Inhibit Iron Absorption Research Articles

Impact of Iron Tablet and Moringa Leaf Capsule Supplementation on Hemoglobin Levels in Anemic Pregnant Women in Pariaman City, 2016

Background: Iron deficiency anemia is a prevalent global nutritional problem, particularly affecting pregnant women in developing countries. This study aimed to evaluate the effects of iron tablet supplementation and Moringa leaf capsules on hemoglobin (Hb) levels in anemic pregnant women in Pariaman City, Indonesia. Method: A total of 60 pregnant women were divided into two groups: one receiving iron tablets and the other Moringa leaf capsules for four weeks. Hemoglobin levels were measured before and after the intervention. Findings: In the iron supplementation group, the average Hb level increased from 9.05 g/dL to 9.46 g/dL, with a significant improvement (p = 0.001). Similarly, the Moringa capsule group showed an Hb increase from 8.99 g/dL to 9.27 g/dL (p = 0.019). While iron tablets resulted in a greater increase in Hb, Moringa capsules, rich in natural iron, also demonstrated significant effectiveness. The study concludes that both iron supplements and Moringa capsules are effective in increasing Hb levels, with Moringa capsules being a potential natural alternative for combating anemia in pregnant women. However, optimizing the dosage of Moringa could further enhance its efficacy. Factors such as adherence, diet, and knowledge of iron absorption enhancers and inhibitors play crucial roles in the success of the interventions.

Metabolic and Inflammatory Aspects of Iron Deficiency in Obese

Obesity is a chronic disease with a complex etiology, characterized by a persistent inflammatory state induced by various pro-inflammatory cytokines, including interleukin-6. This condition leads to increased production of hepcidin, a protein hormone responsible for regulating iron homeostasis. Hepcidin's primary function is to inhibit iron absorption by enterocytes, the cells lining the small intestine. Symptoms of iron deficiency, which is crucial for oxygen transport, energy production, and immune system support, can be varied and often nonspecific, such as general weakness, pallor, or concentration difficulties, potentially prolonging the diagnostic process. This article aims to analyze the relationship between obesity and iron deficiency in the metabolic context. Obesity, being one of the most prevalent health issues of the modern world, is associated with numerous complications, including disturbances in iron metabolism. Iron deficiency in obese individuals can lead to anemia, reduced physical performance, and cognitive impairments. Traditional treatment methods for this micronutrient deficiency involve supplementation. However, supplementation shows reduced efficacy in overweight and obese individuals, likely due to elevated hepcidin levels. A more effective approach should include interventions targeting not only the supplementation of the missing micronutrient but also weight reduction.

Bonobo geophagy at Wamba.

Geophagy, the deliberate consumption of earth materials, is widely observed in animals. While anecdotal evidence exists of bonobos (Pan paniscus) consuming soil from Cubitermes termite mounds, the functions of their geophagic behavior remains unexplored. This study aims to examine a preliminary hypothesis that termite mound geophagy of free-ranging bonobos at Wamba are helpful for iron supplementation. Here, we tested the following three predictions: (1) the soil of Cubitermes termite mounds at Wamba would have high iron content, (2) bonobos would engage in termite mound geophagy regularly across all seasons, and (3) termite mound soil would be more often consumed by (a) females than males, (b) pregnant than non-pregnant females, and (c) adolescents than adults. As predicted, soil samples collected from the pointy protrusions on the caps of the mushroom-shaped mounds, the part typically consumed by bonobos, had a much higher iron content than other food items for them. In addition, geophagic behavior was noted on 48 out of 116 days (41.3%) with full-day focal animal sampling, and was observed throughout the entire study duration without any bias in frequency toward a certain period. However, contrary to our prediction, there was no significant variation in the frequency of geophagic behavior by sex nor by pregnancy status, although it occurred more frequently among adolescents than adults. Our findings partially support the Iron Supplementation Hypothesis, suggesting that Cubitermes termite mound soils could offer a readily accessible source of iron for bonobos. However, we cannot draw definitive conclusions on the function of their geophagic behavior from our findings without in vitro studies examining whether the ingested iron is bioavailable and whether the soil does not have properties inhibiting iron absorption. Nonetheless, this study is a first step to explore the health implications of geophagy in bonobos, extending our knowledge of this behavior in primates.

