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Barth-Jaeggi T, Moretti D, Kvalsvig J, Holding PA, Njenga J, Mwangi A, Chhagan MK, Lacroix C, Zimmermann MB. In-home fortification with 2.5 mg iron as NaFeEDTA does not reduce anaemia but increases weight gain: a randomised controlled trial in Kenyan infants. MATERNAL AND CHILD NUTRITION 2016; 11 Suppl 4:151-62. [PMID: 25420455 DOI: 10.1111/mcn.12163] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In-home fortification of infants with micronutrient powders (MNPs) containing 12.5 mg iron may increase morbidity from infections; therefore, an efficacious low-dose iron-containing MNP might be advantageous. Effects of iron-containing MNPs on infant growth are unclear. We assessed the efficacy of a low-iron MNP on iron status and growth and monitored safety in a randomised, controlled, double-blind 1-year trial in 6-month-old infants (n = 287) consuming daily a maize porridge fortified with either a MNP including 2.5 mg iron as NaFeEDTA (MNP + Fe) or the same MNP without iron (MNP - Fe). At baseline, after 6 and 12 months, we determined haemoglobin (Hb), iron status [serum ferritin (SF), soluble transferrin receptor (sTfR) and zinc protoporphyrin (ZPP)], inflammation [C-reactive protein (CRP)] and anthropometrics. We investigated safety using weekly morbidity questionnaires asking for diarrhoea, cough, flu, bloody or mucus-containing stool and dyspnoea, and recorded any other illness. Furthermore, feeding history and compliance were assessed weekly. At baseline, 71% of the infants were anaemic and 22% iron deficient; prevalence of inflammation was high (31% had an elevated CRP). Over the 1 year, Hb increased and SF decreased in both groups, without significant treatment effects of the iron fortification. At end point, the weight of infants consuming MNP + Fe was greater than in the MNP - Fe group (9.9 vs. 9.5 kg, P = 0.038). Mothers of infants in the MNP + Fe group reported more infant days spent with cough (P = 0.003) and dyspnoea (P = 0.0002); there were no significant differences on any other of the weekly morbidity measures. In this study, low-dose iron-containing MNP did not improve infant's iron status or reduce anaemia prevalence, likely because absorption was inadequate due to the high prevalence of infections and the low-iron dose.
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Affiliation(s)
- Tanja Barth-Jaeggi
- Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Diego Moretti
- Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | | | - Penny A Holding
- International Centre for Behavioural Studies, Mombasa, Kenya
| | - Jane Njenga
- Department of Food, Technology and Nutrition, University of Nairobi, Nairobi, Kenya
| | - Alice Mwangi
- Department of Food, Technology and Nutrition, University of Nairobi, Nairobi, Kenya
| | - Meera K Chhagan
- Department of Pediatrics and Child Health, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - Christophe Lacroix
- Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
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Bertinato J, Sherrard L, Plouffe LJ. EDTA disodium zinc has superior bioavailability compared to common inorganic or chelated zinc compounds in rats fed a high phytic acid diet. J Trace Elem Med Biol 2012; 26:227-33. [PMID: 22579270 DOI: 10.1016/j.jtemb.2012.04.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Revised: 03/15/2012] [Accepted: 04/12/2012] [Indexed: 11/21/2022]
Abstract
Different zinc (Zn) compounds have unique properties that may influence the amount of Zn absorbed particularly in the presence of phytic acid (PA), a common food component that binds Zn and decreases its bioavailability. In this study, 30-day-old male rats (n=12/diet group) were fed diets supplemented with PA (0.8%) and low levels (8mg Zn/kg diet) of inorganic (Zn oxide, Zn sulphate) or chelated (Zn gluconate, Zn acetate, Zn citrate, EDTA disodium Zn, Zn orotate) Zn compounds for 5 weeks. Two control groups were fed diets supplemented with low or normal (30mg Zn/kg diet) Zn (as Zn oxide) without added PA. Control rats fed the low Zn oxide diet showed depressed Zn status. Addition of PA to this diet exacerbated the Zn deficiency in rats. Growth (body weight gain and femur length) and Zn concentrations in plasma and tissues were similar in rats fed Zn oxide, Zn sulphate, Zn gluconate, Zn acetate, Zn citrate or Zn orotate. Rats fed EDTA disodium Zn showed enhanced growth compared to rats fed Zn oxide or Zn gluconate and had higher Zn concentrations in plasma and femur compared to rats fed all other Zn compounds. Only the haematological profile of rats fed EDTA disodium Zn did not differ from control rats fed normal Zn. These data indicate that in rats fed a high PA diet, bioavailability of commonly used inorganic or chelated Zn compounds does not differ appreciably, but Zn supplied as an EDTA disodium salt has superior bioavailability.
