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Background: Supplementation of iron (Fe) tablets are essential to prevent pregnant women from iron deficiency anemia. Several other factors, such as knowledge, attitude, side effects, and personal access to information about iron tablet supplements, reduce the compliance of pregnant women to consume iron tablets. This study uses a combination of interventions, Short Message Service (SMS) reminders, and counseling. Purpose: This research aims to discover the effects of SMS reminders and counseling as well as factors that influence pregnant women's compliance in consuming Fe tablets. Methods: 170 pregnant women in Balowerti Public Health Center were divided into control and intervention groups. Each group received pre and post-test. The intervention group was given the treatment of SMS reminders and counseling for seven days before the post-test. The data analysis was using McNemar's paired test. Results: McNemar test results obtained the effects of the SMS Reminder and counseling on knowledge (p = 0.01), attitude (p = 0.00), and adherence (p = 0.00) of pregnant women in the intervention group as compared to the control group at the time of the post-test. The logistic regression analysis found that the factors that influence the compliance of pregnant women to consume Fe tablets (p <0.05) during the post-test comprise attitude and number of Ante Natal care (ANC). Conclusion: SMS reminders and counseling interventions improve pregnant women's adherence, knowledge, and behavior to consuming iron tablets. This result is important as a strategy to reach women's empowerment in reproductive health. [ABSTRACT FROM AUTHOR]

Objective: To review the pharmacology, efficacy, and safety of ferric maltol (FM), an oral iron formulation, for iron deficiency anemia (IDA). Data Sources: A MEDLINE/PubMed and EMBASE (January 1, 1985, to June 19, 2020) literature search was performed using the terms ferric maltol, accrufer, feraccru, iron maltol, ferric trimaltol, iron deficiency, iron deficiency anemia, inflammatory bowel disease, and chronic kidney disease. Additional data sources included prescribing information, abstracts, and the National Institutes of Health Clinical Trials Registry. Study Selection/Data Extraction: English language literature evaluating FM pharmacology, pharmacokinetics, efficacy, or safety in the treatment of IDA were reviewed. Data Synthesis: FM is a ferric, non–salt-based oral iron formulation demonstrating improved tolerance in patients with previous intolerance to other iron formulations. Phase 3 trials demonstrated significant improvements in anemia and serum iron parameters in patients with inflammatory bowel disease (IBD) and chronic kidney disease (CKD). Common adverse effects were gastrointestinal intolerance. Relevance to Patient Care and Clinical Practice: FM is an effective and well-tolerated alternative to oral iron salts for patients with IBD or CKD and IDA. Emerging data suggest that FM is noninferior to intravenous (IV) ferric carboxymaltose in patients with IBD and IDA. Prior to selecting FM over IV iron products, consideration should be given to time to normalization of Hb, ease of administration, cost, and tolerability. Conclusion: FM is a relatively safe, effective oral iron therapy that may be better tolerated than other oral iron formulations. FM may be an effective alternative to IV iron in patients with IBD. [ABSTRACT FROM AUTHOR]

Background: While iron deficiency (ID) is a frequent cause of anemia in hemodialysis patients, the clinical impact of ID without anemic level of hemoglobin remains unclear. As such, this study was designed to clarify the manifestations of ID itself in subjects on hemodialysis. Methods: Maintenance hemodialysis patients achieving target hemoglobin levels (≥ 10.0g/dL) under treatment in our clinic were stratified for comparison from three perspectives: ID (transferrin saturation [TSAT] < 20% or ferritin < 100ng/mL) vs non-ID, level of TSAT (< or ≥ 20%), and level of serum ferritin concentration (< or ≥ 100ng/mL). The severity of frequent symptoms was determined by a self-rating symptom score questionnaire, and the rate of those with severe manifestations was calculated for each symptom. Significant difference was examined between groups; univariate and adjusted multivariate odds ratios and 95% confidence intervals were obtained by logistic regression. Results: Among 154 subjects selected for analysis, the ratio of severe arthralgia and fatigue was significantly higher in the ID group (n = 94) compared to the non-ID group (n = 60), in both univariate and adjusted multivariate analyses. Moreover, in multivariate analysis, low TSAT was significantly associated with exacerbation of pain during vascular access puncture and intradialytic leg cramps, while low serum ferritin concentration was related to significant increase in severe arthralgia, fatigue, intradialytic headache and leg cramps. Conclusions: ID was identified as a risk factor regarding severity of several symptoms even without low hemoglobin level among chronic hemodialysis patients, and supplementation of iron was considered efficacious for improving critical symptoms affecting those undergoing maintenance dialysis. [ABSTRACT FROM AUTHOR]

