant changes were seen in mean haemoglobin , ferritin or serum retinol values from baseline to the end of the supplementation period . During the trial , 82.4 % ( 267/324 ) of children maintained their non-anaemic status . Sprinkles were well accepted without complications . At 12 months post-supplementation , 77.1 % ( 162/210 ) of children with no intervention remained non-anaemic . This proportion was similar for children among the four groups . CONCLUSION In most children previously treated for anaemia , further supplementation was not needed to maintain their non-anaemic status . These results may have important implication s for community intervention programmes in which initial high-dose treatment is needed because of a high prevalence of anaemia BACKGROUND Iron deficiency without anemia has been shown to reduce both muscle-tissue oxidative capacity and endurance in animals . However , the consequences of iron deficiency in humans remain unclear . OBJECTIVE We investigated the effects of iron supplementation on adaptation to aerobic training among marginally iron-depleted women . We hypothesized that iron supplementation for 6 wk would significantly improve iron status and maximal oxygen uptake ( VO(2)max ) after 4 wk of concurrent aerobic training . DESIGN Forty-one untrained , iron-depleted , nonanemic women were r and omly assigned to receive either 50 mg FeSO(4 ) or a placebo twice daily for 6 wk in a double-blind trial . All subjects trained on cycle ergometers 5 d/wk for 4 wk , beginning on week 3 of the study . RESULTS Six weeks of iron supplementation significantly improved serum ferritin and serum transferrin receptor ( sTfR ) concentrations and transferrin saturation without affecting hemoglobin concentrations or hematocrit . Average VO(2)max and maximal respiratory exchange ratio improved in both the placebo and iron groups after training ; however , the iron group experienced significantly greater improvements in VO(2)max . Both iron-status and fitness outcomes were analyzed after stratifying by baseline sTfR concentration ( > and < or = 8.0 mg/L ) , which showed that the previously observed treatment effects were due to iron-status and fitness improvements among subjects with poor baseline iron status . CONCLUSIONS Our findings strongly suggest that iron deficiency without anemia but with elevated sTfR status impairs aerobic adaptation among previously untrained women and that this can be corrected with iron supplementation
Quantitative relations between baseline iron status , study duration , and iron dose on changes in iron-status biomarkers , which were generated from the meta-analyses , can be used to predict effects of trials of iron supplementation and fortification and to design iron-intervention programs
BACKGROUND The response of status biomarkers to an increase in iron supply depends on several physiologic and environmental factors , which make it difficult to predict the outcome of an intervention .
OBJECTIVE We assessed effects of baseline iron status , sex , menopausal status , duration of intervention , iron form , and daily dose on the change in iron status in response to iron supplementation .