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Affiliation(s)
- Jesse Bertinato
- Nutrition Research Division, Health Products and Food Branch, Health Canada, Sir Frederick G. Banting Research Centre, Ottawa, Ontario, Canada.
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Cooper GJS. Therapeutic potential of copper chelation with triethylenetetramine in managing diabetes mellitus and Alzheimer's disease. Drugs 2011; 71:1281-320. [PMID: 21770477 DOI: 10.2165/11591370-000000000-00000] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
This article reviews recent evidence, much of which has been generated by my group's research programme, which has identified for the first time a previously unknown copper-overload state that is central to the pathogenesis of diabetic organ damage. This state causes tissue damage in the blood vessels, heart, kidneys, retina and nerves through copper-mediated oxidative stress. This author now considers this copper-overload state to provide an important new target for therapeutic intervention, the objective of which is to prevent or reverse the diabetic complications. Triethylenetetramine (TETA) has recently been identified as the first in a new class of anti-diabetic molecules through the original work reviewed here, thus providing a new use for this molecule, which was previously approved by the US FDA in 1985 as a second-line treatment for Wilson's disease. TETA acts as a highly selective divalent copper (Cu(II)) chelator that prevents or reverses diabetic copper overload, thereby suppressing oxidative stress. TETA treatment of diabetic animals and patients has identified and quantified the interlinked defects in copper metabolism that characterize this systemic copper overload state. Copper overload in diabetes mellitus differs from that in Wilson's disease through differences in their respective causative molecular mechanisms, and resulting differences in tissue localization and behaviour of the excess copper. Elevated pathogenetic tissue binding of copper occurs in diabetes. It may well be mediated by advanced-glycation endproduct (AGE) modification of susceptible amino-acid residues in long-lived fibrous proteins, for example, connective tissue collagens in locations such as blood vessel walls. These AGE modifications can act as localized, fixed endogenous chelators that increase the chelatable-copper content of organs such as the heart and kidneys by binding excessive amounts of catalytically active Cu(II) in specific vascular beds, thereby focusing the related copper-mediated oxidative stress in susceptible tissues. In this review, summarized evidence from our clinical studies in healthy volunteers and diabetic patients with left-ventricular hypertrophy, and from nonclinical models of diabetic cardiac, arterial, renal and neural disease is used to construct descriptions of the mechanisms by which TETA treatment prevents injury and regenerates damaged organs. Our recent phase II proof-of-principle studies in patients with type 2 diabetes and in nonclinical models of diabetes have helped to define the pathogenetic defects in copper regulation, and have shown that they are reversible by TETA. The drug tightly binds and extracts excess systemic Cu(II) into the urine whilst neutralizing its catalytic activity, but does not cause systemic copper deficiency, even after prolonged use. Its physicochemical properties, which are pivotal for its safety and efficacy, clearly differentiate it from all other clinically available transition metal chelators, including D-penicillamine, ammonium tetrathiomolybdate and clioquinol. The studies reviewed here show that TETA treatment is generally effective in preventing or reversing diabetic organ damage, and support its ongoing development as a new medicine for diabetes. Trientine (TETA dihydrochloride) has been used since the mid-1980s as a second-line treatment for Wilson's disease, and our recent clinical studies have reinforced the impression that it is likely to be safe for long-term use in patients with diabetes and related metabolic disorders. There is substantive evidence to support the view that diabetes shares many pathogenetic mechanisms with Alzheimer's disease and vascular dementia. Indeed, the close epidemiological and molecular linkages between them point to Alzheimer's disease/vascular dementia as a further therapeutic target where experimental pharmacotherapy with TETA could well find further clinical application.
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Affiliation(s)
- Garth J S Cooper
- Centre for Advanced Discovery and Experimental Therapeutics, NIHR Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, UK.
