Effects of Iron deficiency on Physical and Mental functions in Children.

Dr. S.P. Srivastava

Normal Child No Iron Deficiency

Functions of Iron

Formulation of hemoglobin Formulation of cytochrome myoglobin Binding O 2 to RBC and transport Regulation of Body temperature Muscle activity Catacholamine metabolism Immune system – T cell antibodies Brain Dev & function Depressed thyroid function

Iron Deficiency (6-24 months)

Difficulty with language Poor Motor Co-ordination and balance Poorer rating on attention Poor Responsiveness Poor Performance of motor

Physical Growth and performance

Weight gain, growth velocity Further compounded associated with infection anorexia Poor work capacity Endurance, work capability Rapid gain of weight & endurance with iron therapy.

Mental and psychomor dev

Poor attentiveness Poor memory Poor academic performance vocabulary, reading, writing, arithmetic Disruptive, irritable, restlessness Poor performance in test

Iron Acquisition In Brain

The Basal Ganglia (Frontal Section)

Iron In Brain

Iron In Brain

Concentration of Iron in Brain

Highest at birth Decrease at weaning Increase at onset of Myelination Maximum at expression of T f mRNA

Iron Concentration In Brain

100% 75% 50% 25% Maximum Myelination Birth 2 Years 10 Years Adult Human

Iron def, Infection, physical growth

T cell and antibodies diminishes Cell mediated immunity defective Killing bacteria capabilities poor Capacity of leucocyte defense poor

Iron and Neurotransmitor

Dopaminergic system dev in early post natal life Rapid increase in number and density of DA transporter, receptor Monoamine for axonal growth and synapse formation Neurotransmission

Iron and Neurotransmitters

Enzyme involve in N.T are – Tryptorhan hydrolase (Serotonin) Tyrosin Hydolase (Ne. and Da) Cp factor for Ribonucleotide reductase Electron Transfer for lipid metabolism Brain Energy

Restless leg syndrome

Iron Deficiency & Cognitive Development Birth to 2 years - Sensorimotor Period 7 to 12 years

-

concrete operations 2 to 7 years

-

Preoperation period Above 12 years

-

Formal operations

Behavioral and Emotion 65% Common Behavioral Midbrain Iron, DA Transmitter & D1 Receptors 35% Anxity – DA Transporter, D2 Rece Improve with Iron

Critical Period

Irriversible effect on nerve conduction in iron deficiency Timing of iron deficiency is of great importance Lead to toddler developmental delay if iron def earlier Sequence – Cell migration significant myelination cellular differentiation increase expression of neuropeptides

Study Scales

BS.ID – Bayley Scale of infant Dev IBR – Infant behavior records MDI – Mental dev index PDI Psychomotor dev index Wise – Wechsler intelligence scale of childhood

Stages of Iron Deficiency

Decrease Iron Storage Latent Deficiency serum feritin < 10mcg/L Iron deficiency – 0.80 to 1.8 mg/L

Iron Value per 100gm for Common Food

Food Rice Rice Pufed Wheat Bengal gram Bengal G Dal Rajma Soyaneam Milk Gagery Apple Banana Amranth Iron (mg) 6.4

4.6

11.5

10.2

9.1

5.8

11.5

.1-.3

10.5

0.66

0.36

25.5

Food Iron (mg) Bengal G Leave 23.8

Coriander L Mustard L Spinach Ginger Muster Seed Date Fish Dried Fish Fresh Egg Mutton Honey 18.5

16.5

10.9

10.5

17.9

7.3

20-25 1-4 2.1

2.5

0.69

Conclusion Iron deficiency is major public health problem It is an essential nutrition not only for normal growth health and Survival of children but also for their development and congnitive Functioning iron deficiency anemia is associated with significantly poorer performance on Psychomotar and mental development scale and behavioral rating is in infant and children.

Iron supplimentation improves mental development score modestly and improve physical capacity and endurance.0

Thanks

Dr. S.P. Srivastava