ich würde es als sinnvoller ansehen, zu gucken,
woher/wieso eine Fe-Mangel-Anämie besteht.....
...denn auch mit "Floradix" kann man sich "schaden", wenn man auf einen der Inhaltsstoffe eine Allergie/Kreuzallergie haben sollte......
In den u.a. abstracts geht es zwar meistens um Kinder - aber viele von "uns Erwachsenen" können da ebenso mitreden!
LG
Uli
http://www.pulsus.com/Paeds/08_07/edie_ed.htm
Use of whole cow’s milk in late infancy – Change tack or stay the course?
Robert M Issenman MD
In this edition of Paediatics & Child Health, Drs Leung and Sauve provide a compelling argument to change the present Canadian Paediatric Society’s recommendations for the use of iron-fortified formula in nonbreastfed infants from nine to 12 months of age to the American recommendation of 12 months (1,2). At first glance this seems to be a ‘no brainer’. Iron deficiency anemia is an important nutritional deficiency in both Canadian and American children (3-8). Iron deficiency associated with the use of whole cow’s milk in infants derives from a combination of poor dietary availability and the presence of occult blood loss in infants under six months of age (3,4). Early iron deficiency may result in lower developmental and behavioural scores in children later in early childhood (9,10).
On closer scrutiny, the case for a change may be less secure. Iron deficiency is essentially a condition that reflects a poverty of body iron stores. This may result from the impoverished nutritional endowment associated with prematurity. Alternatively, iron deficiency directly reflects the economic poverty of families. Native infants and children from poor families account for the largest proportion of anemic children detected at one year of age (6). Infants from Canadian families of oriental background are also at risk (7). In most instances, anemia is due to the use of whole cow’s milk from early infancy in spite of the current recommendation that counsels against this practice. It is unlikely that a recommendation for extension in the use of infant formula to one year of age would in any way impact the early introduction of ‘store milk’ in the population at greatest risk of this problem. In many instances, parents use ‘store milk’ because they cannot afford to purchase more expensive formula. In other words, a recommendation to extend the use of formula is most likely to be adopted by a population of parents least likely to have affected children and least likely to be adopted in circumstances most likely to result in anemia. This phenomenon is not unique to iron deficiency anemia and is common to many problems in nutrition across a population.
There are two rebuttals to this logic. The first is that, by adopting the recommendation for a longer period of formula feeding, Americans have lowered the prevalence of iron deficiency. The second is that, in the absence of any
additional risk, extending the use of formula may help some children.
However, it is most likely that the lower incidence of iron deficiency in the United States has resulted from the Special Supplemental Nutrition Program for Women, Infants and Children that provides nutritional supplements to pregnant women and their infants from lower socioeconomic groups (11). In other words, the more effective part of the policy was the targeting of poor families as the population at risk of iron deficiency owing to the early introduction of whole cow’s milk. Canadian health authorities have considered this approach but have shied away from providing free or subsidized formula to poor families because they fear being criticized for undermining breastfeeding.
The second hypothesis is similarly skewed. A recommendation to extend the use of formula from the present nine to 12 months of age to 12 months of age would require families to purchase formula rather than milk for nonbreastfed infants. This would affect close to 350,000 families purchasing 1 L per day of formula at a premium of approximately
$2 per day for an additional 90 days (12). Families with young children have many competing priorities for the $63,000,000 in increased expenditure.
By purchasing store milk rather than formula, a family might benefit more by investing the $180 in additional vaccine coverage or a registered education savings plan for their child, especially if there is no evidence that the extra expense would provide additional health benefits. If whole cow’s milk is introduced at nine months of age with appropriate meats or iron-rich foods, the risk of iron deficiency is lessened. The risk is further decreased by limiting milk and juice intake to optimize the intake of these other foods.
These phenomena are characteristic of many issues in population nutrition. It is tempting, but often ineffective, to use broad stroke national policy to deal with issues such as vitamin D deficiency or iron deficiency in a country as diverse as Canada. In these matters, we should ask, whether we would be better to invest limited funds in populations at risk, rather than adopting a recommendation that may be least likely followed in the sector where the problem exists. If we are going to change course, why not steer toward the cause of anemia and invest more in nurturing the mothers of infants vulnerable to this problem?