KEBIASAAN KONSUMSI KOPI DAN TINGKAT KECUKUPAN ZAT BESI DENGAN ANEMIA PADA REMAJA PUTRI

Anemia is a nutritional deficiency problem that is prone to be experienced by adolescent girls. Anemia can be influenced by iron intake from food sources and other factors such as coffee consumption habits. The aim of this research was to analyze the relationship between coffee consumption habits and iron sufficiency levels with anemia in adolescent girls at SMAN 1 Manyar Gresik. The research method used was observational with a cross-sectional design. The total population consisted of 487 female students from grades X and XI at SMAN 1 Manyar Gresik. The sample size was 78 individuals selected using proportional random sampling technique. Data on iron sufficiency levels and coffee consumption habits were obtained from filling out the SQ-FFQ questionnaire. Respondents' anemia status data were obtained by measuring hemoglobin levels using a hemoglobinometer (easy touch). Data analysis was conducted using the Chi-square test. This study showed that 23% of respondents had anemia and the results of statistical tests indicated that there was a relationship between the time of coffee consumption (p= 0.005) and the level of iron intake (p=0.003) with anemia. The research concluded that sufficient iron intake and consumption of coffee more than 2 hours before/after meals will reduce the risk of anemia. Therefore, respondents are advised to pay attention to the timing of coffee consumption to avoid inhibiting iron absorption.

Correlation between antenatal care (ANC) visits and caffeine beverage consumption habits with the incidence of anemia in third trimester pregnant women in Health Centers, Bantul Region

<p><em>mother and baby. Efforts made by health workers to reduce the occurrence of anemia by conducting Antenatal Care (ANC) visits, and providing Communication, Information, and Motivation (KIM) and administering Fe tablets. Consumption of Fe tablets is better consumed using plain water because if Fe tablets are taken together with tea and coffee it can inhibit iron absorption.</em></p><p><strong><em>Objectives: </em></strong><em>Determine the relationship between Antenatal Care (ANC) visits and consumption habits of caffeinated drinks with the incidence of anemia in third trimester pregnant women at the Health Center in Bantul.</em></p><p><strong><em>Methods: </em></strong><em>This type of research uses quantitative research with a cross sectional approach. Sampling using simple random sampling and quota sampling with the number of respondents 180 pregnant women using predetermined characteristics. The research instrument used a questionnaire on the variable ANC visits and consumption habits of caffeinated drinks and used the KIA handbook on the variable incidence of anemia in pregnant women. The bivariate analysis technique uses the Kendal Tau test.</em></p><p><strong><em>Results: </em></strong><em>In the ANC visit variable, a p value = 0.029 (p <0.05) was obtained, indicating that there is a relationship between Antenatal Care (ANC) visits and the incidence of anemia in third trimester pregnant women. In the habitual variable of caffeine consumption, the p-value = 0.004 (p <0.05), indicating that there is a relationship between the habit of consuming caffeinated drinks and the incidence of anemia in third trimester pregnant women.</em></p><p><strong><em>Conclusions : </em></strong><em>There is a relationship between Antenatal Care (ANC) visits and the incidence of anemia and there is a relationship between the habit of consuming caffeinated drinks and the incidence of anemia in third trimester pregnant women at the Health Center in Bantul.</em></p>

Penyuluhan Skrining Anemia dan Pemberian Tablet Fe pada Remaja di SMP 4 Menggala

Anemia is a condition where the hemoglobin level in the blood is less than the normal level. Adolescent girls are at high risk of anemia, because during this period there is an increased need for iron due to growth and mensturation. School activities and high extracurricular activities will have an impact on irregular eating patterns, besides the habit of consuming drinks that inhibit iron absorption will affect one's hemoglobin levels. Adolescent girls are required to take Blood Addition Tablets because they experience menstruation every month. Blood Add Tablet is useful to replace iron lost due to menstruation and to fulfill iron needs that have not been fulfilled from food. Iron in adolescent girls is also useful for improving learning concentration, maintaining fitness and preventing anemia in future mothers. The implementation of this community service activity was held at SMP 4 Tulang Bawang Regency on January 14, 2024. Participants who took part in the education "Counseling on Anemia Screening and Providing Fe Tablets to Adolescents" were 20 junior high school students from SMP 4 menggala. Based on the counseling care carried out, it is known that knowledge about anemia in adolescents, the average knowledge before is 50.5 and after is 87.5, it can be seen that there is an effect of the counseling provided, from counseling it is also seen that the mean difference is 37%. The p-value = 0.000 (p-value < α = 0.05) means that there is an effect of counseling on knowledge about anemia in adolescents.

