Measurement of the total daily dietary iron absorption by the extrinsic tag model

Efficacy of Pneumatophorus japonicus meat as an iron fortificant in whole-wheat flour in preventing iron deficiency

Iron deficiency anemia (IDA) is a global health concern affecting one-third of the world's population, particularly those dominated by plant-based food. Fortifying staple foods with iron has been an effective strategy for preventing IDA. Pneumatophorus japonicus is an essential economic fish in China. Pneumatophorus japonicus dark meat is usually underutilized as a byproduct, though it contains bounteous nutrients, including heme iron (10.50 mg/100 g). This study aimed to investigate the iron bioavailability of P. japonicus dark meat and to evaluate its potential as an iron fortifier for whole-wheat flour, a typical staple food, using an in vitro digestion/Caco-2 cell culture system. Our results suggested the excellent iron bioavailability of P. japonicus dark meat in comparison with beef (a heme dietary iron reference), whole-wheat flour (a non-heme dietary iron reference), and FeSO₄ (a conventional iron supplement). The addition of P. japonicus dark meat notably enhanced iron solubility, bioavailability, and protein digestibility of whole-wheat flour. The flour-dark meat mixture yielded 1.96 times the iron bioavailability compared to beef per gram. The iron bioavailability was further improved by adding vitamin C, a commonly used dietary factor, at the Vc/iron mass ratio of 2:100-5:100. Our findings reveal the promise of P. japonicus dark meat as a significant source of bioavailable iron, providing a basis for developing fish byproducts as alternatives for iron supplementation. PRACTICAL APPLICATION: This study investigated the iron bioavailability of Pneumatophorus japonicus meat using in vitro digestion/Caco-2 cell culture system. These results could be used to improve the utilization of Pneumatophorus japonicus byproduct (dark meat) and develop the potential of the byproduct as an iron fortifier for whole-wheat flour.

The Effect of the Meat Factor in Animal-Source Foods on Micronutrient Absorption: A Scoping Review

The EAT-Lancet Commission's planetary health guidelines suggest a reduction in the consumption of animal-source foods (ASFs) for better health and more sustainable food systems. ASFs are highly nutrient dense, therefore suited to address the widespread issue of micronutrient deficiencies, particularly in low-resource settings where diets are predominantly plant based. ASFs are also believed to contain the meat factor, a substance enhancing the absorption of micronutrients from plant-based foods. We conducted a scoping review with the objective of systematically mapping the available evidence on the meat factor. The MEDLINE/PubMed and Web of Science databases were searched for literature published up to September 2021. Articles eligible for inclusion were all studies assessing the effect of adding ASFs and/or ASF fractions on micronutrient absorption from a plant-based meal or the overall diet in animal models and human subjects. Screening and data extraction were performed, and results were charted into 12 categories. We identified 77 articles eligible for inclusion, 52 of which were conducted in human subjects, 24 in animal models, and 1 in both. The addition of muscle tissue and muscle tissue fractions to single plant-based meals steadily increased absorption of iron and zinc across studies. The efficacy of the meat factor in increasing iron and zinc absorption in the overall diet is less clear. No clear differences emerged between red meat, poultry, and fish in promoting the meat factor effect. No clear evidence indicates that milk and egg products contain the meat factor. Our review highlights the importance of muscle tissue for the potential of the meat factor to enhance absorption of micronutrients of concern. Although the literature supports including sustainable and economically accessible forms of these ASFs into the diet, we found limited studies in resource-poor countries and of diets with low meat intake.

A food synergy approach in a national program to improve the micronutrient status of preschoolers: a randomized control trial protocol

Iron deficiency anemia (IDA) is a significant public health issue in India affecting nearly all vulnerable segments of the population. Causes of IDA include low consumption of iron-rich foods combined with poor iron bioavailability of nonheme iron sources. To date, interventions aimed at correcting IDA focus on increasing iron intake through iron supplementation or fortification strategies. In contrast, dietary diversification is a long-term sustainable approach to improve bioavailable iron intake. In this context, the inclusion of vitamin C-rich fruits in the regular diet has proven to improve iron absorption, but the effect on iron status is inconclusive. Considering the ongoing national program for preschoolers in India, we designed a cluster randomized controlled trial (RCT) to test the hypothesis that inclusion of vitamin C-rich fruit in a regular meal would improve iron absorption and lead to better child iron and micronutrient status, cognitive development, gut health, and growth while reducing morbidity. This paper illustrates a context-specific framework and activities to design and functionalize an open-label, three-arm cluster RCT to test a specific hypothesis. The results of this designed trial should generate evidence to inform policy on the effect of a food-based intervention on iron status.

