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2011 Iron Deficiency in Somalia Somalia Darcy Dau, Tanya Thomforde, Leah Hettrick, Annette Gooch 4/28/2011 Table of Contents About Iron ................................................................. 2 Iron needs ................................................................... 3 Men ......................................................................... 3 Women ................................................................... 3 Infants and Children................................................ 3 When can Iron Deficiency Occur? ............................... 4 Iron Deficiency Anemia ............................................... 5 How do I know I am Iron Deficient?............................ 5 Good Sources of Iron in Food......................................... 6 Garden Tool Kit .......................................................... 8 Planting Directions ..................................................... 8 Healthy Recipes ....................................................... 10 Bibliography ............................................................ 11 1 About Iron Iron, one of the most abundant metals on Earth, is essential to most life forms and to normal human physiology. Iron is an integral part of many proteins and enzymes that maintain good health. In humans, iron is an essential component of proteins involved in oxygen transport. It is also essential for the regulation of cell growth and differentiation. A deficiency of iron limits oxygen delivery to cells, resulting in fatigue, poor work performance, and decreased immunity. On the other hand, excess amounts of iron can result in toxicity and even death. Almost two-thirds of iron in the body is found in hemoglobin, the protein in red blood cells that carries oxygen to tissues. Smaller amounts of iron are found in myoglobin, a protein that helps supply oxygen to muscle, and in enzymes that assist biochemical reactions. Iron is also found in proteins that store iron for future needs and that transport iron in blood. Iron stores are regulated by intestinal iron absorption. 2 Iron Needs: Males Age Needs 9-13 yrs: 8 mg 14-18 yrs: 11 mg 19-50 yrs: 8 mg 50+ yrs: 8 mg Females Age Needs 9-13 yrs: 8 mg 14-18 yrs: 15 mg 19-50 yrs: 18 mg 51+ yrs: 8 mg Pregnancy 14-18 yrs: 27 mg 19-50 yrs: 27 mg Lactation 14-18 yrs: Additional 10 mg 19-50yrs: Additional 9 mg Infants and Children Age Needs 7-12 m: 11 mg 1-3 yrs: 7 mg 4-8 yrs: 10 mg 3 When Can Iron Deficiency Occur? The World Health Organization considers iron deficiency the number one nutritional disorder in the world. As many as 80% of the world's population may be irondeficient, while 30% may have iron deficiency anemia. Iron deficiency develops gradually and usually begins with a negative iron balance, when iron intake does not meet the daily need for dietary iron. This negative balance initially depletes the storage form of iron while the blood hemoglobin level, a marker of iron status, remains normal. Iron deficiency anemia is an advanced stage of iron depletion. It occurs when storage sites of iron are deficient and blood levels of iron cannot meet daily needs. Blood hemoglobin levels are below normal with iron deficiency anemia. Iron Deficiency Anemia Iron deficiency anemia can be associated with low dietary intake of iron, inadequate absorption of iron, or excessive blood loss. Women of childbearing age, pregnant women, preterm and low birth weight infants, older infants and toddlers, and teenage girls are at greatest risk of developing iron deficiency anemia because they have the greatest need for iron. Women with heavy menstrual losses can lose a significant amount of iron and are at considerable risk for iron deficiency. Adult men and postmenopausal women lose very little iron, and have a low risk of iron deficiency. 4 Vitamin A helps mobilize iron from its storage sites, so a deficiency of vitamin A limits the body's ability to use stored iron. This results in an "apparent" iron deficiency because hemoglobin levels are low even though the body can maintain normal amounts of stored iron. Chronic malabsorption can contribute to iron depletion and deficiency by limiting dietary iron absorption or by contributing to intestinal blood loss. Most iron is absorbed in the small intestines. Gastrointestinal disorders that result in inflammation of the small intestine may result in diarrhea, poor absorption of dietary iron, and iron depletion. How do I know I am Iron Deficient? Signs of iron deficiency anemia include: Feeling tired and weak Decreased work and school performance Slow cognitive and social development during childhood Difficulty maintaining body temperature Decreased immune function, which increases susceptibility to infection Glossitis (an inflamed tongue) Eating nonnutritive substances such as dirt and clay often referred to as pica or geophagia, is sometimes seen in persons with iron deficiency. There is disagreement about the cause of this association. Some researchers believe that these eating abnormalities may result in an iron deficiency. Other researchers believe that iron deficiency may somehow increase the likelihood of these eating problems. 