Improve Iron Status Research Articles

Iron Status of Pregnant Women at Nsukka, Enugu State, South East Nigeria

Background: Anaemia is a serious health issue, particularly in remote areas such as Nsukka, Enugu State, South East geopolitical zone of Nigeria as a result of poor awareness. A comprehensive study on the iron status of pregnant women attending antenatal clinic in Nsukka, is rare. Objectives: The study aimed to evaluate the iron status of pregnant women living at Nsukka in Enugu State, South, East Nigeria via monitoring prevalence and severity of anaemia in pregnant women in first, second and third trimester using haemoglobin and ferritin concentration as bio- indicators of anaemia among the subjects, effect of age, gestational age and intake of routine drugs on haemoglobin and ferritin concentration of the subjects. Methods: A cross-sectional study was conducted involving 127 pregnant women, within the ages of 20-49years, grouped based on the stages of pregnancy namely first trimester 30 pregnant women (23.6%), second trimester 40 pregnant women 31.5%, and third trimester 57 pregnant women (44.9%), attending antenatal clinic in Nsukka Divisional Health Centre were recruited for the study using simple random technique. All data and statistical analyses were conducted using Statistical Package for Social Sciences software, version 27. Descriptive statistics such as means and percentages were calculated and reported by groups. Test of statistical significance was carried out using One-Way Analysis of Variance (ANOVA). Pearson test was performed to assess the correlation between haemoglobin, ferritin concentrations with other stated variables. Results: The age distributions of the 127 pregnant women were 20 – 24 years (26.8%), 25 – 29 years (37%), 30 – 34 years (20.4%), 35 – 39 years (12.6%), 40 -44 years (2.4%) and 45 – 49 years (0.8%). Study revealed that 39.4% of the pregnant women were anaemic because their haemoglobin concentration was less than 11 g/dl. Exactly 27.6% of women were anaemic based on ferritin concentration below 15 µg/l. None of the subjects were anaemic in first trimester, 26% of the subjects were anaemic in second trimester while 11.3% of the subjects were anaemic in third trimester. Based on ferritin level alone, 66.6% of the subjects were anaemic in first trimester, 46% in second trimester while 53.5% of the subjects in third trimester were anaemic. Conversely, 16.7% of the subjects in first trimester, 22% in second trimester and 23.9% in third trimester were anaemic based on low haemoglobin and ferritin level respectively. Haemoglobin concentration significantly (p < 0.05) showed negative correlation with age effect and positive correlation with ferritin concentration although not significant (p > 0.05). Gestational age correlated with haemoglobin and ferritin concentration showed negative correlation which was not significant (p > 0.05). Intake of routine drug correlated with haemoglobin and ferritin respectively showed negative and positive correlation respectively, although not significantly different (p > 0.05). Conclusion and Recommendations: Maternal iron status is heavily affected by pregnancy even in a high-resource, generally iron-supplemented population. Our study revealed that anaemia during pregnancy was highly prevalence in Nsukka, Enugu State because more than halve of the subjects screened were anaemic in both first, second and third trimester. Early screening of pregnant women for iron status using serum or plasma ferritin standard measure of iron deficiency according to the world Health Organization is highly encouraged. There is a need to educate and implement strategies that will improve iron status of pregnant women for the safety of the mother and the unborn child.