Inclusion of guava enhances non-heme iron bioavailability but not fractional zinc absorption from a rice-based meal in adolescents

Assessing the bioavailability of non-heme iron and zinc is essential for recommending diets that meet the increased growth-related demand for these nutrients. We studied the bioavailability of iron and zinc from a rice-based meal in 16 adolescent boys and girls, 13-15 y of age, from 2 government-run residential schools. Participants were given a standardized rice meal (regular) and the same meal with 100 g of guava fruit (modified) with (57)Fe on 2 consecutive days. A single oral dose of (58)Fe in orange juice was given at a separate time as a reference dose. Zinc absorption was assessed by using (70)Zn, administered intravenously, and (67)Zn given orally with meals. The mean hemoglobin concentration was similar in girls (129 ± 7.8 g/L) and boys (126 ± 7.1 g/L). There were no sex differences in the indicators of iron and zinc status except for a higher hepcidin concentration in boys (P < 0.05). The regular and modified meals were similar in total iron (10-13 mg/meal) and zinc (2.7 mg/meal) content. The molar ratio of iron to phytic acid was >1:1, but the modified diet had 20 times greater ascorbic acid content. The absorption of (57)Fe from the modified meal, compared with regular meal, was significantly (P < 0.05) greater in both girls (23.9 ± 11.2 vs. 9.7 ± 6.5%) and boys (19.2 ± 8.4 vs. 8.6 ± 4.1%). Fractional zinc absorption was similar between the regular and modified meals in both sexes. Hepcidin was found to be a significant predictor of iron absorption (standardized β = -0.63, P = 0.001, R(2) = 0.40) from the reference dose. There was no significant effect of sex on iron and zinc bioavailability from meals. We conclude that simultaneous ingestion of guava fruit with a habitual rice-based meal enhances iron bioavailability in adolescents.

The beneficial effect of Mediterranean dietary patterns on dietary iron utilization in male adolescents aged 11-14 years

The effects of a diet based on Mediterranean patterns on iron bioavailability and iron status in adolescents were studied. The study was divided into two periods: basal period, in which 21 male adolescents consumed their habitual diet (basal diet); and nutritional intervention period, during which an experimental diet based on the Mediterranean model was consumed. Dietary iron utilization was studied by means of iron intake and iron output in faeces and urine, and iron status was analysed in fasting blood samples collected at the end of each period. No differences in total iron intake were found between diets, but consumption of the experimental diet increased iron absorption and retention compared with the basal diet. Biochemical parameters related to iron metabolism did not vary after the intervention period, although serum ferritin tended to increase. Therefore, a diet based on Mediterranean dietary patterns may improve dietary iron utilization during adolescence and may prevent iron deficiency.

Education and improved iron intakes for treatment of mild iron-deficiency anemia in adolescent girls in southern Benin

BACKGROUND

To our knowledge, the impact of a nutrition education program combined with an increase in bioavailable dietary iron to treat iron-deficiency anemia has never been studied in adolescent girls.

OBJECTIVE

To evaluate the impact of an intensive dietary program for the treatment of iron-deficiency anemia in 34 intervention and 34 control boarding-school girls aged 12 to 17 years from Benin.

METHODS

A quasi-experimental design consisting of 4 weeks of nutrition education combined with an increase in the content and bioavailability of dietary iron for 22 weeks was implemented in the intervention school, but not in the control school. Data were obtained from both groups from a nutrition knowledge questionnaire, 24-hour dietary recalls, anthropometric measurements, measurement of iron status indices, and screening for malarial and intestinal parasitic infections.

