Health Worlds

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Time : Food Business Network
Abstract: Iron deficiency anemia is a worldwide prevalence of nutritional diseases, because the body stores of iron deficiency leads to reduced hemoglobin synthesis and the formation of an anemia. Many nutrients are associated with iron deficiency anemia, such as protein, energy, carbohydrates, vitamins, trace elements and so on. This paper introduces the vitamins and trace elements and the relationship between iron deficiency anemia.
Key words: iron deficiency anemia; vitamins; trace elements
CLC number: R556.3; R151.3(Sino-Germen Joint Research Institute, The key Laboratory of Food Science (Nanchang University) Ministry of Education, Nanchang, 330047)
Abstract: Iron deficiency anemia, the most prevalent nutritional disorder worldwide. Iron deficiency anemia develops when an individual's iron stores are depleted and heme formation becomes depressed. Micronutrients such as protein, energy, carbohydrates, vitamins, microelements play important role in iron deficiency anemia. This paper mainly introduced the effect of vitamins and microelements on iron deficiency anemia.Iron deficiency anemia (iron deficiency anemia, IDA) is the body stores of iron deficiency leads to reduced hemoglobin synthesis and the formation of an anemia, hypochromic small cell anemia is a typical example. IDA is also a body of iron deficiency (iron deficiency, ID) of the final performance.
IDA is a worldwide prevalent nutritional disease. Women of childbearing age (especially pregnant women) and infants in the high incidence of IDA. World Health Organization estimates 58% of pregnant women in developing countries suffer from anemia [1]. Currently, the world's population suffering from IDA has more than 7 billion [2]. In Western populations, 10% -20% of children (2-4 years) and premenopausal women, iron deficiency exists, of which 3% were iron-deficiency anemia, particularly minorities and the poor. Elderly men and rates of iron deficiency and IDA had a lower incidence (less than 3%). Currently, IDA proportion of male and female patients were 7.5% and 8.9% [3].
Many causes of IDA, mainly: (1) increase in body iron requirements; (2) iron malabsorption; (3) iron supply; (4) various causes of iron loss increases.
Many nutrients are related with the IDA, such as protein, energy, carbohydrates, fats, vitamins, trace elements and so on. The following vitamins and trace elements only describes the impact of the IDA.Riboflavin is one of the essential trace elements the body, riboflavin and animals will lead to a lack of iron absorption, storage, use reduced. Test showed that the blood can increase the index of riboflavin, iron supplementation enhanced the response. Many domestic and international animal experiments show that riboflavin deficiency group of hemoglobin and liver iron concentration was significantly lower than control group [4]. Population survey also showed that normal and riboflavin nutritional status compared to an average hemoglobin of riboflavin deficiency (Hb) content and serum ferritin (SF) concentrations were lower than normal, the rate of iron deficiency anemia and increased whole blood glutathione reductase activity coefficient (BGRAC) and Hb, SF had a negative correlation [4].
In animal studies found that when both riboflavin and iron deficiency, riboflavin deficiency on iron status of iron deficiency in rats will not only accelerate the deterioration of synergy, on the contrary there is a degree of mitigation. The reason may be that both riboflavin and iron deficiency, the lack of riboflavin in rats significantly inhibited the growth of the slow growth of the body weight, blood volume expansion is not obvious, so that the body is relatively lower demand for iron, that riboflavin lack of iron status of "sparing effect '(sparing effect). and pure iron, the weight gain far less inhibited both riboflavin and iron deficiency was, is still a lot of blood volume expansion, the body's demand for iron, iron deficiency can not feed are added to iron status prone to deterioration. Therefore, both are lacking, the lack of riboflavin on the growth inhibition through its iron to cover up the deterioration [5]. Fishman proved by animal experiments such as nuclear The lack of flavin can lead to anemia because of limited available iron absorption and application of [6].
