Geissler, Singh (2011) Heavy Metal for Preschoolers
(The Research Paper)
Background and Thesis
My interest in iron deficiency in preschoolers was originally sparked when my 3-year-old daughter was found to have low-iron. This interest was rekindled when experimenting with iron deficiency in the lab in regards to the tomato plant. I was very interested in seeing how the iron deficient tomato plant seems weaker, smaller and less vibrant overall. Observing the iron deficient tomato plant reminded me of the challenges I had with my child. Mainly, I was interested in how to correct iron deficiency in preschoolers in developed nations. This caused me to wonder if supplementing was always the answer or could change in diet be used with the same or better results?
Research Information and Data
My research led me to some questions first. Such as, why is iron important to a preschool-aged child? It is common knowledge that iron deficiency is a health problem, especially when it becomes anemia. Less well known however, is that
preschoolers development can be negatively affected by low iron. Because preschoolers bodies are developing, changing, and growing at an advanced pace this causes a large demand for micronutrients such as iron (Bruins, et al., 2016). Iron is an essential mineral in the human body, the main use is to transport oxygen through our bodies.
Now that we understand why iron is important, how much iron do we need to feed our preschoolers daily? The current recommendation from the National Institutes of Health (NIH) is 7mg for children aged 1-3 years and 10mg for children aged 4-6 years.
Of course, knowing how much iron we need per day only creates more questions, as any scientist will tell you. Which brings us to ask, how can we correct low iron and is there a best way to go about this? I am learning about iron after the fact, so to speak; my daughter’s iron levels came back low during a recent blood test and I was told to give her iron supplements. I did what the pediatrician suggested, not completing my own research at the time; I trusted that the doctor knew best. As my child’s pediatrician suggested, supplementation is the most common way to correct low iron.
There are many kinds of iron supplements available and choosing one can be tricky unless you have done your research. In hindsight asking the pediatrician more questions and getting a more detailed response would have helped my child during this process. Ferrous sulfate, ferrous fumarate, ferrous gluconate, ferrous glycine sulfate and iron polysaccharide are the most commonly used forms of iron for supplementation. Each of these types of iron differ in how well they are absorbed but all are typically better absorbed than multivitamins (Geissler, Singh, 2011). Now that you have chosen an iron supplement for your child you need to know that you do not give it to her indefinitely. In fact, iron supplements are typically only used for a short time to get extra iron into the body if iron is low (Geissler, Singh, 2011). It appears there there is a large variation in the amount of iron a preschooler can consume as long as the child receives enough iron to prevent deficiency.
A considerable range of intakes appears to be safe, provided that sufficient bioavailable iron is consumed to prevent functional iron deficiency. There are only isolated reports of clinically significant iron overload occurring as the result of the consumption of large quantities of iron over an extended period of time in individuals not suffering from an iron-loading disorder. Therefore, the Subcommittee on Upper Levels of Micronutrients of the Institute of Medicine based the upper level for iron intake on a side effect of iron supplementation or treatment that is primarily associated only with discomfort referred to as "gastrointestinal distress." They set the level at 40 mg/day for children up to the age of 13 years^ . There I was, happily supplementing my child’s diet with her iron multivitamin when she started complaining of stomach aches. I called the pediatrician back and was told to stop the supplement because it can cause preschoolers to have stomach aches. The pediatrician went on to suggest that I focus on an iron-rich diet in lieu of supplementing. We will explore a modified diet to correct low iron next.
When using diet to increase iron stores, there are two main types of iron: heme or non-heme. Heme is found in animal products mainly. Non-heme iron is found in animal and plant tissues, fortified foods, and supplements. Heme iron is absorbed more efficiently from the diet than non-heme iron. A number of dietary components have been shown to increase or reduce non-heme iron absorption from single test meals. The main enhancers of non-heme iron absorption are meat, and ascorbic acid found in fruit and vegetables. The main inhibitors of non-heme iron absorption are calcium, phytates in cereals and legumes, and phenolic compounds found in tea, coffee, and other beverages. However, single meal absorption studies do not take account of adaptive absorptive responses to qualitative and quantitative changes in the diet. Studies over longer periods indicate that single meal studies overestimate the effects of enhancers and inhibitors of iron absorption.‡ Because heme iron is found almost exclusively in animal foods I was concerned that I would need to increase the meat my daughter eats which is a challenge for me since we buy virtually no meat. I was glad to learn that vegetarians with a well-planned diet can have adequate iron stores. In general, a vegetarian dietary pattern … if well balanced, can be compatible with a healthy lifestyle and optimal nutritional status … and may offer some long-term health benefits % . Beans and legumes are good sources of protein and fiber and while they may inhibit some iron absorption it is better to consume them with some modifications, such as soaking dried beans and discarding the soaking water before cooking the beans {which} helps absorb iron because water-soluble inhibitors (phytates) are removed in the water %
The most important determinant of dietary iron absorption is systemic iron need: more iron is absorbed from the diet in a state of iron deficiency and less is absorbed when iron depots are replete ‡. For my child, the solution has been diet based. Her iron stores were very minimally affected and she is not anemic. Since her low-iron was only a slight concern I decided to focus on offering her more iron-rich foods. The side-effects of the iron multivitamin were too painful for her to bear and a modified diet was a better answer for us as a family. However, even mild iron deficiency in {preschoolers} is important because if it progresses to iron deficiency anemia, impairments in cognitive function and behavioral problems arise, which may not be reversible with iron therapy. %
Conclusion and Summary
Based on the research I found it appears that iron-deficiency in preschoolers in developed nations is a complex issue. There are many factors to consider including: the amount of iron lacking in the person, if each individual chooses to supplement, and the type of diet they choose just to name a few. The ultimate solution depends on the individual and their specific need. For my daughter, she is doing great on a modified diet and I will have her iron levels tested again soon to be sure she is not deficient.