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Scheuchzer P, Sinawat S, Donzé AS, Zeder C, Magalie S, Garcia-Garcera M, Ricci C, Kamontham T, Zimmermann MB, Baumgartner J. Iron Absorption from an Iron-Fortified Follow-Up Formula with and without the Addition of a Synbiotic or a Human-Identical Milk Oligosaccharide: A Randomized Crossover Stable Isotope Study in Young Thai Children. J Nutr 2024:S0022-3166(24)00467-X. [PMID: 39179207 DOI: 10.1016/j.tjnut.2024.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 07/26/2024] [Accepted: 08/17/2024] [Indexed: 08/26/2024] Open
Abstract
BACKGROUND Previous studies showed that pre- and probiotics may enhance iron absorption. Probiotics combined with prebiotics (synbiotics), including human-identical milk oligosaccharides (HiMOs), are commonly added to infant and follow-up formula (FUF). Whether these additions enhance iron absorption from iron-fortified commercial milk formula is uncertain. OBJECTIVES We determined the effect of adding 1) a synbiotic [galacto-oligosaccharide [GOS] + Limosilactobacillus reuteri (L. reuteri)] or 2) the HiMO 2'-fucosyllactose (2'FL) to iron-fortified FUF on iron absorption in young Thai children. METHODS In a randomized, controlled, single-blinded (participants) crossover study, 82 Thai children aged 8-14 mo were enrolled to consume single servings (235 mL) of FUF with isotopically labeled ferrous sulfate (2.2 mg iron) with 1) the synbiotic (400 mg/100 mL GOS and L. reuteri DSM 17938), 2) the HiMO 2'FL (100 mg/100 mL), and 3) without synbiotic and 2'FL (control) in random order and a 3-d washout period between administrations. Fractional iron absorption [FIA (%)] was assessed by measuring erythrocyte incorporation of isotopic labels 14 d (n = 26) and 28 d (n = 76) after consumption of the last test FUF. RESULTS Median (IQR) FIA from iron-fortified FUF with the synbiotic [8.2 (5.2, 12.9)%] and with 2'FL [8.4 (5.5, 14.1)%] did not differ from the control FUF [8.1 (4.8,14.7)%] (synbiotic compared with control, P = 0.24; 2'FL compared with control, P = 0.95). FIA from all FUF did not differ when measured after 14 and 28 d of erythrocyte incorporation (Time, P = 0.368; FUF, P = 0.435; Time × FUF, P = 0.937). Fecal pH and hemoglobin were negatively associated with FIA. CONCLUSIONS In young Thai children, the addition of a synbiotic (GOS + L. reuteri) or 2'FL to iron-fortified FUF did not impact FIA from a single serving. The study was registered at clinicaltrials.gov as NCT04774016.
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Affiliation(s)
- Pornpimol Scheuchzer
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Sangsom Sinawat
- College of Allied Health Sciences, Suan Sunandha Rajabhat University, Bang Kaeo, Samut Songkhram, Thailand
| | - Anne-Sophie Donzé
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Christophe Zeder
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Sabatier Magalie
- Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé S.A., Vers-Chez-Les-Blanc, Lausanne, Switzerland
| | - Marc Garcia-Garcera
- Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé S.A., Vers-Chez-Les-Blanc, Lausanne, Switzerland
| | - Cristian Ricci
- Africa Unit for Transdisciplinary Health Research, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Thavatchai Kamontham
- College of Allied Health Sciences, Suan Sunandha Rajabhat University, Bang Kaeo, Samut Songkhram, Thailand
| | - Michael B Zimmermann
- Medical Research Council Translational Immune Discovery Unit, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Jeannine Baumgartner
- Department of Nutritional Sciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom.
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Giorgetti A, Nyilima S, Stoffel NU, Moretti D, Mwasi E, Karanja S, Zeder C, Speich C, Netland C, Jin Z, Zimmermann MB, Brittenham GM. Stable iron ( 58Fe) isotopic measurements in Kenyan toddlers during 3 months of iron supplementation demonstrate that half of the iron absorbed is lost. Br J Haematol 2024; 204:2057-2065. [PMID: 38302093 DOI: 10.1111/bjh.19319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/28/2023] [Accepted: 01/16/2024] [Indexed: 02/03/2024]
Abstract
Increased iron loss may reduce the effectiveness of iron supplementation. The objective of this study was to determine if daily oral iron supplementation increases iron loss, measured using a stable isotope of iron (58Fe). We enrolled and dewormed 24 iron-depleted Kenyan children, 24-27 months of age, whose body iron was enriched and equilibrated with 58Fe given at least 1 year earlier. Over 3 months of supplementation (6 mg iron/kg body weight [BW]/day), mean (±SD) iron absorption was 1.10 (±0.28) mg/day. During supplementation, 0.55 (±0.36) mg iron/day was lost, equal to half of the amount of absorbed iron. Supplementation did not increase faecal haem/porphyrin or biomarkers of enterocyte damage and gut or systemic inflammation. Using individual patient data, we examined iron dose, absorption and loss among all available long-term iron isotopic studies of supplementation. Expressed in terms of body weight, daily iron loss was correlated significantly with iron absorption (Pearson's r = 0.66 [95% confidence interval 0.48-0.78]) but not with iron dose (r = 0.16 [95% CI -0.10-0.40]). The results of this study indicate that iron loss is increased with daily oral iron supplementation and may blunt the efficacy of iron supplements in children. This study was registered at ClinicalTrials.gov as NCT04721964.