1.2 Vitamin C
Iron is the formation of hemoglobin in red blood cells mature stage of the necessary material, vitamin C although not involved in the formation of hemoglobin, but vitamin C is a reducing agent, can make the iron in a low state (the formation of divalent iron ions), when the stomach PH value is low, vitamin C, and the whole thing with Fe3 form, with the chyme reaches the small intestine to maintain its solubility to facilitate the absorption of iron. Experimental and epidemiological data at home and abroad have proved that VC has a close relationship with the IDA [7]. Chi-wing, anemia and other popular features of the residents in Anhui Province and the relationship between dietary IDA patients were investigated and analyzed the intake of VC lower than the normal population [8]. In Western countries, dietary iron intake, 80% of non-heme iron, non-heme iron can be converted into ferritin uptake by the duodenum and proximal jejunum. Ascorbic acid and acid reaction in this transformation plays an important role in promoting the absorption of iron [9].
1.3 Vitamin A
In recent years, some foreign epidemiological data show that in developing countries, low population levels of serum VA often exist with IDA. VA deficiency in preschool children suffering from about 253 million. Neal and so on with VA deficiency and IDA conducted a survey of preschool children and found that VA deficiency, respectively, and the IDA with the proportion of children were 59.9% and 23.8%, while children with VA and IDA 33.2 %, aged 1-5 years generally [10]. The study confirmed, VA and iron are co-dependent relationship, and that the VA may act as a cofactor or activator of transcription, in sugar-based synthesis of ferritin transport [11]. VA In another study confirmed that the regulation of iron metabolism also play a role. That the serum retinol concentration and the direct relationship between hemoglobin. Supplement for children and pregnant women, VA, hemoglobin and serum iron concentration was significantly increased [12].
1.4 Vitamin E
VE is a fat-soluble antioxidant that can eliminate free radicals, protecting cell membranes in polyunsaturated fatty acids, and prevent oxidative damage. As a result of inadequate nutrition situation of the lack of VE less. But the lack of VE, because of hemolysis (red blood cells release protein free) to accelerate the decomposition rate of red blood cells can lead to IDA. Animal experiments have proved that chronic VE deficiency can develop into severe anemia. Porter's experiments show that reticular cells may stimulate additional increase in VE, but also improve the blood hemoglobin index. Horwiit VE experiment also proved to increase the number of people in the reticular cells. VE deficiency leads to anemia may be due to the lack of anti-oxidant potential of the oxidant increases the damage on the reticular cells [12].
1.5 folic acid and vitamin B12
Folic acid (FA) and vitamin B12 is a hematopoietic vitamin, is important in the process of DNA synthesis of coenzyme, DNA synthesis is the basic condition for cell proliferation. Therefore, the blood disease anemia in patients with the abnormal proliferation of blood cells, in vivo metabolism of folic acid and VB12 of the disorder will also appear. Cheng Shengli and other iron deficiency anemia in patients with serum folate, vitamin clinical significance was tested and found that detection of serum folate and vitamin B12 concentrations and ferritin levels correlated positively (r = 0.6838,0.6926, p <0.01) [13 ]. In recent years, pregnant women folic acid level monitoring has attracted considerable attention. Folic acid in an important role in cell proliferation, involved in purine and pyrimidine synthesis, is the same form of methionine into cysteine methyl methyl donor, so the addition of folic acid deficiency of hematopoietic function, limits the fetus in early pregnancy and placenta rapidly developing, resulting in a miscarriage or fetal malformation. WHO experts recommended daily intake of folic acid given amount (RDA) of pregnant women to 800 g / d. Adult day health through effective enterohepatic circulation of bile excretion from the repeated absorption of vitamin B12, it does not occur the normal consumption of vitamin B12 deficiency. In the latter half of pregnancy, fetal absorbed every day saved by the mother about 0.2 g vitamin B12, vitamin B12 requirement therefore significantly increased during pregnancy. Vitamin B12 deficiency of blood and clinical manifestations of neurological damage. The clinical manifestations of folate deficiency and vitamin B12 are usually caused by hematological features similar to [14]. Chen Shengfang other urban pregnant women with anemia diet were analyzed, that the second trimester and third trimester of pregnancy the incidence of vitamin B12 deficiency are similar, but the third trimester compared with second trimester serum vitamin B12 levels decreased, suggesting that vitamin B12 in the reserve gradually during late pregnancy depletion. And found different levels of folic acid deficiency conditions [14].