Serum Hepcidin Is an Early Predictor of Iron Depletion in Non-Anemic Blood Donors

Introduction Iron deficiency is one of the major concerns in repeated whole blood donors. Although taking iron supplementation, frequent whole blood donors sometimes suffer from iron depletion which contributes to adverse impact on donor's health and may reduce the donor blood pool. Laboratory parameters identifying iron depleted status could help early recognize donors at risk of iron deficiency. Hepcidin is a key iron regulator, which blocks ferroportin to inhibit iron absorption and iron release from hepatocytes. In iron depletion, hepcidin down regulates to encourage iron absorption. Previous data reported that serum hepcidin at less than 10 ng/mL was significantly associated with iron deficiency. According to the biological function and physiological response of hepcidin, we hypothesize that hepcidin could be an early predictor of iron deficiency status in non-anemic individuals. Methods This cross-sectional study was conducted at the Blood Bank Center at Chiang Mai University Hospital, Chiang Mai, Thailand in May 2023. After the informed consent was obtained, ninety-seven healthy repeated whole blood donors who had donated blood at least twice in the past year were recruited. The medical records were reviewed. Basic characteristics and laboratories including complete blood count, reticulocyte indices, iron parameters, and serum hepcidin were evaluated. Donors who had serum ferritin level less than 30 and 30-100 ng/mL were categorized as iron deficiency, and low ferritin group, respectively. Those who had ferritin more than 100 ng/mL were the control group. Logistic regression analysis was done to determine the value of serum hepcidin in predicting iron deficiency status in each group. Results The total of 97 repeated whole blood donors were recruited, 48 (49.5%) were women. Mean age was 34.6 ± 10.7 years. There were 8 donors in the iron deficiency group, 38 in the low ferritin group, and 51 donors in the control group. Mean hemoglobin levels were 13.4 ± 1.1, 13.8 ± 1.2, and 14.2 ± 1.2 g/dL in the iron deficiency, low ferritin group and control, respectively, (p = 0.796). White blood cell and platelet count were not different in these groups. Similarly, red cell indices including mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW), and reticulocyte indices showed no difference among groups. Serum hepcidin had a significant difference between the three groups. Median levels of hepcidin were 2.61 (1.37, 3.4) and 12.35 (10.12, 15.57) ng/mL in the iron deficiency and the low ferritin group, respectively, compared to 26.01 (21.36, 39.08) ng/mL in the control group, (p < 0.001). Low serum hepcidin (less than 10 ng/mL) were found in 14 (36.8 %) donors who had ferritin levels less than 100 ng/mL, compared to only 1 (2.4%) donor in the control group, (p < 0.001). In addition, serum hepcidin showed a strong correlation with ferritin levels (r = 0.779). Logistic regression model showed that only female sex (OR: 2.87; 95% CI: 1.26, 6.56) and hepcidin (OR: 0.76; 95% CI: 0.66, 0.86) were significant predictors of repeated donors who were at risk of iron depletion and had the ferritin levels less than 100 ng/mL. Conclusions Frequent blood donors are at risk of iron depletion. Serum hepcidin was a significant predictor of iron depleted status in non-anemic donors. Serum hepcidin also showed a significant correlation with ferritin levels. The downregulation of serum hepcidin was detected prior to the changes of red blood cell indices and reticulocyte responses. Early recognition and identification of donors at risk of iron depletion and prompt iron restoration are the key to ensuring the donor safety and preserving adequate blood donor pool.

Factors affecting iron absorption and the role of fortification in enhancing iron levels.

Iron is an important micronutrient required for a number of biological processes including oxygen transport, cellular respiration, the synthesis of nucleic acids and the activity of key enzymes. The World Health Organization has recognised iron deficiency as the most common nutritional deficiency globally and as a major determinant of anaemia. Iron deficiency anaemia affects 40% of all children between the ages of 6 and 59 months, 37% of mothers who are pregnant and 30% of women between the ages of 15 and 49 years worldwide. Dietary iron exists in two main forms known as haem iron and non-haem iron. Haem iron is obtained from animal sources such as meat and shows higher bioavailability than non-haem iron, which can be obtained from both plant and animal sources. Different components in food can enhance or inhibit iron absorption from the diet. Components such as meat proteins and organic acids increase iron absorption, while phytate, calcium and polyphenols reduce iron absorption. Iron levels in the body are tightly regulated since both iron overload and iron deficiency can exert harmful effects on human health. Iron is stored mainly as haemoglobin and as iron bound to proteins such as ferritin and hemosiderin. Iron deficiency affects individuals at increased risk due to factors such as age, pregnancy, menstruation and various diseases. Different solutions for iron deficiency are applied at individual and community levels. Iron supplements and intravenous iron can be used to treat individuals with iron deficiency, while various types of iron-fortified foods and biofortified crops can be employed for larger communities. Foods such as rice, flour and biscuits have been used to prepare fortified iron products. However, it is important to ensure the fortification process does not exert significant negative effects on organoleptic properties and the shelf life of the food product.

