Preventing Iron Deficiency through Food Fortification

One way to prevent iron deficiency anemia in developing countries is through the fortification of food products with iron. In addition to avoiding undesirable color and flavor changes, the main challenge is to protect the fortification iron from potential inhibitors of iron absorption present in commonly fortified food

NaFe3+EDTA as a food fortificant: influence on zinc, calcium and copper metabolism in the rat

The general acceptance of NaFe3+EDTA for food Fe fortification has been partly restricted by concern over the influence of EDTA on the metabolism of other nutritionally important trace elements and minerals. We have investigated the influence of NaFe3+EDTA, and of increasing dietary levels of Na2EDTA, on Zn, Cu and Ca metabolism in rats fed on Zn-sufficient and Zn-deficient soya-bean-isolate- based diets. With the Zn-deficient diets, changing the dietary Fe compound from FeSO4 to NaFe3+- EBTA significantly (P < 0·05) increased mean apparent Zn absorption from 50·2 to 67·4%. urinary Zn excretion from 2·0 to 4·0% of intake, and Zn retention from 48·2 to 63·4%. Increasing the dietary EDTA level to 1000 mg/kg further increased Zn absorption to 78·1%, urinary Zn excretion to 15·6% of intake and Zn retention to 62·5%. Increased Zn retention was accompanied by a significant increase in weight gain indicating that the extra Zn was available for normal metabolic processes. With rats fed on the Zn-sufficient diet, NaFe3+EDTA and Na2EDTA similarly increased the absorption, urinary excretion and retention of Zn but to a lesser extent. NaFe3+EDTA, however, had no influence on the absorption, urinary excretion and retention of Cu and Ca, and additional Na2EDTA caused only minor increases in Cu absorption and retention and in the urinary excretion of Ca. We conclude that using NaFe3+EDTA as a food fortificant would have no detrimental effect on the metabolism of Zn, Cu and Ca and, in some situations, could improve Zn absorption and retention from low-bioavailability diet

Inhibition of non-haem iron absorption in man by polyphenolic-containing beverages

The effects of different polyphenol-containing beverages on Fe absorption from a bread meal were estimated in adult human subjects from the erythrocyte incorporation of radio-Fe. The test beverages contained different polyphenol structures and were rich in either phenolic acids (chlorogenic acid in coffee), monomeric flavonoids (herb teas, camomile (Matricaria recutita L.)), vervain (Verbena officinalis L.), lime flower (Tilia cordata Mill.), pennyroyal (Mentha pulegium L.) and peppermint (Mentha piperita L.), or complex polyphenol polymerization products (black tea and cocoa). All beverages were potent inhibitors of Fe absorption and reduced absorption in a dose-dependent fashion depending on the content of total polyphenols. Compared with a water control meal, beverages containing 20-50 mg total polyphenols/serving reduced Fe absorption from the bread meal by 50-70 %, whereas beverages containing 100-400 mg total polyphenols/serving reduced Fe absorption by 60-90 %. Inhibition by black tea was 79-94 %, peppermint tea 84 %, pennyroyal 73 %, cocoa 71 %, vervain 59 %, lime flower 52 % and camomile 47 %. At an identical concentration of total polyphenols, black tea was more inhibitory than cocoa, and more inhibitory than herb teas camomile, vervain, lime flower and pennyroyal, but was of equal inhibition to peppermint tea. Adding milk to coffee and tea had little or no influence on their inhibitory nature. Our findings demonstrate that herb teas, as well as black tea, coffee and cocoa can be potent inhibitors of Fe absorption. This property should be considered when giving dietary advice in relation to Fe nutritio

Fractional magnesium absorption is significantly lower in human subjects from a meal served with an oxalate-rich vegetable, spinach, as compared with a meal served with kale, a vegetable with a low oxalate content

The aim of the present study was to evaluate Mg absorption from a test meal served with an oxalate-rich vegetable, spinach, as compared with a test meal served with a vegetable with a low oxalate content, kale. Mg absorption was measured by a stable-isotope technique based on extrinsic labelling of the test meals and faecal monitoring of the excreted isotope labels. Nine healthy adults participated in the study. The test meals were based on 100g phytate-free white bread, served with 300g spinach (6·6mmol oxalate; 0·7mmol 25Mg label added, 5·0mmol total Mg) or 300g kale (0·1mmol oxalate; 1·2mmol 26Mg label added, 4·8mmol total Mg). The test meals were served on days 1 and 3, at breakfast and lunch, using a cross-over design. The results from the present study demonstrated that apparent Mg absorption was significantly lower from the meal served with spinach (26·7 (sd 10·4) %) than the meal served with kale (36·5 (sd 11·8) %) (P=0·01). However, the lower fractional apparent Mg absorption from the test meal served with spinach can be assumed to be, at least partly, counterbalanced by the higher native Mg content of spinach as compared with kale. Although based on indirect evidence, i.e. not based on an evaluation of added (or removed) oxalic acid, the difference in Mg absorption observed in the present study is attributed to the difference in oxalic acid content between the two vegetable

