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Although hepcidin synthesis is stimulated by inflammation and inhibited by Fe deficiency, the strength of their opposing effects on serum hepcidin (SHep) in humans remains unclear. It was recently shown that an inflammatory stimulus in anaemic women did not increase SHep or decrease Fe absorption. The enhancing effect of ascorbic acid on Fe absorption may not be effective during inflammation because of increased SHep. Our study aim was to test whether reducing inflammation in Fe-depleted overweight (OW) women with low-grade inflammation would lower SHep and improve Fe absorption with and without ascorbic acid, compared with normal-weight (NW) women without inflammation. Before and after 14 d of anti-inflammatory treatment (3 × 600 mg ibuprofen daily) in OW and NW women (n 36; 19–46 years of age), we measured SHep and fractional Fe absorption (FIA) (erythrocyte Fe incorporation) from 57Fe- and 58Fe-labelled test meals with and without ascorbic acid. There were significant group effects on IL-6, C-reactive protein, serum ferritin and SHep (for all, P < 0·05). There was a significant treatment effect on SHep (P < 0·05): in OW women, treatment decreased IL-6 by approximately 30 % and SHep by approximately 45 %. However, there were no significant treatment or group effects on FIA. Body Fe stores (BIS) were a significant positive predictor of SHep before and after treatment (P < 0·001), but IL-6 was not. Reducing chronic inflammation in OW women halved SHep but did not affect Fe absorption with or without ascorbic acid, and the main predictor of Fe absorption was BIS.
To describe and analyse the sociodemographic, anthropometric, behavioural and dietary characteristics of different types of Swiss (no-)meat eaters.
No-, low-, medium- and high-meat eaters were compared with respect to energy and total protein intake and sociodemographic, anthropometric and behavioural characteristics.
National Nutrition Survey menuCH, the first representative survey in Switzerland.
2057 participants, aged 18–75 years old, who completed two 24-h dietary recalls (24-HDR) and a questionnaire on dietary habits, sociodemographic and lifestyle factors. Body weight and height were measured by trained interviewers. No-meat eaters were participants who reported meat avoidance in the questionnaire and did not report any meat consumption in the 24-HDR. Remaining study participants were assigned to the group of low-, medium- or high-meat eaters based on energy contributions of total meat intake to total energy intake (meat:energy ratio). Fifteen percentage of the participants were assigned to the low- and high-meat eating groups, and the remaining to the medium-meat eating group.
Overall, 4·4 % of the study participants did not consume meat. Compared with medium-meat eaters, no-meat eaters were more likely to be single and users of dietary supplements. Women and high-educated individuals were less likely to be high-meat eaters, whereas overweight and obese individuals were more likely to be high-meat eaters. Total energy intake was similar between the four different meat consumption groups, but no-meat eaters had lowest total protein intake.
This study identified important differences in sociodemographic, anthropometric, behavioural and dietary factors between menuCH participants with different meat-eating habits.
Obesity is characterized by chronic low-grade inflammation. Visceral adipose tissue (VAT) is heavily infiltrated by macrophages producing pro-inflammatory cytokines (IL-6), therefore VAT predicts greater systemic inflammation compared to peripheral fat. Thus, central adiposity may cause increased serum hepcidin (SHep) and may affect iron metabolism more than peripheral adiposity. Although increased total body fat (BF) is linked to disordered iron homeostasis, the potential effects of body fat distribution on iron metabolism have not been studied. Therefore, the aim of this study was to assess the effect of BF distribution on iron and inflammation parameters, SHep and iron metabolism.
We enrolled 37 normal-weight women and 81 overweight/obese women in this cross-sectional study. Body composition was assessed using DXA and iron- and inflammation parameters and SHep were measured. The overweight/obese women were assigned to a peripheral (n = 54) and a central (n = 27) fat deposit group, according to their android fat percentage. All women received 100 mg oral iron as ferrous citrate and the change in serum iron was assessed after 2 h to determine iron absorption.
The three groups differed significantly in body weight, BMI, waist circumference, android fat, gynoid fat, total fat, android/gynoid ratio and VAT (for all p < 0.001). Hemoglobin, serum ferritin, body iron stores (BIS), serum iron and transferrin saturation (TSAT) were lowest and transferrin receptor was highest in central obesity. CRP was higher in central obesity compared to both, peripheral obesity (p < 0.05) and normal-weight (p < 0.001). SHep was higher in central and peripheral obesity compared to normal-weight (both p < 0.01), with no difference between the two overweight/obese groups. Δserum iron was ≈30% and ≈20% lower in central obesity compared to normal-weight and peripheral obesity. We performed linear regression analysis on SHep, CRP, TSAT and Δserum iron: Android fat and BIS were positive predictors of SHep (p < 0.05, p < 0.001), android fat was a positive predictor of CRP (p < 0.001), BIS was a positive, android fat was a negative predictor of TSAT (p < 0.001, p < 0.05) and TSAT and android fat were both negative predictors of Δserum iron (p < 0.001, p < 0.05).
