Skip to 0 minutes and 8 secondsSo, overall anemia of inflammation is the anemia that is caused by an underlying chronic inflammatory disease that activate hepcidin. Old people, individuals with obesity-related complications or chronic diseases are more likely to develop anemia of inflammation. It can be difficult to differentiate anemia of inflammation from iron deficiency anemia And the two conditions may coexist So, treatment of anemia or inflammation should have focus on the underlying disease because increased inflammation reduced iron availability. So, the next questions we are going to discuss is the iron absorption rate in obese and normal weight or underweight people. The bioavailability of iron in the diet is influenced by several factors, like iron status.

Skip to 1 minute and 17 secondsSo, normally if you have low a serum iron now, the intestine will increased the iron absorption rate. Another factor is the type of iron in the diet. For example, the red meat contains high amount of heme iron and him iron has a higher iron absorption rate compared to non-heme iron. Also diet composition may affect the iron bioavailability. For example, is there any iron inhibitor or enhancer in your diet, so like we just said before, the vitamin C can enhance or help non-heme iron are being absorbed; whereas tea or coffee can inhibit iron absorption. Also if you take a high dosage of calcium supplementation Calcium may also inhibit iron absorption. The last factor is the elevated serum hepcidin.

Skip to 2 minutes and 22 secondsSo if you have high level of serum hepcidin, then this will also interfere the iron absorption rate. And most of the dietary iron bioavailability data have been derived from malnutrition subjects. So whether obese people exhibit the same iron absorption rate as malnutrition people remains unclear. Only the recent discovery of hepcidin-ferroportin axis has provided new aspects on how our body responds to iron status, particularly, in the inflammatory state. So using radioactively labeled ferric citrate, an animal study showed that high-fat diet-induced obese mice had lower iron absorption rate compared to normal weight mice. An study also showed that overweight and obese women who consumed high fat and low carbohydrate diet were 10 times more likely to develop iron deficiency anemia.

Skip to 3 minutes and 34 secondsA human study involved 92 healthy premenopausal Thai women who received reference meals of rice and vegetables containing around 4 mg of isotopically labeled fortification iron. And authors found that an inverse relationship between body mass index (BMI) and iron absorption rate. So this data suggests that obesity may decrease iron absorption rate. The last question we are going to discuss about is can weight loss improved serum iron status? So a study showed that loss of greater than 10% initial body weight was associated with a better iron status regardless of the type of diet and hepcidin levels. Other study also found that weight loss can prevent iron retention in the liver.

Skip to 4 minutes and 36 secondsSo this data suggests that weight lost can help to release the tracking iron in the tissue or cells and this may helped to prevent the iron mediate tissue injury. So in conclusion, mechanisms underlying obesity-related hypoferremia are different from iron deficiency, associated with under weight or normal weight individuals. Life-style modification like weight loss can help to restore normal body iron circulation in healthy overweight and obese people. Although hepcidin-ferroportin based therapeutic methods remain to be tested in clinical trials, it is probably more relevant for patients with anemia of inflammation. So thank you so much for your attention

Recommendations on iron intake

Iron-related blood diseases are highly associated with obesity. Researches had shown that obesity decreased the blood iron level. Also, some food choices may increase the absorption of iron in human body.

In this video, Prof. Chang will summarize the recommendation for iron-deficiency patients.

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This video is from the free online course:

Nutrition and Disease Prevention

Taipei Medical University