Zinc absorption in adult humans: the effect of iron fortification

The effect of Fe fortification on the absorption of Zn was studied by radioisotopic labelling of single meals, followed by measurements of whole-body retention of 65Zn at 14 d after intake. Healthy adult volunteers participated in the study. Weaning cereal, wheat bread and infant formula, foods that are all frequently Fe-fortified, were evaluated in the study. The amounts of Fe added as FeSO4 were similar to the levels in commercial products in Europe and the USA, and were 200 or 500 mg Fe/kg (weaning cereal), 65 mg Fe/kg (white wheat flour) and 12 mg Fe/1 (infant formula). For comparison, Zn absorption was measured in the same subjects, from identical test meals containing no added Fe. No statistically significant differences were found when Zn absorption from the Fe-fortified test meals was compared with that from non-Fe-fortified test meals. Fractional Zn-absorption values from Fe-fortified v. non-fortified meals were 31·1 (sd 1·19) v. 30·7 (SD 7·0)% (weaning cereal; 200 mg Fe/kg), 37·7 (SD 16·6) v. 30·2 (SD 9·9)% (weaning cereal; 500 mg Fe/kg), 36·5 (SD 14·4) v. 38·2 (SD 18·1)% (bread; 65 mg Fe/kg flour) and 41·6 (SD 8·1) v. 38·9 (SD 14·5)% (infant formula; 12 mg Fe/1). The addition of Fe to foods at the currently used fortification levels was thus not associated with impaired absorption of Zn and the consumption of these Fe-fortified foods would not be expected to have a negative effect on Zn nutritio

Inhibition of non-haem iron absorption in man by polyphenolic-containing beverages

The effects of different polyphenol-containing beverages on Fe absorption from a bread meal were estimated in adult human subjects from the erythrocyte incorporation of radio-Fe. The test beverages contained different polyphenol structures and were rich in either phenolic acids (chlorogenic acid in coffee), monomeric flavonoids (herb teas, camomile (Matricaria recutita L.)), vervain (Verbena officinalis L.), lime flower (Tilia cordata Mill.), pennyroyal (Mentha pulegium L.) and peppermint (Mentha piperita L.), or complex polyphenol polymerization products (black tea and cocoa). All beverages were potent inhibitors of Fe absorption and reduced absorption in a dose-dependent fashion depending on the content of total polyphenols. Compared with a water control meal, beverages containing 20–50 mg total polyphenols/serving reduced Fe absorption from the bread meal by 50–70 %, whereas beverages containing 100–400 mg total polyphenols/serving reduced Fe absorption by 60–90 %. Inhibition by black tea was 79–94 %, peppermint tea 84 %, pennyroyal 73 %, cocoa 71 %, vervain 59 %, lime flower 52 % and camomile 47 %. At an identical concentration of total polyphenols, black tea was more inhibitory than cocoa, and more inhibitory than herb teas camomile, vervain, lime flower and pennyroyal, but was of equal inhibition to peppermint tea. Adding milk to coffee and tea had little or no influence on their inhibitory nature. Our findings demonstrate that herb teas, as well as black tea, coffee and cocoa can be potent inhibitors of Fe absorption. This property should be considered when giving dietary advice in relation to Fe nutrition

Iron absorption from experimental infant formulas based on pea (Pisum sativum)-protein isolate: the effect of phytic acid and ascorbic acid