Proton Pump Inhibitors and Hyporesponsiveness to Erythropoiesis-Stimulating Agents in Hemodialysis Patients: Results from the Japan Dialysis Outcomes and Practice Patterns Study.

Hyporesponsiveness to erythropoiesis stimulating agents (ESAs) is important problem in dialysis patients. While proton pump inhibitors (PPIs) may inhibit iron absorption, few studies have examined associations between PPIs and ESA-resistant anemia in hemodialysis patients. This study examined the associations between PPIs and ESA-resistant anemia in hemodialysis patients. The present study was a cross-sectional study using repeated 4-month observations, up to eight observations/patient, from the Japan Dialysis Outcomes and Practice Patterns Study (J-DOPPS). The primary outcome was erythropoietin resistance index (ERI). ESA dose, hemoglobin, proportion of erythropoietin-resistant anemia, transferrin saturation (TSAT), and ferritin were also examined. Linear or risk-difference regression models were used with generalized estimating equations to account for repeated measurements. Of 1,644 patients, 867 patients had PPI prescriptions (52.7%). Patients prescribed PPI had higher ERI, higher ESA dose, and lower TSAT levels. Multivariable analysis for 12,048 four-month observations showed significantly greater ERI in PPI users (adjusted difference 0.95 IU/week/kg/[g/dL] [95% CI: 0.40-1.50]). Significant differences were also found in ESA dose (336 IU/week [95% CI: 70-602]) and the prevalence of erythropoietin-resistant anemia (3.9% [2.0-5.8%]) even after adjusted for TSAT and ferritin. Among possible mediators between the association of PPIs and anemia, TSAT was significantly different between PPI users and non-users (adjusted difference, -0.82% [95% CI: -1.56 to -0.07]). This study showed the associations between PPI and ERI, ESA dose, and TSAT in hemodialysis patients; physicians should consider anemia's associations with PPIs in hemodialysis patients.

RISK FACTORS FOR THE INCIDENCE OF ANEMIA IN YOUNG WOMEN

Background: The prevalence of anemia in adolescents is still high in Jambi Province at 60.45%. Anemia can cause a decrease in body resistance and fitness, thereby inhibiting adolescent productivity. Purpose: Research objectives to determine the prevalence of anemia and risk factors for the incidence of anemia in young women. Methods: Cross-sectional research design, located in State Senior High School 8 of Jambi City from January to April 2019. Population 552 girls, with a sample of 83 girls in classes X and XI. The proportioned stratified random sampling technique was taken. The research variables were knowledge, breakfast, tablets, blood consumption, nutritional status, enhancing foods and iron absorption inhibitors, infectious diseases, and heavy meal frequency. The dependent variable was anemia. Interviews and secondary data from the measurement of Hb were conducted for primary data collection. Data would be analyzed with chi-square analysis. Results: The incidence of anemia among young women was 42.17%. There was relationship of knowledge (PR=2.05; 95% CI=1.30-3.24), blood tablet supplementation (PR=2.95; 95% CI =1.02-8.54), Breakfast (PR=3.03; 95% CI=1.41-6.48), and frequency of heavy eating (PR = 0.52; 95% CI=0.28-0.97) with the incidence of anemia. Conclusion: Factors associated with anemia among young women are knowledge, consumption of tablets plus blood, breakfast, and frequency of heavy eating.

Spray Encapsulation of Iron in Chitosan Biopolymer for Tea Fortification

Aim. Tea was studied as a carrier for iron in a fortification strategy to reduce iron deficiency. Iron forms insoluble coloured complexes with tea polyphenols which lower consumer acceptability. Complexation of iron by polyphenols and quinones derived from tea inhibits iron absorption in the first segment of the small intestine. Spray-dried chitosan-iron microcapsules were prepared to prevent iron-polyphenol interaction before the beverage is consumed. A competing chelating agent (EDTA) or antioxidant (sodium ascorbate) was added to prevent interactions and help improve iron bioavailability. Methods. The effect of concentration of chitosan (0.2–1.5%w/w), iron loading (10–60% w/w FeSO4), addition of secondary coatings on particle morphology, surface iron exposure and release, and bioaccessibility were evaluated. Tea-containing chitosan microcapsules and chelating agents to enable iron absorption were evaluated for sensory acceptability. Results. The iron release profile at pH 1 and pH 7 exhibited reverse enteric behaviour of non-cross-linked chitosan microcapsules. Increasing the iron content leads to more iron exposure on the surface due to a high core to coat ratio. Cross-linked chitosan effectively encapsulated iron, and its release in tea was inhibited, as indicated by lower delta E values in comparison with untreated tea and positive sensory testing scores. The use of maltodextrin as secondary coating slightly improved the spray process and produced larger particles, with less exposed iron on the surface. However, it did not improve the colour performance in milk tea. Conclusions. Tea fortified with encapsulated iron and a chelating agent providing 40% of the daily iron requirement of an adult, prepared in a traditional South Asian manner, i.e., with milk and water, resulted in tea with acceptable colour and taste. However, further research is required to develop an encapsulation formulation for stable iron encapsulation in hot tea and exploration of equivalent plant-based chitosan sources to address concerns of consumers with dietary restrictions.

