Iron Deficiency Anemia: Cause, Plant Based Iron, Fortification and Impact on Lifestyle and Socioeconomic Parameters

Plant-Based Iron, Fortification and Impact on Lifestyle and Socioeconomic Parameters

Authors

  • Saira Ahmad University Institute of Diet and Nutritional Sciences, The University of Lahore, Lahore, Pakistan
  • Huma Bader Ul Ain University Institute of Diet and Nutritional Sciences, The University of Lahore, Lahore, Pakistan
  • Tabussam Tufail University Institute of Diet and Nutritional Sciences, The University of Lahore, Lahore, Pakistan
  • Makia Nasir College of Nutrition, Multan Medical Dental College, Multan, Pakistan
  • Aiza Qamar Department of Nutrition and Health Promotion, University of Home Economics, Lahore, Pakistan
  • Zunaira Mushtaq Department of Human Nutrition and Dietetics, Riphah International University Faisalabad, Pakistan

DOI:

https://doi.org/10.54393/pbmj.v5i3.336

Keywords:

Anemia, Iron Deficiency Anemia, Iron, Plant-Based Foods, Fortification

Abstract

Micronutrient deficiency is prevelant in both high income and low-income countries globally causing major health issues, especially iron deficiency which causes hypoproliferative microcytic anemia. Iron deficieny anemiais effecting more than two billion population on earth especially pregnant woman, infants and woman of reproductive. Iron plays a key role in the formation of red blood cells and reactions occurring in the human body. Food is one of the best and safe options to prevent and cure iron deficiency anemia. In the present study, we highlighted different foods with special reference to plant-based foods for the treatment and prevention of iron deficiency anemia. Literature revealed that major cereal flours, cumin seeds, green leafy vegetables, moringa leaves, papaya with supplements, beet root, apples, pomegranate, bael, sugar molasses and berries are best sources of iron due to presence of ascorbic acid. Prebiotics and probiotics fortification can also increase the iron absorption in the gut by providing optimum pH for absorption. In addition to change in dietary patterns, fortification of major crops, flours and salt should be made mandatory by as in many countries. Moreover, Iron fortified formulas, complementary food, beverages, baked items (cookies) and confectionary are best ways to prevent and cure iron deficiency anemia in children and adults. Similarly, sugar molasses from sugar industry is one of the superabundant sources of iron which can be used as supplement for value addition. However, human research is required to check the efficacy of fortified products to prevent iron deficiency anemia in future generations.

References

Bailey RL, West Jr.KP and Black RE. The epidemiology of global micronutrient deficiencies. Ann Nutr Metab. 2015. 66(2).doi.org/10.1159/000371618

Gupta UC and Gupta SC. Sources and deficiency diseases of mineral nutrients in human health and nutrition: a review.Pedosphere. 2014. 24(1): 13-38. .doi.org/10.1016/S1002-0160(13)60077-6

Spengler RN. Origins of the apple: The role of megafaunal mutualism in the domestication of Malus and rosaceous trees. Frontiers in plant science, 2019. 10: 617.doi.org/10.3389/fpls.2019.00617

Patocka J et al. Malus domestica: A Review on Nutritional Features, Chemical Composition, Traditional and Medicinal Value. Plants.2020.9(11): 1408.https://www.mdpi.com/2223-7747/9/11/1408#

Abbaspour N, Hurrell R and Kelishadi R. Review on iron and its importance for human health. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences.2014. 19(2):164.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3999603/

Johnson-Wimbley TD and Graham DY. Diagnosis and management of iron deficiency anemia in the 21st century. Therapeutic advances in Gastroenterology.2011. 4(3): 177-184. doi.org/10.1177/1756283X11398736

Turner J, Parsi M and Badireddy M. Anemia. StatPearls. 2021. NCBI PMID: 29763170https://www.ncbi.nlm.nih.gov/books/NBK499994/

Usuki K. Anemia: From Basic Knowledge to Up-to-Date Treatment. Topic: IV. Hemolytic anemia: Diagnosis and treatment. Nihon Naika Gakkai Zasshi. 2015. 104(7):1389-96 doi: 10.2169/naika.104.1389

WHO, The Global Prevalence of Anaemia in 2011, World Health Organization, Geneva, 2015. https://apps.who.int/iris/bitstream/handle/10665/177094/9789241564960_eng.pdf