RESULTS

Nutrition knowledge scores and mean intakes of nutrients, including dietary iron, absorbable iron, and vitamin C, were significantly higher in the intervention group (p < .05) than in the control group after 26 weeks. Mean hemoglobin and serum ferritin values were also significantly higher in the intervention group than in the control group (122 vs. 112 g/L [p = .0002] and 32 vs. 19 microg/L [p = .04], respectively), whereas the prevalence of anemia (32% vs. 85% [p = .005] and iron-deficiency anemia (26% vs. 56% [p = .04]) was significantly lower in the intervention group than in the control group. No significant differences between the groups were observed in intestinal parasitic infections or malaria status postintervention.

CONCLUSIONS

A multidietary strategy aiming to improve available dietary iron can reduce iron-deficiency anemia in adolescent girls.

Effect of a nutrition education program and diet modification in Beninese adolescent girls suffering from mild iron deficiency anemia

A 26-week nutrition intervention, including 4 weeks of nutrition education, combined with an increase in the content and bioavailability of dietary iron for 22 weeks was carried out in 34 intervention and 34 control adolescent girls suffering from mild iron deficiency anemia (IDA). In post-intervention, hemoglobin and serum ferritin were significantly higher in the intervention group, whereas the incidence of IDA was significantly lower in the intervention group compared to the control group. Nutrition knowledge scores were significantly higher in intervention girls compared to control girls. Dietary changes to improve available dietary iron can reduce iron deficiency anemia.

Iron absorption in young Indian women: the interaction of iron status with the influence of tea and ascorbic acid

BACKGROUND

Ascorbic acid (AA) enhances and tea inhibits iron absorption. It is unclear whether iron status influences the magnitude of this effect.

OBJECTIVE

We evaluated the influence of the iron status of young women on iron absorption from a rice meal with or without added tea or AA.

DESIGN

Two stable-isotope iron absorption studies were made in 2 groups of 10 subjects with iron deficiency anemia (IDA) and 10 subjects who were iron replete (control subjects). In study 1, the reference rice meal was fed alone or with 1 or 2 cups of black tea. In study 2, the reference meal was fed alone or with AA (molar ratio to iron, 2:1 or 4:1). Iron absorption was measured by the erythrocyte incorporation of (57)Fe and (58)Fe labels at 14 d.

RESULTS

Mean fractional iron absorption from the reference rice meal was approximately 2.5 times as great in the IDA group as in the control group (P < 0.05). The consumption of 1 or 2 cups of tea decreased iron absorption in the control subjects by 49% (P < 0.05) or 66% (P < 0.01), respectively, and in the IDA group by 59% or 67% (P < 0.001 for both), respectively. AA (molar ratio to iron, 2:1 or 4:1) increased iron absorption by 270% or 343%, respectively, in control subjects and by 291% or 350%, respectively, in subjects with IDA (P < 0.001).

CONCLUSIONS

The inhibitory effect of tea and the enhancing effect of AA on iron absorption were similar in the 2 groups. Overall differences in iron absorption in the 2 groups, however, continued to be dictated by iron status.

Erythorbic acid is a potent enhancer of nonheme-iron absorption

BACKGROUND

Erythorbic acid, a stereoisomer of ascorbic acid with similar physicochemical properties, is widely used as an antioxidant in processed foods.

OBJECTIVES

The aims of the present study were to evaluate the effect of erythorbic acid on iron absorption from ferrous sulfate at molar ratios of 2:1 and 4:1 (relative to iron) and to compare the effect of erythorbic acid directly with that of ascorbic acid at a molar ratio of 4:1.

DESIGN

Iron absorption from iron-fortified cereal was measured in 10 women on the basis of erythrocyte incorporation of stable iron isotopes ((57)Fe or (58)Fe) 14 d after administration. Each woman consumed 4 ferrous-sulfate-fortified test meals (containing 5 mg Fe/meal) with or without added erythorbic or ascorbic acid. The data were evaluated by use of paired t tests, and the results are presented as geometric means.