Iron deficiency anemia: A global public health concern

Iron deficiency anemia (IDA) remains a significant global public health concern, affecting populations across both developing and developed nations. The World Health Organization (WHO) estimates that in 2019, approximately 1.62 billion people were affected by anemia, with iron deficiency being the most common cause. This condition disproportionately impacts vulnerable groups, including women, children, and populations in low- and middle-income countries. In the United States, the Centers for Disease Control and Prevention (CDC) reports a substantial prevalence of IDA, particularly among certain demographic groups, including pregnant women and young children (CDC, 2020). The impact of IDA is particularly evident in regions like India, where the Indian Council of Medical Research (ICMR) highlights concerning trends and the need for targeted interventions to address iron deficiency, particularly among women and children. Studies suggest that improved iron status in populations is essential for reducing the prevalence of IDA and its associated complications, such as cognitive impairment, fatigue, and weakened immune function. Recent advances in diagnostics, including point-of-care testing, have improved the identification and management of anemia in primary healthcare settings. Addressing IDA involves comprehensive strategies such as iron supplementation, dietary improvements, and public health initiatives like the Weekly Iron and Folic Acid Supplementation Program in India. The global efforts to combat nutritional anemia underscore the importance of multifaceted approaches to prevention and control. Ultimately, tackling IDA in India will require a multi-sectoral approach, with collaboration between government agencies, healthcare providers, research institutions, and local communities to ensure the widespread success of interventions in reducing iron deficiency and improving overall health outcomes.

Daily iron supplementation does not impact on prevalence of exclusive breastfeeding or growth in young breastfed Gambian infants

BackgroundIn a randomised placebo-controlled trial among exclusively breastfed rural Gambian infants aged 6–10 weeks at randomisation, daily iron supplementation for 14 weeks improved iron status. This secondary analysis explores the...

Tackling Adolescent Anemia: A Systematic Review of Integrated Interventions

Background: Anemia in adolescent girls, particularly iron deficiency anemia, significantly affects health, including cognition, growth, and quality of life. The high prevalence of anemia in Indonesia underscores the importance of a comprehensive approach to increasing hemoglobin levels. Objective: To review the effectiveness of integrated strategies of diet, education, and supplementation in increasing hemoglobin levels in adolescent girls. Methods: The method used is a systematic literature review (SLR) with PICOS criteria (population, intervention, comparison, outcome, study design) to select relevant articles published in the last five years. Out of the 596 articles obtained, 28 relevant articles were selected. Results: The results show that integrated interventions are more effective in increasing hemoglobin levels compared to single approaches. The integration of diet, education, and supplementation resulted in significant improvements in iron status, nutritional understanding, and healthier eating habits. Conclusions: An integrated approach is a sustainable solution for addressing anemia in adolescent girls.

Effectiveness of Dietary Intervention on Iron Deficiency Anemia among Nursing Students in Selected Nursing Colleges, Mangaluru

Introduction: Anemia is a medical condition characterized by low red blood cell counts, which lead to hypoxia, or insufficient oxygenation of body tissue. Anemia is caused by an inadequate Iron supply in the body. Raising hemoglobin levels is essential in preventing anemia. Anemia is a major nutritional problem in India. The prevalence of anemia is higher among developing nations, because of low socioeconomic status and lack of access to the healthcare services. A study was aimed to evaluate the effectiveness of dietary interventions on Iron deficiency anemia among selected 1st year B.Sc. Nursing and GNM students in Mangaluru. Method s: An evaluative approach with one- group pre test post test design was used for the study. Permission was obtained from the concerned authority for conducting the study. The purposive sampling technique was used to draw 30 female nursing students. On day 1, Students were assessed for signs and symptoms of Iron deficiency anemia using signs and symptoms checklist and classified as mild, moderate, and severe anemia. Level of anemia was assessed by checking the hemoglobin percentage using hemoglobinometer. The samples who were having Hb percentage below 12gmdl were administered dietary intervention which included rice flake balls (125 gms) and a gooseberry (10 gms) for 30 days and on day 31st, samples were checked for Hb percentage and signs and symptoms of Iron deficiency anemia. Result: In the pre test mean Hb percentage was 10.620 0.875 and in the post test mean Hb percentage was 12.003 1.046 Hb values were increased in the post test. In the pretest majority 70 of them had mild anemia and 30 had moderate anemia. Whereas in the post test all had mild anemia. The pre test mean signs and symptoms score was 4.1 0.9 and the post test mean signs and symptoms score was 1.86 0.68. This shows the post test mean signs and symptoms score was reduced from the pre test. Interpretation: The finding of the study proved that the dietary intervention was an effective measure to improve the hemoglobin level of nursing students. Conclusion: It was concluded that dietary intervention of rice flakes balls and gooseberry administered may be effective in improving iron status of nursing students to prevent Iron deficiency anemia.