Elmaghraby DA et al. Assessment of community awareness of the possible relationship between black tea consumption and iron deficiency anemia. Clinical Nutrition ESPEN.2021. doi.org/10.1016/j.clnesp.2021.04.018

Bukva M et al. Iron content in fruits, vegetables, herbs and spices samples marketed in Sarajevo, Bosnia and Herzegovina. Kemija u industriji: Časopis kemičara i kemijskih inženjera Hrvatske.2019. 68(7-8): 281-287. doi.org/10.15255/KUI.2019.001

Paulino CTD, Nishijima SM and Sarti FM. Association of Iron Supplementation Programs with Iron-Deficiency Anemia Outcomes among Children in Brazil. Nutrients.2021. 13(5): 1524.https://www.mdpi.com/2072-6643/13/5/1524#

Camaschella C. New insights into iron deficiency and iron deficiency anemia. Blood Rev. 2017.31(4):225–233. doi.org/10.1016/j.blre.2017.02.004

Kassebaum NJ et al. A systematic analysis of global anemia burden from 1990 to 2010. Blood.2014.123(5):615–624. doi.org/10.1182/blood-2013-06-508325

Sonnweber, T., et al., Anaemia, iron homeostasis and pulmonary hypertension: a review. Internal and emergency medicine. 2020. 1-13.doi.org/10.1007/s11739-020-02288-1

Knijff M, et al., Frequent Consumption of Micronutrient-Rich Foods Is Associated With Reduced Risk of Anemia Among Adolescent Girls and Boys in Indonesia: A Cross-Sectional Study. Food and Nutrition Bulletin. 2021;42(1_suppl):S59-S71. doi:10.1177/0379572120977455

Muckenthaler MU, Rivella S, Hentze MW, Galy B, A red carpet for iron metabolism. Cell.2017. 168(3):344–361. doi.org/10.1016/j.cell.2016.12.034

Muñoz M, Villar I and García-Erce JA. An update on iron physiology. World J Gastroenterol. 2009. 15(37):4617-26. doi: 10.3748/wjg.15.4617

Clifford J, Niebaum K and Bellows L. Iron: an essential nutrient (Doctoral dissertation, Colorado State University. Libraries). 2015. https://extension.colostate.edu/docs/pubs/foodnut/09356.pdf

Coad J and Pedley K. Iron deficiency and iron deficiency anemia in women. Scand J Clin Lab Invest Suppl. 2014.244: 82-9; discussion 89. doi.org/10.3109/00365513.2014.936694

Moustarah F & Mohiuddin SS. Dietary Iron. In StatPearls. StatPearls Publishing. 2020. https://pubmed.ncbi.nlm.nih.gov/31082013/

Basrowi RW & Dilantika C. Optimizing iron adequacy and absorption to prevent iron deficiency anemia: The role of combination of fortified iron and vitamin C. World Nutrition Journal. 2021, 5(1-1), 33-39doi.org/10.25220/WNJ.V05.S1.0005

Sheldon JR, Laakso HA and Heinrichs DE. Iron Acquisition Strategies of Bacterial Pathogens. Microbiol. Spectr. 2016. 4(2): 4-2.doi.org/10.1128/microbiolspec.VMBF-0010-2015

Fuqua BK, Vulpe CD and Anderson GJ. Intestinal iron absorption. J. Trace Elem. Med. Biol. 2012.26: 115–119. doi.org/10.1016/j.jtemb.2012.03.015

West AR and Oates PS. Mechanisms of heme iron absorption: Current questions and controversies. World J. Gastroenterol. 2008.14: 4101–4110. doi.org/10.3748%2Fwjg.14.4101

Gomme PT and McCann KB. Transferrin: Structure, function and potential therapeutic actions. Drug Discov. Today. 2005. 10: 267–273. doi.org/10.1016/S1359-6446(04)03333-1

Anderson ER and Shah YM. Iron homeostasis in the liver. Compr. Physiol. 2013. 3: 315–330.10.1002/cphy.c120016

Przybyszewska J and Zekanowska E. The role of hepcidin, ferroportin, HCP1, and DMT1 protein in iron absorption in the human digestive tract. Prz. Gastroenterol. 2014.9: 208–213. doi.org/10.5114%2Fpg.2014.45102

