Whilst iron is considered a trace mineral in our body, it is still essential because iron is an important component of hemoglobin. This is why Iron Deficiency Anaemia (IDA) is a grave health concern because the British Nutrition Foundation (2004) reported that “3% of men and 8% of women have a haemoglobin concentration indicative of iron deficiency anaemia… Whilst in children, 3% of boys and 8% of girls aged 4-6 years, 1% of boys and 4% of girls aged 7-10 years, and 1% of boys and 9% of girls aged 15-18 years have haemoglobin concentrations indicative of iron deficiency anaemia. In addition, 11% of men and 9% of women aged 65 years and over have haemoglobin concentrations indicative of iron deficiency anaemia”. The World Health Organization (WHO) has more alarming facts about IDA because they reported that IDA is the most common nutritional disorder in the world. They reported 3.7 billion people to have iron deficiency and most of them are women. Worse, more than half of pregnant women (58%) in developing countries are anemic.
The occurrence of IDA is a sad fact because can be easily taken from many food sources. Andrews (1999) informed that the form of iron in foods influences greatly how much is absorbed. About 40% of the total iron in animal flesh is in the form of hemoglobin (the same form as in red blood cells) and myoglobin (pigment found in muscle cells). This heme iron is absorbed about two to three times more efficiently than the simple elemental iron, called non-heme iron. If neither the diet nor body stores can supply the iron needed for hemoglobin synthesis, the number of red blood cells will decrease in the bloodstream. The blood hemoglobin concentration also falls. Physicians use both the percentage of red blood cells (called the hematocrit) and the hemoglobin concentration to assess iron status, along with the amount of iron and iron-containing proteins in the bloodstream. When hematocrit and hemoglobin fall, an iron deficiency is suspected. In severe deficiency, hemoglobin and hematocrit fall so low that the amount of oxygen carried in the bloodstream is decreased. Such a person has anemia, defined as a decreased oxygen-carrying capacity of the blood.
Hemoglobin metabolism involves formation and breakdown. The formation is initiated by the process of absorption. Unlike most elements, iron has no specific mechanism for excretion so that absorption must be closely monitored to control body content and ensure replacement of the daily loss. Many factors influence absorption, especially gastric acid, which can degrade iron salts and prevent their precipitation in the duodenum. In the duodenum, iron rapidly enters the mucosal cells of the intestinal villi, where the iron is released from heme by the enzyme heme oxygenase. There, the ferrous iron destined for the formation of hemoglobin in the developing red cells of the marrow (the erythroblasts) is converted to ferric ions by ceruloplasmin and is attached to the transport glycoprotein transferrin. The non-assimilated iron remains in the intestinal cell and is combined with the storage protein apoferritin to form ferritin, which is lost by the body when the mucosal cells are shed after their 3-5-day life cycle. The mechanism by which the mucosal cell knows what to discard and what to assimilate is unknown (Andrews, 1999).
Infants, young children, pregnant women, and pre-menopausal women are the people who are most susceptible to IDA because they need more iron. During development, the baby draws iron away from its mother for itself. When the baby is born, the iron requirements are met by stores of iron in the infant’s body together with iron in the breast or formula milk. By 6 months, the stores have been used up and milk alone does not provide enough iron for the infant. This is why, “solid food should be provided after 6 months of age should include rich sources of iron, e.g. red meat” (British Nutrition Foundation, 2004). Active children need iron also because they are rapidly building up muscles. The variation in menstrual blood loss, and hence, loss of iron, makes it difficult to set iron requirements for women. Women who menstruate more heavily and longer than average may need even more dietary iron than those who have lighter and shorter flows.
Ultimately, the causes of iron deficiency are easy to understand when one accepts the fact that there is no physiologic pathway for iron excretion. Iron deficiency will result from any condition in which dietary iron intake does not meet the body’s demands. To reduce the incidence of IDA, it is recommended that people should not neglect iron-rich food sources in their diets. Good iron food sources are liver, blood sausage, red meat, eggs, whole-grain bread, cereals and molasses. Vegetarians need to take Vitamin C in order to absorb iron effectively from vegetables. However, the most important step in curbing IDA will be the awareness of people about iron deficiency. When they are properly informed, people would not neglect iron food sources in their diets. Government policies in requiring food companies to fortify their products with iron can also help in a little way. Iron supplements can also be recommended but because of the risk of toxicity, any use of iron supplements should be supervised by a physician.
Bibliography
Andrews, N. 1999, December 23. Disorders of iron metabolism, The New England Journal of Medicine, 341(26): 1986-1996.
British Nutrition Foundation. 2004. Iron and health. Web.