Project Details

A novel stable iron isotope method to define iron needs and improve iron nutrition in HIV+ children

Michael Zimmermann, MD

Summary

BACKGROUND: Anemia frequently complicates pediatric HIV infection and predicts disease progression and mortality, but iron requirements and the specific contribution of iron deficiency to anemia in pediatric HIV infection remains uncertain. A novel method based on isotopic dilution of whole body iron labeled with stable, non-radioactive isotopes of iron could directly quantify iron turnover and requirements, as well as iron absorption from interventions. GAP: This method could offer, for the first time, a long-term quantitative measure of iron balance, requirements and absorption from iron interventions, and provide reliable data on which to base nutrition recommendations for pediatric HIV infection. HYPOTHESIS: The hypothesis is that this new method will enable direct quantification of iron turnover and requirements, as well as iron absorption from interventions, in HIV-infected children. METHODS: In step 1, using stable isotope labeled single meal/doses we will quantify the impairment in dietary iron absorption in children with and without HIV infection from an iron fortified maize meal, a lipid-based nutritional supplement and an oral iron supplement. In step 2, we will apply the principle of long-term isotope dilution to quantify the daily iron requirement in children with and without HIV infection. In step 3, we will apply the principle of long-term isotope dilution in a randomized 3-month trial of oral iron supplements in children with and without HIV infection. RESULTS: Pending IMPACT: The findings would provide the evidence base for establishing the daily iron requirement for HIV infected children and for effective and safe iron interventions for this group. Website Link: http://www.humannutrition.ethz.ch

Publications:

Goosen C, Proost S, Baumgartner J, Mallick K, Tito RY, Barnabas SL, Cotton MF, Zimmermann MB, Raes J, Blaauw R. Associations of HIV and iron status with gut microbiota composition, gut inflammation, and gut integrity in South African school-age children: A two-way factorial case-control study. J Hum Nutr Diet. 2023 Jun;36(3):819-832. https://doi: 10.1111/jhn.13171. Epub 2023 Apr 16. PMID: 36992541.

Goosen C, Baumgartner J, Mikulic N, Barnabas SL, Cotton MF, Zimmermann MB, Blaauw R. Anaemia, iron, and vitamin A status among South African school-aged children living with and without HIV. S Afr J Child Health 2022;16(2):105-110. https://doi.org/10.7196/SAJCH.2022.v16i2.1897

Goosen C, Proost S, Tito RY, Baumgartner J, Barnabas SL, Cotton MF, Zimmermann MB, Raes J & Blaauw R. The effect of oral iron supplementation on the gut microbiota, gut inflammation, and iron status in iron‑depleted South African school‑age children with virally suppressed HIV and without HIV. European Journal of Nutrition, January 2022. https://doi.org/10.1007/s00394-021-02793-9

Goosen C, Baumgartner J, Mikulic N, Barnabas SL, Cotton MF, Zimmermann MB & Blaauw R. Examining Associations of HIV and Iron Status with Nutritional and Inflammatory Status, Anemia, and Dietary Intake in South African Schoolchildren. Nutrients 2021, 13, 962. https://doi.org/10.3390/nu13030962

Goosen C & Blaauw R. The development of a quantified food frequency questionnaire for assessing iron nutrition in schoolchildren from resource-limited settings in Cape Town, South Africa. Ecology of Food and Nutrition. 2021. https://doi.org/10.1080/03670244.2021.1881896

Goosen C & Blaauw R. Development of an Abbreviated Food Frequency Questionnaire for Assessing Dietary Iron Intake in Schoolchildren: Lessons Learnt. Ann Nutr Metab 2020:16. [IF 2.84] https://doi.org/10.1159/000505528