Corrigenda tipped to title page. Bibliography: leaves 313-353. This study investigated the iron status and dietary intakes in 6-24 month old children in Australia and Ghana and assessed the effects of dietary calcium on intestinal iron absorption. The true prevalence of non-anaemic iron deficiency (NAID) and iron deficiency anaemia (IDA) and dietary intakes in infants and toddlers from a broad socio-economic background were assessed by haematological and biochemical parameters, semi-quantitative diet recall and anthropometric measurements. The high prevalence of iron deficiency and anaemia found in Australian and Ghanaian children can be attributed to the low intake of bioavailable iron in weaning diets which are often ingested with large amounts of calcium. While calcium has been shown to inhibit the absorption of iron, its mechanism of interaction with iron absorption at the intestinal level is not known. The rat was used as an experimental model to investigate the effects of dietary calcium on duodenal iron uptake. The results indicate there is a critical period during weaning when the consumption of high dietary calcium with low iron can retard growth potential. Dietary calcium significantly inhibits non-haem iron absorption at the intracellular level by up-regulating villus enterocyte ferritin concentrations under iron deficiency conditions.

No description available.

Motivation and study design: Iron deficiency is a common condition in infancy, particularly in lower socio-economic groups. In Cape Town it remains a problem in spite of public health measures taken against it: a recent survey found a prevalence of iron deficiency anaemia of 34% in healthy 1-year old term infants who had ready access to a municipal health clinic where iron fortified milk formula is sold at subsidized prices. The consequences of iron deficiency extend beyond anaemia- to involve all organ systems including the immune system. Since Helen Mackay's report in 1928 of a striking decrease in incidents of infection in infants treated with iron, clinicians have assumed that iron deficiency predisposes to infection. Despite a sound theoretical basis for this belief, the clinical evidence for the assumption is poor as studies to date have displayed methodological deficiencies. On the other hand, iron is also essential for the growth of micro-organisms. As such, supplemental iron may predispose to infection. Indeed, there is much laboratory and clinical evidence to show that excess iron can result in the recrudescence of quiescent infections and increase the virulence of newly acquired infections. Thus, the competition between host and parasite may sometimes hinge on the relative availability of iron and it has been speculated that excess iron in infant milk formula may increase susceptibility to infectious diarrhoeal disease. The problem addressed by this thesis was to determine the utility of increasing the level of iron fortification of infant milk formula. Three questions were posed: Does increasing the level of iron fortification of conventional infant milk formula improve the iron nutrition of normal infants fed on the formula? Does increased iron fortification of infant milk formula alter immunity as reflected by incidence of infection and laboratory tests of immune function? Are there any handful effects of increasing the quantity of iron in conventional infant milk formula? A double blind randomized trial was carried out in 1983 and 1984 to answer these questions. A group of 149 healthy, well-nourished infants from a lower socio-economic community of so called Cape Coloureds were followed from the age of 3 months to 1 year. Half of the infants, the Control group, were given a commercially available infant milk formula (Lactogen Full Protein) which has 8.3 mg Fe/ 100 g formula and 37 mg ascorbic acid/ 100 g. The other half of subjects, the Test group, were given the same milk formula but fortified with iron to a concentration of 40 mg Fe/ 100 g. The children were examined every 3 or 4 weeks and any infection or history of infection was noted. Laboratory tests were done at the start of the trial and again on completion. During the trial, laboratory tests were performed only if clinically indicated. The tests included full blood count and differential analysis, red cell zinc protoporphyrin, plasma ferritin, plasma and hair zinc and lymphocyte subtyping with monoclonal antibodies. Within each group, half of the infants were randomly selected for assay of neutrophil bactericidal activity. The other half were assayed for lymphocyte blastogenic response to stimulation with phytohaemagglutinin. Tests of delayed cutaneous hypersensitivity to Candida antigen and PPD were done and all children and their mothers had antibodies to tetanus and polio determined. Results: 74 infants in the Control group started the trial and 62 completed it. In the Test group, 75 infants began and 70 completed the study. Intake of milk and solid foods was not quantified, but the ages of weaning and of introduction of new foods were determined. The Control and Test groups did not differ significantly on any test item. The mean age of completion of weaning was 3.60 months for the Control group and 4.04 months for the Test group. The Control group was first given meat or fish at a mean age of 5.19 months; the Test. group had meat or fish introduced to their diets at a mean age of 4.36 months. These differences were not statistically significant. The children in the Control group were lighter and shorter than the Test group at the end of the year. Mean standard deviation scores for weight were 0.23 and 0.48 respectively (P = 20%), while for length the SD scores were -0.13 and 0.06 (P = 20%).