RESULTS

Iron absorption from the test meal without any added enhancer was 4.1%. The addition of erythorbic acid (at molar ratios of 2:1 and 4:1 relative to iron) increased iron absorption 2.6-fold (10.8%; P < 0.0001) and 4.6-fold (18.8%; P < 0.0001), respectively. The addition of ascorbic acid (molar ratio of 4:1) increased iron absorption 2.9-fold (11.7%; P = 0.0004). At a molar ratio of 4:1, erythorbic acid was 1.6-fold (P = 0.0002) as potent an enhancer of iron absorption as was ascorbic acid.

CONCLUSION

Although erythorbic acid is a potent enhancer of iron absorption, its lack of antiscorbutic activity limits its usefulness in iron-fortification programs. However, it may play a major role in enhancing iron bioavailability from mixed diets that include foods preserved with erythorbic acid.

Ascorbic acid from lime juice does not improve the iron status of iron-deficient women in rural Mexico

BACKGROUND

Although ascorbic acid (AA) increases dietary iron bioavailability, there has been no food-based community trial of its efficacy in improving iron status.

OBJECTIVE

The objective was to assess the efficacy of 25 mg AA as agua de limón (limeade), consumed with each of 2 daily meals, in improving the iron status of iron-deficient women.

DESIGN

Two rural Mexican populations were randomly assigned to an AA or a placebo group, each with 18 iron-deficient women. The AA group was given 500 mL limeade containing 25 mg AA twice a day, 6 d/wk, for 8 mo. The placebo group was given a lime-flavored beverage free of AA or citric acid. Beverages were consumed within 30 min of 2 main daily meals. Data were collected on morbidity (3 times/wk), dietary intake (on 6 d), socioeconomic status, parasites (twice), medical history, and response to treatment. Blood samples at 0, 2, 4, 6, and 8 mo were analyzed for hemoglobin, plasma AA, plasma ferritin, transferrin receptors, and C-reactive protein.

RESULTS

AA intake was significantly (P < 0.0001) higher in the AA group, but nonheme iron, heme iron, and phytic acid intakes did not differ significantly. Plasma AA was significantly (P < 0.01) higher in the AA group at 2, 4, 6, and 8 mo. There were no final differences between groups in hemoglobin, plasma ferritin, or transferrin receptor concentrations or in the ratio of transferrin receptors to plasma ferritin after control for initial concentrations.

CONCLUSION

Increasing dietary AA by 25 mg at each of 2 meals/d did not improve iron status in iron-deficient women consuming diets high in phytate and nonheme iron.

Can dietary treatment of non-anemic iron deficiency improve iron status?

OBJECTIVE

To investigate the efficacy of, first, a dietary regimen involving increased consumption of iron-rich foods and enhancers of iron absorption and decreased consumption of inhibitors of iron absorption and, second, a low dose iron chelate iron supplement, for increasing iron stores in young adult New Zealand women with mild iron deficiency (MID).

METHODS

The study was a 16 week randomized placebo-controlled intervention. Seventy-five women aged 18 to 40 years with MID (serum ferritin < 20 microg/L and hemoglobin > or = 120 g/L) were assigned to one of three groups: Placebo, Supplement (50 mg iron/day as amino acid chelate) or Diet. Participants in the Diet Group were given individual dietary counseling to increase the intake and bioavailability of dietary iron. Dietary changes were monitored by a previously validated computer-administered iron food frequency questionnaire.

RESULTS

Diet Group members significantly increased their intake of flesh foods, heme iron, vitamin C and foods cooked using cast-iron cookware and significantly decreased their phytate and calcium intakes. Serum ferritin increased in the Supplement and Diet Groups by 59% (p=0.001) and 26% (p=0.068), respectively, in comparison to the Placebo Group. The serum transferrin receptor:serum ferritin ratio decreased by 51% in the Supplement Group (p=0.001), and there was a non-significant decrease of 22% (p=0.1232) in the Diet Group.

CONCLUSIONS

This study is the first, to our knowledge, to demonstrate that an intensive dietary program has the potential to improve the iron status of women with iron deficiency.

Estimation of nonheme-iron bioavailability from meal composition

BACKGROUND

Considerable data are available on the individual effects of dietary factors on nonheme-iron absorption, but their combined effect when they are present in the same meal is not known.