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Affiliation(s)
- Ambra Giorgetti
- Laboratory of Human Nutrition, ETH, Zurich, Switzerland
- MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Suzane Nyilima
- Public and Community Health Department, Jomo Kenyatta University, Nairobi, Kenya
| | - Nicole U Stoffel
- Laboratory of Human Nutrition, ETH, Zurich, Switzerland
- MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Diego Moretti
- Nutrition Group, Swiss Distance University of Applied Sciences, Regensdorf, Switzerland
| | - Edith Mwasi
- Paediatric Department, Msambweni District Hospital, Msambweni, Kwale County, Kenya
| | - Simon Karanja
- Public and Community Health Department, Jomo Kenyatta University, Nairobi, Kenya
| | | | | | | | - Zhezhen Jin
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Michael B Zimmermann
- Laboratory of Human Nutrition, ETH, Zurich, Switzerland
- MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Gary M Brittenham
- Department of Paediatrics, College of Physicians and Surgeons, Columbia University, New York, New York, USA
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McKay AKA, Anderson B, Peeling P, Whitfield J, Tee N, Zeder C, Zimmermann MB, Burke LM, Moretti D. Iron Absorption in Highly Trained Male Runners: Does it Matter When and Where You Eat Your Iron? Med Sci Sports Exerc 2024; 56:118-127. [PMID: 38098150 DOI: 10.1249/mss.0000000000003272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
PURPOSE We examined iron absorption and its regulation during two common scenarios experienced by endurance athletes. Our aims were to: (i) compare the effects of preexercise versus postexercise iron intake on iron absorption; and (ii) compare the impact of training at altitude (1800 m) on iron absorption preexercise. METHODS Male runners (n = 18) completed three exercise trials over a 5-wk period, each preceded by 24 h of standardized low-iron diets. First, athletes completed two 60-min treadmill running trials at 65% V̇O2max at near sea-level (580 m). In a randomized order, preexercise and postexercise test meals labeled with 4 mg of 57Fe or 58Fe were consumed 30 min before or 30 min after exercise. Then, the same exercise trial was performed after living and training at altitude (~1800 m) for 7 d, with the labeled test meal consumed 30 min preexercise. We collected venous blood samples preexercise and postexercise for markers of iron status and regulation, and 14 d later to measure erythrocyte isotope incorporation. RESULTS No differences in fractional iron absorption were evident when test meals were consumed preexercise (7.3% [4.4, 12.1]) or postexercise (6.2% [3.1, 12.5]) (n = 18; P = 0.058). Iron absorption preexercise was greater at altitude (18.4% [10.6, 32.0]) than at near sea-level (n = 17; P < 0.001) and hepcidin concentrations at altitude were lower at rest and 3 h postexercise compared with near sea level (P < 0.001). CONCLUSIONS In an acute setting, preexercise and postexercise iron absorption is comparable if consumed within 30 min of exercise. Preexercise iron absorption increases 2.6-fold at altitude compared with near sea-level, likely due to the homeostatic response to provide iron for enhanced erythropoiesis and maintain iron stores.
