title: Effect of oral iron therapy on the symptoms of anaemia. Iron fortification of domestic drinking water to prevent anemia among low socioeconomic families in Brazil. Iron supplementation improves endurance after training in iron-depleted, nonanemic women. Adaptation in iron absorption: iron supplementation reduces nonheme-iron but not heme-iron absorption from food. Longitudinal changes of manganese-dependent superoxide dismutase and other indexes of manganese and iron status in women. Regular consumption of NaFeEDTA-fortified fish sauce improves iron status and reduces the prevalence of anemia in anemic Vietnamese women. Tissue iron deficiency without anemia impairs adaptation in endurance capacity after aerobic training in previously untrained women. Studies of the elderly in Boston. I. The effects of iron fortification on moderately anemic peole. Increased lean red meat intake does not elevate markers of oxidative stress and inflammation in humans. Iron treatment normalizes cognitive functioning in young women. Iron supplementation improves progressive fatigue resistance during dynamic knee extensor exercise in iron-depleted, nonanemic women. Comparison of the efficacy of wheat-based snacks fortified with ferrous sulfate, electrolytic iron, or hydrogen-reduced elemental iron: randomized, double-blind, controlled trial in Thai women. Iron status in exercising women: the effect of oral iron therapy vs increased consumption of muscle foods. The use of NaFeEDTA-fortified fish sauce is an effective tool for controlling iron deficiency in women of childbearing age in rural Vietnam. Iron supplementation does not affect the susceptibility of LDL to oxidative modification in women with low iron status. Prevalence and type of anaemia in female cotton mill workers in Beijing, China. Effects of iron and ascorbic acid supplementation on hemoglobin level and work efficiency of anemic women. Iron-biofortified rice improves the iron stores of nonanemic Filipino women. Improvement in iron deficiency anemia through therapy with ferric ammonium citrate and vitamin C and the effects of aerobic exercise. Effect of oral iron supplementation on unstimulated salivary flow rate: a randomized, double-blind, placebo-controlled trial. Randomized, double-blind, placebo-controlled trial of an iron-fortified food product in female soldiers during military training: relations between iron status, serum hepcidin, and inflammation. Iron-deficiency anaemia and its effect on worker productivity and activity patterns. Efficacy of a microencapsulated iron pyrophosphate-fortified fruit juice: a randomised, double-blind, placebo-controlled study in Spanish iron-deficient women. Clinical Trial of Iron Therapy on Psychomotor Function in Anaemic Women Response in serum ferritin and haemoglobin to iron therapy in blood donors Efficacy of Iron-Fortified Ultra Rice in Improving the Iron Status of Women in Mexico Iron supplementation maintains ventilatory threshold and improves energetic efficiency in iron-deficient nonanemic athletes Efficacy of wheat-based biscuits fortified with microcapsules containing ferrous sulfate and potassium iodate or a new hydrogen-reduced elemental iron: a randomised, double-blind, controlled trial in Kuwaiti women. Response of serum transferrin receptor to iron supplementation in iron-depleted, nonanemic women. Efficacy of oral iron in patients with restless legs syndrome and a low-normal ferritin: A randomized, double-blind, placebo-controlled study. Can Dietary Treatment of Non-Anemic Iron Deficiency Improve Iron Status? Randomized, double-blind, placebo-controlled trial of iron supplementation in female soldiers during military training: effects on iron status, physical performance, and mood. Evaluation of iron supplements in prevention of iron-deficiency anaemia. The effects of hemoglobin supplements on maximal oxygen uptake in females. Effects of low-dose iron supplementation in women with low serum ferritin concentration. Quick- and slow-release iron: A double-blind trial with a single daily dose regimen The haematinic effect of iron in flour. Effects of long-term moderate exercise on iron status in young women. Studies on the prevalence of reduced salivary flow rate in relation to general health and dental caries, and effect of iron supplementation. The effect of iron supplementation on the physical work capacity in the elderly. Serum ferritin Random serial sampling to evaluate efficacy of iron fortification: a randomized controlled trial of margarine fortification with ferric pyrophosphate or sodium iron edetate.
abstract: In a study published elsewhere ( Wood and Elwood , 1966 ) the associations between the severity of various symptoms and haemoglobin levels in subjects who took part in a community survey is described . The present paper describes a double-blind r and omized clinical trial of the effects on these symptoms of  oral iron therapy  in a sample of the women seen during the community survey . In addition some limited data relating to a separate trial conducted in severely anaemic women identified in a hospital out-patient clinic are presented Iron deficiency anaemia is a most common micronutrient deficiency affecting mostly the low socioeconomic population s of the developing world . The objective of this study was to evaluate the feasibility of iron fortification of household drinking water to prevent iron deficiency anaemia among members of the low socioeconomic families of Southern Brazil . A total of 21 low socioeconomic families representing 88 subjects including 1 - 6 years old children whose haemoglobin level was between 10 and 12 g/dl were selected to participate in this study . Nine families in the control group were supplied with placebo solution and 12 families in the experimental group were supplied iron solution with ascorbic acid to be added to their domestic drinking water over a period of 4 months . The feasibility and acceptability of iron fortified drinking water was assessed through home visits and question naires . Blood sample s were collected at the beginning and after 4 months of the study for the determination of haemoglobin and serum ferritin levels . The results of this study indicated that iron fortified drinking water was well received by the low socioeconomic families and that it was effective in improving the haemoglobin and serum ferritin levels . It can be concluded from this study that iron fortification of household drinking water is a simple and effective alternative for developing countries along with other technological approaches to iron fortification of foods Our objective was to investigate the effects of iron depletion on adaptation to aerobic exercise , assessed by time to complete a 15-km cycle ergometer test . Forty-two iron-depleted ( serum ferritin < 16 microg/l ) , nonanemic ( Hb > 12 g/dl ) women ( 18 - 33 yr old ) received 100 mg of ferrous sulfate ( S ) or placebo ( P ) per day for 6 wk in a r and omized , double-blind trial . Subjects trained for 30 min/day , 5 days/wk at 75 - 85 % of maximum heart rate for the final 4 wk of the study . There were no group differences in baseline iron status or in 15-km time . Iron supplementation increased serum ferritin and decreased transferrin receptors in the S compared with the P group . The S and P groups decreased 15-km time and respiratory exchange ratio and increased work rate during the 15-km time trial after training . The decrease in 15-km time was greater in the S than in the P group ( P = 0.04 ) and could be partially attributed to increases in serum ferritin and Hb . These results indicate that iron deficiency without anemia impairs favorable adaptation to aerobic exercise BACKGROUND Results of cross-sectional studies suggest that in healthy people , iron absorption adapts to meet physiologic needs and stabilize iron stores , but this has not been adequately tested in longitudinal studies . OBJECTIVE We tested whether heme- and nonheme-iron absorption decrease in response to increased iron intake and whether iron stores reach a steady state . DESIGN In a r and omized , placebo-controlled trial , heme- and nonheme-iron absorption by healthy men and women ( n = 57 ) were measured before and after 12 wk of supplementation with 50 mg Fe/d as ferrous sulfate .  