Controlling for iron status, inflammation and SHep are increased in women with central obesity and predict lower iron absorption and hypoferremia compared to women with more peripheral fat distribution. Thus, women with central fat distribution may be at increased risk for iron deficiency and anemia.
Today's high interest for no- or low-meat diets is driven by evidence-based associations between high meat consumption and unhealthy lifestyle factors as well as increased risk of various chronic diseases. This study aims to characterize no-, low- and high-meat consumers and describe their protein intake using data from the Swiss nutrition survey menuCH.This first national survey assessed descriptive factors by a questionnaire and dietary intake by 24-hour dietary recall (24 HDR) across all three linguistic regions, German, French and Italian of Switzerland (N = 2057). Data from the questionnaire (food avoidance) and two 24 HDRs were used to categorize total participants (N) into four subgroups: no meat (4.4%); low (15%), medium (65.6%), or high-meat eaters (15%), based on meat-energy contributions of 0; 0–2.4; 2.4–18.7; 18.7–48.4, respectively. Contributions of overall macronutrients and protein from the different food groups were described for each subgroup to identify quantitative and qualitative differences. Multinomial logistic regression analysis was applied to predict the probability of belonging to one of the four subgroups according to the following sociodemographic and behavioral variables: sex, language region, age, nationality, marital status, education, gross household income, BMI, physical activity, smoking, dietary supplements and overall health status. The subgroups differed in protein intake with 11.5%, 12.8%, 15.4% and 19.1% of total energy intake for no-, low-,medium- and high-meat diets, respectively, weighted for sampling design, non-response, weekdays and season. In general, no- and low-meat consumers included a greater variety of foods contributing to protein intake than meat consumers, including more dairy products and meat-alternatives. None of the subgroups met the Swiss Food-based Dietary Guidelines of three portions of dairy products per day. The regression analysis showed that sex, taking dietary supplements or not and BMI were important determinants of the subgroups: women had a higher predicted probability than men to be no- and low-meat eaters and for these same subgroups, individuals showed higher probabilities for taking dietary supplements. Overweight and obese participants showed higher probabilities to be high-meat eaters.
These findings show considerable differences in protein intake and in variety of protein-food selections, between extremes of meat intake (no- to high meat consumption). Future surveys should include frequency methods to allow conclusions about habitual meat intake or avoidance and health status screening to analyse individuals health data.
Overweight/obesity (owob) causes low-grad systemic inflammation and thereby an up-regulation of hepcidin and a reduction in fractional iron absorption (FIA) even with low iron stores. Pregnancy increases iron needs because of the expansion of maternal blood volume and fetal needs. It is unclear to what extent owob pregnancy influences FIA, iron supply of the fetus and risk of iron deficiency. Therefore, the main aim of this study was to determine the effect of maternal owob on iron absorption during pregnancy and on the iron transfer to the fetus. Secondary objectives were to investigate the development of hepcidin, plasma ferritin and inflammatory markers over the course of pregnancy dependent on weight status. In this multicenter case-control study we included 44 normal weight (nw) and 36 owob women around pregnancy week (PW) 12. We administered 57Fe or 58Fe labeled FeSO4 to women during the 2nd and 3rd trimester of pregnancy. We measured FIA determining erythrocyte incorporation of iron stable isotopes 14 days after administration. From PW 12 until PW 36 iron-, inflammation and hepcidin were monitored. Iron transfer to the fetus was determined as iron stable isotope concentration in cord blood. Sample analysis is currently ongoing, all results will be available in October. Subject characteristics in PW 12 for the nw (n = 26) and owob (n = 10) were: mean BMI: 21.4 ± 2.2 and 36.7 ± 6.8 kg/m2, mean hemoglobin: 12.4 ± 1.2 and 12.4 ± 0.9 g/dL and median plasma ferritin: 41.3 (29.6–83.6) and 61.6 (24.3–119.0) μg/L. Preliminary results indicate FIA increased by 2.4 fold in the nw and by 1.3 fold in the owob women between the 2nd and the 3rd trimester of pregnancy. Iron stores decreased in both groups over the course of pregnancy. Hepcidin was still significantly higher in the owob women in the 3rd trimester. Inflammation tended to be higher in owob women throughout pregnancy. Iron isotopes were highly detectable in cord blood. The 58Fe:57Fe-ratio determined in cord blood corresponded to the 58Fe:57Fe-ratio determined in the mother in the 3rd trimester. Thus, in owob women, the increase in FIA throughout pregnancy to support iron needs of mother and fetus is blunted compared to nw women. This is consistent with elevated hepcidin in the 3rd trimester and higher inflammation throughout pregnancy. Thus, even though iron demands are strongly increased, owob may prohibit an adequate iron supply to the expecting mother and the fetus due to persistent subclinical inflammation.