Iron (Fe) deficiency affects more than 3 billion of the global population. The objectives of this study were to (1) determine the genetic and environmental variation of seed Fe concentration and food matrix factors that govern Fe bioavailability in field peas (Pisum sativum L.) grown in North Dakota, USA in 2010 and 2011, and (2) determine the genetic variation of Fe uptake by field pea grown under greenhouse conditions with different Fe treatments. Seed Fe concentration in field pea samples from the field study ranged between 46-53 mg/kg with a mean of 51 mg/kg. Mean concentrations of the food matrix factors in those field peas were as follows: phytic acid=5.1 mg/g, xanthophyll=17.3 mg/100 g, canthaxanthin=86.8 mg/100 g, beta-carotene=516.8 μg/100 g, kestose=1697 mg/100g, quercetin=54.3 mg/100 g, and ferulic acid=46.9 mg/100 g. DS Admiral and CDC Golden showed high concentrations of Fe promoter compounds and low concentrations of phytic acid. DS Admiral showed high Fe uptake with increasing Fe fertilizer rates in the greenhouse study. Therefore, DS Admiral and CDC Golden could be potential field pea genotypes for future Fe biofortification efforts.

Adequate nutrition is fundamental to optimal physical and cognitive growth in the second year of life. Toddlers, however, are particularly vulnerable to poor nutrition due to their high nutrient needs in relation to their body size and energy intakes. Nutrient-dense diets are therefore essential during this period. However, no practical quantitative food-based dietary guidelines directed at this age group are available to help caregivers choose nutrient-rich foods for their toddler. Such guidelines are needed not only to ensure adequate intakes of all nutrients during the period of dietary transition from infant to family foods, but also to emphasise intakes of nutrients for which toddlers are at particular risk of deficiency. Biochemical evidence suggests that iron nutrition requires special attention in New Zealand toddlers. The overall aim of this thesis was to design and assess the efficacy of practical food-based strategies for toddlers to ensure optimal nutritional status of 12-24 month old New Zealand children, with a specific focus on iron nutrition. To achieve these overall aims, the research was carried out in three stages. In the first stage, secondary data analysis of food intake data for New Zealand toddlers identified the foods commonly consumed by New Zealand toddlers, the serving sizes and frequency of consumption of these foods, and the nutrients that New Zealand toddlers are at risk of consuming in suboptimal amounts. The food intake data were obtained from 3-day weighed food intakes that had been collected on non-consecutive days in an earlier community-based cross-sectional survey of 188 randomly selected non-breastfeeding 12-24 month old urban South Island New Zealand children. In addition to describing the food consumption patterns of New Zealand toddlers, the secondary data analysis also identified that nearly 40% of New Zealand toddlers were at risk of suboptimal iron intakes. The results of these analyses were used in the second stage of the thesis to develop three food-based strategies. To do this a 4-phase approach based on linear and goal programming was used to design and hypothetically evaluate three sets of food-based strategies for 12-24 month old non-breastfeeding New Zealand children, and to identify the key problem nutrients for each set of strategies. The three sets of strategies were based on: (1) all foods consumed by toddlers including iron-fortified infant and toddler foods, (2) family foods only, or (3) family foods that are not fortified with iron. The mathematical modelling confirmed that iron was the key problem nutrient in the diets of New Zealand toddlers. The analysis showed that only food-based strategies that included a recommendation for the replacement of non-fortified cow�s milk with an iron-fortified toddler milk (500 mL), i.e. strategy set 1, achieved the Australian-New Zealand Recommended Dietary Intakes for all nutrients, including iron. In fact, inclusion of a recommendation for a substantially increased consumption of flesh foods was identified as the only possible alternative to the iron-fortified toddler milk recommendation for improving iron nutrition in New Zealand toddlers. Although the set of strategies including this flesh food recommendation did not provide as much total iron as those including the iron-fortified toddler milk recommendation, the