25-Hydroxycholecalciferol Improves Cardiac Metabolic Adaption, Mitochondrial Biogenetics, and Redox Status to Ameliorate Pathological Remodeling and Functional Failure in Obese Chickens.

Broiler breeder hens allowed ad libitum (Ad) feed intake developed obesity and cardiac pathogenesis and thereby were susceptible to sudden death. A supplement of 69 µg 25-hydroxycholecalciferol (25-OH-D3)/kg feed rescued the livability of feed-restricted (R) and Ad-hens (mortality; 6.7% vs. 8.9% and 31.1% vs. 48.9%). Necropsy with the surviving counterparts along the time course confirmed alleviation of myocardial remodeling and functional failure by 25-OH-D3, as shown by BNP and MHC-β expressions, pathological hypertrophy, and cardiorespiratory responses (p < 0.05). 25-OH-D3 mitigated cardiac deficient bioenergetics in Ad-hens by rescuing PGC-1α activation, mitochondrial biogenesis, dynamics, and electron transport chain complex activities, and metabolic adaptions in glucose oxidation, pyruvate/lactate interconversion, TCA cycle, and β-oxidation, as well as in TG and ceramide accumulation to limit lipotoxic development (p < 0.05). Supplemental 25-OH-D3 also sustained Nrf2 activation and relieved MDA accumulation, protein carbonylation, and GSH depletion to potentiate cell survival in the failing heart (p < 0.05). Parts of the redox amendments were mediated via lessened blood hematocrit and heme metabolism, and improved iron status and related gene regulations (p < 0.05). In conclusion, 25-OH-D3 ameliorates cardiac pathological remodeling and functional compromise to rescue the livability of obese hens through metabolic flexibility and mitochondrial bioenergetics, and by operating at antioxidant defense, and heme and iron metabolism, to maintain redox homeostasis and sustain cell viability.

A young child formula supplemented with a synbiotic mixture of scGOS/lcFOS and Bifidobacterium breve M-16V improves the gut microbiota and iron status in healthy toddlers.

Early-life gut microbiota development depends on a highly synchronized microbial colonization process in which diet is a key regulator. Microbiota transition toward a more adult-like state in toddlerhood goes hand in hand with the transition from a milk-based diet to a family diet. Microbiota development during the first year of life has been extensively researched; however, studies during toddlerhood remain sparse. Young children's requirement for micronutrients, such as dietary iron, is higher than adults. However, their intake is usually sub-optimal based on regular dietary consumption. The Child Health and Residence Microbes (CHaRM) study, conducted as an adjunct to the GUMLi (Growing Up Milk "Lite") trial, was a double-blind randomized controlled trial to investigate the effects on body composition of toddler milk compared to unfortified standard cow's milk in healthy children between 1 and 2 years of age in Brisbane (Australia). In this trial, fortified milk with reduced protein content and added synbiotics [Bifidobacterium breve M-16V, short-chain galactooligosaccharides, and long-chain fructooligosaccharides (ratio 9:1)] and micronutrients were compared to standard unfortified cow's milk. In the present study, the effects of the intervention on the gut microbiota and its relationship with iron status in toddlers were investigated in a subset of 29 children (18 in the Active group and 11 in the Control group) who completed the CHaRM study. The toddler microbiota consisted mainly of members of the phyla Firmicutes, Bacteroidota, and Actinobacteriota. The abundance of the B. breve species was quantified and was found to be lower in the Control group than in the Active group. Analysis of blood iron markers showed an improved iron status in the Active group. We observed a positive correlation between Bifidobacterium abundance and blood iron status. PICRUSt, a predictive functionality algorithm based on 16S ribosomal gene sequencing, was used to correlate potential microbial functions with iron status measurements. This analysis showed that the abundance of predicted genes encoding for enterobactin, a class of siderophores specific to Enterobacteriaceae, is inversely correlated with the relative abundance of members of the genus Bifidobacterium. These findings suggest that healthy children who consume a young child formula fortified with synbiotics as part of a healthy diet have improved iron availability and absorption in the gut and an increased abundance of Bifidobacterium in their gut microbiome.