OBJECTIVE

Our objective was to predict the bioavailability of iron from complex meals that are consumed commonly in the United States on the basis of the contents of factors that are known to promote or inhibit food iron absorption.

DESIGN

Radioisotopic measurements of nonheme-iron absorption from 25 meals were made in 86 volunteer subjects by using extrinsic radioiron labeling. The meal contents of nonheme iron, calcium, ascorbic acid, polyphenols, and phytic acid were determined by biochemical analysis; energy and protein contents were estimated from food-composition tables. Animal tissue content was based on weight or was obtained from the manufacturer.

RESULTS

After adjusting iron absorption for differences in iron status, the significant biochemical predictors of iron absorption as determined by multiple regression analysis were the contents of animal tissue (P = 0.0001), phytic acid (P = 0.0001), and ascorbic acid (P = 0. 0441). Collectively, these 3 variables accounted for 16.4% of the variation in absorption. On the basis of the multiple regression analysis, we developed the following equation to estimate iron absorption: Ln absorption, % (adjusted to serum ferritin concentration of 30 microg/L) = 1.9786 + (0.0123 x animal tissue in g) - (0.0034 x phytic acid in mg) + (0.0065 x ascorbic acid in mg).

CONCLUSION

For the 25 meals evaluated, only the contents of animal tissue, phytic acid, and ascorbic acid were useful for estimating nonheme-iron absorption.

PIGE-PIXE analysis of medicinal plants and vegetables of pharmacological importance

PIGE and PIXE techniques were employed to the study of elemental constituents of some traditional medicinal plants generally used in curing many diseases and ailments in southwestern Nigeria. Analyses were also carried out on commonly edible vegetables of medicinal and pharmacological importance. PIGE measurements were carried out using 3.5-MeV collimated protons from the 7 mV CN Van-de-Graaff accelerator of INFN, LNL, Legnaro (Padova), Italy, whereas the PIXE measurements were carried out using 1.8 MeV from the 2.5 MV AN 2000 Van-de-Graaff accelerator of the same laboratory. The results show that many of the medicinal plants contain elements of cardinal importance in human metabolism. The results from the vegetables also show the presence of vital elements that are needed for growth and development. In addition, some of the toxic elements, which include As, Cd, Hg, and so forth, were not detected. However, some of the recipes contain trace amounts of Pb at very low concentrations. This calls for proper control of dose rates in some samples to prevent the attendant negative cumulative effects.

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 foods.

Strategies for the prevention of iron deficiency through foods in the household

Iron deficiency can be caused not only by diets deficient in iron but by poor absorption of available dietary iron. Extrinsically tagging foods with radioiron allows the exact measurement of iron absorbed from heme and nonheme iron foods. It has furthered the study of the effect of enhancers and inhibitors of iron absorption. As a result, we have a greater understanding of why iron deficiency and iron deficiency anemia are prevalent in populations of low socioeconomic status and of which food vehicles and iron compounds are most suitable for iron fortification.

A quantitative model for prediction of iron bioavailability from Indian meals: an experimental study

The major goal of the study was to explore the possibility of developing an updated model that integrates the effect of various enhancers and inhibitors for predicting the potential availability of iron from typical Indian vegetarian meals. The interaction effects of four constituents namely ascorbic acid, citric acid, tannic acid and calcium phosphate was studied using a standard cereal meal (STD meal) providing 3 mg non-heme iron/250 ml homogenate. Based on the data, a regression equation was evolved which was tested for its predictive power as applied to a set of 10 typical Indian meals. Regression analysis of the data revealed that both ascorbate and citrate emerged as equally strong enhancers while tannate and calcium phosphate demonstrated strong inhibitory effect on iron availability in the STD meal. Further, when the prediction equation, generated on the basis of the interaction effect data was applied to the typical Indian meals, it showed a high correlation coefficient (r = 0.76) between the analysed values for iron availability vs the values computed using the enhancer and inhibitor contents of the meals. Comparison with the only other model available in the literature namely that of Monsen & Balintfy (1982) revealed that the present model was far better in predicting iron availability from cereal based Indian meals (r = 0.76) than Monsen's model (r = 0.19). The findings of the present study substantiated the hypothesis that a regression model, evolved from a cereal meal, by integrating the effect of enhancers as well as inhibitors, rather than only enhancers, provides a more precise estimate of iron availability from typical Indian meals. A limitation of the model however, was that phytate could not be incorporated into the equation.