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Affiliation(s)
- Alannah K A McKay
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Vic, AUSTRALIA
| | | | | | - Jamie Whitfield
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Vic, AUSTRALIA
| | - Nicolin Tee
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Vic, AUSTRALIA
| | - Christophe Zeder
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zürich, Zurich, SWITZERLAND
| | - Michael B Zimmermann
- Medical Research Council Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, University of Oxford, Oxford, UNITED KINGDOM
| | - Louise M Burke
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Vic, AUSTRALIA
| | - Diego Moretti
- Nutrition Group, Health Department, Swiss Distance University of Applied Sciences (FFHS), Zürich, SWITZERLAND
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Burgos G, Liria R, Zeder C, Kroon PA, Hareau G, Penny M, Dainty J, Al-Jaibaji O, Boy E, Mithen R, Hurrell RF, Salas E, Felde TZ, Zimmermann MB, Fairweather-Tait S. Total iron absorbed from iron-biofortified potatoes is higher than from non-biofortified potatoes: a randomized trial using stable iron isotopes in women from the Peruvian highlands. J Nutr 2023:S0022-3166(23)35553-6. [PMID: 37059395 DOI: 10.1016/j.tjnut.2023.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 04/05/2023] [Accepted: 04/11/2023] [Indexed: 04/16/2023] Open
Abstract
BACKGROUND Yellow fleshed potatoes biofortified with iron have been developed through conventional breeding but the bioavailability of the iron is unknown. OBJECTIVES Our objective was to measure iron absorption from an iron-biofortified yellow fleshed potato clone in comparison with a non-biofortified yellow fleshed potato variety. METHODS We conducted a single-blinded, randomized, crossover, multiple-meal intervention study. Women (n = 28; mean±SD plasma ferritin 21.3±3.3 μg/L) consumed 10 meals (460 g) of both potatoes, each meal extrinsically labelled with either 58Fe sulfate (biofortified) or 57Fe sulfate (non-fortified) , on consecutive days. Iron absorption was estimated from the iron isotopic composition in erythrocytes 14 days after administration of the final meal. RESULTS Mean±SD iron, phytic acid and ascorbic acid concentrations in the the iron-biofortified and the non-fortified potato meals (mg/per 100 mg) were 0.63±0.01 and 0.31±0.01 , 39.34±3.04 and 3.10±1.72 , and 7.65±0.34 and 3.74±0.39 , respectively (P < 0.01) while chlorogenic acid concentrations were 15.14±1.72 and 22.52±3.98 , respectively (P <0.05). Geometric mean (95% CI) fractional iron absorption (FIA) from the iron-biofortified clone and the non-biofortified variety was 12.1% (10.3-14.2%) and 16.6% (14.0-19.6%), respectively (P <0.001). Total iron absorption (TIA) from the iron-biofortified clone and the non-biofortified variety was 0.35 mg (0.30-0.41mg) and 0.24 mg (0.20-0.28 mg) per 460 g meal, respectively (P <0.001). CONCLUSIONS TIA from the iron-biofortified potato meals was 45.8% higher than from the non-biofortified potato meals, suggesting iron biofortification of potatoes through conventional breeding is a promising approach to improve iron intakes in iron-deficient women (p<0.01). The study was registered at www. CLINICALTRIALS gov (Identifier number NCT05154500).
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Affiliation(s)
- Gabriela Burgos
- Genetics, Genomics, and Crop Improvement Program, International Potato Center, Lima, Peru
| | - Reyna Liria
- Instituto de Investigación Nutricional, Lima, Peru
| | - Christophe Zeder
- ETH Zürich, Laboratory of Human Nutrition, Institute of Food, Nutrition, and Health, Department of Health Sciences and Technology, Zurich, Switzerland
| | - Paul A Kroon
- Quadram Institute Bioscience, Norwich Research Park, Norwich NR4 7UQ, United Kingdom
| | - Guy Hareau
- Genetics, Genomics, and Crop Improvement Program, International Potato Center, Lima, Peru
| | - Mary Penny
- Instituto de Investigación Nutricional, Lima, Peru
| | - Jack Dainty
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Olla Al-Jaibaji
- Quadram Institute Bioscience, Norwich Research Park, Norwich NR4 7UQ, United Kingdom
| | - Erick Boy
- HarvestPlus /International Food Policy Research Institute, Washington, DC, USA
| | - Richard Mithen
- Liggins Institute, Waipapa Taumata Rau - The University of Auckland, 85 Park Road, Auckland 1142, New Zealand
| | - Richard F Hurrell
- ETH Zürich, Laboratory of Human Nutrition, Institute of Food, Nutrition, and Health, Department of Health Sciences and Technology, Zurich, Switzerland
| | - Elisa Salas
- Genetics, Genomics, and Crop Improvement Program, International Potato Center, Lima, Peru
| | - Thomas Zum Felde
- Genetics, Genomics, and Crop Improvement Program, International Potato Center, Lima, Peru
| | - Michael B Zimmermann
- ETH Zürich, Laboratory of Human Nutrition, Institute of Food, Nutrition, and Health, Department of Health Sciences and Technology, Zurich, Switzerland