Safety and efficacy of iron supplementation with 3 months of daily ferrous sulphate in children living with HIV and mild-to-moderate anaemia in Uganda: a double-blind, randomised, placebo-controlled trial

Iron deficiency is the most common nutritional deficiency in the world, but iron supplementation can increase risk of opportunistic infections, especially in children living with HIV. We aimed to assess the effect of supplemental iron on haemoglobin concentration in children living with HIV and mild-to-moderate anaemia in Uganda. We did a double-blind, randomised, placebo-controlled trial of iron supplementation in children aged 6 months to 12 years living with HIV at two sites (ie, Kampala and Fort Portal, Uganda). Inclusion criteria were confirmed diagnosis of HIV and stable treatment with antiretroviral therapy for at least 6 months. Exclusion criteria were already taking iron supplementation, acute illness, current opportunistic infection, fever, known sickle cell disease, severe undernutrition, or any chronic illness requiring medical attention. Children were randomly assigned (1:1) via simple randomisation to an 84-day course of either ferrous sulphate or identical placebo tablets once per day. Randomisation codes were computer-generated and stratified by age (ie, 6-23 months or 24 months and older) by the Toronto Institute of Pharmaceutical Technology, the tablet manufacturer. Participants and all individuals giving the interventions, assessing outcomes, and analysing data were masked to group assignment. Children aged 6-23 months received tablets of 12·5 mg ferrous sulphate or identical placebo; children aged 24 months or older received tablets of 30·0 mg ferrous sulphate or identical placebo. Caregivers were instructed to give the supplement after a meal, preferably after an evening meal. The primary outcome was mean haemoglobin concentration at day 84. All analyses were intention to treat. This trial is registered at ClinicalTrials.gov (NCT03596996). Between May 5, 2018, and Nov 6, 2019, 973 children living with HIV were screened, of whom 200 (20%) met all inclusion criteria and were enrolled. 102 (51%) were randomly assigned to receive iron and 98 (49%) to receive placebo. In the iron group, 57 (56%) of 102 children were male and 45 (44%) were female. In the placebo group, 44 (45%) of 98 children were male and 54 (55%) were female. Iron supplementation was associated with improvement in haemoglobin in unadjusted analysis (p=0·029), but not adjusted analysis (p=0·10), and with improvement in ferritin and hepcidin in both adjusted (p=0·0046; p=0·0079) and unadjusted (p<0·0001; p<0·0001) analyses at day 84. There were four hospital admissions, all for children in the iron group; none were fatal: two children were admitted to hospital with pneumonia, one with severe malaria, and one with hepatitis. Frequency of admissions was not significantly different between groups (p=0·12). Iron could have haematological benefit and improve iron status in children living with HIV in Uganda. Future studies powered for morbidity outcomes with longer follow-up are needed, as are those that evaluate the effects of iron supplementation on neurocognitive outcomes. Minnesota Masonic Charities, the Department of Pediatrics at the University of Minnesota, the Hennepin Healthcare Research Institute, and the US National Institutes of Health.

A Randomized Crossover Trial of Acceptability of Quadruple-Fortified Salt in Women and their Households in Southern India

