Category: Blog

Foege W. Keynote address: Issues in overcoming iron deficiency. The journal of nutrition 2002; 132:790S-93S.

Gibson R. Principles of Nutritional Assessment. 1990: Oxford University Press; New York, U.S.A.

Heinz Handbook of Nutrition. (Editor: D. Yeung). 1995: Heinz Corporate Research Center; H.J. Heinz Company, U.S.A.

Nestel P. & Alnwick D. Iron/Multi-Micronutrient supplements for young children. (monograph). Summary and conclusions of a consultation held at UNICEF, Copenhagen, Denmark, August 19-20 1996. UNICEF.…

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Introduction

Dr. Zlotkin’s research group at the Hospital for Sick Children, University of Toronto, Canada has been committed to the goal of reducing micronutrient deficiencies including iron deficiency anemia among infants and young children particularly in the developing countries. Iron deficiency is the most widespread, but preventable nutritional deficiency affecting up to 750 million infants and children worldwide. The research group has been engaged to undertake a number of important activities to support the distribution and use of micronutrient Sprinkles in countries and population groups with high prevalence of iron deficiency anemia. These included a wide variety of (i) community-based research studies, (ii) program development for the distribution of Sprinkles and (iii) general support for the manufacturing of Sprinkles.

Community-based research refers to a series of efficacy and effectiveness studies testing the impact of Sprinkles containing iron and other essential micronutrients in treating and preventing anemia. These studies also assessed …

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IRON ABSORPTION FROM INTRINSICALLY LABELED MICROENCAPSULATED FERROUS FUMARATE (SPRINKLES) IN ANEMIC & NON-ANEMIC INFANTS
M. Tondeur, S. Zlotkin, C. Schauer, S Newton, S Owusu-Agyei: Departments of Paediatrics, Nutritional Sciences, and Centre for International Health, University of Toronto; The Hospital for Sick Children, Research Institute, Canada; The Kintampo Health Research Centre Health Research Unit, Ministry of Health, Ghana.

Microencapsulated ferrous fumarate (Sprinkles) is a new supplement for
‘home-fortification’. The contents of a sachet can be added to any
complementary food without changing the colour or taste. We believe this
intervention may decrease the burden of iron deficiency anemia (IDA) in
the developing world. However, the most appropriate dose of iron (Fe) to
include is not known since its bioavailability has not been studied. Aim:
To determine the absorption of 2 doses of Sprinkles when added to a
complementary food provided to anemic and non-anemic infants.
Methods: In a prospective triple-masked, randomized …

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Impact of “Micronutrient Sprinkles” for the Treatment and Prevention of Iron Deficiency in Canadian First Nations and Inuit Infants 4-18 months old.

A. Christofides, S. Zlotkin, C. Schauer. Departments of Paediatrics and Nutritional Sciences, University of Toronto; The Hospital for Sick Children, Research Institute, Canada.

Iron deficiency (ID) is a concern in First Nation (FN) and Inuit infants. H. Pylori infection may contribute to ID. Standard treatment of anemia in infants is ferrous sulphate (DROPS), however, compliance is universally poor. SPRINKLES containing microencapsulated iron in powder form can be easily added to food without organoleptic changes.
Aim: To compare DROPS and SPRINKLES for the treatment and prevention of anemia in FN and Inuit infants.

Methods: A multi-center RCT was performed in Attawapiskat, Fort Albany and Igloolik (total N=94). Anemic infants (Hb?100 g/L) were randomized to DROPS (30 mg Fe/day) or SPRINKLES (60 mg Fe/day) for 3 mo. Non-anemic infants (Hb>100 …

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Fortification:

The fortification of staple foods such as wheat or other grains is likely to increase iron intake for those populations that have
access to them. However, infants and children who have a limited capacity to eat large quantities of fortified food are not likely
to benefit significantly form this strategy. Targeted fortification (for example, the fortification of weaning foods specifically
eaten by infants and children) as is practiced by the developed world, is an excellent way to increase the intake of iron in children.
However, fortified commercially prepared infant foods are relatively expensive and may not be affordable for many families with
children at highest risk of iron deficiency (Taken from Zlotkin, 2002-Editorial Current Issues for the prevention of iron deficiency
anemia).