bioavailability of the iron is likely to be greater because flesh foods provide highly bioavailable haem iron (red meat being a particularly rich source) and have an enhancing effect on the absorption of non-haem iron. The two key recommendations for achieving New Zealand toddlers� iron needs were, therefore, a recommendation to consume an iron-fortified toddler milk and a recommendation to consume substantial amounts of red meat. In the third stage, the efficacy of an increased intake of red meat or the use of an iron-fortified milk for improving biochemical iron status in healthy non-anaemic 12-20 month old New Zealand children was investigated in a 20-week partial double-blind randomised placebo-controlled intervention trial. The study also examined the effect of these two interventions on dietary iron intakes and growth, and investigated the association between the amount of meat consumed and biochemical iron parameters. Participants (n=225) were assigned to one of three groups: Meat Group (n=90), Fortified Milk Group (n=45), or Placebo Group (n=90). Children in the Meat Group were encouraged to consume two red meat dishes per day (~ 2.6 mg of iron). In the Fortified Milk Group and Placebo Group, the children�s regular milk was replaced with iron-fortified cow�s milk (1.5 mg of iron per 100 g of prepared milk), or non-fortified cow�s milk (< 0.1 mg of iron per 100 g of prepared milk), respectively. Geometric mean dietary iron intakes (95% CI) increased from 4.7 (4.1, 5.3) to 5.3 (4.7, 6.0) mg per day in the Meat Group (P=0.007), and from 4.3 (3.7, 5.0) to 10.4 (9.0, 12.2) mg per day in the Fortified Milk Group (P<0.001). These increased iron intakes differed significantly from the Placebo Group (both P<0.001), which declined from 5.1 (4.5, 5.7) to 4.6 (4.1, 5.2) mg per day during the intervention (P=0.047). Over 20 weeks, adjusted geometric mean serum ferritin concentration increased by 44% (95% CI: 14%, 82%) in the Fortified Milk Group (P=0.002), tended to decrease in the Placebo Group (14% decrease (95% CI: -27%, 1%; P=0.063)), and did not significantly change in the Meat Group (10% increase (95% CI: -7%, 30%; P=0.241)). However, because iron status declined in the Placebo Group, both groups fared significantly better than the Placebo Group: serum ferritin concentration at 20 weeks was 68% (95% CI: 27%, 124%; P<0.001) greater in the Fortified Milk Group than in the Placebo Group, and 29% (95% CI: 2%, 63%; P=0.033) greater in the Meat Group than in the Placebo Group. There were no intervention effects on haemoglobin or serum transferrin receptor concentration. The cross-sectional analysis showed that a daily intake of 1 g of red meat was associated with 0.65% (95% CI: 0.18%, 1.11%; P=0.007) higher serum ferritin concentration. No adverse effects of the interventions on the toddlers� growth were detected. In conclusion, this thesis shows that food-based strategies can be designed that, if adhered to, should ensure adequate iron status in New Zealand toddlers. Although both the iron-fortified milk recommendation and the increased red meat recommendation are likely to prevent the decline in body iron stores that can occur during the second year of life, only consumption of iron-fortified milk can successfully increase iron stores. Therefore, food-based strategies for New Zealand toddlers will need to include a recommendation that encourages the consumption of foods developed specifically for toddlers that are fortified with iron.

The aim of this research was to determine the influence of iron deficiency on both the efficacy and metabolic patterns of albendazole in mice infected with Heligmosomoides polygyrus. Anthelmintic efficacy was markedly decreased in iron-deficient mice; the deficiency was also associated with a decrease in body weight, altered hematological parameters and a decreased net egg output; worm establishment in the deficient group was not affected by the deficiency. Although anthelmintic efficacy was significantly decreased by the iron deficiency, plasma concentration profiles of the main metabolites, albendazole sulphoxide and albendazole sulphone, were not changed by the deficiency. Levels of intestinal cytochrome P-450, the main metabolizing enzyme of albendazole however, was significantly depressed in iron-deficient mice. These observations suggest that although pharmacokinetic parameters are not affected by iron deficiency, nutritional status has the potential to influence anthelmintic efficacy and thus warrants further study.