2 trace
The relationship between IDA and trace elements over the past decade increasingly by domestic and foreign scholars. Iron and other trace elements in the discussion of the relationship between the scholars pointed out that iron and copper, zinc, vanadium, lead, cadmium, nickel, calcium, magnesium, cobalt, there is a certain synergy.
2.1 iron and copper
Iron and copper and body are closely related to hematopoiesis, erythrocyte iron is an important component of hemoglobin, and copper is mainly through the promotion of iron absorption, transport and utilization in hematopoietic processes. In addition, plasma ceruloplasmin copper is the main component of ceruloplasmin oxidase with the nature of iron, are also involved in iron absorption, transport and metabolism, and therefore iron or copper deficiency can cause anemia. Dong Guoqing and other studies suggest that low-fat low-fat iron and copper in infants and young children the incidence of anemia was 73.16% and 15.79%, the latter the former is about 5 times that cause iron deficiency anemia more easily than copper deficiency [15].
Iron and copper also immune function. Lymphoid tissue iron can directly affect the development and resistance to infection, iron deficiency can cause a variety of tissues in vivo changes and functional disorders, and sterilization depends on the iron or iron enzyme activity was reduced. Many studies have shown that iron deficiency anemia or iron deficiency-specific immune function of children (including cellular and humoral immune function) and non-specific immune function have a certain degree of damage, it is susceptible to infection [15].
Copper in the body is a special catalyst, more than 35 enzymes involved in the synthesis of protein in iron oxidation, transport, use and mature red blood cells have an important role in other aspects, and catalytic synthesis of hemoglobin [16]. When the body of iron and copper ratio of 50:1, the hemoglobin can be rapidly synthesized. This is because the copper can promote organic inorganic iron into iron, as well as lifting of the role of inhibition of iron absorption factor.
2.2 Zinc
Prevalence of zinc deficiency has been shown that the phenomenon of IDA. Zinc for the maintenance of normal appetite is very necessary and zinc on the rapid regeneration of taste buds cells play an important role in the diminished sense of taste zinc deficiency, reduced activity of acid saliva, taste buds dysfunction, anorexia, reduced food intake, and cause or aggravate IDA [15 ]. Another survey made with the hemoglobin content of zinc is proportional to the treatment of IDA in children with iron can improve zinc absorption. In addition, zinc is also important enzymes in the body in many metals, zinc enzymes involved in-aminolevulinic acid dehydratase, which is indispensable for the synthesis of hemoglobin, an enzyme that directly promote the synthesis of hemoglobin, increased use of iron; the same time, zinc The absence of transferrin protein synthesis decreased, affecting the transport of iron; In addition, zinc can maintain the stability of red cell membrane to protect the red blood cells from some of the role of hemolysin [17].
2.3 Cadmium
Cadmium is a cumulative poison, can cause cell damage a variety of mechanisms, but also a variety of animals can cause anemia, but the type is different. Ding and other studies of the effects of cadmium on carp hemoglobin. The results show that high doses of cadmium in carp in the first 30 days appeared in iron deficiency anemia, low-dose exposure to cadmium in the fish does not appear iron deficiency anemia. They think that cadmium causes the mechanism of iron-deficiency anemia is the obstruction in the intestine of cadmium absorption of iron, after the intake of cadmium, significantly increased urinary iron, in addition to cadmium can inhibit the synthesis of hemoglobin [18].
2.4 V
Vanadium increases the regeneration of iron on erythrocytes. Studies have shown that animals fed glucose V, hemoglobin, reticulocytes and red blood cell count will increase. Vanadium can stimulate the hematopoietic function, the mechanism has not been determined. It has been reported that vanadium inhibited oxidation - reduction system, causing hypoxia, thus stimulating the bone marrow hematopoietic system. There are also reports that, vanadium and cobalt, copper, manganese and other metals have similar catalytic [19].