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Mohammadi M, Abedi AS, Azizi MH, Ahmadian FS, Pouraram H. Development of fortified biscuit using NaFeEDTA. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2011; 91:1984-1989. [PMID: 21495037 DOI: 10.1002/jsfa.4405] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2010] [Revised: 02/09/2011] [Accepted: 03/01/2011] [Indexed: 05/30/2023]
Abstract
BACKGROUND Sodium iron ethylenediaminetetraacetic acetate (NaFeEDTA) is a promising iron fortificant for populations consuming high-phytate diets. It produces fewer organoleptic effects than other fortificants do, especially when the matrix of the food vehicle contains fat, and has a bioavailability two to four times higher than that of ferrous sulfate. This study investigated the effects of varying levels of NaFeEDTA (576-1152 mg kg(-1)) on the physicochemical and sensory characteristics of Petit Beurre biscuits. RESULTS There were no significant differences in pH, ash, moisture and breaking strength values among all formulae. The iron content (7.2-14.4 mg per 100 g) of the biscuits increased with increasing fortificant level. During a 60 day storage period the peroxide value increased in both fortified and non-fortified formulae, especially after 28 days. The addition of NaFeEDTA had a significant (P < 0.05) effect on the colour, texture and flavour of fortified biscuits. CONCLUSION Based on the range proposed for the use of NaFeEDTA as a fortification agent (10 mg iron and 67 mg EDTA per person per day), the results of this study reveal that 720 mg kg(-1) NaFeEDTA (9 mg iron per 100 g) is the optimum level for iron fortification in Petit Beurre biscuits.
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Affiliation(s)
- Mehrdad Mohammadi
- Department of Food Technology Research, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Scientific Opinion on the use of ferric sodium EDTA as a source of iron added for nutritional purposes to foods for the general population (including food supplements) and to foods for particular nutritional uses. EFSA J 2010. [DOI: 10.2903/j.efsa.2010.1414] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Social mobilization and social marketing to promote NaFeEDTA-fortified soya sauce in an iron-deficient population through a public–private partnership. Public Health Nutr 2009; 12:1751-9. [DOI: 10.1017/s136898000800431x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveThe present pilot project aimed to assess the effectiveness of social mobilization and social marketing in improving knowledge, attitudes and practices (KAP) and Fe status in an Fe-deficient population.DesignIn an uncontrolled, before–after, community-based study, social mobilization and social marketing strategies were applied. The main outcomes included KAP and Hb level and were measured at baseline, 1 year later and 2 years later.SettingOne urban county and two rural counties in Shijiazhuang Municipality, Hebei Province, China.SubjectsAdult women older than 20 years of age and young children aged from 3 to 7 years were selected from three counties to attend the evaluation protocol.ResultsAfter 1 year, most knowledge and attitudes had changed positively towards the prevention and control of anaemia. The percentage of women who had adopted NaFeEDTA-fortified soya sauce increased from 8·9 % to 36·6 % (P ≤ 0·001). After 2 years, Hb levels had increased substantially, by 9·0 g/l (P ≤ 0·001) in adult women and 7·7 g/l (P ≤ 0·001) in young children.ConclusionSocial mobilization and social marketing activities had a positive impact on the KAP of adult women, and resulted in marked improvements in Hb levels in both adult women and young children. This should be recommended as a national preventive strategy to prevent and control Fe deficiency and Fe-deficiency anaemia.
