Iron Deficiency in Developing Countries - Essay Example

Discuss the strengths and limitations of each of the following strategies that may be used to reduce the prevalence of iron deficiency in developing countries 1) Dietary diversification of foods and more bio available iron 2) Fortification of staple foods 3) Iron Supplementation. Introduction: Iron Deficiency in Developing countries Iron deficiency is one of the most common nutritional deficiencies especially in developing countries. It is common among children and women of reproductive age and can be life threatening. Iron is important to our health as the presence of ion in the body in sufficient amounts means a healthy blood system. The transportation of oxygen all over the body depends on a good supply of iron (to make haemoglobin) and is one of the most important functions of iron in our bodies. Therefore without enough iron to allow for the transportation of oxygen all living organisms are at risk of death. Other effects of the deficiency include stunted growth; iron deficiency induced anaemia and impaired muscle function. Some of the symptoms of iron deficiency include fatigue, rapid heart rate, palpitations and rapid breathing on exertion, smooth tongue and brittle nails. Iron deficiency can also be detected through a blood test for feritin levels. Iron is obtainable through diet and supplementation. These foods are recommended as being high in iron, beef or chicken liver, potatoes with skin, soy, and spinach and other green leafy vegetables, pumpkin seeds among others. It is important to know that certain other healthy foods may inhibit the absorption of iron even when the diet has been adjusted to increase iron levels in the body. These are; red wine, coffee & tea vegetables: spinach, chard, beet greens, rhubarb and sweet potato whole grains and bran soy products. Foods that enhance the absorption of iron in the body include; meat/fish/poultry, fruits: orange, orange juice, cantaloupe, strawberries, grapefruit and vegetables: broccoli, Brussels sprouts, tomato, tomato juice, potato, green & red peppers white wine. Iron deficiency is a serious problem in developing countries due to a number of factors. According to the World Health Organisation 2 billion people suffer from iron deficiency world wide. Most of these people live in developing countries where the problem is exacerbated by other conditions and factors like: diseases; malaria, HIV status, hook worm infestation schistosomiasis, and tuberculosis, poverty hence poor nutrition and insufficiently heath care services. Overall, it is the most vulnerable, the poorest and the least educated who are disproportionately affected by iron deficiency, and it is they who stand to gain the most by its reduction WHO (2009). It is important to manage iron deficiency because it affects the productivity of workers in these developing countries. Iron deficiency leads to underperformance and missed work days. The WHO believes that iron deficiency should be tackled together with anaemia as they occur together and that measures should be broad ranged and multisectoral and should be adapted to local conditions (Ibid). Some of the measures identified include; increase iron intake, control infection, improve nutritional status. Increasing iron deficiency can be arrived at through three major methods; dietary diversification including iron-rich foods, and enhancement of iron absorption, food fortification and iron supplementation. This paper will now discuss the strengths and limitations of each one of these three methods. Dietary diversification of foods and more bio available iron Dietary diversification for the prevention and treatment of iron deficiency involves the promotion of wider selection of food that may be iron rich. Dietary diversification is important to ensure maximum absorption of iron. As seen above certain foods act as iron absorption inhibitors while others are simply very low sources of iron. The diets of most peole in developing countries are iron poor due to the high cost of iron rich foods. In a research carried out in Bangladesh where the staple diet is rice; very high in phytates which chelates iron, thus diminishing its absorption IFPRI (2000). Dietary diversification offers advantages in that it ensures consumption of needed vitamins and minerals, but also gives access to other elements, such as antioxidants and probiotics that occur naturally in food and have important health benefits FORTAF (2009). However, they require a lot of input in terms of costs and the time it takes to register any improvements. Fortification of staple foods Staples foods can be fortified with any of the nutrients in question. Milk and flour have for a long time been