Correction of iron deficiency and iron deficiency anemia in women following a vegetarian and vegan diet
DOI:
https://doi.org/10.15574/PP.2020.82.42Keywords:
pregnancy, vegan diet, vegetarians, iron deficiency anemia, iron deficiencyAbstract
The aim. To investigate the presence of iron deficiency and iron deficiency anemia in women who adhere to a vegan diet and the effectiveness of antianemic therapy with Sorbifer Durules.
Materials and methods. 32 women of reproductive age who followed a vegetarian and vegan diet were examined preconceptively. Blood counts in general blood tests and ferritine were studied before and after treatment with Sorbifer Durules. Women received the oral iron preparation Sorbifer Durules, 1 tablet twice a day (4 mg/kg/day). Monitoring the effectiveness of treatment was assessed by the rate of reticulocytes, the concentration of hemoglobin and ferritin on 8-th day, 3–4 weeks and 12 weeks after antianemic treatment. Among all the women studied, 24 (75%) became pregnant and were also examined in the first trimester for iron deficiency and anemia.
Results and conclusions. In women who have certain dietary restrictions (vegetarians and vegan women), were observed iron deficiency (low concentrations of ferritin). Important is the fact that hemoglobin and iron metabolism are significantly lower in the group of women who are vegans compared to vegetarians, which is due to the peculiarities of nutrition with a more limited intake of iron from food. The effectiveness of antianemic therapy with this drug has been proven by the occurrence of recyculocytosis, which is observed 7–8 days after the start of treatment. The normalization of the iron depot occurs 3 months after the start of therapy, which proves the need for long-term therapy with Sorbifer. It is important that among women who became pregnant after pregravidarum consultation and correction of anemia, in the first trimester of pregnancy, hemoglobin and ferritin values were within the reference values. The study proves the need for the administration of oral iron medications (according to the WHO recommendation in an intermittent mode) in order to reduce the risk of anemia and increase hemoglobin concentrations in women at risk (vegetarians and vegans.)
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies.
References
Agnoli C, Baroni L, Bertini I, Ciappellano S, Fabbri A, Papa M, Pellegrini N, Sbarbati R, Scarino M, Siani V, Sieri S. (2017). Position paper on vegetarian diets from the working group of the Italian Society of human nutrition. Nutrition, Metabolism & Cardiovascular Diseases. 27: 1037–1052. https://doi.org/10.1016/j.numecd.2017.10.020; PMid:29174030
Alexander D, Ball M, Mann J. (1994). The nutrient intake and haematological status of vegetarians and age-sex matched omnivores. Eur J Clin Nutr. 48: 538—546. PubMed, Google Scholar.
Baines S, Powers J, Brown WJ. (2006, Feb 13). How does the health and well-being of young Australian vegetarian and semi-vegetarian women compare with non-vegetarians. Public Health Nutrition. 10 (5): 436–442. https://doi.org/10.1017/S1368980007217938; PMid:17411462
Cullum-Dugan D, Pawlak R. (2015). Position of the Academy of Nutrition and Dietetics: Vegetarian Diets. J Acad Nutr Diet. 115 (5): 801–810. https://doi.org/10.1016/j.jand.2015.02.033; PMid:25911342
Haider LM, Schwingshackl L, Hoffmann G, Ekmekcioglu C. (2018). The effect of vegetarian diets on iron status in adults: A systematic review and meta-analysis. Crit Rev Food Sci Nutr. 58 (8): 1359–1374. https://doi.org/10.1080/10408398.2016.1259210; PMid:27880062
Hallberg L, Rossander–Hulthen L. (1991). Iron requirements in menstruating women. Am J Clin Nutr. 54 (6): 1047–1058. https://doi.org/10.1093/ajcn/54.6.1047; PMid:1957820
Hunt JR. (2002). Moving toward a plant-based diet: Are iron and zinc at risk? Nutr Rev. 60 (5 Pt 1): 127–134. https://doi.org/10.1301/00296640260093788; PMid:12030275
Hunt JR. (2003). Bioavailability of iron, zinc, and other trace minerals from vegetarian diets. Am J Clin Nutr. 78 (3): 633S-639S. https://doi.org/10.1093/ajcn/78.3.633S; PMid:12936958
Institute of Medicine (US) Panel on Micronutrients. (2001). Food and Nutrition Board and Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press.
Institute of Medicine. (2016, April 15). Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. URL: http://www.nap.edu/download.php?record_id=10026.
Phillips F. (2005). Vegetarian nutrition. British Nutrition Foundation Nutrition Bulletin. 30: 132—216. https://doi.org/10.1111/j.1467-3010.2005.00467.x
Richter M, Boeing H, Grunewald-Funk D, Heseker H, Kroke A, Leschik-Bonnet E, Oberritter H, Strohm D, Watzl B. (2016). Vegan diet. Position of the German Nutrition Society (DGE). Ernahrungs Umschau. 63 (04): 92–102.
Saunders AV, Craig WJ, Baines SK, Posen JS. (2013). Iron and vegetarian diets. Med J Aust. 199 (4): 11–16. https://doi.org/10.5694/mja11.11494
Saunders V, Craig J, Baines K, Posen S. (2013). Iron and vegetarian diets. Med J Aust. 199 (4): S11-S16. PubMed, Google Scholar. https://doi.org/10.5694/mja11.11494
Schlemmer U, Frolich W, Prieto RM, Grases F. (2009). Phytate in foods and significance for humans: food sources, intake, processing, bioavailability, protective role and analysis. Mol Nutr Food Res. 53 (2): S330-S375. PubMed, Google Scholar. https://doi.org/10.1002/mnfr.200900099; PMid:19774556
Siah CW, Ombiga J, Adams LA. (2006). Normal iron metabolism and the pathophysiology of iron overload disorders. Clin Biochem Rev. 27 (1): 5–16.
Skalnaya AA, Skalnaya OA, Cheng–Chi Wu, Demidov VA. (2016). Hair essential trace elements in bangladesh women: influence of vegetarianism. Trace Elements in Medicine. 17 (3): 36–44. https://doi.org/10.19112/2413-6174-2016-17-3-36-40
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