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Kibangou I, Bureau F, Allouche S, Arhan P, Bouglé D. Interactions between ethylenediaminetetraacetic acid (EDTA) and iron absorption pathways, in the Caco-2 model. Food Chem Toxicol 2008; 46:3414-6. [DOI: 10.1016/j.fct.2008.08.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2007] [Revised: 03/17/2008] [Accepted: 08/14/2008] [Indexed: 11/27/2022]
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Zhu L, Miller DD. Tissue iron distribution and urinary mineral excretion vary depending on the form of iron (FeSO4 or NaFeEDTA) and the route of administration (oral or subcutaneous) in rats given high doses of iron. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2007; 55:8793-9. [PMID: 17880165 DOI: 10.1021/jf0717135] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Sodium iron ethylenediaminetetraacetate (NaFeEDTA) has considerable promise as an iron fortificant in food. However, effects of administering high levels of NaFeEDTA on tissue iron distribution and mineral excretion are not well understood. The objectives of this study were to assess nonheme iron distribution in the body and urinary excretion of Ca, Mg, Cu, Fe, and Zn after daily administration of high levels of iron to rats over 21 days. Iron was either given orally with food or injected subcutaneously, as either FeSO 4 or NaFeEDTA. Selected tissues were collected for nonheme iron analysis. Estimated total body nonheme iron levels were similar in rats fed NaFeEDTA or FeSO 4, but the tissue distribution was different: it was 53% lower in the liver and 86% higher in the kidneys among rats fed NaFeEDTA than among those fed FeSO 4. In contrast, body nonheme iron was 3.2-fold higher in rats injected with FeSO 4 than in rats injected with NaFeEDTA. Administering NaFeEDTA orally elevated urinary Cu, Fe, and Zn excretion compared with FeSO 4 (1.41-, 11.9-, and 13.9-fold higher, respectively). We conclude that iron is dissociated from the EDTA complex prior to or during intestinal absorption. A portion of intact FeEDTA may be absorbed via a paracellular route at high levels of intake but is mostly excreted in the urine. Metal-free EDTA may be absorbed and cause elevated urinary excretion of Fe, Cu, and Zn.
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Affiliation(s)
- Le Zhu
- Department of Food Science, Cornell University, Ithaca, New York 14853, USA
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Abstract
Fe absorption was measured in adult human subjects consuming different cereal foods fortified with radiolabelled FeSO4, ferrous fumarate or NaFeEDTA, or with radiolabelled FeSO4or ferric pyrophosphate in combination with different concentrations of Na2EDTA. Mean Fe absorption from wheat, wheat–soyabean and quinoa (Chenopodium quinoa) infant cereals fortified with FeSO4or 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 FeSO4or ferrous fumarate, and that Na2EDTA can be added to cereal foods to enhance absorption of soluble Fe-fortification compounds such as FeSO4.
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Igarashi K, Nakanishi Y, Hirunuma R, Enomoto S, Kimura S. Multitracer study on the uptake of various trace elements in anemic rats: influence of NaFeEDTA and ferrous sulfate. Nutr Res 2006. [DOI: 10.1016/j.nutres.2006.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Hotz C, DeHaene J, Woodhouse LR, Villalpando S, Rivera JA, King JC. Zinc absorption from zinc oxide, zinc sulfate, zinc oxide + EDTA, or sodium-zinc EDTA does not differ when added as fortificants to maize tortillas. J Nutr 2005; 135:1102-5. [PMID: 15867288 DOI: 10.1093/jn/135.5.1102] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The fortification of staple foods with zinc may play an important role in achieving adequate zinc intakes in countries at risk of zinc deficiency. However, little is known about the relative bioavailability of different zinc compounds that may be used in food fortification. The objective of this study was to measure and compare fractional zinc absorption from a test meal that included a maize tortilla fortified with zinc oxide, zinc sulfate, zinc oxide + EDTA, or sodium-zinc EDTA. A double isotopic tracer ratio method ((67)Zn as oral tracer and (70)Zn as intravenous tracer) was used to estimate zinc absorption in 42 Mexican women living in a periurban community of Puebla State, Mexico. The test meal consisted of maize tortillas, yellow beans, chili sauce, and milk with instant coffee; it contained 3.3 mg zinc and had a phytate:zinc molar ratio of 17. Fractional zinc absorption did not differ significantly between the test groups (ANOVA; P > 0.05). Percent absorptions were (mean +/- SD) zinc oxide, 10.8 +/- 0.9; zinc sulfate, 10.0 +/- 0.02; zinc oxide + EDTA, 12.7 +/- 1.5; and sodium-zinc EDTA, 11.1 +/- 0.7. We conclude that there was no difference in zinc absorption from ZnO and ZnSO(4) when added as fortificants to maize tortillas and consumed with beans and milk. The addition of EDTA with zinc oxide or the use of prechelated sodium-zinc EDTA as fortificants did not result in higher zinc absorption from the test meal.
