Iron

 Most iron is found in hemoglobin

 Small amounts are present in myoglobin
 Free iron involved in capture of energy
released during breakdown of proteins and
fats
The Hemoglobin Molecule
Iron in Hemoglobin
 Iron readily combines with oxygen
 Iron in hemoglobin attaches to oxygen in
the lungs
 Hemoglobin releases oxygen from iron to
cells
 Free iron picks up carbon dioxide from
cells
 Blood returns to lungs, carbon dioxide is
released
 Free iron combines with oxygen
 The cycle continues
Iron in Myoglobin
 Iron in myoglobin traps oxygen, stores it,
and releases it as needed for energy for
muscle activity
 Myoglobin boosts oxygen available to
muscles
 These functions require supply of iron that
is sufficient
Iron is transported by special
transport proteins
 Iron can be stored by attachment to a
protein called Ferritin in the mucosal
lining of the intestine.
 Iron is transported through the blood
attached to another protein, Transferrin.
Iron that enters the mucosal cells of the small intestine may
either be bound to ferritin or transported in the blood by the
protein transferrin. Iron trapped in the mucosal cell by ferratin is
lost when the dell dies. Iron transported by transferrin reaches
body cells that need iron. When iron levels are high, more iron
is stored as ferritin.
Iron in the Body
Iron
 Iron occurs in two forms in foods
 Some is bound into heme
 The iron-containing part of hemoglobin and myoglobin in
meat, poultry and fish
 Some is nonheme iron
 Found in foods from plants and in nonheme iron of
meats
 Heme iron is more reliably absorbed than
nonheme iron
 Healthy people with adequate iron stores absorb heme
iron at a rate of ≈23%
 People absorb nonheme iron at rates of 2%-20%
 Depending on dietary factors and iron stores
Iron
 MFP factor
 Found in meat,
fish and poultry
 Promotes the absorption of nonheme iron from
other foods eaten at the same time
 Vitamin C can triple absorption of
nonheme iron from foods eaten in the
same meal
 Citric acid, lactic acid, hydrochloric acid,
sugars
Iron
 Impairment of iron absorption
 Tannins
 Found in tea and coffee
 Calcium and phosphorus
 Milk
 Phytate and oxalate
 Found in the fiber of lightly processed legumes and
whole-grain cereals
 EDTA
 The amount of iron absorbed
from a meal depends partly
on the interaction between
promoters and inhibitors of
iron absorption
 Cooking in an iron pan adds
iron to food
 This iron is in the form of
iron salts somewhat like
those in supplements
 The iron content of 100
grams of spaghetti sauce
 Simmered in a glass dish =
3mg
 Cooked in a black iron skillet
= 87mg
Iron – Why do we need it?
 Because it is readily oxidized, iron is part of
many proteins involved in oxygen transport and
oxidation/ reduction reactions:
 Hemoglobin – the protein of red blood cells that carries
oxygen molecules
 Myoglobin – a protein similar to hemoglobin found in
the cytoplasm of muscle cells
 Enzymes and electron carrier molecules in the energy
metabolism pathway
 Proteins involved in drug metabolism, the immune
system, and protection against free radicals
What foods contain iron?
 Heme iron is part of hemoglobin and
myoglobin and is obtained from meat of
all types.
 Non-heme iron is found in leafy green
vegetables, legumes, and meat and is
absorbed at about half the rate of heme
iron.
 Non-heme iron can also leach out of iron
cookware into food.
Food Sources of Iron
Iron deficiency is a significant
concern worldwide
 Iron deficiency occurs most often when
there is a regular, significant loss of blood,
as in the monthly cycle of women.
 Iron deficiency affects children and women
with high need and low consumption
 Iron deficiency anemia due to
insufficient hemoglobin is the primary
symptom of iron deficiency.
A Negative Iron Balance Leads to
Progressively More Severe Conditions
Consequences
 People with iron deficiency
 are weak and tired
 have short attention span
 have poor appetite
 are susceptible to infection
 become irritable easily
Excess doses of iron can be toxic
 A single large dose of iron can cause:
 Damage to the intestinal lining
 Abnormalities in body pH
 Shock
 Liver failure
 Chronic iron overload is the gradual
accumulation of excess iron and is most
likely due to abnormalities in iron
absorption.
Overdosing on Iron
 Excess iron absorbed into the body cannot be
easily excreted
 Hemochromatosis is inherited disease of over
absorption of iron
 In hereditary iron overload, the intestine
continues to absorb iron at a high rate despite
the excess iron building up in the body tissues
 Early symptoms are general and vague: fatigue, mental
depression, abdominal pains
 Later, tissue damage occurs, with liver failure, abnormal
heart beats, diabetes
 Infections are likely because bacteria thrive on iron-rich
blood
 Folate
• Role
– Part of coenzymes THF (tetrahydrofolate) and
DHF (dihydrofolate) used in DNA synthesis
and therefore important in new cell formation
– Amino acid metabolism – interconversions of
amino acids
Folate
 Deficiency
• Because immature red and white blood cells and
cells of the GI tract divide rapidly, they are most
vulnerable to a deficiency
• Megaloblastic anemia – bone marrow cell
develop blood cells cannot duplicate their DNA
and cannot divide, fewer matured cell produces,
oxygen-carrying capacity reduced
– Related to anemia of vitamin B12 malabsorption
• Diminished immunity
• Abnormal digestive function
 Deficiency
• Neural tube birth defects (spina bifida –
spinal fluid bulge through the back)
– Range from slight problems in the spinal cord
to mental retardation
– Severely diminished brain size
– Death shortly after birth
– Arise in the first few days or weeks of
pregnancy
• Most women eat too few fruits and vegetables to
supply even 50% of the folate needed to prevent
such birth defects
 Deficiency
• May result from
– Inadequate intake
– Illnesses that impair folate absorption
– Increased excretion
– Medications that interact with folate, or
otherwise increase the body’s need
 Toxicity
• UL for synthetic folate from supplements
and enriched foods is 1,000
micrograms/day for adults
• Folate can mask vitamin B12 deficiency
• Excess folate may be antagonistic to the
actions of some anticancer drugs
 Vitamin B12
• Role
– Vitamin B12 is activated by folate
– Folate is activated by vitamin B12
– Maintenance of the sheaths that surround and
protect nerve fibers
– Part of coenzymes methylcobalamin and
deoxyadenosylcobalamin used in new cell
synthesis
 Deficiency
• Numbness, tingling, memory loss,
disorientation due to degeneration of
nerve sheaths  creeping paralysis
• General malfunctioning of nerves and
muscles
 Deficiency
• Pernicious anaemia (parietal cells destroyed)
• Absorption of B12 – requires stomach acid,
pepsin, intrinsic factor, pancreatic enzymes
• The stomach’s acid liberates vitamin B12 from
food; intrinsic factor then binds to the vitamin
• The complex is then absorbed from the small
intestine into the blood
 Deficiency
• In a few people an inherited defect in the gene
for intrinsic factor makes vitamin B12 absorption
abnormal, beginning in mid-adulthood
• In later years, many people lose the ability to
produce sufficient stomach acidity and intrinsic
factor
• Leaving them vulnerable to chronic stomach
infections and reduced ability to absorb vitamin
B12
• 90% of vit. B12 deficiency caused by a defect in
B12 absorption, not the inadequate intake
Coenzymes derived from
B vitamins play many
roles in energy
metabolism
ANEMIA
 What is anemia?