Influence of the consumption of casein, or tuna in the raw, cooked or canned form, on the utilization of iron in the diet of weanling rats

A study was made of the influence of the consumption of white tuna (subjected to various thermal treatments) on the bioavailability of dietary iron. Biological assays were carried out on Wistar rats fed semi-synthetic diets varying only in the protein source, casein-methionine, or tuna provided in the following forms: raw, cooked in brine, sterilized with or without soybean oil, and canned and stored for a period of 1 or 3 years. Feed intake, the fecal and urinary excretion of iron, and the iron content of the liver were monitored. Absorption of iron was enhanced by consuming the diet containing raw white tuna. However, the beneficial effect of raw tuna was greatly reduced by cooking it in brine, and even more so by sterilization, especially in the presence of oil. The benefit was partly restored by storing the conserves for a period of 1 or 3 years. It is hypothesized that structural alterations to the protein caused by thermal processes can affect the solubility and bioavailability of iron.

Iron disorders can mimic anything, so always test for them

Routinely measuring iron status is necessary because not only are about 6% of Americans in significant negative iron balance, but about 1% have iron overload. Serum ferritin is in equilibrium with body iron stores, and is the only blood test that measures them. Barring inflammation, each one ng (0.0179 pmol) ferritin/ml of serum indicates approximately 10 mg (0.179 mmol) of body iron stores. Very early Stage I positive balance is best recognized by measuring saturation of iron binding capacity. Conversely, serum ferritin best recognizes early (Stage I and II) negative balance. Deviations from normal are: 1. Both stages of iron depletion (i.e. low stores, no dysfunction). Negative iron balance Stage I is reduced iron absorption producing moderately depleted iron stores. Stage II is severely depleted stores, without dysfunction. These stages include over half of all cases of negative iron balance. Treated with iron, they never progress to dysfunction, i.e. to disease. 2. Both stages of iron deficiency. Deficiency is inadequate iron for normal function, i.e. dysfunction, disease. Negative balance Stage III is dysfunction without anemia; Stage IV is with anemia. 3. Positive iron balance: Stage I is a multi-year period without dysfunction. Supplements of iron and/or vitamin C promote progression to dysfunction (disease). Iron removal prevents progression. Stage II is iron overload disease, encompassing years of insidiously progressive damage to tissues and organs from iron overload. Iron removal arrests progression.

Ascorbic acid safety: analysis of factors affecting iron absorption

The potential for excessive iron absorption by subjects ingesting ascorbic acid doses above the recommended dietary allowance (60 mg) was evaluated by examining published literature (24 studies, 1412 subjects) in which ascorbic acid was part of a test meal given to determine effects on iron absorption. Three parameters associated with iron absorption were identified: (1) a relatively shallow slope for the dose-response curve relating ascorbic acid dosage (1-1000 mg) and percent iron absorption; (2) no significant effect of ascorbic acid on the absorption of high (60 mg) iron doses; and (3) an inverse relationship between iron absorption and plasma transferrin saturation. Ascorbic acid did not increase the incidence of 'high' iron absorbers (greater than 2 SD from population mean) above control levels; limited data for ascorbic acid doses greater than 100 mg/d indicated no change in the distribution of iron absorption values.

