Iron Supplementation
in Pregnancy – Does the Preparation Matter?
Melamed N, et al.
Arch Gynecol Obstet, 2007 Dec ; 276(6) :601-4.
The objective was to assess the use, side effects and
discontinuation rates of iron preparations during pregnancy.
Six
hundred and twelve randomly selected postpartum women
completed a questionnaire on iron supplement use in the
second and third trimesters. The results showed that of the
517 women (84.5%) reported using iron supplements, 453
were eligible for the study. The most common preparation was
ferrous fumarate (46.8%, P < 0.01), followed by
ferrous sulfate (31.8%), ferric polymaltose (12.4%), and
ferric bisglycinate (7.3%). Almost half the participants
(45%)
reported at least one adverse effect, especially
constipation (27.4%, P < 0.01), and nausea (10.8%).
Multivitamin
preparations and ferric bisglycinate were associated with
the fewest side effects (23.7, 21.2% respectively, P <
0.01),
and ferrous fumarate and immediate-release ferrous sulfate
with the most (56.3, 53.7% respectively). Eighty-three
women discontinued their originally prescribed iron
preparation, mainly (89%) due to side effects.
Discontinuation
rates were lowest for the multivitamin and ferric
bisglycinate (10.5, 9.1%, respectively). In most cases, the
specific
preparation was recommended by the women's physician (76%).
Ferrous fumarate-containing multivitamin
preparations and ferric bisglycinate, although infrequently
recommended as the first-line of iron supplementation, may
be associated with less side effects and better compliance.
Cell (Patho) Physiology
of Magnesium
Wolf EI, et al.
Clin Sci (Lond), 2008 Jan ; 114(1) :27-35.
There is an unsettled debate about the role of magnesium as
a 'chronic regulator' of biological functions, as opposed to
the well-known role for calcium as an 'acute regulator'. New
and old findings appear to delineate an increasingly
complex and important role for magnesium in many cellular
functions. This review summarizes the available evidence
for a link between the regulation of intracellular magnesium
availability and the control of cell growth, energy
metabolism and death, both in healthy and diseased
conditions. A comprehensive view is precluded by technical
difficulties in tracing magnesium within a multicompartment
and dynamic environment like the cell; nevertheless, the
last few years has witnessed encouraging progress towards a
better characterization of magnesium transport and its
storage or mobilization inside the cell. The latest findings
pave the road towards a new and deeper appreciation of
magnesium homoeostasis and its role in the regulation of
essential cell functions.
Iron Deficiency Anaemia Influences
Cognitive Functions
Petranovic D, et al.
Med Hypotheses, 2008 ; 70(1) :70-2.
Many diseases, different nutritional, metabolic and hormonal
changes, ageing and drugs can alter cognitive functions.
Anemia via cerebral hypoxia and other possible mechanisms
has been suggested to have a great influence on cognition.
Iron deficiency anemia, the most common form of anemia, has
been suggested to result in cognitive deterioration and
alteration of neurological functions. Previous studies
resulted in significant discrepancies considering
correlation
between anemia and cognitive achievement mainly because
different or not sensitive enough tests used to measure
cognition. We suggest a significant influence of iron
deficiency anemia on dynamic properties and functional
features of the central nervous system activity. Cognitive
achievement is strongly related to hemoglobin level and
could be
expected in all patients. Higher hemoglobin level results in
better CNS function. As a first step in confirming or
refuting
our hypotheses we suggest standardization of the method used
to measure cognition, such as a very sensitive apparatus
like Complex reactiometer Drenovac (CRD).
Effect of Daily or Weekly
Multiple-Micronutrient and Iron Foodlike Tablets on Body
Iron Stores of Indonesian Infants Aged 6-12 Mo: A
Double-Blind, Randomized,
Placebo-Controlled Trial
Wijaya-Erhardt M, et al.
Am J Clin Nutr, 2007 ; 86 :1680-6.
There is still uncertainty about the best procedure to
alleviate iron deficiency. Additionally more reliable
methods are
needed to assess the effect of iron intervention. The
researchers examined the efficacy of daily iron (10 mg),
daily and
weekly multiple-micronutrient supplementation (10 and 20 mg
Fe, respectively) in improving body iron stores of
Indonesian infants. Infants aged 6-12 mo were randomly
allocated to 1 of 4 groups: daily multiple micronutrients (DMM)
foodlike tablets (foodLETs), weekly multiple-micronutrient (WMM)
foodLETs, daily iron (DI) foodLETs, or daily
placebo. Hemoglobin, ferritin transferrin receptors, and
C-reactive protein data were obtained at baseline and 23
wks.
Body iron estimated from the ratio of transferrin receptors
to ferritin was analyzed for 244 infants. At baseline, mean
iron stores (0.5±4.1 mg/kg) did not differ among the groups,
and 45.5% infants had deficits in tissue iron (body iron
<0). At week 23, the group DI had the highest increment in
mean body iron (4.0 mg/kg), followed by the DMM group
(2.3mg/kg; P<0.001 for both). The iron stores in the WMM
group did not change, whereas the mean body iron declined in
the daily placebo group (-2.2 mg/kg;P<0.001). Compared with
the daily placebo group, the DMM group gained 4.55 mg Fe/kg,
the DI group gained 6.23 mgFe/kg (both P<0.001), and the WMM
group gained 2.54 mg Fe-kg (P+0.001). When compliance can be
ensured, DI and DMM foodLETs are efficacious in improving
and WMM is efficacious in maintaining iron stores among
Indonesian infants.
Serum
Zinc and Pneumonia in Nursing Home Elderly
Meydani SN, et al.
Am J Clin Nutr 2007 ; 86 :1167-73.
The objective was to determine whether serum zinc
concentrations in nursing home elderly are associated
with
the incidence and duration of pneumonia, total and
duration of antibiotic use, and pneumonia-associated and
allcause
mortality. This observational study was conducted in
residents from 33 nursing homes in Boston, MA,
who participated in a 1-y randomized, double-blind, and
placebo-controlled vitamin E supplementation trial; all
were given daily does of 50% of the recommended dietary
allowance of essential vitamins and minerals,
including zinc. Participants with baseline (n=578) or
final (n=420) serum zinc concentrations were categorized
as having low (<70 μg/dL) or normal (≥70μg/dL) serum
zinc concentrations. Outcome measures included
the incidence and number of days with pneumonia, number
of new antibiotic prescriptions, days of antibiotic
use, death due to pneumonia, and all-cause mortality.
Compared with subjects with low zinc concentration,
subjects with normal final serum zinc concentrations had
a lower incidence of pneumonia, fewer (by almost
50%) new antibiotic prescriptions, a shorter duration of
pneumonia, and fewer days of antibiotic use (3.9 d
compared with 2.6 d). Normal baseline serum zinc
concentrations were associated with a reduction in
all-cause
mortality. Normal serum zinc concentrations in nursing
home elderly are associated with a decreased number
of new antibiotic prescriptions, and a decrease in the
days of antibiotic use. Zinc supplementation to maintain
normal serum zinc concentrations in the elderly may help
reduce the incidence of pneumonia and associated
morbidity
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