2019 SCIENCELINE  
Journal of Life Science and Biomedicine  
J Life Sci Biomed, 9 (6): 170-173, 2019  
License: CC BY 4.0  
ISSN 2251-9939  
DOI: https://dx.doi.org/10.36380/scil.2019.jlsb27  
Ethnogeographic features of nutrition as a key factor  
in the development of iron deficiency anemia in the  
Bukhara region  
Akhmedova Dilfuza Rakhmatovna  
Tashkent Pediatric Medical Institute, Department of Obstetrics and Gynecology, with pediatric gynecology, Tashkent, Republic of Uzbekistan  
Corresponding author’s Email: samira17-2007@mail.ru  
ABSTRACT  
Original Article  
Introduction. Ecological disasters, industrial pollution, and poor nutrition lead to significant  
changes in the content of microelements (MEs) in food and, as a consequence, in the human  
body, while toxic MEs accumulate, displacing essential ones. Iron deficiency anemia refers  
to biogeochemical poly-microelementosis. For the prevention and treatment of iron  
deficiency anemia (IDA), drugs containing microelements are used along with traditional  
methods of treatment. Aim. This study aimed to investigate the nutritional characteristics  
and the ME content in the diet in order to clarify the etiology of IDA, the role of  
microelementosis in its development, and to also identify indicators of red blood parameters  
in families living in the Qorovulbozor district of the Bukhara region. Methods. Ten families  
were examined, each consisting of a husband, a wife, and female children. In order to  
facilitate the analysis of the results obtained, the husbands and wives selected for  
examination from those were aged between 30 and 45 with daughters from 12-17 years old.  
The content of MEs in erythrocytes and blood serum, in tap water, and in irrigation ditch  
(arch) water was determined. Results. A relatively favorable picture was observed only in  
men, while 1-3 degree IDA was observed with almost the same frequency in both mothers  
(75-78.5%) and their daughters (20-21.4%), respectively. Daily nutrition was roughly  
estimated by dividing the volume of food consumed per week into 7 days and the number of  
family members. Despite this, iron deficiency turned out to be significant for such products  
as meat, milk, bread, eggs, and fruit. This served as the basis for convincing the subjects of  
the need for proper nutrition and the administration of ME containing preparations  
(Vitrum Prenatal Forte). Conclusion. In order to exclude the entry of toxic MEs into the body,  
it is advisable to use mineral water for food, especially during pregnancy, instead of tap  
water. Our findings provide the basis for the need to correct the ME composition of the body  
with the necessary MEs, not only by increasing the volume and quality of food products, but  
also by using medications containing MEs.  
PII: S225199391900027-9  
Rec. 05 October 2019  
Rev. 24 November 2019  
Pub. 25 November 2019  
Keywords  
Microelements (MEs),  
Nutrition,  
Family,  
Iron deficiency anemia  
INTRODUCTION  
According to the researchers, various etiological factors cause iron deficiency anemia (IDA) [1, 2]. Anemia can  
occur in an environmentally disadvantaged region, on the basis of increased consumption of microelements,  
impaired iron resorption in the gastrointestinal tract, due to a lack of exogenous MEs, including iron [3, 4].  
Environmental disasters, man-made pollution, and improper nutrition lead to significant changes in the  
ME content in the human body, at the same time toxic MEs accumulate, displacing essential MEs [5]. The level  
of MEs and their relationship in the body organs depend on the degree of blood supply, peculiarities of  
functional activity and available pathologies. Thus, loss of iron in the blood is one of the most common causes of  
anemic conditions. Iron deficiency anemia refers to polymicroelementoses (pathological processes caused by  
deficiency, excess and imbalance of microelements in the body) of biogeochemical nature. Along with  
traditional methods of treatment, ME-containing medications are used to prevent and treat IDA [6, 7].  
It is known that certain regions have their own specifics for the ME content that distinguishes them from  
others [8]. Hence the traditional approach to the prevention and treatment of IDA is not justified. Literature  
data indicates the need to develop ME-containing preparations for certain regions based on the ME content in  
the air, soil and water [9]. This research is devoted to the study of ME blood composition in families living in the  
Qorovulbozor district of the Bukhara region, where a large oil refinery is located, which has a technogenic  
impact on the region. In addition, families’ food rations were first studied with an estimate of the ME intake.  