High Hepcidin Levels Promote Abnormal Iron Metabolism and Ferroptosis in Chronic Atrophic Gastritis.

Chronic atrophic gastritis (CAG) is a chronic inflammatory disease and premalignant lesion of gastric cancer. As an antimicrobial peptide, hepcidin can maintain iron metabolic balance and is susceptible to inflammation. The objective of this study was to clarify whether hepcidin is involved in abnormal iron metabolism and ferroptosis during CAG pathogenesis. Non-atrophic gastritis (NAG) and chronic atrophic gastritis (CAG) patient pathology slides were collected, and related protein expression was detected by immunohistochemical staining. The CAG rat model was established using MNNG combined with an irregular diet. CAG patients and rats exhibited iron deposition in gastric tissue. CAG-induced ferroptosis in the stomach was characterized by decreased GPX4 and FTH levels and increased 4-HNE levels. Hepcidin, which is mainly located in parietal cells, was elevated in CAG gastric tissue. The high gastric level of hepcidin inhibited iron absorption in the duodenum by decreasing the protein expression of DMT1 and FPN1. In addition, the IL-6/STAT3 signaling pathway induced hepcidin production in gastric tissue. Our results showed that the high level of gastric hepcidin induced ferroptosis in the stomach but also inhibited iron absorption in the intestines. Inhibiting hepcidin might be a new strategy for the prevention of CAG in the future.

Non-alcoholic fatty liver disease as a risk factor for anemia of chronic inflammation (experimental research)

The aim of the study. In recent years, non-alcoholic fatty liver disease (NAFLD) has been considered a hepatic manifestation of the metabolic syndrome. The main consequence of NAFLD is chronic hepatic inflammation, which leads to dyslipidemia, inflammation, increased oxidative stress, and endothelial dysfunction. Immune activation in response to interaction with agents of a metabolic nature induces the release of pro-inflammatory cytokines in the liver, which subsequently cause iron сhomeostasis disorder. This leads to a frequent association of NAFLD with anemia of various etiology. In this regard, we considered it important to assess the severity of the systemic inflammatory response in NAFLD in the experiment in order to -diagnose anemia of chronic inflammation.Materials and methods. The study was carried out on 26 male Wistar rats, which were divided into control and experimental groups. In animals of the experimental group, NAFLD was modeled according to the generally accepted method. In order to assess metabolic disorders, we determined the main biochemical parameters, a complete blood count with the calculation of erythrocyte indices, the concentration of the main pro-inflammatory cytokines – interleukin (IL) 1, IL-6. Results. In laboratory rats with NAFLD, a statistically significant increase of intrahepatic enzymes in blood serum was found. The state of the erythrocyte lineage of hematopoiesis in the experimental group progressively worsened and caused the development of anemic syndrome. Synchronously, a statistically significant increase in serum levels of IL-1, IL-6 was recorded, which confirms the correlation of NAFLD with anemia of chronic inflammation.Conclusions. A high concentration of IL-1, IL-6 cytokines in NAFLD inhibits iron absorption in the duodenum, leads to the activation of macrophages, blocking the release of iron processed from aging erythrocytes into plasma. Further study of the mechanisms of anemia in NAFLD provides important therapeutic targets in the treatment of both NAFLD and its comorbidities.

Low bioavailability of dietary iron among Brazilian children: Study in a representative sample from the Northeast, Southeast, and South regions.

Despite all efforts, iron deficiency anemia remains a serious public health problem among Brazilian children. To evaluate dietary iron intake and dietary practices that interfere with the absorption of this nutrient from three regions of Brazil. Brazil Kids Nutrition and Health Study is a cross-sectional dietary intake study in children aged 4-13.9 years old designed to investigate nutrient intakes and gaps of Brazilian children in a representative sample of households from Northeast, Southeast and South regions. Nutrient intake was assessed based on multiple-pass 24-h dietary recall and U.S. National Cancer Institute method was used to estimate usual micronutrients intakes and compliance with Dietary Reference Intakes. Five hundred sixteen individuals participated in the study (52.3% male). The top three most consumed food sources of iron were products of plant origin. Food sources of animal origin contributed with <20% of the total iron intake. Vitamin C intake was adequate, but the concomitant consumption of food sources of vitamin C with plant food sources of iron was not common. On the other hand, the concomitant intake of plant food sources of iron with food sources of iron chelators (e.g., coffee and teas) was frequent. Adequate iron intake was observed in all three regions in Brazil. Children's diet showed low iron bioavailability and insufficient consumption of food sources of iron absorption stimulants. Frequent presence of iron chelators and inhibitors of iron absorption might help to explain the high prevalence of iron deficiency in the country.