Infant formula based on pea (Pisum sativum)-protein isolate has been suggested as an alternative to soyabean formula in countries where soyabean is not a native crop, or when soyabean protein cannot be used due to allergic reactions or intolerances. In the present study, Fe absorption from experimental infant formulas based on pea-protein isolate was measured in healthy non-anaemic young women. The influence of phytic acid and ascorbic acid on Fe absorption was evaluated, using a stable-isotope technique based on incorporation of Fe stable-isotope labels into erythrocytes 14 d after administration. Geometric mean Fe absorption increased from 20·7 (+1SD 41·6, -1sd 10·3) % to 33·1 (+1sd 58·6, -1sd 18·7) %; (P<0·0001; n 10) after enzymic degradation of virtually all phytic acid. Doubling the molar ratio Fe : ascorbic acid from 1 : 2·1 to 1 : 4·2 in the infant formula with native phytic acid content also increased Fe absorption significantly (P<0·0001; n 10); geometric mean Fe absorption increased from 14·8 (+1sd 32·1, -1sd 6·8) % to 22·1 (+1sd 47·2, -1sd 10·4) %. These results confirm the inhibitory and enhancing effects of phytic acid and ascorbic acid respectively on Fe absorption, but also indicate relatively high fractional Fe absorption from the pea-protein-based formulas. After adjusting for differences in Fe status, our data indicate that Fe absorption from dephytinised pea protein might be less inhibitory than dephytinised soyabean protein as measured in a previous study (

Erythrocyte incorporation of iron by infants: iron bioavailability from a low-iron infant formula and an evaluation of the usefulness of correcting erythrocyte incorporation values, using a reference dose or plasma ferritin concentrations

Bioavailability of iron (Fe) from a low-Fe infant formula was determined by erythrocyte incorporation of 58Fe 14 d after administration in ten healthy, non-Fe-deficient infants. Two feeding protocols were compared, with each infant acting as his/her own control. At 140 and 154 d of age, infants were fed 1000 g of 58Fe-labelled formula (1·44 mg total Fe/1000 g) as six feeds over 24 h (Protocol A) or as two feeds/day on three consecutive days (Protocol B). A water solution with 57Fe and ascorbic acid was given separately as a reference dose in both study protocols. Erythrocyte incorporation of 58Fe and 57Fe was determined by thermal ionisation mass spectrometry. Geometric mean 58Fe incorporation was 7·6 % (range 3·3-13·5 %) with Protocol A as compared to 10·6 % (range 6·7-18·6 %) with Protocol B (P=0·05); paired t test. Inter-individual variability of 58Fe was not reduced by correcting for the incorporation of 57Fe from the reference dose, or by correcting for plasma ferritin concentration. Fractional erythrocyte incorporation of Fe from low-Fe infant formula was in the same range as our earlier published data on erythrocyte incorporation of Fe from human milk extrinsically labelled with 58Fe (). The methodological evaluations included in this study clearly indicate the importance of using standardised study protocols when evaluating Fe bioavailability in infants. Corrections of erythrocyte incorporation data based on plasma ferritin or erythrocyte incorporation of Fe from a reference dose were not found to be usefu

An evaluation of EDTA compounds for iron fortification of cereal-based foods

Fe absorption was measured in adult human subjects consuming different cereal foods fortified with radiolabelled FeSO4, ferrous fumarate or NaFeEDTA, or with radiolabelled FeSO4 or ferric pyrophosphate in combination with different concentrations of Na2EDTA. Mean Fe absorption from wheat, wheat-soyabean and quinoa (Chenopodium quinoa) infant cereals fortified with FeSO4 or ferrous fumarate ranged from 0·6 to 2·2 %. For each infant cereal, mean Fe absorption from ferrous fumarate was similar to that from FeSO4 (absorption ratio 0·91-1·28). Mean Fe absorption from FeSO4-fortified bread rolls was 1·0 % when made from high-extraction wheat flour and 5·7 % when made from low-extraction wheat flour. Fe absorption from infant cereals and bread rolls fortified with NaFeEDTA was 1·9-3·9 times greater than when the same product was fortified with FeSO4. Both high phytate content and consumption of tea decreased Fe absorption from the NaFeEDTA-fortified rolls. When Na2EDTA up to a 1:1 molar ratio (EDTA:Fe) was added to FeSO4-fortified wheat cereal and wheat-soyabean cereal mean Fe absorption from the wheat cereal increased from 1·0 % to a maximum of 5·7 % at a molar ratio of 0·67:1, and from the wheat-soyabean cereal from 0·7 % to a maximum of 2·9 % at a molar ratio of 1:1. Adding Na2EDTA to ferric pyrophosphate-fortified wheat cereal did not significantly increase absorption (P>0·05). We conclude that Fe absorption is higher from cereal foods fortified with NaFeEDTA than when fortified with FeSO4 or ferrous fumarate, and that Na2EDTA can be added to cereal foods to enhance absorption of soluble Fe-fortification compounds such as FeSO