Verna G et al. Iron-Enriched Nutritional Supplements for the 2030 Pharmacy Shelves. Nutrients. 2021. 13(2): 378. https://www.mdpi.com/2072-6643/13/2/378#

Sangeetha T et al. Siginificance of serum hepcidin as a novel biomarker for the assessment of iron status in pregnant women. International journal of scientific research. 2019.8(10): 2277 – 8179. doi.org/10.36106/ijsr

World Health Organisation. Worldwide prevalence of anaemia 1993-2005, Who vitamin and mineral nutrition information system. Geneva: WHO.2008. doi: 10.1017/S1368980008002401

Kassebaum NJ and GBD 2013 Anemia Collaborators. The global burden of anemia. Hematology/oncology clinics of North America. 2016. 30(2):247-308. doi.org/10.1016/j.hoc.2015.11.002

Shah T, Warsi J and Laghari Z. Effect of Maternal Anemia on the Anthropometric Indices of Newborn. JLUMHS.2020a. 19(3): 191–194. https://www.lumhs.edu.pk/jlumhs/Vol19No03/10.pdf

Didzun O. et al. Anaemia among Men in India: A Nationally Representative Cross-Sectional Study. Lancet Global Health.2019.7(12): e1685–e1694.doi.org/10.1016/S2214-109X(19)30440-1

Pasricha SR et al., Iron deficiency. Lancet. 2021. 397:233–48.doi.org/10.1016/S0140-6736(20)32594-0

Guralnik JM et al. Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia. Blood. 2004. 104:2263–8.doi.org/10.1182/blood-2004-05-1812

Lopez A et al. Iron deficiency anaemia. Lancet 2016. 387:907–16.doi.org/10.1016/S0140-6736(15)60865-0

Snook J et al. British Society of Gastroenterology guidelines for the management of iron deficiency anaemia in adults. Gut.2021. 70(11): 2030-2051.doi.org/10.1136/gutjnl-2021-325210

Zaman B et al. Hepcidin as a diagnostic biomarker of iron deficiency anemia during pregnancy. J Matern Fetal Neonatal Med. 2021.34(8):1288-1296. doi.org/10.1080/14767058.2019.1635112

Nusrat FP et al. Assessment of the Patterns of Exercise and Diet Intake among the Pregnant and Pre-Pregnant Women Reported at Gynae OPD Civil Hospital Khairpur, Sindh, Pakistan. J. Pharmaceut. Res. Int. 2021. 33(12): 51–58.

doi.org/10.9734/jpri/2021/v33i1231254.

Shah T et al. Gestational Anemia and its effects on neonatal outcome, in the population of Hyderabad, Sindh, Pakistan. Saudi Journal of Biological Sciences. 2021. doi.org/10.1016/j.sjbs.2021.08.053

Shah T, Warsi J and Zulfiqar L. Anemia and Its Association with Parity. Profess. Med. J. 2020b. 27(5): 968–972. doi.org/10.29309/TPMJ/2020.27.05.3959

Hercberg S, Preziosi P and Galan P. Iron Deficiency in Europe. Public Health Nutr. 2001.4(2B): 537–545. doi:10.1079/PHN2001139

Navas-Carretero S et al. Oily Fish Increases Iron Bioavailability of a Phytate Rich Meal in Young Iron Deficient Women, Journal of the American College of Nutrition.2008. 27(1); 96-101. doi: 10.1080/07315724.2008.10719680

Center for Disease Control: Morbidity and Mortality Weekly report. Current version November 2005. www.cdc.gov/mmwr (Last access 20 September 2005).

Black RE. Global distribution and disease burden related to micronutrient deficiencies.Nestle Nutr Inst Workshop Ser. 2014. 78:21–28.doi.org/10.1159/000354932

Ryckman T et al. Affordability of nutritious foods for complementary feeding in Eastern and Southern Africa. Nutrition reviews. 2021. 79(1): 35-51.doi.org/10.1093/nutrit/nuaa137

Landahl G et al. Iron deficiency and anemia: a common problem in female elite soccer players. International Journal of Sports Nutrition and Exercise Metabolism.2005.15(6): 689-694.doi.org/10.1123/ijsnem.15.6.689

Sim M et al. Iron considerations for the athlete: a narrative review. European Journal of Applied Physiology.2019.119(7): 1463-1478.doi.org/10.1007/s00421-019-04157-y

