We report an outbreak of acute selenium poisoning among suckling pigs; 92 piglets were found dead or moribund without preceding symptoms. Necropsy revealed acute congestion of liver and small intestine. The source was a powdered iron supplement contaminated by sodium selenite.
Data collected from nationally representative samples of HD patients (n = 11,041) in 2002 to 2003 were used to describe current anemia management for long-term HD patients at 309 dialysis units in 12 countries. Analyses of associations and outcomes were adjusted for demographics, 15 comorbid classes, laboratory values, country, and facility clustering.
For patients on dialysis therapy for longer than 180 days, 23% to 77% had a hemoglobin (Hgb) concentration less than 11 g/dL ( or =110 g/L) if they were older; were men; had polycystic kidney disease; had greater albumin, transferrin saturation, or calcium levels; were not dialyzing with a catheter; or had lower ferritin levels. Facilities with greater intravenous iron use showed significantly greater facility mean Hgb concentrations. Mean EPO dose varied from 5,297 (Japan) to 17,360 U/wk (United States). Greater country mean EPO doses were significantly associated with greater country mean Hgb concentrations. Several patient characteristics were associated with greater EPO doses. Even in some countries with high intravenous iron use, 35% to 40% of patients had a transferrin saturation less than 20% (below guidelines).
These findings indicate large international variations in anemia management, with significant improvements during the last 5 years, although many patients remain below current anemia guidelines, suggesting large and specific opportunities for improvement.
For many pregnant Canadian women, usual iron intakes from food appear to be inadequate compared with Dietary Reference Intake requirement estimates.
Dietary intake modeling was undertaken to determine an amount of iron supplementation that would confer acceptably low prevalence of apparently inadequate and apparently excessive intakes.
The distribution of usual dietary iron intakes was estimated with the use of 24-h recalls from pregnant women aged 19-50 y in the Canadian Community Health Survey, Cycle 2.2. The prevalence of usual intakes below the Estimated Average Requirement for pregnancy (22 mg/d) or above the Tolerable Upper Intake Level (45 mg/d) was estimated. Iterative modeling with incremental iron supplement was performed to determine a suitable supplement amount. Because the sample of pregnant women was small (148 day 1 recalls), estimates of the tails of the distributions had large SDs, and supporting analyses based on intake data from nonpregnant women (4540 day 1 recalls) were made.
Daily supplementation shifted the intake distribution curve without changing its shape. Supplementation with 16 mg iron/d was consistent with low (
According to examination, with the help of emission spectrum analysis method, of 24 cadets-athletes of different specialization it was determined that during physical exercise in summer and in winter loss of ferrum and copper with excrements exceeded the intake if these microelements with food. The next day rise of impaction of microelements and decrease of excretion. But despite the positive balance of ferrum and copper, spend of these microelements during physical exercise wasn't compensated for the day of rest. That is why there is a possibility of microelement deficit.
Women (n = 45; 18-48 years) with serum ferritin less than or equal to 20 micrograms/l and haemoglobin greater than 120 g/l participated in an iron supplement bioavailability study. They were randomized to one of three groups and given one of three different low-dose supplements (18-20 mg iron/d) for 6 months. One of the supplements contained haem iron and non-haem iron, the others contained non-haem iron only. Serum ferritin, haemoglobin, serum iron and total iron binding capacity (TIBC) were determined at start and after 1, 3 and 6 months. Dietary intakes were recorded during 4 and 3 consecutive days after 1 and 3 months, respectively, by the aid of household measures and a set of food models. The increase in mean serum ferritin was significant (P less than 0.01) for two of the supplements, the one containing haem iron giving the best result. All the supplements resulted in a significant (P less than 0.011) mean decrease in TIBC. No significant differences between the groups were found in daily intakes of food factors known to influence iron absorption. The improvement in iron status was therefore attributed to the supplements. None of the supplements caused iron intolerance. Thus low-dose iron supplements given to iron depleted non-anaemic women may be an alternative to high-dose therapy.
To assess whether increased body iron stores and dietary iron intake are associated with an increased risk of coronary heart disease mortality.
A prospective population study with a mean mortality follow-up time of 14 years.
Participants attending a health screening examination carried out in several localities in Finland.
All 6086 men and 6102 women aged from 45 to 64 years at the baseline examination without known heart disease, who had had serum iron and total iron binding capacity (TIBC) assessed. In a random fifth of these people, dietary iron intake was assessed by a dietary history.
The study was observational without any interventions.
Mortality from coronary heart disease.
Altogether, 739 of the men and 245 of the women died from coronary heart disease. No relationship between TIBC and coronary mortality was observed in the men; in the women, an inverse although not significant association was found. Transferrin saturation was inversely but not significantly associated with coronary mortality in men; in women, the relationship was U-formed with a higher mortality at both the lower and higher ends of the distribution. Adjustment for other risk factors did not alter the results. No association was found with dietary iron intake and coronary mortality.
