![]() ![]() The paper also highlights priority research needs for moving this important global health agenda forward. Specific considerations for the use and interpretation of biomarkers of iron nutrition across a range of clinical and population-based applications are described. The paper is organized to provide the reader with a full appreciation of the background history of iron as a public health issue, its biology, and an overview of available biomarkers. This review represents the fifth in the series of reviews and covers all aspects of iron biology relevant to the discovery, selection, use, and interpretation of biomarkers. Readers interested in obtaining information on iodine or folate biomarkers that might be of use to their specific needs are encouraged to utilize the interactive BOND Query-Based System located on the BOND website: The reviews for iodine, zinc, vitamin A, and folate have been published previously ( 2– 5). Phase I of the BOND project included the evaluation of biomarkers for six nutrients: iodine, iron, zinc, folate, vitamin A, and vitamin B12. To accomplish this objective, Iron Expert Panel (I-EP) members were recruited to evaluate the literature and draft comprehensive reports on the current state of the science with regard to specific nutrient biology and available biomarkers for assessing nutrient status at clinical and population levels. Specifically, the BOND program provides state-of-the-art information with regard to the selection, use, and interpretation of biomarkers of nutrient exposure, status, function, and effect ( 1). ![]() The Biomarkers of Nutrition for Development (BOND) project is designed to provide evidence-based advice to anyone with an interest in the role of nutrition in health. Finally, alternative approaches to the evaluation of the risk for nutritional iron overload at the population level are presented, because the currently designated upper limits for the biomarker generally employed (serum ferritin) may not differentiate between true iron overload and the effects of subclinical inflammation. The I-EP also highlighted the importance of considering the confounding effects of inflammation and infection on the interpretation of iron biomarker results, as well as the impact of life stage. However, a clear distinction is made between the relative strengths of biomarkers to assess hematological consequences of iron deficiency versus other putative functional outcomes, particularly the relationship between maternal and fetal iron status during pregnancy, birth outcomes, and infant cognitive, motor and emotional development. The I-EP concluded that current iron biomarkers are reliable for accurately assessing many aspects of iron nutrition. The report also covers technical and laboratory considerations for the use of available biomarkers of iron status, and concludes with a description of research priorities along with a brief discussion of new biomarkers with potential for use across the spectrum of activities related to the study of iron in human health. Approaches to assessing intake, including bioavailability, are also covered. The BOND Iron Expert Panel (I-EP) reviewed the extant knowledge regarding iron biology, public health implications, and the relative usefulness of currently available biomarkers of iron status from deficiency to overload. This is the fifth in the series of reviews developed as part of the Biomarkers of Nutrition for Development (BOND) program.
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