Serum and fecal ferritin were measured during supplementation and for 6 mo thereafter . RESULTS Initially , both heme- and nonheme-iron absorption were inversely associated with serum ferritin concentration .  Volunteers who took iron supplements  , even those with serum ferritin < 21 microg/L ( n = 5 ) , adapted to absorb less nonheme iron ( 3.2 % at week 12 compared with 5.0 % at week 0 , P : < 0.001 ) but not less heme iron from a beef-based meal . Serum ferritin concentration was slightly but significantly higher after iron supplementation than after placebo ( difference = 13 microg/L ) . This higher ferritin concentration persisted for > /=6 mo after supplementation , except in subjects with low iron stores , whose serum ferritin returned to baseline within 3 mo . Fecal ferritin excretion increased 2.5-fold ( P : < 0.05 ) during supplementation . CONCLUSIONS Healthy individuals , even those with low iron stores , had reduced nonheme-iron absorption from food in response to iron supplementation . Despite this partial adaptation , iron stores were greater after iron supplementation than after placebo and this difference was sustained , except in individuals with the lowest iron stores The effect of dietary factors on manganese-dependent superoxide dismutase ( MnSOD ) activity in humans has not been studied . We longitudinally evaluated changes in MnSOD activity and other indices of manganese and iron status in 47 women during a 124-d supplementation study . Subjects received one of four treatments : placebo , 60 mg iron , 15 mg manganese , or both mineral supplements daily . Manganese supplementation result ed in significant increases in lymphocyte MnSOD activity and serum manganese concentrations from baseline values but no changes in urinary manganese excretion or in any indices of iron status . Oral contraceptive use and the stage of the menstrual cycle did not confound the use of lymphocyte MnSOD activity or serum manganese to monitor manganese status , but fat intake affected both indices . This work demonstrated that lymphocyte MnSOD activity can be used with serum manganese concentrations to monitor manganese exposure in humans BACKGROUND Fish sauce is consumed daily by a large proportion of the Vietnamese population and could therefore be a potentially useful food vehicle for iron-fortification programs . OBJECTIVE We evaluated the efficacy of iron-fortified fish sauce in improving the iron status of anemic women . DESIGN In a r and omized , double-masked study of 152 anemic ( hemoglobin concentration of 81 - 119 g/L ) women , a meal based on noodles or rice was served 6 d/wk with 10 mL fish sauce containing either 10 mg Fe as NaFeEDTA ( iron-fortified group ) or no added iron ( control group ) . Concentrations of hemoglobin , serum ferritin ( SF ) , and serum transferrin receptor ( TfR ) were measured at baseline and after 3 and 6 mo . RESULTS After 6 mo , hemoglobin and SF concentrations were higher and TfR concentrations were lower in the iron-fortified group than in the control group [ hemoglobin : 116.3 + /- 8.7 ( + /- SD ) compared with 107.6 + /- 11.0 g/L ( P < 0.0001 ) ; SF : 30.9 ( 95 % CI : 23.4 , 40.6 ) compared with 14.6 ( 11.3 , 19.0 ) micro g/L ( P = 0.0002 ) ; TfR : 7.2 ( 6.4 , 7.9 ) compared with 9.0 ( 8.1 , 9.9 ) mg/L ( P = 0.002 ) ] . The prevalence of iron deficiency ( SF < 12 micro g/L or TfR > 8.5 mg/L ) and iron deficiency anemia ( iron deficiency with hemoglobin < 120 g/L ) was lower in the iron-fortified group than in the control group [ 32.8 % compared with 62.5 % ( P = 0.0005 ) and 20.3 % compared with 58.3 % ( P < 0.0001 ) , respectively ] . CONCLUSIONS Regular consumption of iron-fortified fish sauce significantly reduced the prevalence of iron  deficiency anemia in Vietnamese women during the 6-mo intervention . Fortifying fish sauce with iron by using a water-soluble , highly bioavailable compound ( NaFeEDTA ) is a promising strategy for combating iron deficiency anemia in Vietnam BACKGROUND We previously showed that iron supplementation significantly improves iron status and maximal work capacity in previously untrained , marginally iron-deficient women with a baseline serum transferrin receptor concentration > 8.0 mg/L. However , the effect of transferrin receptor status on adaptation in endurance capacity after aerobic training in these subjects has not been fully explored . OBJECTIVE Our objective was to examine the effect of baseline serum transferrin receptor status on adaptations in endurance capacity . DESIGN Forty-one untrained , iron-depleted , nonanemic women were r and omly assigned to receive either 100 mg FeSO(4 ) or a placebo for 6 wk in a double-blind trial . All subjects trained on cycle ergometers 5 d/wk for the last 4 wk of the study . Endurance capacity was assessed at baseline and after treatment by using a 15-km time trial conducted on a cycle ergometer . RESULTS Significant treatment effects were observed for time to complete the 15-km time trial , work rate , and percentage of maximal oxygen uptake in subjects with a baseline serum transferrin receptor concentration > 8.0 mg/L. No significant treatment effects were observed in subjects with a normal baseline transferrin receptor concentration . CONCLUSIONS Our findings suggest that , in the presence of overt tissue iron deficiency , iron deficiency without anemia impairs adaptation in endurance capacity after aerobic training in previously untrained women . This impairment can be corrected with iron supplementation It has been reported that large numbers of elderly Americans are moderately anemic because of iron deficiency anemia . In the present study , information has been obtained concerning blood composition , health , and nutritional habits of 779 people over 60 years of age , institutionalized or free-living in the Boston area . This paper presents the results of their blood examinations . Two hundred twenty-one of the free-living people examined who showed hemoglobin levels between 9 and 12.9 g/dl agreed to participate in an iron fortification study .  Two-thirds of them received iron-fortified grain products daily for 6 to 8 months . The rest received the same foods without added iron . At the end of the experimental period a marked increase in hemoglobin levels averaging 1.4 g/dl was observed in both groups . This appeared to be attributable to an undefined intervention effect ; no measurable effects attributable to the iron fortification were observed . Three months of daily ferrous sulfate administration to those whose hemoglobin levels remained below 13 g/dl was without effect . Examination of the data obtained suggests that the cause of the moderately low hemoglobin levels initially observed was not occult bleeding or folic acid or iron deficiency Red meat intake has been associated with increased risk of coronary heart disease and type 2 diabetes , but it remains uncertain whether these associations are causally related to unprocessed lean red meat . It has been proposed that iron derived from red meat may increase iron stores and initiate oxidative damage and inflammation . We aim ed to determine whether an increase in unprocessed lean red meat intake , partially replacing carbohydrate-rich foods , adversely influences markers of oxidative stress and inflammation .  Sixty participants completed an 8-wk parallel- design ed study . They were r and omized to maintain their usual diet ( control ) or to partially replace energy from carbohydrate-rich foods with approximately 200 g/d of lean red meat ( red meat ) in isoenergetic diets .  