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Dietary iron supplementation: a proinflammatory attack on the intestine?
  1. Guenter Weiss
  1. Correspondence to Professor Guenter Weiss, Department of Internal Medicine VI, Infectious Disease, Immunology, Rheumatology, Pneumology, Medical University of Innsbruck, Anichstr. 35, Innsbruck A-6020, Austria; guenter.weiss{at}i-med.ac.at

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Iron deficiency is a global health problem affecting likewise two billion people, and this condition is more prevalent in developing than in industrialised countries. Specifically, in childhood, iron deficiency and subsequent iron deficiency anaemia are considered to negatively affect the development of children causing growth and mental retardation.1 This is due to the fact that iron is essential for oxygen transport as being the central molecule in haemoglobin and referred to the metal's function as an essential compound of many vital enzymes in mitochondrial respiration, metabolism, hormone synthesis and DNA replication. In order to prevent the negative consequences of iron deficiency on children's development, several controlled clinical trials were initiated to study the effects of dietary fortification with iron and other micronutrients on children's health mostly in rural sites of developing countries where such nutrients are scarce and where iron deficiency is highly prevalent. However, the results of these studies were staggering because iron supplementation resulted in a significant increase of infection related mortality, mostly related to malaria and invasive bacterial infections or increased morbidity due to diarrhoea.2 ,3 The mechanisms underlying these observations remained elusive thus far but may be linked to two major …

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