McCormick R et al. Refining Treatment Strategies for Iron Deficient Athletes. Sports Medicine.2020. 1-13.doi.org/10.1007/s40279-020-01360-2

Sheridan HC, Parker LJ and Hammond KM. Dietary supplements for consideration in elite female footballers. European Journal of Sport Science.2021:1-17.doi.org/10.1080/17461391.2021.1988149

Badenhorst CE et al. Iron status in athletic females, a shift in perspective on an old paradigm. Journal of sports sciences.2021: 1-11. doi.org/10.1080/02640414.2021.1885782

Akalu Y et al. Iron-rich food consumption and associated factors among children aged 6–23 months in sub-Saharan Africa: A multilevel analysis of Demographic and Health Surveys. Plos one. 2021, 16(6): e0253221. doi.org/10.1371/journal.pone.0253221

Baker RD, Greer FR and Committee on Nutrition American Academy of P. Diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0-3 years of age). Pediatrics. 2010.126:1040-50.doi.org/10.1542/peds.2010-2576

Davis KE et al. Infant feeding practices and dietary consumption of US infants and toddlers: National Health and Nutrition Examination Survey (NHANES) 2003- 2012. Public Health Nutr. 2018.21:711-720.

doi.org/10.1017/S1368980017003184

Eldridge AL et al. Trends in mean nutrient intakes of US infants, toddlers, and young children from 3 Feeding Infants and Toddlers Studies (FITS). J Nutr 2019.149:1230-1237.doi.org/10.1093/jn/nxz054

Centers for Disease Control and Prevention. Breastfeeding among U.S. children born 2010–2017, CDC National Immunization Survey. 2017. Available from https://www.cdc.gov/breastfeeding/data/nis_data/results.html.

Van Elswyk ME, Murray RD and McNeill SH. Iron-rich Complementary Foods: Imperative for All Infants. Current Developments in Nutrition. 2021.doi.org/10.1093/cdn/nzab117

Estecha QS et al. Adolescent undernutrition in South Asia: A scoping review. Nutrition Research Reviews.2021: 1-11. doi:10.1017/S0954422421000068

Habib MA et al. Prevalence and determinants of iron deficiency anemia among nonpregnant women of reproductive age in Pakistan. Asia Pacific J. Clin. Nutrit.2018.27(1): 195–203. doi.org/10.6133/apjcn.042017.14. 29222899.

Usman M et al. Malabsorption; acase of Microcytic Anemia in Pakistan. Baqai J. Health Sci. 2019. 2(2).https://baqai.edu.pk/baqaiassets/bjhs/admin/articlefiles/2021/1623906814upl0.pdf

Lone NM et al. Role of TMPRSS6 rs855791 (T> C) polymorphism in reproductive age women with iron deficiency anemia from Lahore, Pakistan. Saudi journal of biological sciences.2021. 28(1): 748-753.doi.org/10.1016/j.sjbs.2020.11.004

Imran IK et al. Incidence of Anemia in the Population of Dir (Lower) Khyber Pakhtunkhwa. RADS Journal of Pharmacy and Pharmaceutical Sciences.2021. 9(1): 1-6. doi.org/10.37962/jpps.v9i1.419

Ali H et al. Assessment of nutritional status of lactating mothers in Multan, Pakistan: A case study. The Professional Medical Journal.2021. 28(06): 813-818.doi.org/10.29309/TPMJ/2021.28.06.6119

Abdelhaleim AF, Amer AY and Abdo Soliman JS. Association of zinc deficiency with iron deficiency anemia and its symptoms: results from a case-control study, Cureus. 2019.doi: 10.7759/cureus.3811.

Migone De Amicis M et al., Acquired Refractory Iron Deficiency Anemia. Mediterranean journal of hematology and infectious diseases. 2021. 13(1): e2021028. doi.org/10.4084/MJHID.2021.028

Harrabi MA et al. Iron deficiency anemia induces postural control disorders in young women. Journal of Trace Elements in Medicine and Biology.2021. 68: 126868.doi.org/10.1016/j.jtemb.2021.126868

Mantadakis E, Chatzimichael E and Zikidou P. Iron deficiency anemia in children residing in high and low-income countries: risk factors, prevention, diagnosis and therapy. Mediterr. J Hematol Infect Dis. 2020.12(1): e2020041, doi.org/10.4048/MJHID.2020.041

Griffin IJ and Rogido M. Temporal Trends in Iron Intake, Iron Fortification, and Iron Deficiency. The Journal of Nutrition. The Journal of Nutrition Commentary. 2021. doi.org/10.1093/jn/nxab141.