The contribution of milk and dairy products to daily iodine intake is high but variable in many industrialised countries. Factors that affect iodine concentrations in milk and dairy products are only poorly understood. Our aim was to: (1) assess the effect of feed iodine concentration on milk iodine by supplementing five groups of five cows each with one of five dosages from 0–2 mg iodine/kg DM; (2) quantify iodine losses during manufacturing of cheese and yogurt from milk with varying iodine concentrations and assess the effect of cellar-ripening; and (3) systematically measure iodine partitioning during heat treatment and skimming of milk. Milk iodine reached a near-steady state after 3 weeks of feeding. Median milk iodine (17–302 μg/l for 0–2 mg iodine/kg DM) increased linearly with feed iodine (R2 0·96; P < 0·001). At curd separation, 75–84 % of iodine was lost in whey. Dairy iodine increased linearly with milk iodine (semi-hard cheese: R2 0·95; P < 0·001; fresh cheese and yogurt: R2 1·00; P < 0·001), and cellar-ripening had no effect. Heat treatment had no significant effect, whereas skimming increased (P < 0·001) milk iodine concentration by only 1–2 μg/l. Mean daily intake of dairy products by Swiss adults is estimated at 213 g, which would contribute 13–52 % of the adults’ RDA for iodine if cow feed is supplemented with 0·5–2 mg iodine/kg DM. Thus, modulation of feed iodine levels can help achieve desirable iodine concentrations in milk and dairy products, and thereby optimise their contribution to human iodine nutrition to avoid both deficiency and excess.
Milk and dairy products are important iodine sources and contribute about 30–40 % of total iodine in the Swiss diet. Information about variation in milk iodine concentration (MIC) in Switzerland is limited. We examined MIC and its potential determinants in milk from organic and conventional farms. We collected bulk milk samples at 3-month intervals over 1 year from thirty-two farms throughout Switzerland and Aosta valley, North-West Italy. We sampled all feed components including tap water, collected information on farm characteristics, feeding and teat disinfection practices by questionnaire and estimated the cows’ winter and summer iodine intake. Iodine in milk and feed components was measured using inductively coupled plasma MS. The overall median MIC was 87 (range 5–371) µg/l. In multivariate analysis, predictors of MIC were as follows: (1) farm type: median MIC from organic and conventional farms was 55 and 93 µg/l (P=0·022); (2) season: 53, 97 and 101 µg/l in September, December and March (P<0·002); and (3) teat dipping: 97 µg/l with v. 56 µg/l without (P=0·028). In conclusion, MIC varied widely between farms because of diverse farming practices that result in large differences in dairy cow exposure to iodine via ingestion or skin application. Standardisation of MIC is potentially achievable by controlling these iodine exposures. In order for milk to be a stable iodine source all year round, dietary iodine could be added at a set level to one feed component whose intake is regular and controllable, such as the mineral supplement, and by limiting the use of iodine-containing teat disinfectants.
Fe fortification of wheat flour was proposed in Haiti to combat Fe deficiency, but Fe bioavailability from fortificants has never been investigated in Haitian women or preschool children, two key target groups. We aimed to investigate the bioavailability of ferrous fumarate (FeFum), NaFeEDTA and their combination from fortified wheat flour. We recruited twenty-two healthy mother–child pairs in Port au Prince, Haiti, for an Fe-absorption study. We administered stable Fe isotopes as FeFum or NaFeEDTA individually in low-extraction wheat flour bread rolls consumed by all participants in a randomised, cross-over design. In a final, identical meal, consumed only by the women, FeFum+NaFeEDTA was administered. We measured Fe absorption by using erythrocyte incorporation of stable isotopes 14 d after consumption of each meal, and determined Fe status, inflammatory markers and Helicobacter pylori infection. Fe absorption (geometric mean was 9·24 (95 % CI 6·35, 13·44) and 9·26 (95 % CI 7·00, 12·31) from FeFum and 13·06 (95 % CI 9·23, 19·10) and 12·99 (95 % CI 9·18, 18·39) from NaFeEDTA in mothers and children, respectively (P<0·05 between compounds). Fe absorption from FeFum+NaFeEDTA was 11·09 (95 % CI 7·45, 17·34) and did not differ from the other two meals. H. pylori infection did not influence Fe absorption in children. In conclusion, in Haitian women and children, Fe absorption from NaFeEDTA was 40 % higher than from FeFum, and the combination FeFum+NaFeEDTA did not significantly increase Fe absorption compared with FeFum alone. In the context of Haiti, where the high costs of NaFeEDTA may not be affordable, the use of FeFum at 60 mg Fe/kg flour may be a preferable, cost-effective fortification strategy.
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