State Institution "National Research Center for Radiation Medicine, Hematology and Oncology of the NAMS of Ukraine", Kyiv, Ukraine

Abstract. The main task of modern medicine is the development and implementation of effective large-scale programs aimed at optimizing the qualitative and quantitative composition of food rations. Modern environmental conditions (pollution of soils with pesticides, heavy metals, radionuclides, etc.) require constant control and correction of the plastic, energetic and catalytic components of food. Iron, as a food ingredient, is an important component of energy metabolism, synthesis of nucleic acids
and cell proliferation.
To prevent iron-deficiency anemia (IDA) of alimentary origin, it is necessary to quickly and effectively replenish the losses and reserves of iron in the body, which is possible with a timely increase in the supply of this trace element with food.
The most rational ways to prevent IDA of alimentary genesis can be substantiated dietary recommendations that take into account a sufficient variety of nutrition, the use of animal products, and substances that increase the assimilation of iron.
Aim. To evaluate the supply of iron to residents of radioactively contaminated territories of Ukraine and to establish the impact of the latter on the development of diseases of alimentary origin.
Materials and Methods. In order to assess the supply of iron to the population of the territories affected by the consequences of the accident at the Chernobyl Nuclear Power Plant (ChNPP) and to determine its impact on morbidity and mortality, a cohort
of people of working age (men and women aged 18–29, 30–39, 40–60 years old at the time of the accident at the ChNPP), who live in ecologically dangerous areas of Zhytomyr region, was analyzed.
The source of initial information for epidemiological research and analysis was own observations and data from the Ukrainian Center for Information Technologies and the National Register of the Ministry of Health of Ukraine. The total cohort consisted of 163,047 people of both sexes, including: men – 72,654 or 44.6%, women – 90,393 or 55.4%.
To achieve the goal, the following methods were used: bibliosemantic; theoretical analysis of the generalization of data on the problem of health and nutrition of the population living in disadvantaged regions of Ukraine; mathematical statistics.
Results. Between 60 and 65% of the population living in areas radioactively contaminated by the accident at the Chernobyl nuclear power plant are diagnosed with iron-deficiency anemia.
The primary cause of the lack of essential substances, including iron, in food is a decrease (by 2.0–2.5 times) in energy expenditure and a decrease in the volume of food consumed. In addition, the impetus for the deformation of the relationship between
essential substances in the diet is the increase in the use of technologically processed and anthropogenically contaminated products.
Our research established that the nutrition of both men and women did not meet the recommended values. Thus, the diets of men of different groups of labor intensity were the most deficient in the content of meat and meat products – up to 55%, fish and fish products – up to 72%, milk and milk products – up to 57%, fruits – up to 58%. At the same time, they consumed a surplus of bread, legumes, cereals, lard, potatoes, sour cream, and eggs.
The most unbalanced was the nutrition of women. Thus, the shortage of bread and bakery products was 41.4%, meat and meat products – 63.9%, milk and milk products – up to 40.0%, vegetables – up to 25.5%, hard cheese – up to 80.0 % of the
recommended values. At the same time, women consumed an excess of cereals, eggs, potatoes and confectionery.
The content of iron in the diets of men, regardless of physical exertion, exceeded the recommended values from 12.0 to 28.0%.
At the same time, the lack of iron in women's diets amounted to 13.2–34.0%.
Conclusions. The use of international models for the prevention of iron-deficiency conditions among the population living in the territories of Ukraine affected by the accident at the Chernobyl nuclear power plant requires information on reliable estimates and a list of demographic data, life expectancy, incidence of malignant neoplasms, and mortality from all causes.
Keywords: dietary iron, heme iron, iron-deficiency anemia, prevention, population of ecologically dangerous regions, accident at Chornobyl NPP.

СПИСОК ВИКОРИСТАНИХ ДЖЕРЕЛ / REFERENCES

1. Lapach SN, Chubenko AV, Babich PN. Statistical methods in medical and bi-ological research using Excel. 2nd ed. Kyiv: MORION; 2001. 408 p.

2. https://moyaosvita.com.ua/himiya/klasifikaciya-biogennix-elementiv.

