除缺铁外,营养性贫血的复杂因素的揭示——一篇叙述性综述。

IF 2.6 Q3 NUTRITION & DIETETICS
Richa Soni , Deepak Verma , Rajni Chopra , Vishakha Singh , Dweipayan Goswami
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引用次数: 0

摘要

背景与目的:营养性贫血是一个广泛存在的公共卫生问题,影响着全球约四分之一的人口(2021年为24.3%;约19.2亿人)。缺铁性贫血(IDA)是最常见的贫血形式,主要由饮食摄入不足、铁吸收不良或生理需求增加引起。然而,营养性贫血的复杂性不仅限于缺铁,还涉及其他微量营养素,如维生素B12、叶酸、锌、铜和维生素a。此外,抗吸收性饮食抑制剂(如植酸盐、多酚、草酸盐)、慢性感染和炎症加剧了病情。本文旨在全面了解营养性贫血的多因素病因,并讨论其预防和管理的新见解和创新方法。目的:严格检查各种微量营养素缺乏的贡献,抗吸收饮食抑制剂的影响,以及社会经济和环境决定因素的影响。该综述还评估了现代饮食趋势的挑战,例如植物性饮食的兴起,并探讨了减轻贫血患病率的有希望的策略。方法:叙述性综述,综合近期文献证据,包括流行病学研究、临床试验和公共卫生干预措施。这种综合方法提供了对营养性贫血的全面了解,并确定了当前知识和干预策略的差距。见解:该综述强调了微量营养素缺乏、饮食抑制剂和社会环境因素之间复杂的相互作用,这些因素导致了贫血的高患病率。诸如hepcidin调节、生物强化和新型铁制剂等新兴解决方案已在临床和公共卫生环境中显示出前景。然而,减少贫血努力的成功程度因地区而异,这就强调需要采取适合不同文化的多管齐下的方法。结论:解决营养性贫血需要一个综合战略,包括提高微量营养素的生物利用度,实施有效的公共卫生政策,并解决潜在的社会和环境决定因素。持续的跨学科研究和政策制定对于创造可持续的、有影响力的解决方案至关重要,特别是针对最弱势群体,包括幼儿、育龄妇女和老年人。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Demystifying intricate factors of nutritional anemia beyond iron deficiency–A narrative review

Background & aims

Nutritional anemia is a widespread public health issue, impacting about one-quarter of the global population (24.3 % in 2021; ∼1.92 billion people). Iron-deficiency anemia (IDA) is the most prevalent form, primarily caused by inadequate dietary intake, poor iron absorption, or increased physiological needs. However, the complexity of nutritional anemia extends beyond iron deficiency, involving other micronutrients such as vitamin B12, folate, zinc, copper, and vitamin A. Additionally, anti-absorptive dietary inhibitors (e.g., phytates, polyphenols, oxalates), chronic infections, and inflammation exacerbate the condition. This review aims to provide a comprehensive understanding of the multifactorial etiology of nutritional anemia and discuss emerging insights and innovative approaches for its prevention and management.

Objective

To critically examine the contributions of various micronutrient deficiencies, the impact of anti-absorptive dietary inhibitors, and the influence of socioeconomic and environmental determinants. The review also evaluates the challenges of modern dietary trends, such as the rise of plant-based diets, and explores promising strategies for mitigating anemia prevalence.

Approach

Narrative review synthesizing evidence from recent literature, including epidemiological studies, clinical trials, and public health interventions. This integrative approach provides a holistic understanding of nutritional anemia and identifies gaps in current knowledge and intervention strategies.

Insights

The review highlights the intricate interplay of micronutrient deficiencies, dietary inhibitors, and socio-environmental factors that contribute to the high prevalence of anemia. Emerging solutions such as hepcidin modulation, biofortification, and novel iron formulations have shown promise in clinical and public health settings. However, the success of anemia reduction efforts varies across different regions, emphasizing the need for culturally tailored, multi-pronged approaches.

Conclusions

Addressing nutritional anemia requires an integrated strategy that includes improving micronutrient bioavailability, implementing effective public health policies, and addressing underlying social and environmental determinants. Continued interdisciplinary research and policy development are crucial to creating sustainable, impactful solutions, particularly for the most vulnerable populations, including young children, women of reproductive age, and the elderly.
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来源期刊
Clinical nutrition ESPEN
Clinical nutrition ESPEN NUTRITION & DIETETICS-
CiteScore
4.90
自引率
3.30%
发文量
512
期刊介绍: Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.
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