fortified with vitamin d and folic acid respectively with positive results. Similarly salt has been fortified with iodine for the prevention of thyroid disorders with good results; 75 % of households worldwide use iodine fortified salt WHO (2007). Foods that can be fortified with iron include rice, wheat flour, and manufactured food items like biscuits. There are some advantages to using this method; there will be adequate and frequent consumption of the target staple food by the population in question because it is the staple food. If other foods that are not indigenous to the region are used a good number of people may be missed. At the same time local staple foods will be easily affordable by local people in developing countries where imported food may be costlier for the average citizen. Secondly, it is easier to identify suppliers and other stakeholders and to bring them to play a role in the program of fortification. Thirdly, it is easier to deal with a smaller number of stakeholders on a regional basis than in a large scale program. Fourthly targeting staple foods also stimulates the local economy by encouraging local production. Some of the drawbacks of this method include the fact that the shelf-life of fortified milled cereals is reduced as compared with unfortified unmilled cereals. Also monitoring of quality control is essential, an element which may be lacking or of poor standard in developing nations whose governments may be weak or lack the necessary resources to implement a suitable quality control program. A good quality control program will guard against toxicity concerns and ensure appropriate levels are being added to the foods. Iron Supplementation Iron supplementation is recommended when feretin levels are very low or there has been a drastic reduction of iron levels due to illness or heavy haemorrhage. The most common and cheapest form of iron II sulphate or any of the other salts like Feratab, Fer-Iron or Slow –FE. Iron supplements are commonly given orally though they can also be administered intravenously in cases of impaired absorption or gastrectomy surgery. Iron supplement tablets can be blended with other nutrients to aid in its absorption like with ascorbic acid. Iron supplementation is important for adverse conditions as it is bioavailable and is readily absorbed. Taking supplements will increase vigour and improve learning in school children. Iron supplements are also necessary for certain patients like expectant mothers and malaria sufferers. Administering iron supplements with other medications like folic acid or with prophylactic drugs increases the cost effectiveness of these interventions. Because Malaria depletes iron levels adding iron supplements to treatment regime for malaria decreases morbidity levels due to low iron levels Gonzalez et al (2000,5). Iron supplementation comes with certain unpleasant side-effects for the patient which include; diarrhoea and constipation, and dose dependence. Liquid forms can discolour teeth. Increasing the blood iron levels may lead to a reduction of other nutrients necessary for its absorption of for health and so needs to be monitored closely. When iron supplement are injected it is painful and discolouration may occur. Iron supplements also react with other drugs limiting own and other drugs absorption like tetracycline and quinolones. There is the risk of toxicity so iron supplements must be prescribed by qualified personnel and kept away from children. References 1. Wikipedia, Iron Deficiency, http://en.wikipedia.org/wiki/Iron_deficiency_(medicine), accessed 19th April 2009 2. Anemia Glossary, http://www.anemia.org/patients/glossary/, accessed 19th April 2009 3. Glossary of Poverty-Related Terms, http://library.thinkquest.org/05aug/00282/other_glossary.htm, accessed 19th April 2009 4. WHO, 2009, Micronutrient deficiency, Iron deficiency anaemia, http://www.who.int/nutrition/topics/ida/en/index.html, accessed 19th April 2009 5. IFPRI, 2000, Gender and Intrahousehold, Aspects of Food Policy, http://www.ifpri.org/themes/mp17/briefs/mp17_brief04.pdf, accessed 19th April 2009 6. WHO, 2007, Food Fortification in the Pacific, http://www.wpro.who.int/NR/rdonlyres/A34ED9E6-B46F-4E94-99C6-7B5905107B92/0/PIC7_9_Food_fortification.pdf, accessed 19th April 2009 7. Prinzo, Z. Weise, Benoist B. de, 2002, Meeting the challenges of micronutrient deficiencies in emergency-affected populations, http://www.who.int/nutrition/publications/micronutrients/PNSvol61no2may02.pd f, accessed 19th April 2009 8. Gonzalez, Alonso et al, 2000, Cost–effectiveness of iron supplementation and malaria chemoprophylaxis in the prevention of anaemia and malaria among Tanzanian infants, Bulletin of the World Health Organisation Read More