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Affiliation(s)
- Christine Hotz
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
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Cooper GJS, Chan YK, Dissanayake AM, Leahy FE, Keogh GF, Frampton CM, Gamble GD, Brunton DH, Baker JR, Poppitt SD. Demonstration of a hyperglycemia-driven pathogenic abnormality of copper homeostasis in diabetes and its reversibility by selective chelation: quantitative comparisons between the biology of copper and eight other nutritionally essential elements in normal and diabetic individuals. Diabetes 2005; 54:1468-76. [PMID: 15855335 DOI: 10.2337/diabetes.54.5.1468] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We recently showed that treatment with the Cu(II)-selective chelator, trientine, alleviates heart failure in diabetic rats, improves left ventricular hypertrophy in humans with type 2 diabetes, and increases urinary Cu excretion in both diabetic rats and humans compared with nondiabetic control subjects. In this study, we characterized the homeostasis of Cu and eight other nutritionally essential elements in diabetes under fully residential conditions in male subjects with type 2 diabetes and age-matched control subjects. We then probed elemental balance with oral trientine in a parallel-group, placebo-controlled study in these subjects. Before treatment, there were no detectable between-group differences in the balance of any element, although urinary output of several elements was greater in diabetic subjects. Mean extracellular superoxide dismutase (EC-SOD) activity was elevated in diabetic subjects, and its activity correlated strongly with the interaction between [Cu]serum and HbA1c. Trientine caused the Cu balance to become negative in diabetic subjects through elevated urinary Cu losses and suppressed elevated EC-SOD. Basal urinary Cu predicted urinary Cu losses during treatment, which caused extraction of systemic Cu(II). We suggest that cardiovascular complications in diabetes might be better controlled by therapeutic strategies that focus on lowering plasma glucose and loosely bound systemic Cu(II).
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Affiliation(s)
- Garth J S Cooper
- School of Biological Sciences, Faculty of Science, University of Auckland, Auckland, New Zealand.
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Davidsson L, Ziegler E, Zeder C, Walczyk T, Hurrell R. Sodium iron EDTA [NaFe(III)EDTA] as a food fortificant: erythrocyte incorporation of iron and apparent absorption of zinc, copper, calcium, and magnesium from a complementary food based on wheat and soy in healthy infants. Am J Clin Nutr 2005; 81:104-9. [PMID: 15640467 DOI: 10.1093/ajcn/81.1.104] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Phytic acid is a strong inhibitor of iron absorption from fortified foods. In adults, this inhibitory effect can be overcome by adding ascorbic acid with the iron fortificant or by using a "protected" iron compound such as NaFeEDTA. In addition, the use of NaFeEDTA as an iron fortificant has been reported to increase zinc absorption in adult women. No information is available on iron bioavailability from NaFeEDTA or the influence of NaFeEDTA on minerals and trace elements in infants. OBJECTIVE We aimed to compare iron bioavailability from a complementary food based on wheat and soy fortified with either NaFeEDTA or ferrous sulfate plus ascorbic acid. The apparent absorption of zinc, copper, calcium, and magnesium was evaluated in parallel. DESIGN Stable-isotope techniques were used in a crossover design to evaluate erythrocyte incorporation of iron 14 d after administration of labeled test meals and the apparent absorption of zinc, copper, calcium, and magnesium on the basis of fecal monitoring in 11 infants. RESULTS Geometric mean erythrocyte incorporation of iron was 3.7% (NaFeEDTA) and 4.9% (ferrous sulfate plus ascorbic acid) (P = 0.08). No significant differences in the apparent absorption of zinc, copper, calcium, or magnesium were observed between test meals (n = 10). CONCLUSIONS Iron bioavailability from a high-phytate, cereal-based complementary food fortified with either NaFeEDTA or ferrous sulfate plus ascorbic acid was not significantly different. NaFeEDTA did not influence the apparent absorption of zinc, copper, calcium, or magnesium. NaFeEDTA does not provide any nutritional benefit compared with the combination of a highly bioavailable iron compound and ascorbic acid.
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Affiliation(s)
- Lena Davidsson
- Institute of Food Science and Nutrition, Swiss Federal Institute of Technology, Ruschlikon, Switzerland.