2.5 Lead
Higher lead content of human toxicity can occur when the body can lead to excessive lead in blood disorders, severe cases can lead to anemia. May be due to lead with the divalent metal iron, and ferritin in the process of integration, the two competitive inhibition of iron absorption is low, will lead to excessive absorption of lead and lead excess heme may also be affected generation, resulting in anemia [20]. Juzhong Ling, who more than 50 cases of nutritional anemia in children's hair and trace elements were tested and found that hair lead levels in children with IDA was significantly higher than the normal group, while the IDA group, hair lead levels in children with low average level of hemoglobin hair lead content was significantly higher than the group, and confirmed that lead levels in hair were negatively associated with anemia (P <0.05). Therefore, iron supplements can reduce the amount of lead absorption, to prevent the adverse effects of lead [20].
2.6 Other
Some studies suggest that calcium and magnesium may also inhibit the absorption of iron. However, y, and Cook recently reported that calcium absorption for non-heme iron had no effect, it is worth noting that the range of calcium intake varies from individual to individual. Men 273-1712mg / d, women 121-1894mg / d. Therefore, in the dietary intake of individual differences should be considered [3]. Cobalt - there are interactions between iron and cobalt can stimulate hematopoiesis, iron absorption increases, also increases the absorption of cobalt [16]. Ni can improve the absorption of iron, nickel lack of animal growth is low, the iron content of hemoglobin and red blood cells are low, iron supplementation can reduce the shortage of nickel after the symptoms [16]. Therefore, the interaction between trace elements is extremely complex, the incidence of IDA is also very important and can not be ignored.
3 IDA prevention and control
IDA is the primary means to prevent iron supplementation. For infants and young children, adolescents and pregnant and lactating women of the Yi Shi iron-rich foods, and excessive menstrual blood loss in women and chronic patients should be eating "high-iron diet." In the diet, the highest iron content of food of animal liver and other internal organs, followed by lean meat and egg yolk. Vegetables with mustard, rapeseed, radish, tomato and other iron more; fruit Zeyi apricots, peaches, plums, grapes, dates, bayberry, oranges, grapefruit, fig and other iron more.
However, many patients get enough iron after the disease has not been improved. Recently, medical research, prevention and control of IDA, not only to give iron supplementation for all the high-risk groups, and the need to strengthen nutrition education for the public to change dietary behavior irrational. First, pay attention to daily living, IDA patients to clean their environment, the air should be fresh, as little as possible to go to public places, and careful not to touch people with colds and infectious diseases in order to avoid infection worse. Secondly, strengthening exercise. Appropriate physical exercise is a good way to control IDA. Bedridden or loneliness, depression, and there will be loss of appetite, resulting in and increase the incidence of anemia. Mild anemia may be appropriate to participate in physical exercise, not only can increase gastrointestinal motility and secretion, stimulates the appetite, but also improve resistance to diseases, thereby reducing infectious diseases. Again, more food containing protein, vitamins and folic acid and vitamin B12 in the diet is also very important. Proteins are the body's building materials of all organizations, but also constitutes the main component of hemoglobin and red blood cells. Treatment of IDA's diet should contain adequate protein, such as milk, lean meat, fish, eggs and soy products. Red blood cell folate, and vitamin B12 are essential factors in generating growth, also need to replenish through food. Foods containing these nutrients to the animal liver, kidney and meat in the highest concentrations. Green leafy vegetables contain folate, folic acid absorption through the gastrointestinal tract, and then stored in the liver. Vitamin C can enhance iron absorption. Medical studies suggest that treatment of IDA, in addition to the diet provided by the iron-rich foods, but also must be added to service some of the foods rich in vitamin C, such as fresh oranges, orange, orange, tomato, cabbage and so on. Necessary, to add some vitamin C preparation services, and promote iron absorption.
[1] Galloway R, Dusch E, Elder L et al. Women's perceptions of iron deficiency and anemia prevention and control in eight developing countries [J]. Social Science


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