Ferritin provides a good estimate of body iron stores, but loses its significance during systemic inflammation, a defining feature of insulin resistance (IR). On the other hand, serum transferrin receptor protein (sTfR) represents true iron load of body. This study attempts to identify the utility of sTfR/ferritin index in gestational diabetes mellitus (GDM). Eighty-eight pregnant females were recruited and divided into group A (norm-glycemic pregnant) and group B (GDM) according to the IADPSG criteria. Insulin, hemoglobin, serum iron, ferritin, sTfR, and CRP levels were determined. However, HbA1c and sTfR/ferritin ratio were calculated by formulas. Mann Whitney U and Spearman's rank correlation were used, where p < 0.05 was considered significant. Results showed no difference between the groups in terms of age, weight, and BMI. IR was significantly high in GDM as compared to non-GDM subjects (p < 0.001), however, the insulin levels were found to be low in GDM group. Hemoglobin was comparatively lower in GDM females (p = 0.212). Serum levels of sTfR, ferritin, and hs-CRP were found to be higher in GDM as compared to non-GDM (p = 0.774, p = 0.201, and p = 0.267, respectively). The sTfR/ferritin ratio was lower in the GDM as compared to the healthy controls (p = 0.326). Furthermore, the correlation between sTfR/ferritin ratio and insulin resistance was slightly negative (r = -0.301, p = 0.347). These results suggest that sTfR may be used for the estimation of accurate iron status in the body during gestational diabetes. However, longitudinal studies are required to propose the utility and a cutoff value for this biomarker. [ABSTRACT FROM AUTHOR]

Systemic iron levels must be maintained in physiological concentrations to prevent diseases associated with iron deficiency or iron overload. A key role in this process plays ferroportin, the only known mammalian transmembrane iron exporter, which releases iron from duodenal enterocytes, hepatocytes, or iron-recycling macrophages into the blood stream. Ferroportin expression is tighly controlled by transcriptional and post-transcriptional mechanisms in response to hypoxia, iron deficiency, heme iron and inflammatory cues by cell-autonomous and systemic mechanisms. At the systemic level, the iron-regulatory hormone hepcidin is released from the liver in response to these cues, binds to ferroportin and triggers its degradation. The relative importance of individual ferroportin control mechanisms and their interplay at the systemic level is incompletely understood. Here, we built a mathematical model of systemic iron regulation. It incorporates the dynamics of organ iron pools as well as regulation by the hepcidin/ferroportin system. We calibrated and validated the model with time-resolved measurements of iron responses in mice challenged with dietary iron overload and/or inflammation. The model demonstrates that inflammation mainly reduces the amount of iron in the blood stream by reducing intracellular ferroportin transcription, and not by hepcidin-dependent ferroportin protein destabilization. In contrast, ferroportin regulation by hepcidin is the predominant mechanism of iron homeostasis in response to changing iron diets for a big range of dietary iron contents. The model further reveals that additional homeostasis mechanisms must be taken into account at very high dietary iron levels, including the saturation of intestinal uptake of nutritional iron and the uptake of circulating, non-transferrin-bound iron, into liver. Taken together, our model quantitatively describes systemic iron metabolism and generated experimentally testable predictions for additional ferroportin-independent homeostasis mechanisms. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented regarding the donation interval for blood donors to recover from changes in iron metabolism and prevent from developing iron deficiency (ID).