Markers of oxidative stress and inflammation were measured at baseline and at the end of intervention . Results are presented as the mean between-group difference in change and [ 95 % CI ] . Red meat , relative to control , result ed in : higher protein [ 5.3 ( 3.7 , 6.9 ) % of energy ] , lower carbohydrate [ -5.3 ( -7.9 , -2.7)% of energy ] , and higher iron [ 3.2 ( 1.1 , 5.4 ) mg/d ] intakes ; lower urinary F2-isoprostane excretion [ -137 ( -264 , -9 ) pmol/mmol creatinine ] , lower leukocyte [ -0.51 ( -0.99 , -0.02)x10(9)/L ] counts , and a trend for lower serum C-reactive protein concentrations [ -1.6 ( -3.3 , 0.0 ) mg/L , P=0.06 ] ; and no differences in concentrations of plasma F2-isoprostanes [ -12 ( -122 , 100 ) pmol/L ] , serum gamma-glytamyltransferase [ -0.8 ( -3.2 , 1.5 ) U/L ] , serum amyloid A protein [ -1.4 ( -3.4 , 0.5 ) mg/L ] , and plasma fibrinogen concentrations [ -0.08 ( -0.40 . 0.24 ) g/L ] . Our results suggest that partial replacement of dietary carbohydrate with protein from lean red meat does not elevate oxidative stress or inflammation BACKGROUND Evidence suggests that brain iron deficiency at any time in life may disrupt metabolic processes and subsequently change cognitive and behavioral functioning . Women of reproductive age are among those most vulnerable to iron deficiency and may be at high risk for cognitive alterations due to iron deficiency . OBJECTIVE We aim ed to examine the relation between iron status and cognitive abilities in young women . DESIGN A blinded , placebo-controlled , stratified intervention study was conducted in women aged 18 - 35 y of varied iron status who were r and omly assigned to receive iron supplements or a placebo .  Cognition was assessed by using 8  cognitive performance tasks  ( from Detterman 's Cognitive Abilities Test ) at baseline ( n = 149 ) and after 16 wk of treatment ( n = 113 ) . RESULTS At baseline , the iron-sufficient women ( n = 42 ) performed better on cognitive tasks ( P = 0.011 ) and completed them faster ( P = 0.038 ) than did the women with iron deficiency anemia ( n = 34 ) . Factors representing performance accuracy and the time needed to complete the tasks by the iron-deficient but nonanemic women ( n = 73 ) were intermediate between the 2 extremes of iron status . After treatment , a significant improvement in serum ferritin was associated with a 5 - 7-fold improvement in cognitive performance , whereas a significant improvement in hemoglobin was related to improved speed in completing the cognitive tasks . CONCLUSIONS Iron status is a significant factor in cognitive performance in women of reproductive age . Severity of anemia primarily affects processing speed , and severity of iron deficiency affects accuracy of cognitive function over a broad range of tasks . Thus , the effects of iron deficiency on cognition are not limited to the developing brain BACKGROUND Tissue iron depletion may negatively affect endurance performance and muscle fatigability . OBJECTIVE We investigated tissue-level iron depletion and progressive fatigue of the quadriceps during dynamic knee-extension exercise in young women . DESIGN Twenty iron-depleted ( serum ferritin < 20 micro g/L ) , nonanemic ( hemoglobin > 110 g/L ) women ( macro x + /- SEM age : 29.1 + /- 1.2 y ) received iron ( iron group ) or placebo ( placebo group ) for 6 wk in a r and omized , double-blind trial ( n = 10 per group ) . A protocol integrating 2 - 3-s maximal voluntary static contractions ( MVCs ) with dynamic knee extensions was used to assess fatigue . RESULTS No significant differences between the groups in baseline iron status , MVC at rest , or MVC at the end of the protocol were observed . After treatment , serum iron and transferrin saturation increased significantly in the iron group ( P = 0.02 and P = 0.03 , respectively ) . Serum transferrin receptor concentrations increased significantly in the placebo group ( P < 0.01 ) but not in the iron group . After treatment , the rate of decrease in MVC was attenuated in the iron group but not in the placebo group ( P = 0.01 ) . In the iron group , MVC at the sixth minute of the fatigue protocol and MVC at the end of the protocol were approximately 15 % ( P = 0.04 ) and approximately 27 % higher ( P < 0.01 ) , respectively , after treatment . These improvements were not related to changes in iron-status indexes or tissue iron stores , although power was low ( < 0.50 ) to detect these relations . CONCLUSIONS Iron supplementation was associated with a significant improvement in muscle fatigability . Interpretation regarding the direct role of tissue iron status is limited by the study 's low power to detect relations between tissue iron improvement and decreased muscle fatigue BACKGROUND Although elemental iron powders are widely used to fortify cereal products , little data exist on their efficacy in humans . OBJECTIVE We compared the efficacy of wheat-based snacks fortified with ferrous sulfate , electrolytic iron , or hydrogen-reduced iron in Thai women with low iron stores . DESIGN A double-blind intervention was conducted in 18 - 50-y-old women ( n = 330 ) r and omly assigned into 4 groups to receive either no fortification iron or 12 mg Fe/d for 6 d/wk for 35 wk as ferrous sulfate , electrolytic iron , or hydrogen-reduced iron in a baked , wheat-flour-based snack . Snacks were not consumed with meals , and consumption was monitored . At baseline , 20 wk , and 35 wk , hemoglobin status and iron were measured and the groups were compared . RESULTS Between baseline and 35 wk , geometric mean serum ferritin ( SF ) increased significantly in all 3 groups receiving iron ( P < 0.01 ) , and geometric mean serum transferrin receptor ( TfR ) decreased significantly in the groups receiving ferrous sulfate and electrolytic iron ( P < 0.05 ) . Calculated mean ( + /-SD ) body iron stores increased from 1.5 + /- 2.8 to 5.4 + /- 2.9 mg/kg in the ferrous sulfate group , from 1.5 + /- 3.5 to 4.4 + /- 3.6 mg/kg in the electrolytic iron group , and from 1.3 + /- 3.2 to 3.2 + /- 4.3 mg/kg in the hydrogen-reduced iron group ( P < 0.01 for all 3 groups ) but did not change significantly in the control group . CONCLUSIONS Ferrous sulfate , electrolytic iron , and hydrogen-reduced iron , fortified into wheat-based snacks , significantly improved iron status . On the basis of the change in body iron stores during the 35-wk study , the relative efficacy of the electrolytic and hydrogen-reduced iron compared with ferrous sulfate was 77 % and 49 % , respectively Forty-seven previously sedentary women participating in a 12-wk moderate aerobic-exercise program were r and omly assigned to one of four dietary groups : 50-mg/d iron supplement and a low food-iron diet ( 50 FE + EX ) , 10-mg/d iron supplement and a low food-iron diet ( 10 FE + EX ) , placebo and unrestricted diet ( P + EX ) , and meat supplement and high food-iron diet ( M + EX ) . A sedentary control group ( n = 13 ) received no dietary interventions . Hematocrit , total iron-binding capacity , and hemoglobin , serum iron , serum ferritin , and serum albumin concentrations were measured every 4 wk . Hemoglobin values decreased at the end of 4 wk in all exercising groups compared with the control group . Iron status in the 50 FE + EX and M + EX groups improved after week 4 as indicated by an increase in serum ferritin , serum iron , and hemoglobin concentrations , and a decline in total iron-binding capacity . Thus , short-term , moderate aerobic exercise result ed in compromised iron status that was offset to varying degrees by ingesting iron or meat supplements . However , meat supplements were more effective in protecting hemoglobin and ferritin status than were iron supplements One cost-effective strategy for controlling iron deficiency is the fortification of staple foods or condiments with iron . We evaluated the effectiveness of fortifying fish sauce with NaFeEDTA for improving iron status in women of childbearing age in Vietnam in a double-blind intervention with r and omization by village . All families in the selected villages were supplied with fish sauce that was either unfortified ( Group C , 10 villages ) or fortified with NaFeEDTA [ 9 mmol ( 500 mg ) Fe/L , Group F , 11 villages ] for 18 mo . The effect of fortification was assessed in the 576 women ( n = 288/group ) by measuring hemoglobin and serum ferritin ( SF ) at 6 , 12 , and 