3. Grobbee DE, Roest M. Serum ferritin is a risk factor for stroke in postmenopausal women. Stroke. 2005;36(8):1637–41.

4. The role of alimentary iron in the formation of morbid conditions complicated by the influence of physical and biologics factors / Under the general editorship of Ignat Matasar. Sherman Oaks, California: G.S. Publish Services; 2022. 247 p.

5. Jolobe OM. Hypochromia is more common than microcytosis, with iron-deficiency anemia. European Journal of Internal Medicine. 2013; 24(1):9.

6. Chehun VF, Lozovska YV, Burlaka AP, Hanusevych II. et al. Metalloproteins in the process of formation of the resistant phenotype of Walker-256 carcinosarcoma in rats. Ukr. Biochem. J. 2021; 93(6), NovemberDecember Ukrainian Journal of Biochemistry ISSN 2413-5003 (Online).

7. Moreira AС, Mesquita G, Gomes M. Ferritin: an inflammatory player keeping iron at the core of pathogen-host interactions. Microorganisms. 2020;8(4):589. doi: 10.3390/microorganisms8040589.

8. Sato H, Takai C, Kazama J. et al. Serum hepcidin level, iron metabolism and osteoporosis in patients with rheumatoid arthritis. Sci. Rep. 2020;10(1): 9882. doi: 10.1038/ s 41598 - 020-66945-3.

9. Vidyborets S, Borysenko D. Hepcidin, transferrin, ferritin: physiological role as central regulators of iron metabolism in the body. Sci. Rev. 2019;10(27):8–16. doi.org/ 10.31435/ rsglobal_sr/30122019/6862.

10. Tyha IA. Pathogenetic justification of diagnosis, prevention and treatment of hypothyroid anemia in pregnant women. Problems of environmental and medical genetics and clinical immunology: Collection. of science works Kyiv–Luhansk–Kharkiv.2002; 3(35):112–30.

11.Testa U. Recent developments in the understanding of iron metabolism. Hematol J. 2002;3 (2):63-89. doi: 10.1038/sj.thj.6200163. PMID: 12032869.

12. A HemK class glutamine-methyltransferase is involved in the termination of translation and essential for iron homeostasis in Arabidopsis. Kailasam S., Singh S., Liu M.-J et al. New Phytol. 2020;226(5):1361-1374. doi: 10.1111/nph.16440.

13. Karmi O, Rowland L, King SD. et al. The [2Fe-2S] protein CISD2 plays a key role in preventing iron accumulation in cardiomyocytes. FEBS Lett. 2022; 6(6):747–761. doi: 10.1002/1873-3468.14277.

14. Balogh E, Paragh G, Jeney V. Influence of iron on bone homeostasis. Pharmaceuticals (Basel). 2018;11(4):107. doi: 10.3390/ph11040107.

15. Sharifi R, Tabarzadi MF, Choubsaz P. et al. Evaluation of serum and salivary iron and ferritin levels in children with dental caries: a meta-analysis and trial sequential analysis. Children (Basel). 2021;8(11):1034. doi: 10.3390/children8111034.

16. Mittler R, Darash-Yahana M., Sohn YS. .et al. NEET proteins: A new link between iron metabolism, reactive oxygen species, and cancer. Antioxid Redox Signal. 2019; 30(8): 1083–1095. doi: 10.1089/ars.2018.7502.

17. Shadid A. Iron storage: ferritin. LibreTexts Chemistry. Saint Mary's College. 2018; (last update: May 1, 2022).

18. Yiannikourides A, Latunde-Dada GO. A short review of iron metabolism and pathophysiology of iron disorders. Medicines (Basel). 2019;6(3):85. doi: 10.3390/ medicines 6030085.

19. Barrientos-Moreno L, Molina-Henares MA, PastorGarcía M. et al. Arginine biosynthesis modulates pyoverdine production and release in Pseudomonas putida as part of the mechanism of adaptation to oxidative stress. J. Bacteriol. 2019;201(22):e00454-19. doi: 10.1128/JB.00454-19.

20. Enko D, Moro T, Holasek S. et al. Branched-chain amino acids are linked with iron metabolism. Ann. Transl. Med. 2020;8(23):1569. doi: 10.21037/atm-20-624a.

