Striking While the Iron is Hot: Understanding the Biological and Neurodevelopmental Effects of Iron Deficiency to Optimize Intervention in Early Childhood

Doom, Jenalee R.; Georgieff, Michael

doi:10.1007/s40124-014-0058-4

Cited by 51 publications

(44 citation statements)

References 62 publications

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“…Experimental evidence from animal studies suggests that fetal or neonatal ID impairs brain and especially hippocampal development [9] . Early ID has also been associated with defects in myelination and impairments in dopaminergic neurotransmission [10] . Effects of ID on development of these systems have been hypothesized to produce irreversible damage to cognitive performance.…”

Section: Animal Studiesmentioning

confidence: 99%

Iron and Cognitive Development: What Is the Evidence?

2017

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The theoretical irreversible damage that iron deficiency and iron deficiency anemia can exert on child development makes a compelling argument for action to alleviate the burden. However, a critical analysis of evidence from iron interventions in early life is necessary to determine whether and how iron interventions improve cognitive outcomes. Key iron interventions used in clinical and public health practice include oral iron supplementation and, in young children, iron-containing multiple micronutrient powders. This article examines the evidence to answer 4 main questions. (1) Does antenatal iron supplementation influence long-term child cognitive development? (2) Does oral iron supplementation in preschool children improve short-term cognitive development? (3) Does oral iron supplementation in older children improve cognitive development? And (4), can provision of iron harm cognitive development? Early trials indicated benefit from parenteral iron in young children regardless of anemia status. There also appears to be evidence for benefit using oral iron treatment on cognitive performance in anemic primary school children. However, antenatal and early childhood oral iron intervention studies show inconsistent effects on early and long-term childhood cognitive outcomes. These data suggest either that (a) effects from oral iron on cognitive development in young children are small or nonexistent or that (b) heterogeneity between trials and the low quality of many studies make assessment of effect difficult. Importantly, few large, placebo-controlled trials in under-2-year-old children in low-income settings assessing effects of iron interventions on cognition have been performed; high-quality, placebo-controlled, adequately powered trials of universal iron interventions on cognitive performance in young children are urgently needed to justify policies of universal iron intervention in this group.

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Section: Animal Studiesmentioning

confidence: 99%

Iron and Cognitive Development: What Is the Evidence?

2017

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“…Although the highest prevalence of iron deficiency in young and school-aged children is found in developing countries [2], it is also reported in industrialized areas [3]. In children, iron deficiency can have adverse effects on cognition, decrease motor activity, social attention and school performance, and increase susceptibility to infection [4].…”

Section: Introductionmentioning

confidence: 99%

The bioavailability of iron picolinate is comparable to iron sulfate when fortified into a complementary fruit yogurt: a stable iron isotope study in young women

et al. 2019

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Purpose A technological gap exists for the iron (Fe) fortification of difficult-to-fortify products, such as wet and acid food products containing polyphenols, with stable and bioavailable Fe. Fe picolinate, a novel food ingredient, was found to be stable over time in this type of matrix. The objective of this study was to measure the Fe bioavailability of Fe picolinate in a complementary fruit yogurt. Methods The bioavailability of Fe picolinate was determined using stable iron isotopes in a double blind, randomized crossover design in non-anemic Swiss women (n = 19; 25.1 ± 4.6 years). Fractional Fe absorption was measured from Fe picolinate (2.5 mg 57 Fe per serving in two servings given morning and afternoon) and from Fe sulfate (2.5 mg 54 Fe per serving in two servings given morning and afternoon) in a fortified dairy complementary food (i.e. yogurt containing fruits). Fe absorption was determined based on erythrocyte incorporation of isotopic labels 14 days after consumption of the last test meal. Results Geometric mean (95% CI) fractional iron absorption from Fe picolinate and Fe sulfate were not significantly different: 5.2% (3.8-7.2%) and 5.3% (3.8-7.3%) (N.S.), respectively. Relative bioavailability of Fe picolinate versus Fe sulfate was 0.99 (0.85-1.15). Conclusion Therefore, Fe picolinate is a promising compound for the fortification of difficult-to-fortify foods, to help meet Fe requirements of infants, young children and women of childbearing age.

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“…Numerous randomized trials performed on different pediatric age groups showed that iron supplementation prevented or corrected neurodevelopmental delay. These studies were mostly performed in low-or middle-income countries [55][56][57]. In the study from Costa Rica, iron deficiency and IDA were more frequent in infants fed with nonfortified-iron formula.…”

Section: Neurodevelopmental Signs and Symptomsmentioning

confidence: 99%

Iron Deficiency Anemia in Children

Roganović¹,

Starinac²

2018

Current Topics in Anemia

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Iron deficiency and iron deficiency anemia remain a major and global public health problem that affects particularly infants, young children, and women of childbearing age in developing countries. The prevalence of iron deficiency anemia is still common in industrialized countries despite efforts to improve public awareness and strengthen programs for the prevention and control of iron deficiency. The most common risk factors for iron deficiency in early childhood are rapid growth, perinatal risk factors, poor dietary intake, and gastrointestinal blood loss due to excessive consumption of cow's milk. Iron deficiency and iron deficiency anemia cause a wide variety of symptoms and changes in many different tissues. The most concerning consequences of iron deficiency in children are the alterations of cognitive, motor, and behavioral performance. Persistent neurocognitive changes despite iron repletion have increased the importance of prevention and early detection of iron deficiency. The main principles of treatment include investigation and elimination of the underlying cause, iron supplementation, improvement of nutrition, and education of the patient and family. Oral iron supplements are desirable as first-line therapy. Follow-up is very important to confirm the diagnosis and to ensure that anemia is adequately treated.

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Striking While the Iron is Hot: Understanding the Biological and Neurodevelopmental Effects of Iron Deficiency to Optimize Intervention in Early Childhood

Cited by 51 publications

References 62 publications

Iron and Cognitive Development: What Is the Evidence?

Iron and Cognitive Development: What Is the Evidence?

The bioavailability of iron picolinate is comparable to iron sulfate when fortified into a complementary fruit yogurt: a stable iron isotope study in young women

Iron Deficiency Anemia in Children

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