Dietary Diversification:

Dietary diversification involves promotion of a diet with a wider variety of iron-containing foods, especially meat or fish. This
intervention is often not possible …

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Iron is involved in the transport of oxygen and cellular respiration as a component of hemoglobin, myoglobin and the enzymes: cytochrome oxidase, peroxidase and catalase.

Physiology

In the gut, ferric iron is converted to ferrous iron (the soluble form) in the presence of the acidic pH of the stomach. Luminal iron-binding proteins facilitate the absorption of iron across the intestinal mucosa. Iron is stored in the body as ferritin and hemosiderin in the liver, bone marrow and spleen. A significant portion of iron in the body is a component of hemoglobin and myoglobin. The remainder is bound to iron transport proteins and enzymes.

Food Sources

Heme iron is best absorbed and is found in red meats and liver, heart and kidney. Less bioavailable sources of iron include green leafy vegetables and whole grain cereals.

Deficiency

A deficiency of iron may lead to anemia with physical signs including weakness, fatigue, poor …

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Articles:

2) Presented at the FASB Experimental Biology conference in Orlando, Florida, 2001:

PART 1. RANDOMIZED PROSPECTIVE CONTROLLED TRIAL OF FERROUS SULFATE DROPS VERSUS MICRONENCAPSULATED FERROUS FUMARATE ‘SPRINKLES’ FOR TREATMENT OF ANEMIA IN GHANAIAN INFANTS AND YOUNG CHILDREN. Stanley Zlotkin, Paul Arthur, Kojo Yeboah Antwi, George Yeung. Dept of Paediatrics and Nutr Sci, Hosp For Sick Children, U of Toronto, Toronto, Canada M5R1L9, London School of Hygiene & Trop Med, London, UK, Kintampo Health Res. Centre, Min. of Health, Ghana.>> Background: The standard therapy for anemia in infants is ferrous sulfate drops (DROPS) administered 3-times daily. Unfortunately, adherence to treatment is often poor in both developed and developing countries. One reason for the lack of success is the unpleasant side-effects associated with the use of this form of iron. AIM: In this study we evaluated the use of a new form of iron,
dosing schedule and delivery system to treat …

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Function

Folate is involved in DNA synthesis. It is involved in cell division and replication. The active form in the body is tetrahydrofolic acid (THFA), which is involved in certain biological reactions including amino acid conversions.

Physiology

Folic acid is synthesized by intestinal microflora of the colon. It is stored in the liver and other body tissues. Excretion occurs through feces and urine.

Food Sources

Sources of folate include liver, organ meats, yeast, dark green leafy vegetables, legumes, nuts, whole grain cereals, eggs and fruit.

Deficiency

Deficiencies result in fatigue, insomnia, and anemia. Folate deficiency is particularly high in developing countries such as India, especially in pregnant and lactating women. Deficiency results in anemia (megaloblastic neurocytic), glossitis (inflammation of the tongue), gastrointestinal disturbances, diarrhea, malabsorption and mood changes. Deficiency during pregnancy may result in neurotube defects in newborns.…

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Effectiveness Study:

A study looking at the operational feasibility of an intervention under normal or field conditions.

Efficacy Study:

A study looking at the technical feasibility, where a meaningful response to treatment or intervention is sought under closely supervised conditions.

Dissolution Studies:

Laboratory based studies looking at the solubility of pharmaceutical compounds.

Bitot’s Spots:

Superficial foamy patches forming on the eye. These resemble small dark spots on the whites of the eyes.

Xerophthalmia:

Dryness resulting from inadequate function of the lacrimal glands, which supply water to produce tears.

Bioavailability

The amount of a compound absorbed into the body.…

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