HUBUNGAN STATUS GIZI REMAJA DENGAN KEJADIAN ANEMIA PADA REMAJA PUTRI

Adolescent girls who experience anemia are still high in Indonesia, namely by 23%, mainly due to iron deficiency. This study aims to analyze the nutritional status of adolescents with the incidence of anemia in female adolescents. The design in this study was a cross sectional study. The sample in this study were all students of the Midwifery Study Program Undergraduate Program and Midwifery Study Program Diploma Three STIKES YARSI Mataram who were included in the group of older adolescents, namely 17-20 years of age as many as 80 respondents. Nutritional status was determined based on Body Mass Index (BMI), while anemia status was determined based on hemoglobin levels as measured using the Easy Touch brand hemoglobin strip. Bivariate analysis was tested with Pearson Chi-square. The results showed that anemia was not related to the nutritional status of young women with a value of p=0.475 (p&gt;0.005). This is because anemia has many risk factors, including length of menstruation, iron intake, and consuming iron absorption inhibitors. Therefore, it is recommended for young women to consume iron-rich foods and iron tablets.

Vacuum impregnation as a sustainable technology to obtain iron-fortified broad bean (Vicia faba) flours.

Iron-fortified broad bean flours were obtained by vacuum impregnation during soaking. The impact of vacuum impregnation and iron fortification on the hydration kinetics of broad beans, as well as the processing (soaking, autoclaving, and dehulling) on the iron-absorption inhibitors (phytic acid and tannins), iron content, iron bioaccessibility, and physicochemical and techno-functional properties of flours was investigated. Results showed that the use of vacuum impregnation during soaking reduced the broad beans' soaking time by 77%, and using iron solution instead of water did not affect the hydration kinetics. After soaking, iron-fortified broad bean flours increased twice (without hull) or more (with hull) the iron and bioaccessible iron content regarding non-fortified flours. Cooking broad beans by autoclaving modified the tannin content, the iron content and its bioaccessible fraction, and the physicochemical and techno-functional properties of the flours. Autoclaving increased the water holding capacity and absorption rate, swelling capacity, bulk density, and particle size, while decreased the solubility index, whiteness index, emulsifying capacity, emulsion stability, and gelling capacity. Finally, dehulling did not practically affect the physicochemical and techno-functional properties of flours, but showed a decrease in iron content, although increased iron bioaccessibility was observed, occurred mainly due to the reduction in tannin concentrations. The results obtained in this study demonstrated that vacuum impregnation is a useful technology for obtaining iron-fortified broad bean flours with different physicochemical and techno-functional properties depending on the production process used.

Ferric Pyrophosphate Forms Soluble Iron Coordination Complexes with Zinc Compounds and Solubilizing Agents in Extruded Rice and Predicts Increased Iron Solubility and Bioavailability in Young Women