18 mo . Analysis of the group x time interaction using a repeated- measures test for each response demonstrated a significant effect of fortification on hemoglobin ( P = 0.039 ) and log SF ( P < 0.0001 ) in Group F with no significant changes in Group C. The prevalence of iron deficiency ( SF < 12 microg/L ) decreased from 22.3 to 4.0 % and the prevalence of anemia ( hemoglobin < 120 g/L ) from 24.7 to 8.5 % in Group F with no significant changes in Group C. NaFeEDTA fortification of fish sauce is an effective method for reducing the prevalence of iron deficiency in women in Vietnam Elevated iron stores may or may not promote atherogenesis by increasing free radical formation and oxidative stress , but controlled diet and supplement trials are lacking . We tested the hypothesis that iron supplementation does not increase the susceptibility of LDL to undergo oxidative modification in women with low iron status . A r and omized , double-blind , 2-period crossover study design ( n=26 ) was used to examine the effects of the following diets on measures of LDL oxidation :  average American diet ( AAD ) [ 36 % of energy as fat ; 15 % saturated fatty acids ( SFA ) ] , and a Step 2 diet ( 26 % fat ; 7 % SFA ) . In addition , subjects received either a supplement containing 160 mg of ferrous sulfate ( 50 mg elemental iron ) or a placebo twice daily [ supplement group received a total of 320 mg ferrous sulfate ( 100 mg elemental iron ) daily ] . After supplementation , serum ferritin differed between the supplement and placebo groups ( P=0.008 ) . Measures of LDL oxidation were not affected by supplement intake ; however , they were affected by diet . Lag time was shorter after the women consumed the AAD diet than after the Step 2 diet ( P<0.0001 ) . The diets did not affect the rate of oxidation or total dienes . Although iron status was improved by aggressive iron supplementation , LDL oxidative susceptibility was not affected . As expected , lag time was increased after the women consumed the low fat , low SFA diet . Therefore , the results of this study do not support a relationship between iron status and LDL oxidation The present study investigates the prevalence and type of anaemia in Chinese female cotton mill workers . The prevalence of anaemia is reported in 447 non-pregnant female workers aged between 19 and 45 years . The mean value for haemoglobin ( Hb ) was 123 ( SD 15 ) g/l and 150 of the total 447 subjects had Hb values below 120 g/l ; thus 34 % of the population was anaemic according to World Health Organization ( WHO , 1975 ) criteria . The mean value for free erythrocyte protoporphyrin ( FEP ) was 419 ( SD 215 ) micrograms/l ; 55 % of the total population had FEP values higher than 350 micrograms/l and 72 % among the anaemic subjects . Serum ferritin ( SF ) was tested in all the women with a Hb value less than 120 g/l and 71 % of them had SF values below 12.0 micrograms/l . Eighty women diagnosed as either Fe deficient or with Fe-deficient anaemia were selected for a diagnostic supplementation trial . They were r and omly assigned to FeSO4 ( 60 or 120 mg Fe/d ) or placebo treatment for 12 weeks . Fe supplementation increased mean Hb values from 114 to 127 g/l ( P < 0.001 ) and SF levels from 9.7 to 30.0 micrograms/l ( P < 0.001 ) , and decreased mean FEP values from 570 to 277 micrograms/l ( P < 0.001 ) . The response rate of Hb in the whole Fe-treated group or Fe-treated subjects with an Hb level less than 120 g/l was 90 % or 92 % respectively . These findings indicate that the type of anaemia in this population was mainly Fe deficiency . It was also found that in this population the severity of anaemia , not the prevalence , was significantly related to the use of intra-uterine devices ( IUD ) This study was conducted to examine the relationship between anemia , supplementation with iron and vitamin C , and productivity . Using the cyanmethemoglobin method , 671 female garment factory workers were examined . On the basis of the World Health Organization ( WHO ) st and ard , 98 were found to be mildly or moderately/severely anemic . An equal number was r and omly chosen from the nonanemic workers . The subjects were then r and omly assigned to either the placebo group or the group receiving 525 mg of ferrous sulfate ( 105 mg elemental iron ) and 500 mg ascorbic acid . Only 118 of the 196 subjects completed the three-month study . The mean hemoglobin ( Hb ) and work output , as indicated by efficiency rating ( ER ) , of the placebo group did not change significantly . Mildly anemic workers with supplements showed a significant improvement in mean Hb , but not in mean ER . The moderately/severely anemic group receiving supplements had significant increases in both Hb and ER Iron deficiency is endemic in much of the world , and food system-based approaches to eradication may be viable with new plant breeding approaches to increase the micronutrient content in staple crops . It is thought that conventional plant breeding approaches provide varieties of rice that have 400 - 500 % higher iron contents than varieties commonly consumed in much of Asia . The efficacy of consuming high-iron rice was tested during a 9-mo feeding trial with a double-blind dietary intervention in 192 religious sisters living in 10 convents around metro Manila , the Philippines . Subjects were r and omly assigned to consume either high-iron rice ( 3.21 mg/kg Fe ) or a local variety of control rice ( 0.57 mg/kg Fe ) , and daily food consumption was monitored . The high-iron rice contributed 1.79 mg Fe/d to the diet in contrast to 0.37 mg Fe/d from the control rice . The 17 % difference in total dietary iron consumption compared with controls ( 10.16 + /- 1.06 vs. 8.44 + /- 1.82 mg/d ) result ed in a modest increase in serum ferritin ( P = 0.10 ) and total body iron ( P = 0.06 ) and no increase in hemoglobin ( P = 0.59 ) . However , the response was greater in nonanemic subjects for ferritin ( P = 0.02 ) and body iron ( P = 0.05 ) , representing a 20 % increase after controlling for baseline values and daily rice consumption . The greatest improvements in iron status were seen in those nonanemic women who had the lowest baseline iron status and in those who consumed the most iron from rice . Consumption of biofortified rice , without any other changes in diet , is efficacious in improving iron stores of women with iron-poor diets in the developing world In 781 female college students , there were 41 cases of iron deficiency anemia , 209 of latent iron deficiency , 3 of other anemias , and 528 normal cases . Fifty-four volunteers recruited from the iron deficiency anemia and severe latent iron deficiency groups were r and omly divided into 4 study groups . Groups I and III received 500 mg of vitamin C daily , and groups II and IV received ferric ammonium citrate ( FeAC ; equivalent to 6 mg iron ) in addition to vitamin C for 9 weeks . Groups I and II were loaded by aerobic exercise at 50 % VO2 max . Significant differences between groups were noted in serum ferritin ( SF ) in III/IV , hematocrit ( Ht ) in II/III and III/IV , and reticulocytes ( RET ) in I/II , I/IV , and III/IV . Hemoglobin ( Hb ) and other iron-related blood indices tended to normalize in groups II and IV when compared with the pre-values . VO2 max was elevated in groups I and II regardless of iron treatment , but was augmented more in group II than group BACKGROUND No treatment is known to permanently increase salivary flow in patients with hyposalivation . The objective of this study was to investigate the effect of iron supplementation on salivary flow rate . METHODS A double-blind , r and omized , placebo-controlled trial was carried out on 50 individuals with a low unstimulated whole salivary flow rate and low serum ferritin . Half the individuals received 60 mg iron orally twice a day for 3 months , while the other half received placebo . RESULTS No statistically significant difference was found between the groups after treatment for the unstimulated flow rate and in the subjective assessment s of oral dryness . The serum ferritin values increased significantly in the iron group but not in the placebo group . CONCLUSION Oral supplementation with iron for 3 months has no effect on salivary flow rate among individuals with hyposalivation and low serum ferritin values BACKGROUND Iron status de grade s in female soldiers during military training . Inflammation-mediated up-regulation of hepcidin , a key mediator of iron homeostasis , may be a contributing factor . OBJECTIVE We measured the efficacy of an iron-fortified food product for maintaining iron status in female soldiers during basic combat training ( BCT ) and examined relations between iron status , serum hepcidin concentrations , and inflammation . DESIGN A r and omized , double-blind , placebo-controlled trial was conducted . Volunteers received an iron-fortified food product ( total dose = 56 mg Fe/d ) or a placebo twice daily during the 9-wk BCT course . Iron-status indicators , serum hepcidin concentrations , and markers of inflammation were measured pre- and post-BCT . RESULTS BCT affected iron status ; serum ferritin concentrations decreased ( P < or = 0.05 ) , and concentrations of soluble transferrin receptor ( sTfR ) and hemoglobin and the red cell distribution width increased ( P < or = 0.05 ) . Consumption of the iron-fortified food product attenuated declines in iron status in iron-deficient anemic soldiers ; a group-by-time interaction was observed for hemoglobin and sTfR concentrations ( P < or = 0.05 ) . Serum hepcidin concentrations were not affected by BCT ; however , hepcidin concentrations were lower in iron-deficient anemic soldiers than in those with normal iron status ( P < or = 0.05 ) and were positively associated with serum ferritin ( P < or = 0.05 ) and C-reactive protein ( P < or = 0.05 ) concentrations pre- and post-BCT . CONCLUSIONS Twice-daily consumption of an iron-fortified food product improved iron status in iron-deficient anemic soldiers but not in iron-normal or iron-deficient nonanemic soldiers . Serum hepcidin concentrations were not affected by training but were associated with iron status and inflammation pre- and post-BCT . This trial was registered at clinical trials.gov as NCT01100905 The effects of  iron-deficiency anaemia on  workers productivity  were studied in a tea plantation in Sri Lanka . The quantity of tea picked per day was studied before and after iron supplementation or placebo treatment . After one month 's treatment significantly more tea was picked when the haemoglobin ( Hb ) concentration was increased by iron supplementation than when it was not . The degree of improvement was greater in more-anaemic subjects ( those with concentrations of 6.0 - 9.0 g Hb/dl ) . The level of physical activity of anaemic subjects in their everyday environment was also recorded for four or 24 hours continuously both before and after treatment . After three weeks these levels was significantly greater in the iron-treated than matched placebo-treated subjects . The economic implication s of increased work productively with iron treatment are evident , particularly in developing countries . These results also provide strong evidence for the clinical impression that people with iron-deficiency anaemia suffer from tiredness and weakness Fe-deficiency anaemia is a worldwide health problem . We studied the influence of consuming an Fe-fortified fruit juice on Fe status in menstruating women . A r and omised , double-blind , placebo-controlled study of 16 weeks of duration was performed . Subjects were r and omised into two groups : the P group ( n 58 ) or the F group ( n 64 ) , and consumed , as a supplement to their usual diet , 500 ml/d of a placebo fruit juice or an Fe-fortified fruit juice , respectively . The Fe-fortified fruit juice , containing microencapsulated iron pyrophosphate , provided 18 mg Fe/d ( 100 % of the RDA ) . At baseline and monthly , dietary intake , body weight and Fe parameters were determined : total erythrocytes , haematocrit , mean corpuscular volume ( MCV ) , red blood cell distribution width ( RDW ) , Hb , serum Fe , serum ferritin , serum transferrin , transferrin saturation , soluble transferrin receptor ( sTfR ) and zinc protoporphyrin ( ZnPP ) . The fruit juice consumption involved increased intake of carbohydrates and vitamin C , and increased BMI within normal limits . Ferritin was higher in the F group after week 4 ( P < 0·05 ) and became 80 % higher than in the P group after week 16 ( P < 0·001 ) , and transferrin decreased in the F group compared with the P group after week 4 ( P < 0·001 ) . RDW was higher at weeks 4 and 8 in the F group compared with the P group ( P < 0·05 ) . Transferrin saturation increased after week 8 , and haematocrit , MCV and Hb increased after week 12 , in the F group compared with the P group . Serum Fe did not change . sTfR and ZnPP decreased in the F group at week 16 ( P < 0·05 ) . Iron pyrophosphate-fortified fruit juice improves Fe status and may be used to prevent Fe-deficiency anaemia A variety of aspects of psychomotor function were assessed in 47 women before and after iron therapy .  These women , all of whom had initial haemoglobin levels below 10·5 g./100 ml . , had been drawn from a population sample of 2,283 women seen at a haematological screening survey . There was no evidence of any beneficial effect of a rise in haemoglobin level on psychomotor function or on symptoms . Possibly this is because if an effect does occur it is unlikely to be apparent unless the haemoglobin level is very low . If this is true then anaemia is probably a rare cause of symptoms or impairment in psychomotor function in the community Seven hundred seventeen healthy male blood donors regularly donating four or more units a year were surveyed for haemoglobin and serum ferritin levels . One hundred fiftyone ( 21 % ) had a haemoglobin less than 13.5 g/dl and were therefore disqualified from further blood donation , having a mean serum ferritin of 28 μg/liter . Of the remaining 566 donors with haemoglobin levels equal to or greater than 13.5 g/dl , the mean serum ferritin was 33 μg/liter , although in 299 ( 53 % ) the value was less than 28 μg/liter . To document response to iron therapy  46 donors with haemoglobin levels equal to or greater than 13.5 g/dl were stratified into those with the lowest iron stores ( group 1 ; n = 23 ) , defined as a serum ferritin less than 20 μg/liter , and controls ( group 2 ; n = 23 ) , with serum ferritin between 50 and 150 μg/liter . Within each stratum donors r and omly received ferric polymaltose at a dose of 100 mg elemental iron twice daily for 56 days ( groups 1a and 2a ) or an identical iron‐free placebo tablet administered on the same schedule ( groups 1b and 2b ) . Iron therapy in the iron‐deficient group ( group 1a : n = 11 ) result ed in a significant rise in haemoglobin ( p = .03 ) and iron stores reflected in serum ferritin ( p = .002 ) compared to those receiving placebo ( group 1b ) . In the control group iron therapy or placebo was without significant effect . Thus , ferric polymaltose preparation is bioavailable and is notable for the virtual absence of gastrointestinal tract side effects Background Universal fortification of staple foods with iron has been widely promoted as a cost-effective strategy to reduce iron deficiency in developing-country population s. Nonetheless , relatively few efficacy trials have been reported to date to demonstrate impact on iron status . The Ultra Rice technology provides a means of delivering fortificant iron via rice . Objective The objective of this study was to test the efficacy of rice fortified with microencapsulated , micronized iron pyrophosphate to improve the iron status of women in Mexico in a r and omized , controlled intervention trial . Methods Nonpregnant , nonlactating women 18 to 49 years of age were recruited from six factories . The women received a daily portion of cooked rice 5 days per week for a period of 6 months , before and after which iron status indicators were determined in venous blood sample s. Results The average intake