Protein Metabolism and Erythropoiesis. I. The Anemia of Protein Deprivation

Abstract

(1) Protein deprivation in rats resulted in a rapid depression of iron incorporation. The depression reached its maximum within 6 days. Realimentation with protein was followed within 3 days by a return of iron incorporation to normal values. (2) Red cell mass declined during protein starvation in a linear fashion, indicating a removal of senescent red cells after a life span of 70 days. The increasing severity of the anemia of protein starvation is the cumulative result of this removal in the absence of any significant replacement. (3) Daily injections of 1.3 units of erythropoietin prevented a decrease in red cell mass over an observation period of 28 days of protein starvation. (4) Diminished erythropoietin formation or retardation of protein synthesis in erythroid precursors due to lowered substrate concentration are considered as possible causes of erythropoietic depression.

Erythropoietin Levels in Cord Blood as an Indicator of Intrauterine Hypoxia

“…One must assume that the malnourished foetus will be less able to respond to hypoxia with raised erythropoietin production. I n protein deprived rats the erythropoietin production is known to be significantly lowered [16].…”

Multi-Nutrient Fortified Dairy-Based Drink Reduces Anaemia without Observed Adverse Effects on Gut Microbiota in Anaemic Malnourished Nigerian Toddlers: A Randomised Dose–Response Study

“…Additionally, protein deficiency is a possible cause of non-ID anaemia as protein is necessary for Hb synthesis. This type of anaemia is reversible by feeding a complete protein [ 33 ] such as the cow’s milk protein in the multi-nutrient fortified dairy-based drink in the present study. Therefore, the observed effect of this study might be partly due to increased protein intake.…”

“…Moreover, the consumption of cow’s milk by toddlers is reported to be associated with declining iron stores [ 32 ]. Rivera et al did not discuss this finding in the nonfortified group in detail but the improvement suggests an effect of other nutrients, possibly protein coming with the milk [ 33 ], change in diet, or other features associated with the program. De-worming, which is known to reduce anaemia, did not take place in the Mexican study [ 31 ].…”

“…Although ID in the Mexican study contributed more to the cause of anaemia as compared to our study, it was not the major contributor to anaemia either. Other reported major causes of anaemia are concurrent infection (including parasites), RBC- and/or iron metabolic diseases, acquired- and autoimmune-haemolytic anaemia, hypersplenism, transient erythroblastopenia, hypothyroidism, vitamin B12 or folate shortcomings, and protein deficiency [ 33 , 37 ]. From this list, it is unlikely that vitamin B12 and folate deficiencies were major causes in the present study since their prevalences at baseline were 3% and 12%, respectively.…”

“…However, as a dose–response effect was observed in this study it can be concluded that the multi-nutrient fortified dairy-based drink relevantly contributed to the reduced anaemia. The total composition of multi-nutrient fortified dairy-based drink, but in particular the combination of a good available iron source (ferrous sulphate), sufficient vitamin C (to further stimulate iron availability), and likely also the cow’s milk protein, probably contributed to this beneficial effect on anaemia [ 33 , 45 , 46 ].…”