21. González-Domínguez Á, Visiedo-García FM, Domínguez-Riscart J. et al. Iron metabolism in obesity and metabolic syndrome. Int. J. Mol. Sci. 2020;21(15):5529. doi: 10.3390/ ijms 21155529. 22. Wei S, Zhang W, Wang C. et al. Increased hepcidin expression in adipose tissue as a primary cause of obesity-related inhibition of iron absorption. J. Biol. Regul. Homeost. Agents. 2019;33(4):1135–1141. PMID: 31353879.

23. Rayman MP. Multiple nutritional factors and thyroid disease, with particular reference to autoimmune thyroid disease. Proc. Nutr. Soc. 2019; 78(1):34–44. doi: 10.1017/ S0029665118001192.

24. Kochman J, Jakubczyk K, Bargiel P, Janda-Milczarek K. The influence of oxidative stress on thyroid diseases. Antioxidants (Basel). 2021;10(9):1442. doi: 10.3390/ antiox 10091442.

25. Buzunov VO, Prykashchykova KE, Yaroshenko ZS. et al. Incidence of diseases of the circulatory system in residents of radioactively contaminated areas. Analysis of the impact of chronic ionizing radiation in small doses. Problems of radiation medicine and radiobiology. 2018;23:107–19.

26. Weber S, Parmon A, Kurrle N. et al. The clinical significance of iron overload and iron metabolism in myelodysplastic syndrome and acute myeloid leukemia. Front Immunol. 2021;11:e 627662. doi: 10.3389/fimmu.2020.627662.

27. Prysiazhniuk AE, Gudzenko NA, Fuzik MM, Trotsyuk NK, Babkina NG, Khukhryanska OM. Epidemiological study of the formation of risks of malignant neoplasms in groups of victims of the accident at the Chernobyl nuclear power plant (1990–2019). Report on research work. State registration number 0119U100525. Manuscript; 2021, 148 p.

28. Haidukov SY. Contemporary approaches to the treatment of iron deficiency anemia in patients with uterine bleeding. Doctor (Vrach - Rus.) 2010;7:2–4.

29. Kodentsova VM, Vrzesinskaya OA, Beketova NA. The relationship between vitamin and antioxidant status in children with a low hemoglobin level. Food questions (Voprosy Pitaniya – Rus.).2003;72(3):3–7.

30. Logutova LS. Fetoplacental insufficiency and perinatal complications in pregnant women with iron deficiency anemia. Medical Journal (Meditsynskiy jurnal – Rus.). 2010; 19:12-5.

31. Tsvetkova OA. Medical and social aspects of iron deficiency anemia. Medical Journal (Meditsynskiy jurnal – Rus.).2009. № 5. С. 387.

32. Tikhomirov AL, Sarsania SY. Rational therapy and modern principles of diagnosis of iron deficiency disorders in obstetric and gynecological practice. Pharmacy (Farmateka – Rus.).2009;1:32–9.

33. Matasar IT, Petryshchenko LM, Vodopyanov VM, Gubina GV, Berehova GS. Justification of the norms of physiological needs in basic food substances and energy, taking into account the ecological conditions of the population living in the territories of radioecological control: methodical recommendations. State Institution "National Scientific Center of Radiation Medicine of the National Academy of Sciences of Ukraine". Kyiv; 2021. 43 p. URL: http: //nrcrm.gov.ua/download/2021/mr2021_01.pdf.

34. https://znanija.com › task.

35. https://www.unicef.org/ukraine/stories/iron-where-toget-it.

36. https://dpss.gov.ua › news › obih-kharchovykh-produk.

37. Chernov VM. Principles of treatment of iron deficiency anemia in children. District pediatrician (Uchastkovyi Pediatr – Rus.).2010;2:2–3.

38. Gromova OA. Current issues of vitamin-mineral correction in pregnant and lactating women. Evidencebased medicine data. Method. rec. for doctors M. 2010. 114 p.

39. https://extempore.info › content › article › 9-joornal › 1...

40. https://www.kpnemo.eu/ebooks/medicina-i-sport/...

41. Shrimpton DH. Nutritional implications of micronutrients interactions. Chemist and Druggist. 2004;15:38–41.

42. Sadovnikova II. Iron deficiency anemia: pathogenesis, diagnostic algorithm and treatment. Russian medical journal (Russkiy Medicynskiy Jurnal - Rus.). 2010;9:540.

Стаття надійшла до редакції 02.05.2024 р.

Received May, 02, 2024