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

1. Effects of Iron deficiency on Physical and Mental functions in Children. Dr. S.P. Srivastava

2. Normal Child No Iron Deficiency

4. Functions of Iron • Formulation of hemoglobin • Formulation of cytochrome myoglobin • Binding O2 to RBC and transport • Regulation of Body temperature • Muscle activity • Catacholamine metabolism • Immune system – T cell antibodies • Brain Dev & function • Depressed thyroid function

5. Iron Deficiency (6-24 months) • Difficulty with language • Poor Motor Co-ordination and balance • Poorer rating on attention • Poor Responsiveness • Poor Performance of motor

6. 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.

7. Mental and psychomor dev • Poor attentiveness • Poor memory • Poor academic performance vocabulary, • reading, writing, arithmetic • Disruptive, irritable, restlessness • Poor performance in test

8. Iron Acquisition In Brain

9. The Basal Ganglia (Frontal Section)

10. Iron In Brain

11. Iron In Brain

12. Concentration of Iron in Brain • Highest at birth • Decrease at weaning • Increase at onset of Myelination • Maximum at expression of Tf mRNA

13. Iron Concentration In Brain 100% Myelination 75% 50% Maximum 25% Birth 2 Years 10 Years Adult Human

14. Iron def, Infection, physical growth • T cell and antibodies diminishes • Cell mediated immunity defective • Killing bacteria capabilities poor • Capacity of leucocyte defense poor

15. 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

16. 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

17. Restless leg syndrome

18. 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

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

20. 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

21. 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

22. Stages of Iron Deficiency • Decrease Iron Storage • Latent Deficiency serum feritin - < • 10mcg/L • Iron deficiency –0.80 to 1.8 mg/L

23. Iron Value per 100gm for Common Food Food Iron (mg) Food Iron (mg) Rice 6.4 Bengal G Leave 23.8 Rice Pufed 4.6 Coriander L 18.5 Wheat 11.5 Mustard L 16.5 Bengal gram 10.2 Spinach 10.9 Bengal G Dal 9.1 Ginger 10.5 Rajma 5.8 Muster Seed 17.9 Soyaneam 11.5 Date 7.3 Milk .1-.3 Fish Dried 20-25 Gagery 10.5 Fish Fresh 1-4 Apple 0.66 Egg 2.1 Banana 0.36 Mutton 2.5 Amranth 25.5 Honey 0.69

24. 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

25. Thanks Dr. S.P. Srivastava