of iron from the fortificant was 13 mg/day . Mean plasma ferritin concentration and estimated body iron stores were significantly higher , and transferrin receptors were lower , in the iron-fortified rice group following the intervention . Mean hemoglobin concentration also increased in the treatment group , but the increase was significant only when the analysis was restricted to those with baseline hemoglobin < 12.8 g/dL. The absolute reduction in anemia and iron deficiency was 10.3 and 15.1 percentage points , respectively . Total iron intake from fortificant was a significant covariate of change in body iron stores . The overall prevalence of anemia was reduced by 80 % . Conclusions Fortification of rice with iron using this technology is an efficacious strategy for preventing iron deficiency Objective : To determine the effect of iron supplementation on iron status and endurance capacity . Design : R and omized , double-blind iron supplementation . Setting : University of Missouri-Columbia and surrounding community . Subjects : Twenty iron-deficient ( serum ferritin , sFer<16 μg/l ; serum transferrin receptor , sTfR>8.0 mg/l ; or sTfR/log sFer index > 4.5 ) , nonanemic ( hemoglobin , Hb>120 g/l , women ; > 130 g/l , men ) men and women ( 18–41 years ) were recruited via fliers and newspaper advertisements ; 20 of 31 eligible subjects participated . Interventions : A 30 mg measure of elemental iron as ferrous sulfate or placebo daily for 6 weeks . Results : Dietary iron intake and physical activity did not differ between groups before or after supplementation . Iron supplementation significantly increased sFer compared to placebo ( P=0.01 ) , but did not affect Hb or hematocrit . Iron supplementation prevented the decline in ventilatory threshold ( VT ) observed in the placebo group from pre- to post-supplementation ( P=0.01 ) ; this effect was greater in individuals with lower sFer before intervention ( P<0.05 ) . Changes in sFer from pre- to post-treatment were positively correlated with changes in VT ( P=0.03 ) , independent of supplementation . The iron group significantly increased gross energetic efficiency during the submaximal test ( P=0.04 ) . Changes in sFer were negatively correlated with changes in average respiratory exchange ratio during the submaximal test ( P<0.05 ) . Conclusions : Iron supplementation significantly improves iron status and endurance capacity in iron-deficient , nonanemic trained male and female subjects . Sponsorship : Missouri University Alumni Association , by the Elizabeth Hegarty Foundation and by the Department of Nutritional Sciences Adverse sensory changes prevent the addition of highly bioavailable ferrous sulfate ( FeSO4 ) to most wheat flours . Poorly absorbable reduced Fe powders are commonly used . Encapsulation of FeSO4 can overcome these sensory changes , but the particle size of commercial compounds is too large to be used by flour mills . The first objective of the study was to measure the efficacy in wheat flour of two newly developed Fe compounds , an H-reduced Fe powder ( NutraFine RS ; North America Höganäs High Alloys LLC , Johnstown , PA , USA ) and small particle-sized ( 40 microm ) encapsulated FeSO4 . As a second objective , the microcapsules were evaluated as a vehicle for iodine fortification . A r and omised , double-blind controlled intervention trial was conducted in Kuwaiti women ( n 279 ; aged 18 - 35 years ) with low body Fe stores ( serum ferritin ( SF ) < 25 microg/l ) r and omly assigned to one of three groups ( 20 mg Fe as NutraFine RS , 10 mg Fe as encapsulated FeSO4 and 150 microg iodine , or no fortification Fe ) who consumed wheat-based biscuits 5 d per week . At baseline and 22 weeks , Hb , SF , transferrin receptor , urinary iodine and body Fe stores were measured . Relative to control , mean SF in the encapsulated FeSO4 group increased by 88 % ( P < 0.001 ) and body Fe stores increased from - 0.96 to 2.24 mg/kg body weight ( P < 0.001 ) , while NutraFine RS did not significantly increase SF or body Fe stores . The median urinary iodine concentration increased from 140 to 213 microg/l ( P < 0.01 ) . NutraFine RS added at double the amount of Fe as FeSO4 was not efficacious in improving Fe status . The newly developed microcapsules were highly efficacious in improving both Fe stores and iodine status Serum transferrin receptor ( sTfR ) concentration has been recognized recently as a reliable indicator of functional iron deficiency , but its response to iron supplementation has not been investigated in marginally iron-deficient women . In this r and omized , double-blinded trial , 37 female subjects aged 19 - 35 y with iron depletion without anemia ( hemoglobin > 120 g/L and serum ferritin < 16 microg/L ) received an iron supplement or placebo for 8 wk . Iron status was measured before treatment , after 4 wk of treatment , and posttreatment ( ie , after 8 wk of treatment ) . Iron supplementation of these iron-depleted , nonanemic women result ed in a progressive and significant decrease in sTfR and a significant increase in serum ferritin , and prevented a fall in hemoglobin . The responsiveness of sTfR to iron treatment indicated that sTfR is a sensitive indicator of marginal iron deficiency in iron-depleted , nonanemic women , even when their body iron stores were being replenished BACKGROUND AND PURPOSE Restless Legs Syndrome ( RLS ) is a primary disorder of sensation that affects sleep and has been associated with iron deficiency . The purpose of this study was to determine if symptomatic RLS patients with low-normal serum ferritin levels benefit from oral iron replacement . PATIENTS AND METHODS This was a r and omized , placebo-controlled , double-blinded study . Eligible patients were r and omized to oral iron therapy vs. appearance-matched placebo and followed over a 12 week period . RESULTS Baseline International Restless Leg Scale ( IRLS ) scores for the treatment ( 24.8+/-5.72 ) and placebo ( 23.0+/-5.03 ) groups were similar . Baseline ferritin levels for the treatment ( 40.6+/-15.3ng/ml ) and placebo ( 36.7+/-20.8ng/ml ) groups were also similar . After 12 weeks , IRLS scores decreased more in the treatment arm ( 10.3+/-7.40 ) than in the placebo arm ( 1.14+/-5.64 ) , ( p=0.01 ) . Ferritin levels increased more in the treatment arm ( 25.1+/-20.3ng/ml ) than in the placebo arm ( 7.5+/-13.7ng/ml ) , ( p=0.04 ) . We observed a nonsignificant trend toward improved quality of life in the treated patients , ( p=0.07 ) . CONCLUSIONS This is the first double-blinded , placebo-controlled study to demonstrate statistically significant improvement in RLS symptoms using oral iron therapy in patients with low-normal ferritin . The findings from this study suggest that additional larger r and omized placebo-controlled trials of iron as treatment for patients with low-normal ferritin are warranted Objective : To investigate the efficacy of , first , a dietary regimen involving increased consumption of iron-rich foods and enhancers of iron absorption and decreased consumption of inhibitors of iron absorption and , second , a low dose iron chelate iron supplement , for increasing iron stores in young adult New Zeal and women with mild iron deficiency ( MID ) . Methods : The study was a 16 week r and omized placebo-controlled intervention . Seventy-five women aged 18 to 40 years with MID ( serum ferritin < 20 μg/L and hemoglobin ≥120 g/L ) were assigned to one of three groups : Placebo , Supplement ( 50 mg iron/day as amino acid chelate ) or Diet . Participants in the Diet Group were given individual dietary counseling to increase the intake and bioavailability of dietary iron  . Dietary changes were monitored by a previously vali date d computer-administered iron food frequency question naire . Results : Diet Group members significantly increased their intake of flesh foods , heme iron , vitamin C and foods cooked using cast-iron cookware and significantly decreased their phytate and calcium intakes . Serum ferritin increased in the Supplement and Diet Groups by 59 % ( p=0.001 ) and 26 % ( p=0.068 ) , respectively , in comparison to the Placebo Group . The serum transferrin receptor : serum ferritin ratio decreased by 51 % in the Supplement Group ( p=0.0001 ) , and there was a non-significant decrease of 22 % ( p=0.1232 ) in the Diet Group . Conclusions : This study is the first , to our knowledge , to demonstrate that an intensive dietary program has the potential to improve the iron status of women with iron deficiency BACKGROUND Decrements in iron status have been reported in female soldiers during military training . Diminished iron status adversely affects physical and cognitive performance . OBJECTIVE We wanted to determine whether iron supplementation could prevent decrements in iron status and improve measures of physical performance and cognitive status in female soldiers during basic combat training ( BCT ) . DESIGN In this 8-wk r and omized , double-blind , placebo-controlled trial , soldier volunteers ( n = 219 ) were provided with capsules containing either 100 mg ferrous sulfate or a placebo . Iron status indicator assays were performed pre- and post-BCT . Two-mile running time was assessed post-BCT ; mood was assessed by using the Profile of Mood States question naire pre- and post-BCT . RESULTS The BCT course affected iron status : red blood cell distribution width and soluble transferrin receptor were elevated ( P < 0.05 ) , and serum ferritin was lowered ( P < 0.05 ) post-BCT . Iron supplementation attenuated the decrement in iron status ; group-by-time interactions ( P < 0.01 ) were observed for serum ferritin and soluble transferrin receptor . Iron supplementation result ed in improved ( P < 0.05 ) vigor scores on the Profile of Mood States post-BCT and in faster running time ( P < 0.05 ) in volunteers reporting to BCT with iron deficiency anemia . CONCLUSIONS Iron status is affected by BCT , and iron supplementation attenuates the decrement in indicators of iron status in female soldiers . Furthermore , iron supplementation may prove to be beneficial for mood and physical performance during the training period . Future efforts should identify and treat female soldiers or athletes who begin training regimens with iron deficiency or iron deficiency anemia Abstract In many countries an attempt is made at a national level to prevent iron deficiency by enriching food with iron . The amount by which iron intake should be increased is unknown , and decisions seem to be based on very inadequate evidence . Trials of iron supplements in two at-risk groups revealed an effect on haemoglobin level of a supplement of 10 mg . iron per day , but gave no clear evidence of an effect of a smaller supplement There was no significant change in the maximal oxygen uptake for either the experimental or the control group from the pre-test to the post-test . Five blood chemistry measures were unable to predict the post-maximal oxygen uptake scores using the procedure of stepwise regression . An examination of the blood chemistry profiles indicated that sports anemia did not occur . The factorial breakdown was unable to produce any significant insight into the changes in hemoglobin concentration and oxygen consumption .  Heme-iron supplementation was unable to override the regulatory system of the body and allow the hemoglobin level to become elevated We studied effects of dose and treatment duration during low-dose iron supplementation in premenopausal , non-pregnant women , with initial serum ferritin and haemoglobin concentrations < 20 micrograms x l-1 and > or = 120 g x l-1 , respectively . The study was r and omized , double-blind and placebo-controlled . Three groups completed a 6-month study : placebo ( n = 27 ) , FE-9 ( 9 mg iron x day-1 , n = 18 ) and FE-27 group ( 27 mg iron x day-1 , n = 19 ) . The supplement consisted of 11 % heme and 89 % inorganic iron . In FE-27 , serum ferritin increased from ( mean , 95 % confidence interval ) 11.8 ( 9.7 ; 14.4 ) to 25.3 ( 18.6 ; 34.4 ) micrograms x l-1 in 1 month , and remained stable after that ( ANOVA : group effect , P = 0.0003 ) . In both FE-9 and FE-27 , blood haemoglobin levels increased from 136 ( 132 ; 140 ) to 142 ( 139 ; 145 ) g x l-1 in 1 month , remaining constant after that ( group effect , P = 0.001 ) . Hence , the 27 mg daily dose of organic/inorganic iron corrected both mild anaemia and storage iron depletion , whereas the 9 mg dose did not affect iron stores . Elongation of treatment duration above 1 month brought about only minor changes In a double-blind trial the response to treatment with Ferro-Gradume ( a slow-release preparation of ferrous sulphate ) has been compared in the same individuals with the response to ferrous fumarate in a single daily dose regimen using a similar dose of iron . No significant difference was found in the therapeutic response or in the incidence of side-effects between the two preparations 1 . Two large-scale community based studies of the  haematinic effect of iron added to flour used to bake bread are reported . These were design ed to simulate conditions in the community as closely as possible . 2 . Neither trial gave conclusive evidence of benefit in terms of an effect on circulating haemoglobin level , but in one trial the results suggested a small haematinic effect . 3 . The availability of an iron salt from bread eaten in a normal varied diet is clearly much lower than has been suggested from highly controlled radioactive isotope studies The impact of long-term ( 6-month ) moderate exercise on the iron status of previously sedentary women was determined by r and omly assigning 62 college-age women into one of the following four groups : 1 ) 50 mg.d-1 iron supplement , low iron diet ( N = 16 ) ; 2 ) Placebo , free choice diet ( N = 13 ) ; 3 ) Meat supplement to achieve 15 mg.d-1 iron intake ( N = 13 ) ; and 4 ) Control , free choice diet ( N = 20 ) . All groups except the Control group exercised 3 d.wk-1 at 60%-75 % of their heart rate reserve . VO2max was measured at baseline and week 24 . Blood was sample d at baseline and every 4 wk thereafter for 24 wk to measure iron status and to eluci date the causes for alterations in iron status . Subjects had depleted iron stores throughout the study as indicated by their serum ferritin levels ( < 15 ng.ml-1 ) . Serum iron , total iron binding capacity and transferrin saturation were not compromised with exercise . Mean hemoglobin level in the Placebo/Ex group was significantly ( P < 0.05 ) lower than the 50 Fe/Ex and the Meat/Ex groups by week 24 . However , changes in serum albumin , haptoglobin , and erythropoietin data from the study can not explain these changes BACKGROUND Reduced salivary flow is a condition that affects oral health . Its prevalence is unknown in young and middle-aged adults and there is no known treatment that permanently increases the salivary flow rate . Reduced salivary flow is related to dental caries , the most common oral disease . Reduced salivary flow is often found in individuals with insufficient food intake and thereby insufficient nutrition to the salivary gl and s. One nutrition related factor that has been proposed to effect salivary flow rate is iron deficiency . AIMS The aims of the thesis were to investigate i ) the prevalence of reduced salivary flow rate in different age groups of adults , ii ) the relationship between reduced salivary flow rate , general health and dental caries , iii ) the influence of time of measurement on reduced salivary flow rate , and iv ) if reduced salivary flow rates could be increased by iron supplementation . MATERIAL AND METHODS In Study I saliva was collected from 1427 individuals aged 20 - 69 years . A question naire was answered regarding subjective oral dryness , general diseases , use of drugs , BMI ( Body Mass Index ) and use of tobacco . In Study II saliva was collected from 48 patients with active caries and 48 caries-inactive patients . A blood sample was analysed for serum ferritin . In Study III the unstimulated salivary flow rate was tested at 7:30 and 11:30 a.m. in 108 individuals , age 15 - 46 years . The participants were