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García-Casal MN, Leets I, Layrisse M. Ethylenediaminetetraacetic acid (EDTA) does not increase iron uptake or ferritin synthesis by Caco-2 cells. J Nutr Biochem 2004; 15:261-6. [PMID: 15135149 DOI: 10.1016/j.jnutbio.2003.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Ethylenediaminetetraacetic acid (NaFe-EDTA) is a chelator capable of binding a wide variety of metals, with a high affinity constant for Fe(3+). NaFe-EDTA has been extensively studied and validated as an excellent choice for iron fortification programs and extensive research has demonstrated its high bioavailability specially for cereal based foods. To further evaluate the usefulness of this compound we performed iron uptake experiments with EDTA using the Caco-2 cell system. Cells were incubated in PBS at pH 5.5 or 7.0, containing or not ascorbic acid. Different sources of EDTA, different concentrations of NaFe-EDTA and the inclusion of another iron compound as electrolytic iron, were tested. Also, the ferritin content of Caco-2 cells 24h after 1h incubation with iron compounds was evaluated. Except for the addition of ascorbic acid, under the experimental conditions used, Caco-2 cells were not capable of obtaining iron from NaFe-EDTA. Furthermore, iron uptake from electrolytic iron was inhibited when Na(2) or K(2)-EDTA were included. Ferritin determinations to Caco-2 cells evaluated 24h after 1h incubation periods, showed that NaFe-EDTA did not induce new ferritin synthesis, since iron did not enter the cells. Further studies are required to evaluate incorporation of iron from NaFe-EDTA to a common iron pool and the requirements for iron uptake by Caco-2 cells.
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Affiliation(s)
- María Nieves García-Casal
- Instituto Venezolano de Investigaciones Científicas (IVIC). Carretera Panamericana Km. 11 Altos de Pipe. Apartado Postal 21827, Caracas 1020-A, Venezuela.
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Mendoza C, Peerson JM, Brown KH, Lönnerdal B. Effect of a micronutrient fortificant mixture and 2 amounts of calcium on iron and zinc absorption from a processed food supplement. Am J Clin Nutr 2004; 79:244-50. [PMID: 14749230 DOI: 10.1093/ajcn/79.2.244] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Iron, zinc, and calcium can interact with each other in a way that inhibits their respective absorption. On the other hand, mineral fortification has been used to improve simultaneous iron and zinc absorption from food supplements. OBJECTIVE We evaluated the effect of a novel fortificant mixture consisting of NaFeEDTA, zinc methionine, ascorbic acid, and citric acid on iron and zinc absorption from a dry food supplement designed for preschool children. DESIGN The standard food supplement contained cereal and legume flour, dried milk, and a mixture of micronutrients including ferrous sulfate and zinc sulfate as sources of supplemental iron and zinc, respectively. Standard and novel food products were prepared as porridge with or without the addition of 200 mg Ca as calcium phosphate. Iron absorption and zinc absorption from the food products were evaluated simultaneously in 13 nonpregnant, adult women by extrinsically labeling the products with radioisotopes of iron and zinc and carrying out whole-body counting 7 d after the food products were consumed in random order. RESULTS The absorption of iron from the NaFeEDTA-containing (novel) food product was 1.7 times that from the ferrous sulfate-containing (standard) product (P = 0.015). There was no significant effect of dietary calcium on iron absorption. Zinc absorption was not associated with the form of zinc consumed, but higher dietary calcium was marginally associated with lower zinc absorption (P = 0.071). CONCLUSIONS A mixture of fortificants containing NaFeEDTA, zinc sulfate or zinc methionine, ascorbic acid, and citric acid, but without calcium, can improve iron and zinc absorption from food products. A cost-benefit analysis of the novel fortificant mixture needs to be performed.
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Affiliation(s)
- Concepcion Mendoza
- Program in International Nutrition, Department of Nutrition, University of California, Davis, CA 95616, USA.