Graduation date: 1991

Adequate nutrition is fundamental to optimal physical and cognitive growth in the second year of life. Toddlers, however, are particularly vulnerable to poor nutrition due to their high nutrient needs in relation to their body size and energy intakes. Nutrient-dense diets are therefore essential during this period. However, no practical quantitative food-based dietary guidelines directed at this age group are available to help caregivers choose nutrient-rich foods for their toddler. Such guidelines are needed not only to ensure adequate intakes of all nutrients during the period of dietary transition from infant to family foods, but also to emphasise intakes of nutrients for which toddlers are at particular risk of deficiency. Biochemical evidence suggests that iron nutrition requires special attention in New Zealand toddlers. The overall aim of this thesis was to design and assess the efficacy of practical food-based strategies for toddlers to ensure optimal nutritional status of 12-24 month old New Zealand children, with a specific focus on iron nutrition. To achieve these overall aims, the research was carried out in three stages. In the first stage, secondary data analysis of food intake data for New Zealand toddlers identified the foods commonly consumed by New Zealand toddlers, the serving sizes and frequency of consumption of these foods, and the nutrients that New Zealand toddlers are at risk of consuming in suboptimal amounts. The food intake data were obtained from 3-day weighed food intakes that had been collected on non-consecutive days in an earlier community-based cross-sectional survey of 188 randomly selected non-breastfeeding 12-24 month old urban South Island New Zealand children. In addition to describing the food consumption patterns of New Zealand toddlers, the secondary data analysis also identified that nearly 40% of New Zealand toddlers were at risk of suboptimal iron intakes. The results of these analyses were used in the second stage of the thesis to develop three food-based strategies. To do this a 4-phase approach based on linear and goal programming was used to design and hypothetically evaluate three sets of food-based strategies for 12-24 month old non-breastfeeding New Zealand children, and to identify the key problem nutrients for each set of strategies. The three sets of strategies were based on: (1) all foods consumed by toddlers including iron-fortified infant and toddler foods, (2) family foods only, or (3) family foods that are not fortified with iron. The mathematical modelling confirmed that iron was the key problem nutrient in the diets of New Zealand toddlers. The analysis showed that only food-based strategies that included a recommendation for the replacement of non-fortified cow�s milk with an iron-fortified toddler milk (500 mL), i.e. strategy set 1, achieved the Australian-New Zealand Recommended Dietary Intakes for all nutrients, including iron. In fact, inclusion of a recommendation for a substantially increased consumption of flesh foods was identified as the only possible alternative to the iron-fortified toddler milk recommendation for improving iron nutrition in New Zealand toddlers. Although the set of strategies including this flesh food recommendation did not provide as much total iron as those including the iron-fortified toddler milk recommendation, the bioavailability of the iron is likely to be greater because flesh foods provide highly bioavailable haem iron (red meat being a particularly rich source) and have an enhancing effect on the absorption of non-haem iron. The two key recommendations for achieving New Zealand toddlers� iron needs were, therefore, a recommendation to consume an iron-fortified toddler milk and a recommendation to consume substantial amounts of red meat. In the third stage, the efficacy of an increased intake of red meat or the use of an iron-fortified milk for improving biochemical iron status in healthy non-anaemic 12-20 month old New Zealand children was investigated in a 20-week partial double-blind randomised placebo-controlled intervention trial. The study also examined the effect of these two interventions on dietary iron intakes and growth, and investigated the association between the amount of meat consumed and biochemical iron parameters. Participants (n=225) were assigned to one of three groups: Meat Group (n=90), Fortified Milk Group (n=45), or Placebo Group (n=90). Children in the Meat Group were encouraged to consume two red meat dishes per day (~ 2.6 mg of iron). In the Fortified Milk Group and Placebo Group, the children�s regular milk was replaced with iron-fortified cow�s milk (1.5 mg of iron per 100 g of prepared milk), or non-fortified cow�s milk (< 0.1 mg of iron per 100 g of prepared milk), respectively. Geometric mean dietary iron intakes (95% CI) increased from 4.7 (4.1, 5.3) to 5.3 (4.7, 6.0) mg per day in the Meat Group (P=0.007), and from 4.3 (3.7, 5.0) to 10.4 (9.0, 12.2) mg per day in the Fortified Milk Group (P<0.001). These increased iron intakes differed significantly from the Placebo Group (both P<0.001), which declined from 5.1 (4.5, 5.7) to 4.6 (4.1, 5.2) mg per day during the intervention (P=0.047). Over 20 weeks, adjusted geometric mean serum ferritin concentration increased by 44% (95% CI: 14%, 82%) in the Fortified Milk Group (P=0.002), tended to decrease in the Placebo Group (14% decrease (95% CI: -27%, 1%; P=0.063)), and did not significantly change in the Meat Group (10% increase (95% CI: -7%, 30%; P=0.241)). However, because iron status declined in the Placebo Group, both groups fared significantly better than the Placebo Group: serum ferritin concentration at 20 weeks was 68% (95% CI: 27%, 124%; P<0.001) greater in the Fortified Milk Group than in the Placebo Group, and 29% (95% CI: 2%, 63%; P=0.033) greater in the Meat Group than in the Placebo Group. There were no intervention effects on haemoglobin or serum transferrin receptor concentration. The cross-sectional analysis showed that a daily intake of 1 g of red meat was associated with 0.65% (95% CI: 0.18%, 1.11%; P=0.007) higher serum ferritin concentration. No adverse effects of the interventions on the toddlers� growth were detected. In conclusion, this thesis shows that food-based strategies can be designed that, if adhered to, should ensure adequate iron status in New Zealand toddlers. Although both the iron-fortified milk recommendation and the increased red meat recommendation are likely to prevent the decline in body iron stores that can occur during the second year of life, only consumption of iron-fortified milk can successfully increase iron stores. Therefore, food-based strategies for New Zealand toddlers will need to include a recommendation that encourages the consumption of foods developed specifically for toddlers that are fortified with iron.