BackgroundDouble-fortified salt (DFS; iron, iodine) improved iron status in randomized trials and was incorporated into India’s social safety net programs, suggesting opportunities to address other micronutrient deficiencies. ObjectivesTo evaluate the acceptability of quadruple-fortified salt (QFS; iron, iodine, folic acid, and vitamin B12) in women and their households, using a randomized crossover trial design and triangle tests. MethodsWomen 18–49 y (n = 77) and their households were randomly assigned to receive QFS or DFS in a randomized crossover design over a 3-wk period (week 1: QFS/DFS, week 2: iodized salt, week 3: DFS/QFS). Each week, participants completed a 9-point hedonic questionnaire (1 = dislike extremely to 9 = like extremely) to evaluate 5 sensory domains (color, odor, taste, texture, and overall acceptability) of the intervention, and the remaining salt was weighed using a digital scale. Triangle tests were conducted among women to evaluate sensory discrimination of salt consumed in rice dishes prepared using standardized recipes. Mixed models were used to examine hedonic ratings and salt use; salt type, sequence, and period were included as fixed effects, and household was included as a random effect. Binomial tests were used to evaluate sensory discrimination of salt type in triangle tests. ResultsMean hedonic ratings for most of the 5 sensory domains were ≥7 (like moderately) and did not differ by salt type [overall acceptability mean (SD): QFS: 7.8 (0.7) compared with DFS: 7.7 (1.2); P = 0.68]. Household salt use (weighed) did not differ by salt type. During the 3-wk intervention period, weighed salt use and hedonic ratings significantly increased, indicating a period effect independent of salt type or sequence. In triangle tests, rice samples prepared with QFS, DFS, or iodized salt were not distinguishable. ConclusionsAcceptability of QFS was high, based on individual hedonic ratings and weighed household salt use. Rice dishes prepared with DFS, QFS, and iodized salt were not distinguishable. Findings informed the design of a randomized trial of QFS in this population.This trial was registered at clinicaltrials.gov as NCT03853304 and CTRI/2024/04/066208.

Prevalence, Predictors, and Treatment Outcomes of Anemia in Vietnamese School-Age Children With Helicobacter pylori Infection.

Background A growing number of studies suggest that anemia caused by Helicobacter pylori (H. pylori) infection is prevalent in developing countries. A combination of H. pylori eradication and iron supplementation may be effective intreating iron deficiency anemia (IDA) caused by H. pylori infection. The aim of this study is to assess the prevalence, risk factors, and treatment outcomes of anemia in Vietnamese school-age children infected with H. pylori Methods A cross-sectional study was conducted from April 2023 to April 2024 involving 112 dyspeptic children from 5 to 16 years old who were admitted to Can Tho Children's Hospital, Vietnam. H. pylori infection was diagnosed with a positive histopathology combined with a rapid urease test. A bivariate and multivariate logistic regression model was used to identify independent variables associated with anemia in H. pylori-infected children. Results The prevalence of anemia and IDA (iron deficiency anemia) amongH . pylori-infected children were 28.6% and 53.1%, respectively. The risk factor for anemia was age group from 11 to 16 years of age (OR: 3.24; CI 95%:1.21- 8.70). Iron supplementation (OR: 0.14; CI 95%:0.03 - 0.66) and periodic deworming (OR: 0.29; CI 95%: 0.10-0.89) were protective factors against anemia. After H. pyroli eradication and iron supplementation, all hematological parameters were increased among 32 anemic patients. Hemoglobin increased from 9.9 ±2.1 to 11.9±2.1 g/dL (p<0.001), mean corpuscular hemoglobin increased from 25.1 ± 4.1 to 28.0 ± 3.3 pg (P=0.003), and ferritin (IQR) increased from 16.7 (9.5-45.2) to 27.0 (15.1-47.0) µg/L (p<0.001). Conclusion Anemia in Vietnamese school-age children infected with H. pylori is prevalent. Taking iron supplements and periodic deworming reduces the risk of anemia. H. pylori eradication therapy plus oral iron supplementation will improve iron status in H. pylori-infected children.

Dietary diversity and iron deficiency anemia among a cohort of singleton pregnancies: a cross-sectional study