BackgroundCo-extrusion of ferric pyrophosphate (FePP) with solubilizers, citric acid/trisodium citrate (CA/TSC), or ethylenediaminetetraacetic acid (EDTA) sharply increases iron absorption. Whether this can protect against the inhibition of iron absorption by phytic acid (PA) is unclear. Sodium pyrophosphate (NaPP) may be a new enhancer of iron absorption from FePP. ObjectivesOur objectives were to 1) investigate the ligand coordination of iron, zinc, and solubilizers in extruded rice and test associations with iron solubility and absorption, 2) assess whether co-extrusion of FePP + CA/TSC rice can protect against inhibition of iron absorption by PA; 3) determine the effect of zinc oxide (ZnO) compared with zinc sulfate (ZnSO4), and 4) quantify iron absorption from FePP + NaPP rice. MethodsWe produced labeled 57FePP rice cofortified with ZnSO4 and EDTA, CA/TSC or NaPP, and FePP + EDTA rice with ZnO. We used electron paramagnetic resonance (EPR) to characterize iron-ligand complexes. We measured in vitro iron solubility and fractional iron absorption (FIA) in young women (n = 21, age: 22 ± 2 y, BMI: 21.3 ± 1.5 kg/m2 geometric mean plasma ferritin, 28.5 μg/L) compared with ferrous sulfate (58FeSO4). FIA was compared by linear mixed-effect model analysis. ResultsThe addition of zinc and solubilizers created new iron coordination complexes of Fe(III) species with a weak ligand field at a high-spin state that correlated with solubility (r2 = 0.50, P = 0.02) and absorption (r2 = 0.72, P = 0.02). Phytic acid reduced FIA from FePP + CA/TSC rice by 50% (P < 0.001), to the same extent as FeSO4. FIA from FePP + EDTA + ZnO and FePP + EDTA + ZnSO4 rice did not significantly differ. Mean FIAs from FePP + EDTA + ZnSO4, FePP + CA/TSC + ZnSO4, and FePP + NaPP + ZnSO4 rice were 9% to 11% and did not significantly differ from each other or from FeSO4. ConclusionRice extrusion of FePP with solubilizers resulted in bioavailable iron coordination complexes. In the case of FePP + CA/TSC, PA exerted similar inhibition of FIA as with FeSO4. FePP + NaPP could be a further viable solubilizing agent for rice fortification.This study was registered at clinicaltrials.gov as NCT03703739.

ALK2 Inhibition and a Modified Activin Receptor Type Iia Ligand Trap Cotherapy Maximized Hematologic Improvements in a Mouse Model of Anemia of Inflammation

Introduction: Anemia of inflammation (AI) is commonly seen in patients with chronic diseases, including chronic kidney disease (CKD). Current therapeutic options to mitigate anemia in AI include treating the underlying inflammatory disease, oral or intravenous iron supplementation, erythropoietin, and blood transfusions. The persistent release of inflammatory cytokines in AI not only induces the iron regulator hepcidin to inhibit iron absorption and recycling, but also directly impacts the marrow to suppress erythropoiesis, further worsening the ineffective, iron-restricted erythropoiesis. Therefore, targeting both iron and erythropoiesis could comprehensively address anemia in AI. We previously showed that ALK2 inhibition was sufficient to reduce serum hepcidin and improve hemoglobin in a CKD mouse model. We also demonstrated that a modified activin receptor IIA ligand trap RKER-050 increased hemoglobin and red blood cell production by promoting erythroid differentiation in mice. Here, we explored the potential of additive improvements in hematologic parameters that could be achieved with a combination of hepcidin suppression by ALK2 inhibition and increased hematopoiesis with RKER-050 in a mouse model of AI. Methods: C57BL/6 mice were fed a control or 0.2% adenine with 40 ppm iron diet (Ade 40) for 5 weeks to induce CKD. After confirming anemia, CKD mice were subcutaneously treated with 3 mg/kg isotype control or KTI-m216, a neutralizing antibody against ALK2, twice a week for 4 weeks while continuing the Ade 40 diet or switching to a 0.2% adenine with 3 ppm low iron diet (Ade 3). Combination therapy was evaluated in CKD mice on Ade 40 diet receiving biweekly isotype or KTI-m216 and also received either weekly PBS or 7.5 mg/kg RKER-050 intraperitoneally for 4 weeks. Results: CKD mice developed impaired kidney function and characteristics of AI, including increased serum IL-6 and hepcidin, hypoferremia, tissue iron retention, and anemia compared to control mice. Serum hepcidin was reduced >95% in KTI-m216 treated mice on both Ade diets compared to mice receiving isotype control (CKD control). Transferrin saturation (TSAT) increased 65% in KTI-m216 treated mice on Ade 40 diet, with a similar trend in mice on Ade 3 diet. When compared to CKD control of the same diet, KTI-m216 treated mice had similar hematologic improvements: hemoglobin (+2.2 g/dL), hematocrit (+5.4%), red blood cells (+1.1 M/μl), and reticulocyte hemoglobin (CHr, +1.8 pg). These data support that increased circulating iron by KTI-m216 mediated hepcidin suppression can increase erythropoiesis in CKD mice. Data also suggest that dietary iron contribution is negligible in supporting erythropoiesis in this context. With combination therapy, mice receiving KTI-m216 alone (KTI-m216 and PBS) and a combined KTI-m216 and RKER-050 therapy had a similar reduction in serum hepcidin (>91%) and a similar increase in TSAT (>1.7-fold), compared to mice receiving vehicle (isotype and PBS) controls. Mice treated with KTI-m216 alone increased hemoglobin to 11.4 g/dL compared to vehicle treated mice with hemoglobin of 8.0 g/dL. Treatment with a combined KTI-m216 and RKER-050 therapy showed a further increase in hemoglobin to 13.5 g/dL. Additionally, red blood cell production was 6.4 M/μl in mice given vehicle controls and increased to 8.3 M/μl in KTI-m216 alone and 9.8 M/μl in combined KTI-m216 and RKER-050; hematocrit was 23.4% in vehicle control, 32.5% in KTI-m216 alone and 38.7% in combined KTI-m216 and RKER-050. Although hematocrit was not fully rescued, hemoglobin and red blood cells in mice receiving a combined KTI-m216 and RKER-050 therapy were not different from the non-CKD controls. Conclusion: These data illustrate that inhibition of ALK2 with KTI-m216 could potentially release sufficient iron from the recycling pathway to ameliorate anemia, but not restore RBC parameters to normal levels. Combined treatment with activin receptor ligand trap, RKER-050 and KTI-m216 normalized the RBC production in this preclinical model. These data support that increasing erythropoiesis with RKER-050 combined with iron mobilization with KTI-m216 has the potential to achieve the maximal amelioration of anemia in AI.

