Iron‐deficiency anemia in infant development: Implications for growth, cognitive development, resistance to infection, and iron supplementation

Abstract

Iron plays an important role in many metabolic processes, including oxygen transport, oxidative metabolism, and cellular growth. During infancy, inadequate supply of iron resulting in iron-deficiency anemia is associated with morbidity, impaired growth, and decreased behavior and psychomotor development. Although iron requirements during infancy have become better defined, iron-deficiency anemia persists as one of the most common health problems worldwide, a condition that affects approximately 20-25% of the world's infants. Today, much attention is being given to not only preventing iron-deficiency anemia but also to avoiding excessive iron supplementation. There is concern that excessive and widespread iron supplementation could lead to decreased resistance to infection and promotion of gastrointestinal illnesses. However, the literature on the relationship between iron status and chronic infection and disease contains conflicting viewpoints. Some investigators contend that mild iron-deficiency is beneficial for immunity whereas others argue that any deficits in iron status are detrimental. Iron absorption and metabolism are influenced by interactions between iron and other dietary nutrients. Many components of the diet act to inhibit or enhance iron absorption; this information is critical for food fortification programs designed to prevent iron-deficiency anemia worldwide. This paper reviews some of the biological characteristics of iron metabolism and absorption, iron needs during infancy, interactions of iron with other nutrients, methods for hematological assessment, iron-deficiency anemia and growth, the relationship between iron-deficiency anemia and infant psychomotor development, and the impact that iron supplementation has on resistance to infection and gastrointestinal illnesses. The serious consequences of iron-deficiency anemia for infant health, behavior and development, and the widespread prevalence of this disorder are reasons for its prevention. The benefits of oral supplementation of iron appear to outweigh the possibility of iron excess during infancy, a period of rapid growth and development characterized by a marginal dietary supply of iron.

Porotic hyperostosis and cribra orbitalia in human remains from southern Patagonia

“…While some studies reported similar results (e.g. Stuart-Macadam, 1989, 1998Keenleyside and Panayotova, 2006), others have noted a higher frequency of porotic lesions in women, considering menstruation, childbirth, and lactation as factors that increase the risk of anemia (Ryan, 1997;Stuart-Macadam, 1998). Nevertheless, since porotic hyperostosis is probably developed during childhood, the results are only informative about that period and possibly indicate that girls and boys were not exposed to differential factors that produced anemia.…”

Evolutionary Ecology, Resource Depression, and Niche Construction Theory: Applications to Central California Hunter-Gatherers and Mimbres-Mogollon Agriculturalists

“…Although the specific causes of these lesions continue to be debated (see Walker et al 2009), bioarchaeologists generally interpret the condition as evidence of osseous response to acquired anemia that is initiated in infancy or early childhood (Blom et al 2005;El-Najjar et al 1976;Grauer 1993;Kent 1986;Stuart-Macadam 1985, 1987a, b, 1989Walker 1985Walker , 1986Wright and Chew 1998). However, the likely causes are multifactorial and have been attributed to irondeficient diets, iron loss due to intestinal parasitism or diarrheal disease, or the sequestration of iron due to infection (Holland and O'Brien 1997;Kent 1986Kent , 1992Mensforth et al 1978;Ortner 2003;Ryan 1997;Stuart-Macadam 1992). Acquired anemia is the result of below normal levels of red blood cells or the hemoglobin within them, which affects the efficiency of the transport of oxygen from the lungs to other bodily tissues (Stuart-Macadam 1992).…”

Juvenile Subsistence Effort, Activity Levels, and Growth Patterns

“…High-carbohydrate, low-protein diets appear to have more profound effects on growth delays and faltering than do the nutrient-diverse, but low-calorie, diets typical of foragers. For example, nutritional studies find that iodine and iron deficiencies are associated with delayed growth and compromised stature (Brabin and Brabin 1992;Ryan 1997). These key nutrients are found in fish and meat, which represent about 25% of the Pumé diet but are often limited in carbohydrate-rich and agricultural diets.…”

“…2 Juveniles in preindustrial societies have complex economic relationships with their caretakers, who often provide some portion of what juveniles need (Bird and Bliege Bird 2005;Bliege Bird and Bird 2002;Blurton Jones 1993;Blurton Jones et al 1989, 1994, 1997Cain 1977;Kaplan 1996;Kasarda 1971;Kramer 2002;Lee and Kramer 2002;Nag et al 1978;Reynolds 1991;Sugiyama and Chacon 2005;Turke 1988;Zeller 1987). Juveniles are able to produce some of what they need at the level of their own consumption and other resources in excess of their consumptionfetching water, harvesting, fishing, foraging for fruit, and collecting shellfish are good examples.…”