The effects of fruit juices and fruits on the absorption of iron from a rice meal

The effects of the chemical composition of fruit juices and fruit on the absorption of iron from a rice (Oryza sativa) meal were measured in 234 parous Indian women, using the erythrocyte utilization of radioactive Fe method. The corrected geometric mean Fe absorptions with different juices varied between 0.040 and 0.129, with the variation correlating closely with the ascorbic acid contents of the juices (rs 0.838, P less than 0.01). Ascorbic acid was not the only organic acid responsible for the promoting effects of citrus fruit juices on Fe absorption. Fe absorption from laboratory 'orange juice' (100 ml water, 33 mg ascorbic acid and 750 mg citric acid) was significantly better than that from 100 ml water and 33 mg ascorbic acid alone (0.097 and 0.059 respectively), while Fe absorption from 100 ml orange juice (28 mg ascorbic acid) was better than that from 100 ml water containing the same amount of ascorbic acid (0.139 and 0.098 respectively). Finally, Fe absorption from laboratory 'lemon juice' (100 ml orange juice and 4 g citric acid) was significantly better than that from 100 ml orange juice (0.226 and 0.166 respectively). The corrected geometric mean Fe absorption from the rice meal was 0.025. Several fruits had little or no effect on Fe absorption from the meal (0.013-0.024). These included grape (Vitis vinifera), peach (Prunus persica), apple (Malus sylvestris) and avocado pear (Persea americana). Fruit with a mild to moderate enhancing effect on Fe absorption (0.031-0.088) included strawberry (Fragaria sp.) (uncorrected values), plum (Prunus domestica), rhubarb (Rheum rhaponticum), banana (Musa cavendishii), mango (Mangifera indica), pear (Pyrus communis), cantaloup (Cucumis melo) and pineapple (Ananas comosus) (uncorrected values). Guava (Psidium guajava) and pawpaw (Carica papaya) markedly increased Fe absorption (0.126-0.293). There was a close correlation between Fe absorption and the ascorbic acid content of the fruits tested (rs 0.738, P less than 0.0001). There was also a weaker but significant correlation with the citric acid content (rs 0.55, P less than 0.03). Although this may have reflected a direct effect of citric acid on Fe absorption, it should be noted that fruits containing citric acid also contained ascorbic acid (rs 0.70, P less than 0.002).(ABSTRACT TRUNCATED AT 400 WORDS)

In vitro estimation of iron availability from a range of plant foods: influence of phytate, ascorbate and citrate

Plant foods were digested in vitro and the proportion of iron which diffused across a semi-permeable membrane was used as an index of Fe availability. The mean (with SEM) Fe diffusibility from a group of eighteen cereals, legumes and nuts was very low, 2.1 (0.25)%, whereas from a group of sixteen fruits and vegetables it was high, 31.7 (1.09)%. The difference between the two food groups was highly significant (P less than 0.001). The results for Fe diffusibility correlated well with literature values for the in vivo absorption of Fe from similar foods (r0.84, P less than 0.01). When phytate, citrate and ascorbate were added to selected foods in amounts corresponding to endogenous levels, only phytate and citrate gave the expected effects on Fe diffusibility. Ascorbate only enhanced Fe diffusibility to the expected extent when it was added in much larger amounts, not normally found in foods. When added to cereal foods, orange juice was found to enhance greatly Fe diffusibility even when its content of ascorbate was completely destroyed by boiling followed by prolonged storage. When citrate and ascorbate were added to cereal foods in amounts equivalent to those found in fresh orange juice, both enhanced Fe diffusibility but citrate was far more effective. It is concluded that phytate is a major inhibitor of Fe diffusibility in cereals, legumes and nuts. However, citrate rather than ascorbate would appear to be the major enhancer of Fe diffusibility from many fruits and vegetables. The implications of the present results are discussed in relation to the relative influence of phytate, citrate and ascorbate on dietary Fe availability.

CONSUMO ALIMENTAR DE ESTUDANTES UNIVERSITÁRIOS DO SEXO FEMININO

Realizou-se um estudo dietético com o objetivo de caracterizar o padrão nutritional de estudantes universitários do sexo feminino, utilizando-se o método de pesagem direta dos alimentos. Os resultados revelaram deficiência vitamínico-mineral (predominantemente de ferro, cálcio e tiamina) na dieta, quando comparados com as recomendações dietéticas.