• Symptom of variety nutrition and non-nutrition

related disorder
• Condition of having too few red blood cells or too
little hemoglobin to transport oxygen to tissues
• Nutritional anemia – caused by iron, folate, b12
deficiencies (inadequate intake, poor absorption,
abnormal metabolism)
 Lab test for detecting NA

• Anemia is identified and classified by measurements of

– Hemoglobin – oxygen-carrying protein in the blood
– Hematocrit - % of red blood cell per standardized
volume of blood
– Serum ferritin, folate, vitamin B12
– Mean corpuscular volume – RBC size; determine
microcytic (iron def) or macrocytic (folate/B12 def)
– Mean corpuscular hemoglobin concentration – Hb
conc within average RBC; determine hypochromic
(iron def) or normochromic (folate/B12 def)
 Hb and Hct level used to define anemia

Group Hemoglobin (Hb) Hematocrit (Hct)

Children 6m – 5y <110g/L 0.33%

Children 5 – 11y <115g/L 0.34%

Children 12 – 13y <120g/L 0.36%

Non pregnant <120g/L 0.36%

Pregnant <110g/L 0.33%

Men <130g/L 0.39%

Iron-deficiency anemia
 Iron-deficiency anemia

• Refer to depletion of iron stores that results in a low

Hb conc.
• RBC are pale and small – skin, tongue, eye lining
 Folate and B12 deficiency

• Folate is a central component of human RBC

production as well as DNA
• Folate deficiency contribute to anemia by
retarding cell division (low consumption, poor
absorption, malaria)
• B12 also can cause megaloblastic/macrocytic
anemia (lack of active folic acid)
– Pernicious anemia – poor absorption caused
by lack of intrinsic factor
 Symptoms of anemia

• Fatigue
• Shortness of breath
• Reduce in physical work capacity and mental
productivity
• Poor concentration
• Lack of interest
• Susceptible to infection