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Huo J, Sun J, Miao H, Yu B, Yang T, Liu Z, Lu C, Chen J, Zhang D, Ma Y, Wang A, Li Y. Therapeutic effects of NaFeEDTA-fortified soy sauce in anaemic children in China. Asia Pac J Clin Nutr 2002; 11:123-7. [PMID: 12074178 DOI: 10.1046/j.1440-6047.2002.00277.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The therapeutic effects of NaFeEDTA-fortified soy sauce on anaemic students were investigated. Three hundred and four iron-deficient anaemic school children (11-17 years) were randomly assigned to three treatment groups: control group (consuming non-fortified soy sauce), low-NaFeEDTA group (consuming fortified soy sauce, providing 5 mg Fe/day) and high-NaFeEDTA group (consuming fortified soy sauce, providing 20 mg Fe/day). Blood haemoglobin (Hb) levels were determined before and after 1 month, 2 months and 3 months of intervention. In addition, serum iron (SI), serum ferritin (SF), free erythrocytic porphyrin (FEP), total iron binding capability (TIBC) and transferritin (TF) were measured before and after consumption of soy sauce for 3 months. The results obtained herein show that the parameters measured were not changed remarkably within the 3-month intervention in the control group (P < 0.05). However, increased Hb, SI, SF and TF levels and decreased TIBC and FEP levels were observed in both the high-NaFeEDTA group (P <0.01) and the low-NaFeEDTA group (P < 0.05). The effectiveness of iron intervention in the low-NaFeEDTA group and high-NaFeEDTA group had no statistical significance after 3 months. It was concluded that nutritional intervention for anaemic students using NaFeEDTA-fortified soy sauce could play a positive role in the improvement of iron status and control of anaemia.
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Affiliation(s)
- Junsheng Huo
- Institute of Nutrition and Food Hygiene, Chinese Academy of Preventive Medicine, Beijing, China.
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Heimbach J, Rieth S, Mohamedshah F, Slesinski R, Samuel-Fernando P, Sheehan T, Dickmann R, Borzelleca J. Safety assessment of iron EDTA [sodium iron (Fe(3+)) ethylenediaminetetraacetic acid]: summary of toxicological, fortification and exposure data. Food Chem Toxicol 2000; 38:99-111. [PMID: 10685019 DOI: 10.1016/s0278-6915(99)00125-8] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Iron EDTA [sodium iron (Fe(3+)) ethylenediaminetetraacetic acid (EDTA)], shown to have a significant beneficial effect on iron status by increasing iron bioavailability in human diets, has been proposed for use as a fortificant in certain grain-based products including breakfast cereals and cereal bars. This paper presents an assessment of the safety of iron EDTA for its intended uses in these products. Iron EDTA, like other EDTA-metal complexes, dissociates in the gastrointestinal tract to form iron, which is bioavailable, and an EDTA salt; absorption of the metal ion and EDTA are independent. Because of this dissociation, consideration of information on EDTA compounds other than iron EDTA is relevant to this safety assessment. EDTA compounds are poorly absorbed in the gastrointestinal tract and do not undergo significant metabolic conversion. They have a low degree of acute oral toxicity. EDTA compounds are not reproductive or developmental toxicants when fed with a nutrient-sufficient diet or minimal diets supplemented with zinc. In chronic toxicity studies, diets containing as much as 5% EDTA were without adverse effects. EDTA compounds were not carcinogenic in experimental animal bioassays and are not directly genotoxic. This lack of significant toxicity is consistent with a history of safe use of other EDTA compounds (CaNa(2)EDTA and Na(2)EDTA) approved by the FDA for use as direct food additives. An upper-bound estimated daily intake (EDI) of EDTA from iron EDTA (1.15mg/kg bw/day for the US population) is less than half the acceptable daily intake (ADI) for EDTA of 2. 5mg/kg bw/day established by JECFA. The data collected and published over the past 20 to 30 years demonstrate that iron EDTA is safe and effective for iron fortification of food products and meets the standard of "reasonable certainty of no harm". Based on the published record, iron EDTA may be regarded as generally recognized as safe (GRAS) for the intended food uses and maximum use levels.
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Affiliation(s)
- J Heimbach
- ENVIRON Corporation, 4350 N. Fairfax Drive, Arlington, VA 22203, USA.
