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Newer aspects of Iron supplementation Newer aspects of Iron supplementation
Today’s discussion What we know! What we may not know! What we need to know!
What we know!
Anemia in pregnancy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Anemia in pregnancy  - consequences   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Recommendations to counter IDA ,[object Object],[object Object]
ACOG Recommendations ,[object Object],[object Object],[object Object],[object Object],Which Iron salt?
What me may not know!  How do the iron salts compare, with each claiming to be better!
Different classes of Iron salts ,[object Object],Inorganic Ferrous Sulphate Ferrous Fumarate Ferric ammonium citrate Technological Ferrous ascorbate Elemental Carbonyl Iron Organic Ferric  Polymaltose Chelated iron Ferrous bis glycinate
Iron formulation adoption curve Unrealistic Over-enthusiasm Initial optimism Backlash antipathy Realistic adoption New concept
Iron absorption parameters 6.Bioavailability 5. Elemental iron 7. Phytate inhibition 2. Form administered   4. Dose 3. Status of patient's iron stores 1. Stability in gastric acids
Iron absorption parameters Elemental iron:   Amount of iron in a supplement that is available for absorption. Bioavailability:   Fraction of the elemental iron that reaches the systemic circulation Phytate inhibition  reducing the absorption of iron by 15-fold
Iron absorption parameters ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
1. Iron salts and stomach ,[object Object],[object Object],[object Object],[object Object]
2. Elemental content of Iron salts ,[object Object],[object Object],[object Object]
2. Elemental content of Iron salts  ,[object Object],[object Object]
3. Absorbability of Iron salts  ,[object Object],[object Object]
4. Varying influences & iron absorption ,[object Object],[object Object],[object Object],[object Object]
4. Varying influences & iron absorption ,[object Object],[object Object],[object Object],[object Object]
Relative impact of phytate removal vs. ascorbic acid addition ,[object Object],[object Object]
What we need to know!
Chelated Amino acid Iron complex ,[object Object],1. Bovell-Benjamin AC et al.  Am J Clin Nutr . 2000;71:1563-1569. ,[object Object],[object Object]
Chelated Iron: reactivity ,[object Object]
Chelated Iron: consistency ,[object Object]
Chelated Iron: bio-absorbable ,[object Object]
Chelated Iron: advantages ,[object Object],[object Object],[object Object]
Chelated Iron: no inhibition ,[object Object]
Chelated Iron: tolerability ,[object Object]
Chelated Iron: stability constant ,[object Object],[object Object],[object Object],[object Object],[object Object]
Chelated Iron: absorption ratio ,[object Object],[object Object],[object Object],[object Object]
Chelated Iron: bioavailability ,[object Object],[object Object],[object Object]
Chelated Iron:  ↑  absorption ,[object Object],[object Object],[object Object]
Chelated Iron: -ve feedback ,[object Object],[object Object]
Chelated Iron: regulation ,[object Object],[object Object],[object Object],[object Object]
Chelated Iron: comparison ,[object Object],[object Object],Sodium Ferric Edetate ,[object Object],Ferrous Ascorbate ,[object Object],[object Object],Carbonyl iron
Ferrous ascorbate ,[object Object],The American Society for Nutritional Sciences J. Nutr. 134:395-398, February 2004
Summary ,[object Object],[object Object],[object Object],[object Object],[object Object],Unique chelate design potentially allows for smaller doses with fewer complaints due to better biovailability.

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Iron Salt Comparison New

  • 1. Newer aspects of Iron supplementation Newer aspects of Iron supplementation
  • 2. Today’s discussion What we know! What we may not know! What we need to know!
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  • 8. What me may not know! How do the iron salts compare, with each claiming to be better!
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  • 10. Iron formulation adoption curve Unrealistic Over-enthusiasm Initial optimism Backlash antipathy Realistic adoption New concept
  • 11. Iron absorption parameters 6.Bioavailability 5. Elemental iron 7. Phytate inhibition 2. Form administered 4. Dose 3. Status of patient's iron stores 1. Stability in gastric acids
  • 12. Iron absorption parameters Elemental iron: Amount of iron in a supplement that is available for absorption. Bioavailability: Fraction of the elemental iron that reaches the systemic circulation Phytate inhibition reducing the absorption of iron by 15-fold
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  • 21. What we need to know!
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Editor's Notes

  1. Speaker Notes For purposes of this presentation, we will use the definitions on this and the following 3 slides Many of these definitions have been established by organizations involved in developing nutritional guidelines for groups and populations Some of them were agreed upon by the Council for purposes of the roundtable discussion—these are marked with a double asterisk We will use these definitions to maintain a common language as we discuss prenatal nutrition I won’t comment on all of them, but will focus on those that may not be as familiar as others An adequate intake, or AI, value is established for a nutrient when there is insufficient scientific data available to establish an RDA An AI level generally meets or exceeds the amount of a nutrient needed to maintain an adequate nutritional state in the majority of members of a specific age and gender group Dietary reference intakes , or DRIs , are a comprehensive set of nutrient reference values for healthy populations that can be used to plan and assess appropriate diets DRIs reflect the current state of scientific knowledge regarding nutrient requirements and include RDAs, AIs , and tolerable upper intake levels
  2. Speaker Notes For purposes of this presentation, we will use the definitions on this and the following 3 slides Many of these definitions have been established by organizations involved in developing nutritional guidelines for groups and populations Some of them were agreed upon by the Council for purposes of the roundtable discussion—these are marked with a double asterisk We will use these definitions to maintain a common language as we discuss prenatal nutrition I won’t comment on all of them, but will focus on those that may not be as familiar as others An adequate intake, or AI, value is established for a nutrient when there is insufficient scientific data available to establish an RDA An AI level generally meets or exceeds the amount of a nutrient needed to maintain an adequate nutritional state in the majority of members of a specific age and gender group Dietary reference intakes , or DRIs , are a comprehensive set of nutrient reference values for healthy populations that can be used to plan and assess appropriate diets DRIs reflect the current state of scientific knowledge regarding nutrient requirements and include RDAs, AIs , and tolerable upper intake levels