Sight and Life Magazine 1/2011

12 SIGHT AND LIFE STATEMENTcolonic microflora in African children to create a potentiallymore pathogenic profile. If this is confirmed, it could help to explainthe reported adverse effects of iron supplementation andbolus doses of iron.The other potential mechanism discussed is the formationof non-transferrin-bound iron (NTBI). Recently presented dataon the formation of NTBI 8 after administration of iron in womenwith low iron status (NTBI formation monitored over eight hours),showed that the highest NTBI concentrations were produced bya 60 mg dose without food, followed by 60 mg and 6 mg withfood. These first data indicate that iron administered with foodand through fortification (rather than supplementation) resultedin lower NTBI formation.“The two-step approach of optimizingthe MNP formulation for malariaendemic areas is expected to be saferthan typically used iron doses”In conclusion, based on current knowledge, the two-step approachof optimizing the MNP formulation for malaria endemic areasis expected to be safer than typically used iron doses (12.5 mg).The reduction of the iron dose to levels closer to the amount of ironprovided in food fortification helps to reduce the amount of unabsorbediron in the intestine. Meanwhile, using a highly bioavailableiron compound in combination with iron absorption enhancersis crucial to supplying the individual with the iron needed.References01. WHO/WFP/UNICEF Joint Statement. Preventing and controllingmicronutrient deficiencies in populations affected by an emergency.Multiple vitamin and mineral supplements for pregnant andlactating women, and for children aged 6 to 59 months. WHO,2007.02. Sazawal, S, Black R, Ramsan M et al. Effects of routine prophylacticsupplementation with iron and folic acid on admission to hospitaland mortality in preschool children in a high malaria transmissionsetting: community-based, randomized, placebo-controlled trial.Lancet 2006;367(9505):133–4303. Oppenheimer SJ. Iron and its relation to immunity and infectiousdisease. J Nutr 2001;131(2S-2):616S-633S; discussion 633S–635S.04. Ojukwu J, Okebe J, Yahav D et al. Oral iron supplementation forpreventing or treating anemia among children in malaria-endemicareas. Cochrane Database Syst Rev 2009;(3): CD006589.05. WHO. Conclusions and recommendations of the WHOConsultation on prevention and control of iron deficiency in infantsand young children in malaria-endemic areas. Food Nutr Bull2007;28:S621–S706. Hurrell, R, Ranum P, de Pee S et al. Revised recommendations foriron fortification of wheat flour and an evaluation of the expectedimpact of current national wheat flour fortification programs.Food Nutr Bull 2010;31(1 Suppl):S7–2107. Zimmermann, M, Chassard C, Rohner F et al. The effects of iron fortificationon the gut microbiota in African children: a randomizedcontrolled trial in Côte d'Ivoire. Am J Clin Nutr 2010;92:1406–15.08. Egli I, Brittenham G, Zeder C et al. The influence of supplementationand fortification iron doses on the formation of plasma-nontransferrin-boundiron. (UC Davis) Conference on Bioavailability,Asilomar, CA, September 26–30, 2010 (only abstract available)