The results do not corroborate earlier findings that excess body iron stores and increased iron intake are associated with an elevated risk of coronary heart disease.
To identify associated factors to compliance for multiple micronutrient (MM) or iron and vitamin A (IVITA) supplementation, in children (3 to 24 months old).
A database (n=465 children) from a randomized, controlled, clinical trial, carried out in a semi-rural setting in Mexico, was analyzed. The compliance rate of MM and IVITA supplements was calculated. Adequate compliance rate (AC>80%), and its association with children and households characteristics, was determined.
The compliance mean was high (MM:78.2%, IVITA:80.1%; p
BACKGROUND: Health authorities recommend that populations consume a diet providing sufficient iron, and in order to prevent iron deficiency, a number of countries have fortified certain foods with iron. In Denmark, flour was fortified with iron from 1954 until 1987, at which time the mandatory fortification was stopped. This study examines the effect of iron fortification on iron status by comparing the intake of iron with serum ferritin over time and in relation to the removal of flour fortification. METHODS: In a cohort of 238 Danish men and women, at baseline ages 35-65 years, dietary intake and serum ferritin were measured, first in 1987/1988 and again in 1993/1994. RESULTS: In 1987/1988 the fortification may have supplied up to 25% of total iron intake, and without this enrichment some 35% of the men and 73% of the women may have had iron intakes lower than 10 mg/day. Assuming that no flour was enriched, iron intake was constant during the 6-year study period. Despite this, after flour fortification was stopped in 1987, serum ferritin increased among both men and postmenopausal women. CONCLUSIONS: Considering that mandatory iron fortification of flour affects the entire population, including subjects who are at risk for chronic diseases because of too-high iron stores, the decision to stop the mandatory fortification in Denmark seems to have been well-founded.
Diagnostic criteria for iron deficiency (ID) and iron deficiency anemia (IDA) in infants are poorly defined. Our aim was to establish appropriate cut-off values for hemoglobin (Hb), plasma ferritin, erythrocyte mean cell volume (MCV), zinc protoporphyrin (ZPP) and soluble transferrin receptors (TfR) in infancy. Exclusively breast-fed infants (n = 263) in Honduras and Sweden were randomly assigned to receive iron supplementation or placebo, and blood samples were obtained at 4, 6 and 9 mo of age. Reference ranges were determined using three different approaches for defining iron-replete infants. The usefulness of several variables for predicting the Hb response to iron was evaluated. We found the following 2 SD cut-off values in iron-replete infants: Hb 75 micro mol/mol heme at 4-6 mo and >90 micro mol/mol heme at 9 mo; ferritin 11 mg/L at 4-9 mo. The Hb response to iron was not a useful definition of IDA at 4 mo of age. Hb, MCV and ZPP at 6 mo as well as growth variables predicted the Hb response at 6-9 mo, but ferritin and TfR at 6 mo did not. We conclude that there is need for a reevaluation of the definitions of ID and IDA in infants.
BACKGROUND. The role of diet as a risk factor for osteoporotic fractures is unclear. Earlier studies have yielded conflicting results. METHODS. In two counties in central Sweden we investigated the association between dietary intake and the risk of proximal femoral fractures in a case-control study nested in a cohort. Women born in 1914-1948 were asked to fill out a food frequency questionnaire when invited to attend for mammographic screening between the years 1987 and 1990. More than 65,000 women completed the questionnaire. Those who had participated in the enquiry and subsequently sustained a first hip fracture were defined as cases. For every case, four individually matched controls, by age and county of residence, were selected from the cohort. A second questionnaire concerning confounding factors was mailed to controls and cases. In all, 247 cases and 893 controls could finally be included. Monthly intake of foods and daily intake of nutrients were calculated. RESULTS. When highest quartile of intake was compared to lowest, intakes of iron (adjusted odds ratio [OR] of 3.3, 95% confidence interval [CI]: 1.6-6.9), magnesium (adjusted OR = 2.7, 95% CI: 1.3-6.0) and vitamin C (adjusted OR = 1.9, 95% CI: 1.2-3.1) were found to be independent risk factors for hip fracture. High calcium intake did not protect against hip fracture. Smoking, low physical activity in leisure time, low body mass index, earlier fracture of the distal forearm and diabetes were all risk factors while postmenopausal hormone replacement therapy protected against hip fracture. DISCUSSION. This large study indicates new dietary risk factors for hip fracture. The association between high dietary intake of iron, magnesium and vitamin C and risk of hip fracture has not been reported previously. Further clinical and experimental studies are needed to confirm these findings and to investigate their mechanism of action.