The data obtained will help to clarify the pathogenesis of IDA development in adolescent girls from the  
perspective of microelementosis and to develop a reasonable set of therapeutic and preventive measures.  
Citation: Akhmedova DR. Ethnogeographic features of nutrition as a key factor in the development of iron deficiency anemia in the Bukhara region. J Life Sci  
Biomed, 2019; 9(6): 170-173; www.jlsb.science-line.com  
170  
The research is aimed at studying the nutritional characteristics, the content of microelements in the food  
rations in order to clarify the IDA etiology and the role of microelementosis in IDA development by  
investigating red blood cell parameters in families living in the Qorovulbozor district of the Bukhara region.  
MATERIAL AND METHODS  
Examinations covered ten families, each consisting of a husband, wife, and female children. In order to facilitate  
the analysis of the results obtained, parents aged between 30-45 were selected for the research, with their  
daughters aged between 12 and 17. We studied their medical background, previous diseases that can affect the  
ME composition of blood, Hb concentration, RBC count, blood color index and ESR results. Families were  
identical in terms of social background – employees and workers, as well as in medical background and  
previous diseases. Family members with acute inflammatory diseases or disease recurrences were excluded  
from the analysis. The content of ME was determined in erythrocytes and blood serum, in tap water, and in  
irrigation ditch (arch) water. Since the main source of ME supply in the human body is food, we studied daily  
food rations in families and calculated the daily ME requirement depending on the food assortment. The  
standard indicators of the ME content in 100 g of the product were the basis for comparison [10]. Following the  
results of this analysis, we made recommendations for proper nutrition and prescribed Vitrum preparations  
containing microelements.  
Statistical analysis  
The data obtained during the study was subjected to statistical processing on a Pentium-V personal  
computer using the Microsoft Office Excel-2003 software package, including the use of built-in statistical  
processing functions. We used methods of variational parametric and nonparametric statistics with calculation  
of the arithmetic mean of the studied indicator (M), standard deviation), standard error of the mean (m), relative  
values (frequency, %), the statistical significance of the measurements obtained when comparing the average  
values was determined by the criterion Student (t) with the calculation of the probability of error (P) when  
checking the normality of the distribution (by the excess measure) and the equality of the general variances (F -  
Fisher's test). For statistically significant changes, a confidence level of P <0.05 was taken  
Ethical approval  
The review board and ethics committee of Tashkent Pediatric Medical Institute approved the study  
protocol and informed consents were taken from all the participants.  
RESULTS AND DISCUSSION  
Table 1 presents the results of a general blood test in family members before and after treatment. As can be seen  
from the table, IDA of varying severity was found in the examined population. Thus, stage 1 of the IDA was not  
observed in girls, while stage 2 was observed in 78.5% and stage 3 was present in 21.4% of girls; in their mothers  
we observed stage 1 of the IDA in 5%, stage 2 in 75%, and stage 3 in 20% of subjects, respectively; in their fathers  
we evidenced stage 1 in 65%, stage 2 in 35% of men, respectively, while stage 3 was found in none of the subjects  
Thus, a relatively favorable picture was observed only in men. Stage 2 and stage 3 of the IDA were observed  
with almost the same frequency in both mothers and their daughters: 75% (78.5%), and 20% (21.4%), respectively.  
Thus, IDA develops in children from an early age. The study of the food rations showed that in almost all  
families there is a shortage in the consumption of basic food products compared to the norm. This is confirmed  
by the presence of anemia in the male part of the examined subjects. The data on daily food requirement and  
actual consumption of food products in the studied families is given in Table 2. On short notice, it should be  
mentioned that the volume of consumption per week was roughly estimated and divided into 7 days and the  
number of family members. Despite this, the deficiency turned out to be significant for some products, such as  
meat, milk, bread, eggs, and fruit. This served as the basis for convincing the subjects of the need for proper  
nutrition and prescription of Vitrum Prenatal Forte preparations containing microelements.  
