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Most women of reproductive age (WRA) even when consuming iron-fortified food have few iron reserves and are at risk for iron deficiency (ID) and anemia (IDA). Pregnancy increases demands for iron, and IDĖ IDA poses serious health risks, some permanent, for mothers and their babies. However, pre-pregnancy iron supplementation can prevent ID-IDA. Simultaneously, Dr. Viteri has demonstrated that excess prenatal iron supplementation impairs fetal growth. His lab hypothesizes that during gestation excess iron induces excessive red-blood-cell (RBC) synthesis and oxidative stress, particularly in genetically susceptible populations. Current research addresses these issues and includes scientists in the World Health Organization (WHO), China, Guatemala, Indonesia, Mexico, Spain, and Vietnam. Dr. Viteriís research has already demonstrated that reducing iron supplementation to once weekly (WIS) is as effective and safer than current daily iron supplementation.

Adding folate (vitamin B9) to prepregnancy WIS reduces risk of neural tube defects (NTD). The Viteri lab has shown that with proper doses, weekly folic acid could rapidly achieve and maintain RBC folate levels that prevent NTD. As a result of work at Viteriís lab with his and collaborators, WHO recommends preventive weekly ironfolate supplementation (WIFS) for WRA prior to pregnancy, primarily for low socioeconomic populations.

Dr. Viteri is also investigating the dynamics of folate in RBC, which have 30 to 40 times more folate than plasma. The hypothesis is that RBC serve as active folate reservoirs that buffer variations in plasma and cellular levels. They have demonstrated that RBC release folate as hemoglobin becomes deoxygenated. The Viteri lab and his collaborators are also looking at common genetic mutations that affect folic acid reduction and the effectiveness of a reduced folate that bypasses those mutations. This research may partially explain the about 30% failure to reduce NTD risk of folic-acid-fortified food. Further, the safety of food fortification with folic acid has been questioned because of health risks for the elderly. Targeted WIFS for WRA may be safer than food-fortification.

Revised: Tuesday, July 19, 2016 9:54 AM



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