Paul P, Maiti D and Adhikary T. Iron deficiency anemia-An updated overview. International Journal of Research in Pharmacy and Pharmaceutical Sciences. 2021. 6(4): 28-33.https://www.researchgate.net/publication/354447233

Murray-Kolb LE and Beard JL. Iron treatment normalizes cognitive functioning in young women. The American journal of clinical nutrition. 2007. 85(3): 778-787.doi: 10.1093/ajcn/85.3.778.

Zulfiqar H et al. Dietary association of iron deficiency anemia and related pregnancy outcomes. Food Sci Nutr. 2021. 9:4127–4133. doi: 10.1002/fsn3.2373

Sungkar A. The Role of Iron Adequacy for Maternal and Fetal Health. World Nutrition Journal.2021. 5(1-1): 10-15. doi.org/10.25220/WNJ.V05.S1.0002

Slywitch E et al. Iron Deficiency in Vegetarian and Omnivorous Individuals: Analysis of 1340 Individuals. Nutrients. 2021. 13(9). 2964.https://www.mdpi.com/2072-6643/13/9/2964#

Hou Y et al. Estrogen regulates iron homeostasis through governing hepatic hepcidin expression via an estrogen response element. Gene.2012.511(2): 398-403.doi.org/10.1016/j.gene.2012.09.060

Pasricha SR et al. Control of iron deficiency anemia in low-and middle-income countries. Blood, The Journal of the American Society of Hematology.2013. 121(14): 2607-2617.doi.org/10.1182/blood-2012-09-453522

Samuelson Bannow B, McLintock C and James P. Menstruation, anticoagulation, and contraception: VTE and uterine bleeding. Research and Practice in Thrombosis and Haemostasis.2021. 5(5): e12570.doi.org/10.1002/rth2.12570

Kayande S, Patil S and Ansari IT. Herbal remedies and dietary supplement during menstrual cycle. 2021. 1(2): 38-44.

https://dimpsij.in/wp-content/uploads/2021/09/DIMPSIJ_01_02_04-Shivhari-Shruti.pdf

Zhang YY et al. Opportunities for plant‐derived enhancers for iron, zinc, and calcium bioavailability: A review. Comprehensive Reviews in Food Science and Food Safety. 2021. 20(1): 652-685. doi.org/10.1111/1541-4337.12669

Regula J, Krejpcio Z and Staniek H. Bioavailability of iron from cereal products enriched with dried shittake mushrooms (Lentinula edodes) as determined by iron regeneration efficacy method in female rats. Journal of medicinal food.2010. 13(5): 1189-1194.doi.org/10.1089/jmf.2009.0200

Khoja KK et al. In vitro bioaccessibility and bioavailability of iron from fenugreek, baobab and moringa. Food Chemistry. 2021.335: 127671.

doi.org/10.1016/j.foodchem.2020.127671

Kepp KP. Heme: From quantum spin crossover to oxygen manager of life. Coordination Chemistry Reviews.2017. 344:363– 374. doi.org/10.1016/j.ccr.2016.08.008

Schönfeldt HC and Hall NG. Determining iron bio-availability with a constant heme iron value, Journal of Food Composition and Analysis. 2011. 24(4–5): 738-740. doi.org/10.1016/j.jfca.2011.01.002.

Saunders AV et al. Iron and vegetarian diets. The Medical Journal of Australia.2013. 199(4): S11-S16. doi: 10.5694/mja11.11494

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2022-03-31
CITATION
DOI: 10.54393/pbmj.v5i3.336
Published: 2022-03-31

How to Cite

Ahmad, S., Bader Ul Ain, H. ., Tufail, T. ., Nasir, M. ., Qamar, A. ., & Mushtaq, Z. . (2022). Iron Deficiency Anemia: Cause, Plant Based Iron, Fortification and Impact on Lifestyle and Socioeconomic Parameters: Plant-Based Iron, Fortification and Impact on Lifestyle and Socioeconomic Parameters. Pakistan BioMedical Journal, 5(3), 18–23. https://doi.org/10.54393/pbmj.v5i3.336

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