Next, we studied the shortage of ME intake into the body with food based on the data obtained. Standard  
data on ME content in 100 grams of a product is given in Table 3 based on the indicators specified in [10].  
When comparing the actual consumption of food products (14 basic ones) with the norms of consumption  
and the ME content in these food products, a significant shortage of both essential and conditionally essential  
MEs was found. Due to the fact that less food is consumed, fewer toxic MEs entered the body accordingly. The  
same can also be attributed to pregnant women, since their questioning gave the same results of ME  
consumption shortage. It is noteworthy that the water used in food contains toxic MEs such as Be, Cd, Hg, Al,  
and Pb. Normally, toxic microelements should not be found in water. The fact is that they have the ability to  
competitively bind to proteins, enzymes, and other vital substances and distort their function, displacing  
essential and conditionally essential microelements [11]. The foregoing is one of the reasons for the development  
of not only anemia, but also of other diseases present in the examined population.  
Citation: Akhmedova DR. Ethnogeographic features of nutrition as a key factor in the development of iron deficiency anemia in the Bukhara region. J Life Sci  
Biomed, 2019; 9(6): 170-173; www.jlsb.science-line.com  
171  
Table 1. Red blood cell parameters in family members with complicated IDA  
Family with IDA, n=10  
In daughters, n=10  
In mothers, n=10  
In fathers, n=10  
Parameter  
Pretreatment  
Follow-up  
control  
114.5±3.6  
3.6±0.6  
0.9±0.04  
4.2±1.2  
Pretreatment  
Follow-up  
control  
120.4±4.4  
4.0±0.8  
0.9±0.1  
5.7±2.5  
Pretreatment  
Follow-up  
control  
130.2±4.6  
4.6±1.0  
parameters  
79.8±3.4**  
3.2±0.4*  
parameters  
81.8±3.5**  
3.3±0.2*  
parameters  
102.2±3.8**  
3.7±0.5*  
Hb, g/l  
RBC, 10 12 g/l  
Color index  
ESR  
0.8±0.03*  
4.0±1.1  
0.8±0.06*  
4.8±1.4  
0.9±0.08  
4.2±1.3  
0.9±0.2  
4.3±2.2  
Note: * P<0.05 and **Р<0.01 compared to the parameters in males. IDA= iron deficiency anemia; Hb= hemoglobin; RBC= Red blood cell and  
ESR= erythrocyte sedimentation rate.  
Table 2. The daily food requirement and actual consumption of food products in the examined families living in  
the Qorovulbozor district (Bukhara region, Uzbekistan)  
Standard daily  
requirement  
150 g  
Food consumption  
in a family with IDA  
Shortage in consumption  
Food products  
of food products  
Meat  
Milk  
Rice  
90 g  
290 g  
40 g  
60 g  
210 g  
10 g  
500 ml  
50 g  
Bread  
Chocolate  
250-300 g  
40 g  
150 g  
10 g  
150 g  
30 g  
Eggs  
Potato  
Onion  
Fruit  
Cabbage  
Carrot  
Beet  
Tomato  
Honey  
1-2 (120 g)  
100 g  
150 g  
200-250 g  
300-600 g  
50-100 g  
100-150 g  
200-300 g  
80-100 g  
60 g  
60 g  
0 g  
50 g  
150 g  
400 g  
20 g  
100 g  
200 g  
60 g  
100 g  
100 g  
100 g  
200 g  
80 g  
50 g  
100 g  
40 g  
IDA= iron deficiency anemia  
Table 3. Standard indicators of ME content in 100 g of a product [10]  
Essential microelements  
Toxic microelements  
ME  
Cr  
Mn  
Fe  
Co  
Cu  
Zn  
Se  
Mo  
I
Ni  
Be Al  
Cd Hg Pb  
Food products  
Meat  
Milk  
Rice  
Beans  
Buckwheat  
Green peas  
