Anemia Huma, Nuzhat, Salim-Ur-Rehman, Faqir

Anemia

Huma, Nuzhat, Salim-Ur-Rehman, Faqir Muhammad Anjum, M. Anjum Murtaza, & Munir A.

Sheikh. (2007). Food fortification strategy-preventing iron deficiency anemia

Critical Reviews in Food Science and Nutrition, 47(3), 259-65. Retrieved May

8, 2009, from ProQuest Medical Library database. (Document ID: 1255748601).

Because of regular nutritional fortification of food in the developed world, iron deficiency solely due to poor nutrition is a relative rarity. However, according to the article "Food fortification strategy-preventing iron deficiency anemia: A review" from Critical Reviews in Food Science and Nutrition the problem persists in the developing world. In fact, iron deficiency is the most common nutritional deficiency, affecting more than 20% of the world's population at any one time. Although anemia can have other causes, iron deficiency is the most common culprit in developing nations: an estimated 30-60% of women and children in the developing world are plagued by anemia. Iron deficiency is responsible for 78 to 85% of the anemia exhibited by children below age five (Huma 2007)

The developing world is at particular risk for anemia, given that availability of dietary iron is lower and the body's need for iron is higher in these regions, due to common environmental circumstances. "Limited food availability, inadequate or lack of access to health care, poor environmental sanitation and personal hygiene are socioeconomic factors contributing to iron deficiency...[deficiency] is more prevalent in population groups that have high iron requirements because of rapid growth or blood loss" (Huma 2007). Children's developmental needs and women's needs during menstruation, pregnancy, and lactation increase the need for iron. "Well-documented consequences of anemia include diminished learning ability, reduced work capacity, and increased morbidity from infections and greater risk of death associated with pregnancy and childbirth" (Huma 2007). Even in the developed world pregnant women can easily develop anemia during the second and third trimesters, because dietary needs quickly increase to such an unaccustomed, high level (Huma 2007).

For children, iron deficiency can be especially devastating, as the consequences of lacking the necessary daily requirement for iron can result in long-standing developmental challenges that can extend well into adulthood. "Infants born to anemic mothers are more predisposed to low birth weight and prematurity. Iron deficiency without anemia shows poorer performance on tests of cognitive development in children, depresses human productivity, and affects attention capacity among school children. It also affects the immune function and susceptibility to infection. The presence of anemia in children under five years of age is of particular significance because it has a negative impact on mental development and future social performance. Linear growth and physical work capacity, especially endurance exercise, are also negatively affected" (Hama 2007). Early iron deficiency can thus leave a mark on a child for the duration of his or life, and even inhibit the productive growth of a nation, as generation upon generation of children fail to thrive mentally and physically because of the consequences of anemia.

Direct supplementation is often the best method to immediately counteract the effects of anemia. But supplementation alone on a long-term basis is seldom recommended as the sole course of treatment -- dietary rectification is usually required for sustained improvement. Food -- based strategies can include the introduction of iron-rich foods. But in many nations these types of foods may be poorly available, especially iron-rich meat. Iron fortification of foods is another realistic method for reducing the prevalence of deficiency through consumption. In industrialized countries such as America, breakfast cereals and nutritional bars and shakes are regularly supplemented with iron. The choice of breads and other carbohydrates as the vehicle of iron is deliberate, given that flour-based goods and grains like breads and cereals are "frequently consumed, staple foods. Bread is a particularly useful vehicle as the risk for organoleptic deterioration due to the pro-oxidative properties of iron is lower compared to other foods with a higher lipid content and longer shelf life" (Huma 2009). On a whole, "this has had an important beneficial effect; however, nutritional anemia remains very prevalent in developing countries and iron fortification appears until recently to have had little impact. Two important reasons for the latter situation are inadequate documentation of the magnitude of the iron deficiency component of anemia in different regions of the world, and the use of iron compounds that are poorly bioavailable in fortification programs" (Huma 2007). Poor political leadership is another reason for a lack of fortification initiatives in the developing world. Unlike the United States' FDA, a "lack of a centralized source of food processing and distribution limits the feasibility of fortification. Even though the cost of fortification is relatively small as compared to the cost of production and processing, the food industry does not assume responsibility for improving the nutrition of its products without a legislative mandate, proper advocacy, and linkage between the health sector and industry" which is often lacking in the developing world (Huma 2007).