BackgroundIron deficiency anemia (IDA) is considered one of the most common medical disorders observed during pregnancy. In low- and middle-income countries (LMICs), anemia and micronutrients deficiencies among pregnant women are associated with low consumption of animal products, monotonous starchy-diets, and seasonal consumption of vegetables and fruits.MethodsA cross-sectional study was conducted with 198 pregnant mothers aged between 19–45 years who visited the antenatal care clinics in Northern Jordan to document the prevalence of IDA and to describe the associations between dietary diversity, diet quality scores and oral iron supplementation with the pregnant women iron status. Participants were stratified into three groups by gestational age (n = 66 women per group). Gestational age, blood parameters, minimum dietary diversity score (MDD-W), and prime diet quality score for healthy (PDQSHF) and unhealthy foods (PDQSUF) were assessed using 24- hour dietary recall.ResultsPrevalence of mild to moderate anemia was 27.8% among pregnant women. Third-trimester pregnant women were most affected. 52.5% have depleted iron stores (ferritin < 15 ng/ml), of them 30.8% have iron deficiency, and 21.7% have IDA. The (M ± SD) of the MDD-W, PDQSHF, and PDQSUF were 4.8 ± 1.6, 12.8 ± 3.9, and 7.2 ± 2.8 respectively. 52.5% achieved the MDD-W, 68% consumed < 4 servings/week of healthy food groups, and 50% consumed > 4 servings/week of unhealthy food groups. Mothers with higher MDD-W and PDQS had higher Hb and serum concentrations. Those taking iron supplements had significantly (p = 0.001) higher means of Hb, serum ferritin, and gestational weight gain. Significant differences were also found between PDQSHF, PDQSUF and the first and third trimester.ConclusionsMild to moderate IDA is prevalent among pregnant mothers, especially in the third trimester. However, the prevalence of IDA among Jordanian pregnant women is lower than the global average. A high-quality, diverse diet, combined with oral iron supplementation and food fortification with iron, will help improve iron status, prevent anemia, and reduce its prevalence.

Umbilical cord clamping: Midwife's perspective at one of the regional general Hospitals of Gorontalo Province

The incidence of iron deficiency anemia in infants is a problem that often occurs in all countries, especially in developing countries, which is caused by visible dan invisible blood loss, decreased red blood cell production, premature cell destruction, premature birth, LBW, small gestational age, maternal anemia dan time of umbilical cord clamping. Delaying cord clamping by 1-3 minutes allows blood flow between the placenta dan neonate to continue, which can improve iron status in the baby for up to six months after birth. In Indonesia, 62.7% of births are attended by midwives, so the midwife's perception plays an important role in deciding when to clamp the umbilical cord during childbirth care. Objectives: To determine the perception of midwives in one of the regional general hospitals of Gorontalo province regarding delays in clamping the umbilical cord. Methods: This research uses a qualitative method with a phenomenological approach. Data collection was carried out on 7 informants using in-depth interviews dan the results of the interviews were analyzed using thematic analysis. Results: There is a difference between the informant's perception dan the practice carried out by the informant regarding the delay in clamping the umbilical cord. Conclusion: This difference in perception is caused by the informant's education which is dominated by DIII level, less than optimal training, experience during work, dan the work environment.

WS12.06 Elexacaftor/tezacaftor/ivacaftor improves iron status and is associated with correction of systemic inflammation and improvement of nutritional status: a one-year prospective multicentre study

WS12.06 Elexacaftor/tezacaftor/ivacaftor improves iron status and is associated with correction of systemic inflammation and improvement of nutritional status: a one-year prospective multicentre study

Low-Dose Iron is Safer, Tolerable and Equally Effective to High-Dose Iron in Improving Iron Status in Mild-Anemic Female Participants

Low-Dose Iron is Safer, Tolerable and Equally Effective to High-Dose Iron in Improving Iron Status in Mild-Anemic Female Participants

The association between different nutrients and the risk of iron deficiency: NHANES 2017-2020

Iron homeostasis is important in the human health system. Abnormal iron homeostasis, such as iron deficiency (ID), may cause diseases such as anemia. Iron status is a complex phenomenon that is influenced by a variety of factors, including nutrient intake. This research is needed to understand better the different nutrients which influence iron status and to develop effective strategies for improving iron status in at-risk populations. NHANES 2017-2020 data was used to simulate the linear regression model to predict the relationship between different nutrients the iron status. Results revealed that the positive association was not strong between selected nutrients (Magnesium, Protein.1, Sodium) and ferritin level (r=0.09723); the positive relationship was not strong as well between selected nutrients (Protein.1, Cholesterol, Magnesium) and transferrin. (r=0.2202).

