Sight and Life Magazine 1/2011

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50 IRON FORTIFICATION – NEW REVELATIONS?table 4: Total numbers of bacteria in control and iron groupafter 6 months iron supplementation ¹Control Group¹ Data shown are mean (SE) log number of bacteria/g fecesIron GroupBaseline 11.29 (0.67) 11.62 (0.94)6 Months 11.28 (0.81) 11.78 (0.59)table 5: Comparison of main bacterial groups in feces of Ivorianchildren and young European adultsBacterialIvorian children Young European adultsgroupBacteroidesEnterobacteriaBifidobacteriaLactobacilliData for Ivorian childrenfrom reference Log numberbacteria/g feces1087.56.5from reference 3 and forLog numberbacteria/g feces9.25.99.26.7European adultsof enterobacteria by a further 100 million (log numbers 7.8 to8.3 bacteria/g feces) while reducing the proportion of lactobacilli(Figure 2). If these changes in enterobacteria and lactobacilliare expressed as percentages of the total number of bacteriain the microbiota, there is a four-fold increase in enterobacteriafrom 0.01 to 0.039%, while there is a fourfold fall in the proportionof lactobacilli from 0.004% to 0.001%. There was also afall in bifidobacteria, but this was not significant.Reasons why iron favored the growth ofenterobacteria over lactobacilliIron is a nutrient which is essential for the growth of most bacteria,but not in the case of most Lactobacilli spp (Table 3). Mostenteric gram-negative pathogens, including Salmonella spp,E.coli and Shigella spp, 18 take up iron-siderophore complexesby specific outer membrane receptors and display increasedvirulence in situations of increased iron availability. 32 It is alsointeresting to note that fecal lactoferrin is as good an indicatorof gut inflammation as calprotectin. 33 Lactoferrin is a powerfuliron-binding protein that is particularly effective under acid conditionsand is derived from the polymorphonuclear neutrophilsthat are drawn into the gut lining at the onset of inflammation.Whether the neutrophil lactoferrin depresses pathogen growthat the mucosal lining is not known, but bacterial growth in themicrobiota will be limited by iron availability, and the additionaliron provided by the supplement may have provided a growthadvantage for the enterobacteria, which enabled them to increasecell numbers at the expense of the lactobacilli and possiblythe bifidobacteria.The potential hazards of iron loading are well recognized. 34Not only do we have the results of the recent study in Pemba 1but it has previously been noted that iron given to patients withquiescent tuberculosis appeared to reactivate the disease. 35 Inaddition, Murray and colleagues noted that, in areas of hyperendemicPlasmodium falciparum, patients with clinical irondeficiency enjoyed an attenuated incidence and severity of malariabut when such subjects were fed an iron-replete diet, manyexhibited a recrudescence of malaria 36 and when iron-deficientMaasai pastoralists were treated with iron, there was an increasein amebiasis in the iron group. 37The significant correlation between the increase in enterobacteriaand fecal calprotectin concentrations (r = 0.32, P
SIGHT AND LIFE | VOL. 25 (1) | 2011 IRON FORTIFICATION – NEW REVELATIONS? 5151Fecal Calprotectin μg/g fecesfigure 3: Profile of fecal bacteria in Ivorian childrenbefore iron supplementation80706050403020100Control 0Control 6Iron 0Iron 6Calprotectin concentrations were measured by immunoassay and expressedas μg/g feces. Median calprotectin level in healthy subjectswas described as 26 μg/g. 29 Concentration in the children who receivedadditional iron increased significantly (*, ANOVA with post hoc t-tests,P
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Page 6 and 7: 6What is abrand ?It would be imposs
Page 8 and 9: 8EDITORIALOur history between two c
Page 10 and 11: 10 SIGHT AND LIFE STATEMENTSight an
Page 12 and 13: 12 SIGHT AND LIFE STATEMENTcolonic
Page 16 and 17: 16THE IMPORTANCE OF VITAMIN AThe Im
Page 18 and 19: 18 THE IMPORTANCE OF VITAMIN Afor t
Page 20 and 21: 20 THE IMPORTANCE OF VITAMIN ARetin
Page 22 and 23: 22 THE IMPORTANCE OF VITAMIN ADespi
Page 24 and 25: 24 THE IMPORTANCE OF VITAMIN Afigur
Page 26 and 27: 26 THE IMPORTANCE OF VITAMIN Afigur
Page 28 and 29: 28 THE IMPORTANCE OF VITAMIN A30. M
Page 30 and 31: 30THE FEASIBILITY OF DELIVERING VIT
Page 32 and 33: 32 THE FEASIBILITY OF DELIVERING VI
Page 38 and 39: 38FROM AGRICULTURE TO HORTICULTURE
Page 40 and 41: 40 FROM AGRICULTURE TO HORTICULTURE
Page 42 and 43: 42 FROM AGRICULTURE TO HORTICULTURE
Page 44 and 45: 44IRON FORTIFICATION - NEW REVELATI
Page 46 and 47: 46 IRON FORTIFICATION - NEW REVELAT
Page 56 and 57: 56 OPINION 1 / 2depending upon spec
Page 58 and 59: 58A DAY IN THE LIFE OF JOHANN C JER
Page 60 and 61: 60 A DAY IN THE LIFE OF JOHANN C JE
Page 62 and 63: 62ewsFourth AfricaNutritional Epide
Page 64 and 65: 64 THE FIRST GLOBAL CONFERENCE ON B
Page 66 and 67: 66 THE FIRST GLOBAL CONFERENCE ON B
Page 68 and 69: 68 NEW DEVELOPMENTS IN CAROTENOIDS
Page 70 and 71: 70 NEW DEVELOPMENTS IN CAROTENOIDS
Page 72 and 73: 72Reportfrom GogounouBlessings at t
Page 74 and 75: 74 REPORT FROM KATHMANDUReportfrom
Page 76 and 77: 76 REPORT FROM KATHMANDUPregnant wo
Page 78 and 79: 78 REPORT FROM RATANAKKIRIReport fr
Page 80 and 81: 80nd Life Special Research Grant 20
Page 82 and 83: 82 WHAT'S NEWEach Task Force is fin
Page 84 and 85: 84 WHAT'S NEWgroups; distribution c
Page 86 and 87: 86 WHAT'S NEWFood and nutrition sec
Page 88 and 89: 88 WHAT'S NEWricesYet Again …09Ri
Page 90 and 91: 90 WHAT'S NEWA2Z: The USAID Micronu
Page 92 and 93: 92 WHAT'S NEW4ne Collaboration Join
Page 94 and 95: 94WHAT'S NEW17Atmala’s Medal of S
Page 96 and 97: 96Comments on the Comparison of the
Page 98 and 99: 98Editor’s note: Sight and Life r
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100 PUBLICATIONSOmega-3Fatty Acids
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Sharingknowledgefor improvednutriti
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Buildingbridgesfor betternutrition.
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Sight and Life Magazine 1/2011

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