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18
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19
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Davidsson L, Almgren A, Hurrell RF. Sodium iron EDTA [NaFe(III)EDTA] as a food fortificant does not influence absorption and urinary excretion of manganese in healthy adults. J Nutr 1998; 128:1139-43. [PMID: 9649597 DOI: 10.1093/jn/128.7.1139] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
NaFe(III)EDTA is a promising iron (Fe) compound for food fortification programs because of its high Fe bioavailability from meals containing dietary inhibitors of Fe absorption such as phytic acid. However, this Fe compound is not currently used in any large-scale fortification program because of concern over its possible negative influence on the metabolism of other essential minerals or its possible influence on the absorption of potentially toxic elements, such as manganese (Mn). In this study, Mn absorption and urinary excretion were studied in adults after intake of an Fe-fortified weaning cereal labeled with 54Mn. In a crossover design, the fortification of the weaning cereal with Fe as NaFeEDTA was compared with ferrous sulfate. Manganese absorption was measured by extrapolation from whole-body retention data 10-30 d after intake, and urinary excretion of 54Mn was measured over 7 d. No significant differences in 54Mn absorption or urinary excretion were found; 1.1 +/- 0.15 and 0.91 +/- 0.35% of the ingested dose was absorbed from the cereal fortified with NaFe(III)EDTA and FeSO4, respectively. Urinary excretion of 54Mn was very low; the total radioactivity in urine represented 1.1 +/- 0.55% of the absorbed dose with NaFe(III)EDTA and 0.72 +/- 0.53% of the absorbed dose with FeSO4. Until now, Fe-fortification programs have met with only limited success. The introduction of NaFeEDTA as a food fortificant could be a useful tool to provide bioavailable Fe to vulnerable groups in the population and thus aid in combating Fe deficiency.
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Affiliation(s)
- L Davidsson
- Laboratory for Human Nutrition, Swiss Federal Institute of Technology, ETH Zürich, CH-8803 Rüschlikon, Switzerland
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20
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Patterson AJ, Brown WJ, Roberts DCK. Development, prevention and treatment of iron deficiency in women. Nutr Res 1998. [DOI: 10.1016/s0271-5317(98)00037-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Sheppard RL, Henion J. Quantitative capillary electrophoresis/ion spray tandem mass spectrometry determination of EDTA in human plasma and urine. Anal Chem 1997; 69:2901-7. [PMID: 9253243 DOI: 10.1021/ac9700686] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A quantitative method has been developed for the determination of EDTA in human plasma and urine. The samples are prepared with automated anion-exchange solid-phase extraction using 100 microL of human plasma. The extracts are analyzed by capillary electrophoresis/mass spectrometry using selected reaction monitoring in the negative ion mode. Large-volume injections (10% of the CE capillary volume) are used to improve the concentration level of detection via field-amplified sample injection. The first reported validation of a CE/MS/MS technique was carried out for this method. Using a 13C stable-label isotope for the internal standard, the lower level of detection and lower level of quantitation were determined to be 7.3 and 14.6 ng/mL EDTA in human plasma, respectively. The injection precision had a relative standard deviation (RSD) of 6.1%. The intra-assay precision was less than 15% RSD. The intra-assay accuracy was less than +/- 12% bias from the nominal concentration. The interassay precision was less than 18% RSD and the interassay accuracy was less than +/- 9% bias from the nominal concentration.
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Abstract
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 foods.
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Affiliation(s)
- R F Hurrell
- Institute of Food Science, Swiss Federal Institute of Technology, Zürich, Switzerland
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Ziegler EE, Fomon SJ. Strategies for the prevention of iron deficiency: iron in infant formulas and baby foods. Nutr Rev 1996; 54:348-54. [PMID: 9110563 DOI: 10.1111/j.1753-4887.1996.tb03801.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Iron deficiency is the most prevalent nutrition deficiency among infants and young children in industrialized as well as developing countries. It is a condition that is preventable through appropriate dietary measures. The infant born at term is endowed with a sizable amount of iron, which allows the infant to be fed a nearly iron-free diet (e.g., breast milk) for 4-6 months without becoming overtly iron deficient. This has led some to conclude that depletion of iron stores in healthy infants is a normal and, hence, innocuous process that usually gives way to gradual repletion of iron stores as dietary diversification leads to greater iron intakes. Preservation of maternal iron stores at the expense of infant iron stores may have offered survival advantages to the human species during evolution. But there is no evidence that depletion of iron stores can offer advantages to infants in industrialized or developing countries. On the contrary, there is ample documentation of shortterm as well as long-term adverse effects from iron deficiency. Prudence therefore dictates that a high priority be assigned to the prevention of iron depletion and deficiency among infants and young children worldwide.
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Affiliation(s)
- E E Ziegler
- Department of Pediatrics, University of Iowa, Iowa City 52242-1082, USA
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