The Effect of Iron-Fortified Lentils on Blood and Cognitive Status among Adolescent Girls in Bangladesh

Background: Iron deficiency is highly prevalent in South Asia, especially among women and children in Bangladesh. Declines in cognitive performance are among the many functional consequences of iron deficiency. Objective: We tested the hypothesis that, over the course of a 4-month iron fortification trial, cognitive performance would improve, and that improvement would be related to improvements in iron status. Methods: Participants included 359 adolescent girls attending Bangladesh Rural Advancement Committee (BRAC) clubs as a subsample of a larger double-blind, cluster-randomized community trial in which participants were assigned to one of three conditions: a condition in which no lentils were supplied (NL, n = 118, but which had the usual intake of lentils), a control (non-fortified) lentil condition (CL, n = 124), and an iron-fortified lentil condition (FL, n = 117). In the FL and CL conditions, approximately 200 g of cooked lentils were served five days per week for a total of 85 feeding days. In addition to biomarkers of iron status, five cognitive tasks were measured at baseline (BL) and endline (EL): simple reaction time task (SRT), go/no-go task (GNG), attentional network task (ANT), the Sternberg memory search Task (SMS), and a cued recognition task (CRT). Results: Cognitive performance at EL was significantly better for those in the FL relative to the CL and NL conditions, with this being true for at least one variable in each task, except for the GNG. In addition, there were consistent improvements in cognitive performance for those participants whose iron status improved. Although there were overall declines in iron status from BL to EL, the declines were smallest for those in the FL condition, and iron status was significantly better for those in FL condition at EL, relative to those in the CL and NL conditions. Conclusions: the provision of iron-fortified lentils provided a protective effect on iron status in the context of declines in iron status and supported higher levels of cognitive performance for adolescent girls at-risk of developing iron deficiency.

Comparison of Intake of Moringa Leaf and Green Beans as an Alternative to Increase Hemoglobin Levels of Pregnant Women With Anemia

Anemia is a "potential danger of mother and child". According to Riskedas (2018) anemia prevalence of pregnant women increased within 5 years from 37.1% to 48.9%. The biggest cause of anemia in pregnancy is iron deficiency anemia. One of the causes is lack of pregnant women get iron tablet (SF) less than 90 tablets and have not consume iron tablets correctly and continuously. Improving iron status can be done with non-pharmacological therapy, including the consumption of moringa and green beans. To compare the effectiveness of Moringa leaves and green beans on hemoglobin levels in pregnant women. Search for articles through the databases of Google Schoolar, Science Direct, PubMed, Elsevier (SCOPUS), Medline using Boolean operators (AND and OR). The research inclusion criteria were : Studies with randomized controlled trial (RCT) or quasi experiment design from 2015 to 2020, research participants were pregnant women, the intervention given was Moringa leaves or green beans. The results of the measurement of hemoglobin levels. Eighteen studies met the eligibility criteria and were analyzed. Moringa leaves were more effective in increasing the hemoglobin level of pregnant women with Standardized Mean Different (SMD) by 0.10 compared to green beans (SMD 0.10; CI 93% = -0.38 to 0.58; p&lt;0.00001). Moringa leaves are more effective in increasing hemoglobin levels of pregnant women than green beans.

Sensory evaluations of a novel iron and zinc-enriched powder for the potential treatment and prevention of iron deficiency in women of reproductive age.