Onion  
Bread  
Potato  
Aubergine  
Cabbage  
Tomato  
Cucumber  
Beet  
Carrot  
Pumpkin  
Chocolate  
Honey  
Kefir  
Grapes  
Eggs  
Pear  
Plum  
Minerals in 100 g of a product  
8.7  
2
2.8  
35.0 2090  
67  
3630 2090  
6.0  
0.8  
6.9  
18.7  
3.6  
13.1  
5
3.0  
5
1
3
6
1
2
2
1
-
0.3  
1
238 2820  
12 400  
560 1800 20.0  
580 3210 24.9  
660 2770  
3180  
850  
290 1850  
-
2.0  
9.0  
5.0  
26.7  
39.4  
38.5  
84.2  
-
20.4  
8.0  
10.0  
10.0  
7.0  
1.0  
10.0  
20.0  
-
2.7  
9.0  
2.3  
12.1  
5.1  
5.1  
3.0  
-
5.0  
2.0  
3.0  
2.0  
3.0  
7.0  
5.0  
1.0  
5.5  
2.0  
9.0  
8.0  
20.0  
1.0  
4.0  
2.0  
-
5.5  
-
51.6  
173.2  
-
246.6  
3.0  
20.0  
5.0  
-
15.0  
13.0  
-
-
-
-
-
50  
912  
640  
-
1180  
400  
1400  
860  
815  
570  
-
425  
-
323  
-
-
-
-
-
-
-
-
-
-
-
-
6
10.0 1340 5940  
6.0  
9.0  
2
4.5  
10  
-
5
5
6
20  
3
-
-
-
2
3
4
-
4
1760 8270  
1750 6800  
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
750  
85  
13.1  
-
-
-
-
-
-
-
-
-
-
-
-
2.0  
-
-
-
-
230  
800  
1470 3900  
170  
210  
170  
140  
180  
660  
200  
40  
900  
400  
600  
900  
600  
1400  
700  
400  
140  
135  
75  
110  
100  
140  
80  
180  
495  
59  
10  
80  
83  
120  
87  
360  
290  
400  
200  
215  
425  
400  
240  
-
14.0  
6.0  
-
-
-
3100 5000  
-
-
34  
6
800  
80  
94  
400  
91  
5.0  
3.0  
6.0  
5.0  
8.0  
-
-
-
90  
29  
65  
110  
35  
440  
140  
60  
600  
2500  
2300  
500  
1000  
960  
2
16.0  
-
17.0  
15.0  
-
11.5  
4.0  
6.0  
-
380  
-
-
-
-
570  
650  
-
10  
10  
1
2
25  
-
1110  
190  
100  
90  
590  
100  
450  
2570  
Melon  
Semolina  
Peach  
Fish  
Walnut  
-
47  
70  
50  
60  
-
-
4.3  
14  
55  
-
11.3  
-
600  
1000  
-
-
-
2.0  
5.0  
3.1  
20  
7.3  
4.0  
-
1900 2300  
527  
-
ME= Microelements; Ch=Chrome; Mn=Manganese; Fe=Ferrum; Co=Cobalt; Cu=Cuprum; Zn=Zinc; Se=Selenium; Mo=Molybdenum;  
I=Iodine; Ni=Nickel; Be=Beryllium; Al=Aluminum; Cd=Cadmium; Hg=Mercury; Pb=Lead.  
Citation: Akhmedova DR. Ethnogeographic features of nutrition as a key factor in the development of iron deficiency anemia in the Bukhara region. J Life Sci  
Biomed, 2019; 9(6): 170-173; www.jlsb.science-line.com  
172  
CONCLUSION  
In order to exclude the entry of toxic ME into the human body, it is advisable to use mineral water for food,  
especially during pregnancy, instead of tap water. Our findings provide the basis for the need to correct the ME  
composition of the human body with the necessary MEs, not only by increasing the volume and quality of food  
products, but also by using medications containing MEs. This is evidenced by the indicators of ME blood  
composition, both in the studied families and in pregnant women.  
DECLARATIONS  
Acknowledgements  
This work was supported by Tashkent Pediatric Medical Institute, Tashkent City, Uzbekistan.  
Authors’ contributions  
All authors contributed equally to this work.  
Competing interests  
The authors declare that they have no competing interests.  
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Citation: Akhmedova DR. Ethnogeographic features of nutrition as a key factor in the development of iron deficiency anemia in the Bukhara region. J Life Sci  
Biomed, 2019; 9(6): 170-173; www.jlsb.science-line.com  
173