Thesis (Ph.D.)--University of California, San Francisco, 2004. / Includes bibliographical references. Also available online.

Orientador: Elenice Deffune / Banca: Rosana Rossi Ferreira / Banca: André Filadelpho / Resumo: Trata-se de um trabalho do tipo coorte para avaliar a espoliação dos depósitos de ferro em doadores de sangue. Sabendo-se que um percentual expressivo da população brasileira é portadora de ferro deficiência, e tendo em vista as inovações tecnológicas envolvendo os processos hemoterápicos este projeto teve como objetivo a avaliação da dinâmica de ferro com o monitoramento de parâmetros tais como: hematócrito, hemoglobina, dosagem de ferro e ferritina pré transfusionais e quatro meses após a doação, em quatro diferentes grupos de estudo:A,C,Ce D. Foi feita pelo teste ANOVA simples e para as variáveis sem distribuição normal pelo teste não paramétrico de Mann-Whitney e o teste de Kruskal Wallis, teste T-Pareado e Wilcoxon. No primeiro momento de análise (M1), com análise intra-grupos, as variações estatísticas foram presentes apenas nos parâmetros de Hb (p. 0,017), onde as variações estiveram presentes quando comparados os grupos A x D (p. 0,034) e C x D (p. 0,028) e Ht (p. <0,01) onde as variações estiveram presentes quando comparados os grupos A x D (p. 0,034) e C x D (p. 0,028). No segundo momento de análise (M2) foi identificada diferença entre os grupos, entretanto, devido à baixa significância estatística não foi possível identificar a diferença exata por grupo. Quando comparado entre os momentos um e dois- (M1 x M2) foi identificado redução da média de todos os parâmetros para os grupos A, B e C, significância estatística para o parâmetro de hemoglobina para todos os gru... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: It is a work of the cohort to evaluate the plundering of iron deposits in blood donors. Knowing that a significant percentage of the population is disabled iron, and in view of the technological innovations involving haemotherapic processes this project aimed to evaluate the iron dynamics with the monitoring of parameters such as hematocrit, hemoglobin, iron dosing and pre transfusion ferritin months after the donation, in four different study groups: A, B, C and D. Statistical analyses was made by ANOVA and simple test for variables without normal distribution using the nonparametric Mann-Whitney and Kruskal Wallis test, Paired t-test and Wilcoxon. At first analysis (M1) and intra-group analysis, statistical variations were present only in Hb parameters (p. 0.017), where variations were present when comparing the x groups D (p. 0.034) and C x D (p. 0028) and HT (p. <0.01) in which variations were present when comparing the groups D x (p. 0.034) and C x D (p. 0028). In the second stage of analysis (M2) was identified differences between the groups, however, due to the low statistical significance was not possible to identify the exact difference per group. When compared between one and two- moments (M1 and M2) was identified reduction in the average of all parameters for groups A, B and C for the statistical significance hemoglobin parameter for all groups and significance for the parameter Ferritin except for the B group, which is the only one that showed improvement in optimization of parameters except hemoglobin. Blood donation decreases hemoglobin levels in the short and medium term blood donors when compared in two stages with 4 months apart; for the indicator hematocrit and determination of serum iron there was a decrease of the indices was statistically significant only for the group A (individuals who had never donated before); as the suggestion in... (Complete abstract electronic access below) / Mestre