Iron deficiency (ID) and ID with anaemia (IDA) are serious global health problems that disproportionately affect women aged 15-49 years. Although food fortification is one of the most effective and sustainable ways to combat nutritional deficiencies, iron remains one of the most difficult micronutrients to fortify, given its tendency to react strongly with food constituents. Therefore, it is important to assess the sensory properties of foods fortified with iron to determine the acceptability and palatability in target populations. We aimed to determine the palatability and acceptability of a novel ironand zinc-enriched powder fortified in tap water by conducting sensory evaluations in 35 women of reproductive age using a 9-point hedonic scale, where participants rated the sensory properties of six samples containing different amounts of the active or placebo powder. We found significant differences between samples reconstituted at 1, 2, and 3 g/L for sensory properties, including overall taste. Participants were found to be more willing to drink the mineral-enriched powder when prepared at the lowest concentration (1 g/L) compared to higher concentrations. Our results provide important insight into the sensory qualities of a novel formulation of an ironand zinc-enriched powder for at-home fortification and indicate consumer acceptability in reproductive-aged women, a key group at risk for ID/IDA. If found to improve iron status, novel treatments like this product will contribute to global efforts to develop safe, acceptable and sustainable interventions for ID and IDA.

Does Mobile Phone Tele-Reminder Increased Iron Status and Diet Quality of Pregnant Women Availing Antenatal Care Services at Phebe and Charles B. Dunbar Hospitals Bong County, Liberia A Cluster Randomized Control Trial

Anemia in pregnancy is a serious public health problem in Liberia. This study aimed to assess the effect of mobile phone tele-reminder on the iron status and diet quality of pregnant women in Liberia. A two-arm, double-blinded cluster randomized control trial was conducted in this study, with ANC screening rooms as a unit of randomization. At the Phebe and Charles B. Dunbar hospitals in Bong County, Liberia, 150 pregnant women who had never previously attended an ANC were recruited for the study (75 intervention women and 75 control women). Iron status measured as hemoglobin (g/dl) and diet quality were primary outcomes of this study. Secondary outcome measures were adherence to daily iron and folic acid supplementation and prevalence of anemia among pregnant women with malaria infection. The analysis was an intent-to-treat. The effect of the intervention on the primary study outcome (iron status) was examined using an independent sample t-test (for group-level analysis). Effects of treatment on diet quality was measured using the Fisher’s Exact Test. A binary logistic regression with a 95% Confidence Interval (CI) was used to analyze the effect of treatment on secondary outcomes. Pregnant women assigned to the intervention group had a significantly greater mean hemoglobin level after the two interventions, t (2.4) = 447, p&lt;0.05; d = 0.23). In the intervention group, there were significant odds in the consumption of 2-3 fish/meat/poultry products compared to the control group (93% versus 83%, adjusted odds ratio, 2.93; 95% CI, 0.99-8.70). A trend towards adherence to the IFA supplementation and an increase in consumption of iron-rich foods was observed. In Liberia, mobile phone tele-reminders appeared to be effective in improving iron status, diet quality, and IFA supplementation adherence when integrated into an existing antenatal care protocol.

Iron Status and Physical Performance in Athletes.

Iron is an important mineral in the body, essential for muscle function and oxygen transport. Adequate levels of iron in the blood are necessary for athletes, as iron-deficiency anemia can reduce physical performance. Several studies have investigated iron status and supplementation in iron-deficient athletes, and determined how physical strain can change iron balance and markers related to iron status. The question of how to influence and optimize iron status, as well as other markers that can affect iron metabolism, has been less thoroughly investigated. Therefore, the aim of this review is to take a closer look at the importance of iron values, iron markers, and factors that can change iron metabolism for physical performance and the extent to which physical performance can be influenced in a positive or negative way. A systematic search of the PubMed database was performed, with the use of « iron» or «iron deficiency» or «hemoglobin» AND «athletes» AND «athletic performance» as a strategy of the search. After the search, 11 articles were included in the review after the application of inclusion and exclusion criteria. Major findings include that iron supplementation had the best effect in athletes with the lowest iron status, and effects on physical performance were mostly achieved in those who were originally in a deficit. Iron supplementation could be beneficial for optimal erythropoietic response during altitude training, even in athletes with normal iron stores at baseline, but should be performed with caution. Alteration of the hepcidin response can affect the use of existing iron stores for erythropoiesis. Energy intake, and the amount of carbohydrates available, may have an impact on the post-exercise hepcidin response. Optimal vitamin D and B12 levels can possibly contribute to improved iron status and, hence, the avoidance of anemia.