5 People with chronic infectious, inflammatory, or malignant disorders such as arthritis and cancer may become anemic. However, the anemia that occurs with inflammatory disorders differs from iron deficiency anemia and may not respond to iron supplements. Research suggests that inflammation may over-activate a protein involved in iron metabolism. This protein may inhibit iron absorption and reduce the amount of iron circulating in blood, resulting in anemia. Good Source of Iron in Food Iron is found in both animal and plant foods, but in different forms. Beef and turkey are good sources of heme iron while beans and lentils are high in nonheme iron. Consuming these two forms of heme and nonheme together enhances iron absorption. Nutrient needs should be met primarily through consuming foods, rather than supplements. Vitamin C, commonly found in fruits, also increases iron absorption. Foods provide energy and an array of nutrients that have beneficial health effects. In certain cases, fortified foods and dietary supplements may be a useful source for nutrients that are consumed in quantities less than recommended daily needs. However, dietary supplements, while recommended in some cases, cannot replace a healthful diet. 6 A healthy diet as one that will include the following: An emphasis on a variety of fruits, vegetables, whole grains, and fat-free or low-fat milk and milk products Includes lean meats, poultry, fish, beans, eggs, and nuts Is low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars; and stays within your daily calorie needs. 7 Gardening Kit List of Vegetables Rich in Iron Spinach ½ cup Cooked Lima Beans ½ cup Boiled Peas ½ cup Boiled Pistachio ½ cup Potato Fresh Baked Beets 1 cup Kidney Beans Chickpeas 6.4 mg 1.8 mg 1.6 mg 4.4 mg 4.0 mg 1.8 mg 1.6 mg 1.6 mg Planting Directions Spinach: 1. Pick an area that gets a lot of sun in a cool environment. 2. Use the hoe to sow the spinach seeds thinly in rows. 3. Space seeds about one thumb length apart. 4. Cover lightly with soil. 5. Firm covered soil and water regularly - keep soil moist. 6. Once the plant grows, cut the spinach leaves as needed or harvest the entire plant. 8 Lima Beans: 1. Set two poles 2 feet apart tied together at the top and a pole placed the length of the row to keep still. 2. Use the hoe to form a 1-inch row in the soil. 3. Place the lima bean seeds 2 to 3 inches apart. 4. Water the roots at ground level. 5. Once the plant grows, a lima bean pod will become visible. Peas: 1. Choose site that gets a lot of sunlight. 2. Use hoe to make a 1-inch deep row. 3. Plant the seeds 3 to 4 inches apart in rows about 3 feet apart. 4. Guide the vines upward as soon as they’re long enough to climb. 5. Make sure plants get about ½ inch of water each week. 6. After three weeks and the plants begin to flower, they are ready for picking. 9 Healthy Recipe BEAN MIX CASSOULET 2 quarts of water 2 cups of peas 1 cup of lima beans 2 pounds of ham hocks or 1 large meaty bone 2 ears of corn, kernels sliced off ½ cup of onion 6 small okras sliced 3-4 cups of spinach or collards, deveined & sliced 1 tablespoon powdered ginger Rinse peas and lima beans. Put in a pot. Add ham hocks or bone, simmer for 1 ½ hours until peas and beans are tender. Add corn, onion, okra, ginger and spinach. Simmer for 10-15 minutes longer. Serve in bowls. You can eat with bread on the side too. 10 Bibliography Fat Free Kitchen. (2005). Retrieved April 2011, from Iron Rich Foods: List of Foods High in Iron: http://www.fatfreekitchen.com/nutrition/iron. html Healthy Eating and Dieting. (2011). Retrieved April 2011, from Web MD: http://www.webmd.com/diet/features/top-10iron-rich-foods Somalia. (2011). Retrieved March 2011, from the World Health Organization: http://www.who.int/en/ Jarvis, H. (2010, May 7). Half Somalia’s women and children anaemic. Retrieved April 2011, from Hiiraan Online: http://www.hiiraan.com/news2/2010/may/half _somalia_s_women_and_children_anaemic.asp xs USDA Nutrient Data Base for Standard Reference, Release 12, 1998. US Dept of Agriculture: 1988: Publication No. HNIS/PT-103. Pennington J. Bowe's and Church's Food Values of Portions Commonly Used. 16th ed. Lippincott-Raven; 1994. 11