allocated to one of three groups ( very low < 0.1 mL/min , low 0.1 - 0.2 mL/min and normal > 0.2 mL/min ) based on the the unstimulated salivary flow rate at 7:30 a.m. Different aspects of the perception of oral dryness were rated using Visual Analogue Scales . In Study IV a double-blind , r and omized controlled trial was carried out on 50 individuals with a low unstimulated whole salivary flow rate and low serum ferritin . Half the individuals received 60 mg of iron orally twice a day for 3 months , while the other half received placebo . RESULTS In Study I it was found that the prevalence of very low ( < 0.1 mL/min ) and low ( 0.10 - 0.19 mL/min ) unstimulated salivary flow rate were similar for different age groups up to 50 years , ranging between 10.9 - 17.8 % and 17.3 - 22.7 % , respectively . Multiple logistic regression revealed that above age 50 , female gender , ' having fewer than 20 teeth ' , and taking xerogenic drugs significantly increased the risk of very low unstimulated salivary flow rate . In Study II 32 individuals ( 67 % ) in the caries active group had low unstimulated salivary flow rate compared with 13 individuals ( 27 % ) in the caries inactive group . There was no difference in serum ferritin levels between the two groups . Study III showed for all groups a statistically significant increase in unstimulated salivary flow rate at 11:30 a.m. compared with 7:30 a.m. , all of similar magnitude ( 0.08 - 0.09 mL/min ) . In the group with very low salivary flow rate , 70 % at 11:30 a.m. exceeded the 0.1 mL/min limit . There were significant difference in perception of oral dryness between the normal group and both the low and the very low groups . In Study IV no statistically significant difference was found between the groups after treatment for the unstimulated flow rate and in the subjective assessment s of oral dryness . CONCLUSIONS The prevalence of reduced salivary flow rates is consistent and prevalent in younger and middle-aged adults ( < 50 years ) . Very low salivary flow rates are related to high Body Mass Index ( BMI ) and diagnosed diseases in younger adults , but to medication in older adults . Reduced salivary flow rate in young adult women is related to caries . The time of measurement of salivary flow rates influences diagnosis of hyposalivation . Iron supplementation does not enhance salivary flow . The effect of a high oral iron supplementation ( 120 mg day ) on the physical work capacity has been studied in a group of apparently healthy men and women of ages 58–71 years , and this effect was correlated with the initial values of and changes in some variables constituting usual clinical estimates of the state of iron nutrition . The increase in physical work capacity was about 4 % higher in men and about 12 % higher in women in the group supplemented with iron than in the control ( placebo ) group . In the control group there was a positive correlation between increase in physical work capacity and initial value for stainable iron in the bone marrow , and a negative correlation between increase in physical work capacity and decrease in the value for stainable iron in the bone marrow ; it is pointed out that these findings should not be expected in the iron-supplemented group , where variations in the depot iron will be of less influence . In the iron-supplemented group the total iron binding capacity decreased significantly , while the remaining variables constituting estimates of the state of iron nutrition showed no significant changes . The increase in physical work capacity in the iron-supplemented group did not appear to be correlated to the initial value either for haemoglobin concentration or for other variables estimating the state of iron nutrition . It is concluded that in apparently healthy people the increase in physical work capacity during moderate training is related to the availability of iron PURPOSE : There is increasing evidence that screening for colorectal cancer may save lives , and consequently , both professional and public interest in screening for colorectal cancer is increasing . As yet , however , there is no perfect screening test . Insidious blood loss is a common feature of colorectal cancer and may lead to a fall in serum ferritin before the patient becomes anemic . Measurement of serum ferritin , which is widely available and easily and inexpensively performed , has , therefore , been postulated as a potential screening test for colorectal cancer . METHOD : This study used sample s of serum collected from 148 patients recruited to a screening study for colorectal cancer . All patients were thoroughly investigated by double-contrast barium enema and /or colonoscopy .  Patients were selected r and omly from each of three clinical diagnostic groups : 50 patients with proven colorectal cancer , 49 patients without colon disease , and patients with adenomas of the colon .  Serum ferritin was assayed by immunoradiometry . The expected adult reference range is 25 to 350 µg/l , and results were reported without patient identification . RESULTS : There were no significant differences in serum ferritin levels among any of the three groups . CONCLUSION : Serum ferritin is unlikely to be of value as a screening test for colorectal cancer BACKGROUND R and om serial sampling is widely used in population pharmacokinetic studies and may have advantages compared with conventional fixed time-point evaluation of iron fortification . OBJECTIVE Our objective was to vali date r and om serial sampling to judge the efficacy of iron fortification of a low-fat margarine . DESIGN We conducted a 32-wk placebo-controlled , double-blind , iron-intervention trial in 18 - 40-y-old Swiss women ( n = 142 ) with serum ferritin ( SF ) concentrations < 25 μg/L. Women were r and omly assigned to 3 groups to receive 20 g margarine , with 14 mg added iron as either micronized ground ferric pyrophosphate ( MGFePP ) or sodium iron edetate ( NaFeEDTA ) , or placebo daily . We measured hemoglobin and iron status of subjects at 2 fixed time points ( at baseline and the endpoint ) plus 3 r and omly assigned time points between 4 and 28 wk . With the use of bootstrapping , the number of observations per individual was reduced to 3 and then compared with the 5-time-point data . Mixed-effects models were used to estimate iron repletion over time for r and om sampling , and analysis of covariance was used for fixed time-point sampling . RESULTS Body iron stores increased in women who received MGFePP or NaFeEDTA compared with women who received placebo ( P < 0.05 ) . The increase in body iron stores  with NaFeEDTA fortification was 2 - 3 times the increase with MGFePP fortification ( P < 0.05 ) ; the difference was more marked in women with baseline SF concentrations < 15 μg/L ( P < 0.05 ) . R and om serial sampling reduced the required sample size per group to one-tenth of that for 2 fixed time points . Compared with the 5-time-point analysis , the 3-time-point sparse sampling generated comparable estimates of efficacy . CONCLUSIONS When used to evaluate the efficacy of iron fortificants , r and om serial sampling can reduce the sample size , invasiveness , and costs while increasing sensitivity . R and om serial sampling more clearly describes the pattern of iron repletion and may prove useful in evaluating other micronutrient interventions
target: Quantitative relations between baseline iron status , study duration , and iron dose on changes in iron-status biomarkers , which were generated from the meta-analyses , can be used to predict effects of trials of iron supplementation and fortification and to design iron-intervention programs
background: BACKGROUND The response of status biomarkers to an increase in iron supply depends on several physiologic and environmental factors , which make it difficult to predict the outcome of an intervention .
  OBJECTIVE We assessed effects of baseline iron status , sex , menopausal status , duration of intervention , iron form , and daily dose on the change in iron status in response to iron supplementation .