Fortification of food products with iron is a common strategy to prevent or overcome iron deficiency. However, any form of iron is a pro-oxidant and its addition will cause off-flavours and reduce a product’s shelf life. A highly bioavailable heme iron ingredient was selected to fortify a chocolate cream used to fill sandwich-type cookies. Two different strategies were assessed for avoiding the heme iron catalytic effect on lipid oxidation: ascorbyl palmitate addition and co-spray-drying of heme iron with calcium caseinate. Oxidation development and sensory acceptability were monitored in the cookies over one-year of storage at room temperature in the dark. The addition of ascorbyl palmitate provided protection against oxidation and loss of tocopherols and tocotrienols during the preparation of cookies. In general, ascorbyl palmitate, either alone or in combination with the co-spray-dried heme iron, prevented primary oxidation and hexanal formation during storage. The combination of both strategies resulted in cookies that were acceptable from a sensory point of view after 1 year of storage. [ABSTRACT FROM AUTHOR]

Abstract: To date, the application of synthetic Fe chelates has been the most effective solution to correct Fe chlorosis. Commercial products based on the EDDHA/Fe3+ (ferric ethylenediamine-N,N′-bis(hydroxyphenylacetate)) are the most effective and commonly used; however, their synthesis produces products with a low purity (∼6% chelated Fe). The aims of this work were to study the effectiveness of 2 Fe chelates of higher purity, HJB (N,N′-bis(2-hydroxy-5-methylbenzyl)ethylenediamine-N,N′-diacetic acid) and HBED (N,N′-bis(2-hydroxybenzyl)ethylenediamine-N,N′-diacetic acid), to prevent and correct the Fe deficiency in nectarine and flat peach trees, respectively, grown in alkaline field conditions and to compare their effectiveness with the traditional EDDHA. Tree status was evaluated during 2 growing seasons, and nutritional parameters related to the Fe concentration in leaves and flowers, the SPAD index and micronutrient ratios were evaluated. Moreover, the yield and the size of fruit were evaluated in the experiment with nectarine trees. Parameters such as the SPAD index, the Fe concentration and the Fe/Mn ratio in leaves showed that EDDHA/Fe3+, HJB/Fe3+ and HBED/Fe3+, especially at low doses, presented a similar ability to prevent chlorosis symptoms in nectarine trees. Chlorotic flat peach trees treated with commercial EDDHA/Fe3+ showed a faster regreening (SPAD index) during the first year of chelate application; however, no significant differences among treated trees could be observed at the end of the second growing season. The results of measuring Fe concentration in leaves were not as conclusive; however, flower analysis after the treatment application showed a good recovery in treated trees. These studies show the efficacy of chelates with a purer composition than the traditional EDDHA/Fe3+ to correct and prevent Fe deficiency. [Copyright &y& Elsevier]

Iron is universally abundant and no life can exist without it. However, iron levels should be maintained within a narrow range. Iron deficiency causes anaemia, whereas excessive iron increases cancer risk, presumably by free radical generation. Several pathological conditions such as genetic haemochromatosis, chronic viral hepatitis B and C, conditions related to asbestos fibre exposure and ovarian endometriosis have been recognized as iron overload-associated conditions that also increase human cancer risks. Iron's carcinogenicity has been documented in animal experiments. Surprisingly, these studies have revealed that the homozygous deletion of CDKN2A/2B is a major hallmark of iron-induced carcinogenesis. Recently, the hormonal regulation of iron metabolism has been elucidated. A commonly hypothesized mechanism may be the lack of any iron disposal pathway other than for bleeding and a mechanism of iron re-uptake as catechol chelate has been discovered. Iron overload in neurons via the ferroportin block may play a role in Alzheimer's disease. Furthermore, a recent epidemiological study reported that iron reduction by phlebotomy was associated with decreased cancer risks in a general population. Given that the required amounts of iron decrease during ageing, the fine control of body iron stores would be a wise strategy for chemoprevention of several diseases. [ABSTRACT FROM AUTHOR]

