Zimmermann Michael B, Hurrell Richard F
Laboratory for Human Nutrition, Swiss Federal Institute of Technology, Zürich, Switzerland.
Lancet. 2007 Aug 11;370(9586):511-20. doi: 10.1016/S0140-6736(07)61235-5.
Iron deficiency is one of the leading risk factors for disability and death worldwide, affecting an estimated 2 billion people. Nutritional iron deficiency arises when physiological requirements cannot be met by iron absorption from diet. Dietary iron bioavailability is low in populations consuming monotonous plant-based diets. The high prevalence of iron deficiency in the developing world has substantial health and economic costs, including poor pregnancy outcome, impaired school performance, and decreased productivity. Recent studies have reported how the body regulates iron absorption and metabolism in response to changing iron status by upregulation or downregulation of key intestinal and hepatic proteins. Targeted iron supplementation, iron fortification of foods, or both, can control iron deficiency in populations. Although technical challenges limit the amount of bioavailable iron compounds that can be used in food fortification, studies show that iron fortification can be an effective strategy against nutritional iron deficiency. Specific laboratory measures of iron status should be used to assess the need for fortification and to monitor these interventions. Selective plant breeding and genetic engineering are promising new approaches to improve dietary iron nutritional quality.
缺铁是全球导致残疾和死亡的主要风险因素之一，估计影响着20亿人。当饮食中的铁吸收无法满足生理需求时，就会出现营养性缺铁。在食用单一植物性饮食的人群中，膳食铁的生物利用率较低。发展中国家缺铁的高发生率带来了巨大的健康和经济成本，包括不良的妊娠结局、学业成绩受损以及生产力下降。最近的研究报告了身体如何通过上调或下调关键的肠道和肝脏蛋白质来响应铁状态的变化，从而调节铁的吸收和代谢。有针对性的铁补充、食品铁强化或两者兼而有之，可以控制人群中的缺铁情况。尽管技术挑战限制了可用于食品强化的生物可利用铁化合物的数量，但研究表明，铁强化可以成为对抗营养性缺铁的有效策略。应使用特定的铁状态实验室测量方法来评估强化需求并监测这些干预措施。选择性植物育种和基因工程是提高膳食铁营养质量的有前景的新方法。
