Iron deficiency and neural development: an update.

In Latin America, 10-30% of reproductive age females and upwards of 40-70% of pregnant women may be iron deficient. The true prevalence in young children and infants is often hard to determine because of problems in survey design, data collection, or sampling. There is little doubt, however, that iron deficiency anemia is a significant nutritional problem in many infants within the first 5 years of life. Numerous intervention studies have been performed across the world with varying success and it is clear that in nearly all situations it is a preventable disease with preventable consequences. One such consequence is the alteration in cognition that occurs in iron deficient individuals during the early parts of their life cycle and perhaps at later times as well. While iron deficiency was once presumed to exert most of its deleterious effects only if anemia was present, it is now clear that many organs show morphologic, physiologic, and biochemical changes before there is any drop in hemoglobin concentration. Iron deficiency is associated with alterations in many metabolic processes that may impact brain functioning; among them are mitochondria electron transport, neurotransmitter synthesis and degradation, protein synthesis, organogenesis, and others. It is necessary to separate the developmental aspects of iron deficiency and neural functioning from the aspects of iron deficiency that could occur at any time in life. A number of reviews have discussed the links between brain iron and neuropathology, brain iron, nutrition, and development, and iron status and cognition. New knowledge concerning the acquisition of iron by the brain in early life is being generated by numerous research groups. In the next decade a much clearer understanding of the role of brain iron on neural functioning will probably emerge.