The article offers information on various multivitamin drug supplements for pregnancy. It mentions Neevo DHA from PamLab LLC which contains vitamins including pyridoxine, folic acid, and calcium as tricalcium phosphate. The Prenexa from Upsher-Smith Laboratories Inc. contains iron as ferrous fumarate and calcium as phosphate, and should be taken by adults one capsule per day. Moreover, Fero-Folic-500 tablet from Abbott Laboratories Inc. is prescribed for iron deficiency during pregnancy.

The earliest studies of food iron absorption employing biosynthetically incorporated radioisotopes were published in the 1950s. Wheat flour has been fortified with iron in Canada, the United Kingdom, and the United States since the 1940s. However, half a century later, nutritional iron deficiency (ID) is estimated to affect 1 .5-2 billion people worldwide. The reasons for the apparently limited impact of health and nutrition policies aimed at reducing the prevalence of ID in developing countries are complex. They include uncertainty about the actual prevalence of ID, particularly in regions where malaria and other infections are endemic, failure of policy makers to recognize the relationships between ID and both impaired productivity and increased morbidity, concerns about safety and the risks to iron-sufficient individuals if mass fortification is introduced, and technical obstacles that make it difficult to add bioavailable iron to the diets of those at greatest risk. It is, however, likely that the next decade will see a marked reduction in the prevalence of ID worldwide. More specific assessment tools are being standardized and applied to population surveys. The importance of preventing ID during critical periods of the life cycle is receiving increased attention. Innovative approaches to the delivery of bioavailable iron have been shown to be efficacious. The importance of integrating strategies to improve iron nutrition with other health measures, and economic and social policies addressing poverty as well as trade and agriculture, are receiving increasing consideration. [ABSTRACT FROM AUTHOR]

To investigate whether an intervention including micronutrient-fortified complementary foods can improve iron status, we conducted a randomized controlled trial in 5-mo-old Vietnamese infants In = 2461. Villages In = 291 were randomly divided into those receiving instant flour (FF1 or a food complement IFC) both fortified with micronutrients or nothing control IC)). FF and FC infants received daily for 6 ma at least 2 meals of fortified complementary foods. Micronutrient status was assessed by measurement of hemoglobin (Hb) and plasma ferritin )PF), transferrin receptor, zinc, and retinal. Final Hb Imean ± SD) was higher in the FF1(12.5 ± 8.0 g/L) and FC (114.0 ± 7.0 g/L) groups compared with 01109.0 ± 8.0 g/L; P= 0.0061. PF Igeometric mean ]95% Cl)) was also higher in FF 119.8 μg/L 117.5-22.3]) and FC 120.8 μg/L 18.3-23.6)) compared with C (11.1 μg/L 19.8-12.51; P < 0.0001). Anemia prevalence decreased more in the FC group 1-43.6%) compared with C 1-10.3%; P= 0.006). The change in prevalence of PF < 12 μg/L was different in the FF1-16.4%l and FC 1-6.7%) groups compared with 01+30.4%; P< 0.01). Endpoint prevalence of iron deficiency (ID) and ID anemia (IDA) were lower in the FF113.4 and 6.7%, respectively) and FC 115.2 and 3.8%) groups compared with C 157.5 and 37.5%) IP< 0.0001). Retinal and zinc concentrations did not differ among groups, but endpoint prevalence of zinc deficiency was lower in FF infants 136.1%) than in C infants (52.9%; P = 0.04). Micronutrient-fortified complementary foods significantly improved iron status and decreased the prevalence of anemia, ID, and IDA in Vietnamese infants and can be an important tool to reduce ID in infancy in developing countries. [ABSTRACT FROM AUTHOR]