*****
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http://www.statcan.ca/Daily/English/030326/d030326c.htm> (Version current at June 27, 2003).
http://www.ingentaconnect.com/content/ta...2/art00009
Iron status of children in southern Sweden: effects of cow's milk and follow-on formula
Authors: Bramhagen A-C.1; Axelsson I.
Source: Acta Paediatrica, Volume 88, Number 12, 7 December 1999, pp. 1333-1337(5)
Publisher: Taylor and Francis Ltd
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Abstract:
Aim. The objective of the study was to investigate iron status in children in relation to intake of cow's milk and follow-on formula. Methods. In all, 367 healthy 2.5-y-old children were enrolled in the study. The amounts of cow's milk and formula consumed were recorded. B-haemoglobin, S-ferritin, S-iron, total iron binding capacity and mean corpuscular volume were analysed. Results. Seven percent of the children had iron deficiency anaemia (Hb <110 g/l) and 10% had S-ferritin <12 g/l. Furthermore, 10% of the children were iron deficient, with or without anaemia. Children with iron deficiency had a higher intake of cow's milk (382 ml, 95% confidence interval (CI) 294-496, vs. 257 ml, CI 232-272, p < 0.0001), and fewer consumed follow-on formula (11% vs. 43%, p = 0.0002) compared to those with sufficient iron. Conclusion. Iron deficiency is still common during childhood in Sweden. Intake of cow's milk is significantly higher in children with iron deficiency. In contrast, iron deficiency is less frequent among those consuming follow-on formula.
Affiliations: 1: Department of Pediatrics, University of Lund, Malmö University Hospital, S-205 02 Malmö, Sweden
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1: Pediatr Res. 2005 Oct;58(4):731-4.
Milk proteins and iron absorption: contrasting effects of different caseinophosphopeptides.
Kibangou IB, Bouhallab S, Henry G, Bureau F, Allouche S, Blais A, Guerin P, Arhan P, Bougle DL.
Laboratoire de Physiologie Digestive et Nutritionelle, CHU de Caen, France.
Clusters of phosphoserine residues in cow milk caseins bind iron (Fe) with high affinity. Casein inhibits Fe absorption in humans, but protein hydrolysis lessens this effect. Phosphopeptides from different caseins gave conflicting results on Fe absorption; release of phosphate residues by intestinal alkaline phosphatase could be a key point of that metabolism. The objectives of this study were to compare the absorption of Fe complexed to caseinophosphopeptides (CPP) of the main cow milk caseins beta-casein (beta-CPP) and alpha(s)-caseins (alpha(s1)-CPP) and to assess the role of alkaline phosphatase on this absorption. Two experimental models were used: an in vivo perfused rat intestinal loop and an in vitro Caco-2 cell culture model. In addition, we determined the effect of an intestinal phosphatase inhibitor on these various forms of Fe. Gluconate Fe was used as control. In both models, uptake and net absorption of Fe complexed to CPP from alpha(S1)-caseins were significantly lower than from Fe complexed to beta-CPP. Inhibition of the intestinal phosphatase significantly increased the uptake and the absorption of Fe complexed to beta-CPP without effect on the other forms of Fe. These results confirm the enhancing effect of beta-casein and its CPP on Fe absorption. The differences between CPP could be explained by their structural and/or conformational features: binding Fe to alpha(S1)-CPP could impair access to digestive enzymes, whereas beta-CPP-bound Fe is better absorbed than its free form. The differences in protein composition between cow and breast milk, which does not contain alpha-casein, could explain some of their differences in Fe bioavailability.
PMID: 16189201 [PubMed - in process]
http://www.ncbi.nlm.nih.gov/entrez/query...query_hl=5
...
!
Und außerdem hatte ich vor einem Viertel Jahr eine Ausschabung.