The effect of dechitinization on iron absorption from mealworm larvae (Tenebrio molitor) flour added to maize meals: stable-isotope studies in young females with low iron stores

Edible insects have a low ecological footprint and could serve as an alternative dietary iron source. However, chitin, a major component of insects, avidly binds iron and might inhibit iron absorption. We aimed to measure fractional iron absorption (FIA) from Tenebrio molitor-based test meals with and without dechitinization, and to assess the effect of native and low chitin T. molitor on FIA from iron-fortified maize porridge. We measured iron absorption in young females with low iron stores (n=21) from 1) labeled (54FeSO4) fortified maize porridge (maize alone); 2) intrinsically labeled (57Fe added during rearing) T. molitor larvae with native chitin content (NC) added to maize alone; and 3) dechitinized intrinsically labeled (57Fe) T. molitor larvae with low chitin content (LC) added to maize alone. We determined FIA using erythrocyte isotope incorporation and measured in vitro iron dialyzability from the 3 meals. NC and LC T. molitor had similar mean±SD iron content (12.0±0.1mg/100g). Geometric mean (95% CI) FIAs from the 3 test meals were 1) maize alone: 5.8% (3.2%, 10.8%); 2) maize+NC T. molitor: 5.3% (2.5%, 11.3%) and 4.1% (1.9%, 8.7%); and 3) maize+LC T. molitor: 4.6% (2.0%, 10.3%) and 4.0% (1.8%, 9.2%), for extrinsic and intrinsic labels, respectively. FIA from NC and LC T. molitor did not significantly differ, and both were lower (P<0.005) than FIA from the labeled maize porridge in the 3 meals, which did not significantly differ. The slopes of the relations between FIA and serum ferritin in the different meals and from the intrinsic and extrinsic labels did not significantly differ. T. molitor biomass does not strongly affect iron absorption when added to maize porridge. Our data suggest T. molitor iron is absorbed from the common nonheme iron pool. Native T. molitor is high in iron which is moderately well absorbed, suggesting it could be a valuable dietary iron source.This trial was registered at clinicaltrials.gov as NCT04510831.

Nutritional factors associated with anaemia in pregnant women in Tulang Bawang Lampung

Background: Anemia is the biggest health problem in the world, especially for women who are pregnant, because it can cause fatigue and decreased work productivity. Knowledge is a factor that encourages pregnant women to avoid anemia. If pregnant women know the causes of anemia, the consequences of anemia, and how to prevent it, pregnant women will avoid pregnancy anemia.Purpose: To find out the determinants of the incidence of Anemia in Pregnant Women at the Non-Inpatient of candra mukti health center and Inpatient health center at capable ponet Tulang Bawang Barat working area in 2022.Method: Quantitative analytic research with cross sectional design. The sampling technique used proportional stratified random sampling, and 171 people met the inclusion criteria. Data analysis used the Chi Square test and multivariate analysis used multiple logistic regression.Results: It is known that the distribution of the majority of anemic mothers (59.1 percent). have less knowledge (53.8 percent). have a positive attitude (52.6 percent). obediently consuming Fe tablets (58.5 percent). 1 glass (66.1 percent) of iron absorption inhibiting drinks (tea, coffee, milk). get good family support (59.6 percent). received the support of good health workers (71.9 percent).Conclusion: There is a significant relationship between knowledge, attitudes, adherence to iron consumption, drinking iron absorption inhibitors (tea, coffee and milk), family support and support from health workers with the incidence of anemia in pregnant women with a p-value of &lt; 0.05. Fe consumption is the dominant factor in the incidence of anemia in pregnant women (p-value = 0.002).