Summary [ABSTRACT FROM AUTHOR]

Archaea, which regroup organisms with extreme living conditions, possess many predicted iron-containing proteins that may be metabolically critical; however, their need for iron remains poorly documented. In this report, iron acquisition mechanisms were investigated in the hyperthermophilic archaeon Thermococcus kodakaraensis. Thermococcus kodakaraensis requires iron for its growth and possesses many putative iron uptake systems, including several ATP-binding cassette-like transporters and two FeoAB-like receptors, showing that this organism shares similar features with bacteria. One homolog of the major bacterial iron regulator, ferric uptake regulator (Fur), with about 50% similarity to Escherichia coli Fur was also identified. Thermococcus kodakaraensis Fur was found to be able to specifically bind to a Fur-binding site consensus-like sequence of its own gene promoter. However, its expression has been hindered by a −1 frameshift mutation and the chromosomal repair of this mutation did not affect T. kodakaraensis in vivo phenotypes. Microarrays analyses helped to further characterize T. kodakaraensis iron-dependent growth and revealed no role for the Fur homolog in the global regulatory response of the cells to iron. In contrast, additional evidences indicated that the T. kodakaraensis diphtheria toxin regulator (DtxR) homolog may control the expression of the major iron acquisition effectors, while its inactivation enabled higher resistance to iron deficiency. [ABSTRACT FROM AUTHOR]

Background: Peptides derived from cow’s milk proteins have in vitro protective effects on iron-induced peroxidation that could be used to prevent the side effects of iron fortification. The aim of the study was to confirm these properties in an in vivo model of gut peroxidation. Methods: Iron bound to the 1–25 phosphopeptide of β-casein [Fe-β-CPP(1–25)] was compared to an encapsulated ferric pyrophosphate (Fe-P) in the Caco-2 model. Ferrous sulfate (FeSO4) was used as control (100 μmol/l iron, n = 6 per group). The concentration of malondialdehyde (MDA), a stable byproduct of lipid peroxidation, was used as the marker of peroxidation. Results: The lowest MDA levels were observed in cells grown with Fe-β-CPP(1–25) and the highest with Fe-P. Iron absorption of Fe-β-CPP(1–25) was higher than in the 2 other forms, due to its high cellular uptake and high basolateral transfer, while iron absorption of Fe-P showed high uptake and high cell retention. Conclusions: The enhancing effect of β-CPP(1–25) on iron absorption was associated with a protective effect against enterocyte peroxidation, perhaps due to its low storage by enterocytes. These observations support a role for specific milk components in food fortification to prevent iron deficiency. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Food iron fortification can be a good strategy to prevent iron deficiency. Iron bioavailability from cocoa powder enriched with ferric pyrophosphate encapsulated in liposomes or ferrous fumarate was assessed in rats. Methods: Three groups of rats consumed during 28 days either a control diet or two diets prepared with ferric pyrophosphate- or ferrous fumarate-enriched cocoa powder as the unique source of iron. Body weight and food intake were monitored and last-week feces were collected. On day 28, animals were sacrificed and livers and spleens were removed. Hemoglobin and total iron binding capacity (TIBC) were determined. Results: There were no significant differences in body weight and food intake. Apparent iron absorption and % absorption/intake were significantly lower in rats consuming enriched cocoa compared to the control group, without significant differences due to the iron form. Enriched cocoa groups showed significantly lower spleen iron content and concentration than the control. Liver iron was lower in the ferric pyrophosphate group compared to the other two groups. Hemoglobin and TIBC values showed a deficient iron status in ferric pyrophosphate rats. Conclusion: Cocoa powder is a good vehicle for iron fortification when enriched with ferrous fumarate compared to ferric pyrophosphate encapsulated in liposomes. Copyright © 2007 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The potential impact of wheat flour fortification with iron and folic acid was assessed using data about food purchases from the nationally representative 2000 Guatemalan Living Standards Measurement Survey. Of 7265 households, 35% were indigenous and 57% rural; 11% were extremely poor, 35% were poor, and 54% were nonpoor. The percentage of households that purchased wheat flour, sweet bread, French rolls, and sliced bread in the previous 15 d was 10, 88, 59, and 11%, respectively. The median amount of fortified wheat flour equivalents in purchased foods was 50 g/d per adult equivalent; fortified wheat flour equivalents were 7, 25, and 110 g/d for the poverty groups, 16 g/d in indigenous households and 24 g/d in rural households. Wheat flour fortification contributed 2.3 mg/d of iron and 90 microg/d of folic acid per adult equivalent. Assuming 5% bioavailability, wheat flour fortification provided 2% of the recommended dietary allowance (RDA) and 6% of estimated average requirement (EAR) iron levels for women of reproductive age; values were 1, 3, and 12% of EAR levels for the poverty groups, respectively. Wheat flour fortification met 26% of folic acid RDA and 33% of EAR levels for women; values were 5, 16, and 71% of EAR levels for the poverty groups, respectively. In conclusion, the impact of fortification is likely to be substantial for folate status in nonpoor and urban women but limited in the case of iron status among all social groups. The poorest, rural, indigenous populations who suffer the highest burden of nutritional deficiencies likely benefit least from wheat flour fortification. [ABSTRACT FROM AUTHOR]

