RESUMO
Anemia is highly prevalent, especially in poorly nourished populations living in unsanitary conditions. Studies of the Central American population showed that iron was the predominant deficient hematopoietic micronutrient and that correction of nutrient deficiencies led to hematological normality as defined by WHO. The bioavailability of diverse iron compounds added to the mostly vegetable diets of such populations showed the superior absorption of chelated iron (NaFeEDTA) and its strong effectiveness in correcting iron deficiency when added to sugar. The consequences on development and mental behavioral functions as well as on work capacity of iron deficiency and anemia in infants, children and adults, and the positive effects of their correction was demonstrated. In protein-energy malnourished (PEM) children, the deficit in active tissue mass (basal oxygen consumption) and in total hemoglobin content were closely related. This relationship persisted as the rates of active tissue mass repletion was modified by levels of protein intake. This demonstrated the strong adaptive nature of hemoglobin content in response to oxygen needs in PEM and during recovery. Gastrointestinal functions in PEM and in populations demonstrated the bacterial invasion of the upper GI tract and how this resulted in secondary bile acids that are toxic to the intestinal mucosal cells impairing their absorptive functions. Environmental hygiene in populations reversed gut bacterial migration and improved GI function.
Assuntos
Academias e Institutos/história , Anemia Ferropriva/história , Trato Gastrointestinal/fisiopatologia , Infecções/história , Desnutrição Proteico-Calórica/história , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/fisiopatologia , Anemia Ferropriva/prevenção & controle , América Central/epidemiologia , Sacarose Alimentar , Ácido Edético/administração & dosagem , Ácido Edético/uso terapêutico , Compostos Férricos/administração & dosagem , Compostos Férricos/uso terapêutico , Alimentos Fortificados/história , História do Século XX , Humanos , Higiene , Infecções/complicações , Infecções/fisiopatologia , Política Nutricional/história , Inquéritos Nutricionais , Desnutrição Proteico-Calórica/complicações , Desnutrição Proteico-Calórica/dietoterapia , Desnutrição Proteico-Calórica/fisiopatologiaRESUMO
Pica, the compulsive eating of non edible substances, is known by the medical profession for centuries. In the novel by Miguel de Cervantes "Adventures of the famous knight Don Quixote de la Mancha'', there is a history in which "women that by caprice eat soil, plaster coal and other disgusting substances'' are mentioned. This description configures the clinical diagnosis of pica. This fact has not attracted the attention of the critics of Cervantes' novel, up to now. This unequivocal reference of pica suggests that iron deficiency anemia, caused by chronic hemorrhages in adults, was frequent in 1605, when the book was first published.
Assuntos
Anemia Ferropriva/história , Medicina na Literatura , Pica/história , História do Século XVI , HumanosRESUMO
This is a non-comprehensive overview of the latest 50 years about the evolution of iron metabolism and the methodology we currently have for the diagnosis of iron deficiency and its effects on human health. In the 40's iron absorption was determined by chemistry. The amount of iron absorbed was calculated as the difference between dietary iron and excreted iron. The other methods used to measure dietary iron was hemoglobin repletion. In the 70's the measurement of plasmatic ferritin was an important contribution to iron metabolism to assess iron deficiency and iron overload. In the same decade the extrinsic and intrinsic labelled methodology was an important advancement. The 70's and 80's were years where scientists aimed at finding iron absorption inhibitors, namely coffee, calcium, tea, zinc and fiber. The 80's and 90's were characterized for the emerging knowledge an iron absorption from a food, a meal and a complete diet and for the favorable effect of food iron fortification in developing countries. Also for the effect of iron excess in overall health and myocardial infarction in developed countries were studied.