[Density of iron bioavailable in the usual diet in the State of São Paulo]

O conhecimento do potencial de biodisponibilidade de ferro da dieta de uma população é imprescindível na implantação de um programa de fortificação com esse mineral. A quantificação da capacidade de absorção do ferro dietético foi efetuada em três refeições, habituais entre os paulistas: desjejum (pão, margarina, café com açúcar), almoço (arroz, feijão, carne e café com açúcar) e jantar (arroz, feijão, ovo frito, café com açúcar), servidas a 28 indivíduos adultos, de ambos os sexos, aparentemente sadios. As densidades do ferro biodisponível (dFeB) nas refeições estudadas foram: desjejum dFeB = 0,23; almoço dFeB = 0,73 e jantar dFeB = 0,28. Os valores encontrados, bastante inferiores aos adequados para suprir o requerimento de ferro da mulher, sugerem que a fortificação não é estratégia efetiva no controle da anemia ferropriva, quando aplicada às refeições de composição igual àquelas estudadas.

The inhibitory effect of soy products on nonheme iron absorption in man

Radioiron absorption studies were performed in male volunteer subjects to determine the effect on nonheme iron absorption of various semipurified proteins. When egg albumen and casein were substituted in protein-equivalent quantities in a semisynthetic meal, similar mean absorptions of 2.5 and 2.7% were observed. In contrast, isolated soy protein reduced absorption sharply, to an average of 0.5%. When egg albumen in the semisynthetic meal was replaced with full fat soy flour, textured soy flour, and isolated soy protein, absorption fell from 5.5 to 1.0, 1.9, and 0.4%, respectively, indicating an inhibitory effect by a wide range of soy products. The effect of substituting textured soy flour for meat in a meal containing a hamburger, french fries, and a milkshake was also evaluated. With 3:1 and 2.1 ratios of meat to unhydrated textured soy flour, absorption decreased by 61 and 53%, respectively. The soy products tested in this study have a pronounced inhibitory effect on the absorption of nonheme iron.

Interaction of vitamin C and iron

Food iron is absorbed by the intestinal mucosa from two separate pools of heme and nonheme iron. Heme iron, derived from hemoglobin and myoglobin, is well absorbed and relatively little affected by other foods eaten in the same meal. On the other hand, the absorption of nonheme iron, the major dietary pool, is greatly influenced by meal composition. Ascorbic acid is a powerful enhancer of nonheme iron absorption and can reverse the inhibiting effect of such substances as tea and calcium/phosphate. Its influence may be less pronounced in meals of high iron availability--those containing meat, fish, or poultry. The enhancement of iron absorption from vegetable meals is directly proportional to the quantity of ascorbic acid present. The absorption of soluble inorganic iron added to a meal increases in parallel with the absorption of nonheme iron, but ascorbic acid has a much smaller effect on insoluble iron compounds, such as ferric oxide or ferric hydroxide, which are common food contaminants. Ascorbic acid facilitates iron absorption by forming a chelate with ferric iron at acid pH that remains soluble at the alkaline pH of the duodenum. High cost and instability during food storage are the major obstacles to using ascorbic acid in programs designed to combat nutritional iron deficiency anemia.

Anemia due to inadequate iron sources or poor iron utilization

Anemias due to dietary iron deficiency and poor iron utilization have some features in common. In both, the anemia is hypochromic and microcytic. Also in both, the levels of free erythrocyte protoporphyrin are increased, even though many of the causes of ineffective iron utilization are actually associated with normal or increased iron stores. Appropriate use of currently available assays, including a determination of the level of serum ferritin, can distinguish between many of these disorders. Above all, a logical approach with attention to the clinical response to treatment with iron medications will help achieve a rapid diagnosis.

WHO sponsored collaborative studies on nutritional anaemia in India. The effects of ascorbic acid and protein supplementation on the response of pregnant women to iron, pteroylglutamic acid and cyanocobalamin therapy

1. A study was conducted in two centres in southern and northern India of the effects of the addition of ascorbic acid and protein supplements to iron, pteroyglutamic acid and cyanocobalamin, in the prophylaxis and treatment of anaemia of pregnancy. 2. A dose of 500 mg ascorbic acid/d had no beneficial effect. Women who received 15 g calcium caseinate/d showed a superior haematological response. The reasons for this are unknown, but are more likely attributable to an increased absorption of the supplemental iron than to the correction of a protein deficiency.