The most sustainable way to eradicate iron deficiency is through food fortification. Elemental iron powders are commonly utilized as fortificants due to their low cost and few sensory problems. However, their bioavailability is unknown. Our goals were to measure the bioavailability of elemental iron in Mexican style corn masa flour tortillas and to evaluate the effects of Na(2)EDTA. We used a stable isotope of H(2)-reduced iron powder, with and without Na(2)EDTA in tortillas prepared with corn masa flour. Two groups of 5- to 7-y-old children (n = 12/group) were fed tortillas to which was added 3 mg/100 g of H(2)-reduced (58)Fe with a mean particle size of 15 micro m. In one group, Na(2)EDTA was incorporated at a ratio of 1:2 mol/mol. The next day, (57)Fe ascorbate was given as a reference dose. After 14 d, blood samples were analyzed for isotopic enrichment. When normalized to 40% absorption of the reference dose, the geometric mean (+/-range 1 SD) bioavailability of reduced iron in tortilla was 3.8% (2.7-5.3). The addition of Na(2)EDTA, tended to increase it (P = 0.18) to 5.1% (2.8-9.2). This observed low absorption was compounded by the use of iron isotopes with smaller particle size (mean diameter 15 micro m) than typical of commercial elemental iron powder (<45 micro m). We conclude that H(2)-reduced iron powder is an ineffective fortificant in corn tortillas. [ABSTRACT FROM AUTHOR]

The article provides information on iron supplementation. It states that iron supplementation is important in both the prevention and treatment of iron deficiency. It says that the iron preparation choice is based on the illness' severity. It suggests that significant input with regards to the selection of the right supplement and the effective use of the products can be provided in the pharmacy.

Investigates the feasibility and acceptability of screening children for iron deficiency in Bristol, Great Britain. Assessment of the effectiveness of the dietary education; Abnormalities associated with iron deficiency; Reduction in the prevalence of anemia.

Reports on the Centers for Disease Control and Prevention's release of Recommendations to Prevent and Control Iron Deficiency in the April 3, 1998 edition of the `Morbidity and Mortality Weekly Report.' Questions regarding universal iron supplementation.

Opinion. Comments on the challenge of controlling iron deficiency in Guatemala. Factors contributing to the worldwide prevalence of iron deficiency; System of distributing iron supplements to individuals; Potential approaches in improving the iron content of the diet; Fortification of sugar.