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Scheuchzer P, Syryamina VN, Zimmermann MB, Zeder C, Nyström L, Yulikov M, Moretti D. Ferric Pyrophosphate Forms Soluble Iron Coordination Complexes with Zinc Compounds and Solubilizing Agents in Extruded Rice and Predicts Increased Iron Solubility and Bioavailability in Young Women. J Nutr 2023; 153:636-644. [PMID: 36931746 PMCID: PMC10127525 DOI: 10.1016/j.tjnut.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 12/03/2022] [Accepted: 12/14/2022] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Co-extrusion of ferric pyrophosphate (FePP) with solubilizers, citric acid/trisodium citrate (CA/TSC), or ethylenediaminetetraacetic acid (EDTA) sharply increases iron absorption. Whether this can protect against the inhibition of iron absorption by phytic acid (PA) is unclear. Sodium pyrophosphate (NaPP) may be a new enhancer of iron absorption from FePP. OBJECTIVES Our objectives were to 1) investigate the ligand coordination of iron, zinc, and solubilizers in extruded rice and test associations with iron solubility and absorption, 2) assess whether co-extrusion of FePP + CA/TSC rice can protect against inhibition of iron absorption by PA; 3) determine the effect of zinc oxide (ZnO) compared with zinc sulfate (ZnSO4), and 4) quantify iron absorption from FePP + NaPP rice. METHODS We produced labeled 57FePP rice cofortified with ZnSO4 and EDTA, CA/TSC or NaPP, and FePP + EDTA rice with ZnO. We used electron paramagnetic resonance (EPR) to characterize iron-ligand complexes. We measured in vitro iron solubility and fractional iron absorption (FIA) in young women (n = 21, age: 22 ± 2 y, BMI: 21.3 ± 1.5 kg/m2 geometric mean plasma ferritin, 28.5 μg/L) compared with ferrous sulfate (58FeSO4). FIA was compared by linear mixed-effect model analysis. RESULTS The addition of zinc and solubilizers created new iron coordination complexes of Fe(III) species with a weak ligand field at a high-spin state that correlated with solubility (r2 = 0.50, P = 0.02) and absorption (r2 = 0.72, P = 0.02). Phytic acid reduced FIA from FePP + CA/TSC rice by 50% (P < 0.001), to the same extent as FeSO4. FIA from FePP + EDTA + ZnO and FePP + EDTA + ZnSO4 rice did not significantly differ. Mean FIAs from FePP + EDTA + ZnSO4, FePP + CA/TSC + ZnSO4, and FePP + NaPP + ZnSO4 rice were 9% to 11% and did not significantly differ from each other or from FeSO4. CONCLUSION Rice extrusion of FePP with solubilizers resulted in bioavailable iron coordination complexes. In the case of FePP + CA/TSC, PA exerted similar inhibition of FIA as with FeSO4. FePP + NaPP could be a further viable solubilizing agent for rice fortification. This study was registered at clinicaltrials.gov as NCT03703739.
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Affiliation(s)
- Pornpimol Scheuchzer
- Department for Health Sciences and Technology (D-HEST), Institute of Food, Nutrition and Health (IFNH), Laboratory of Human Nutrition, ETH Zürich, Zürich, Switzerland
| | - Victoria N Syryamina
- Department for Health Sciences and Technology (D-HEST), Institute of Food, Nutrition and Health (IFNH), Laboratory of Food Biochemistry, ETH Zürich, Zürich, Switzerland; Institute of Chemical Kinetics and Combustion, RAS, Novosibirsk, Russian Federation
| | - Michael Bruce Zimmermann
- Department for Health Sciences and Technology (D-HEST), Institute of Food, Nutrition and Health (IFNH), Laboratory of Human Nutrition, ETH Zürich, Zürich, Switzerland
| | - Christophe Zeder
- Department for Health Sciences and Technology (D-HEST), Institute of Food, Nutrition and Health (IFNH), Laboratory of Human Nutrition, ETH Zürich, Zürich, Switzerland
| | - Laura Nyström
- Department for Health Sciences and Technology (D-HEST), Institute of Food, Nutrition and Health (IFNH), Laboratory of Food Biochemistry, ETH Zürich, Zürich, Switzerland
| | - Maxim Yulikov
- Department of Chemistry and Applied Bioscience (D-CHAB), Laboratory of Physical Chemistry (LPC), ETH Zürich, Zürich, Switzerland
| | - Diego Moretti
- Department for Health Sciences and Technology (D-HEST), Institute of Food, Nutrition and Health (IFNH), Laboratory of Human Nutrition, ETH Zürich, Zürich, Switzerland; Department of Health, Nutrition Research, Swiss Distance University of Applied Sciences (FFHS), Zürich, Switzerland.
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Adetola OY, Taylor JRN, Duodu KG. Can consumption of local micronutrient- and absorption enhancer-rich plant foods together with starchy staples improve bioavailable iron and zinc in diets of at-risk African populations? Int J Food Sci Nutr 2023; 74:188-208. [PMID: 36843328 DOI: 10.1080/09637486.2023.2182740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
Iron and zinc deficiencies remain prevalent in developing countries, often due to monotonous starchy diets that are low in bioavailable minerals. This review addresses the question as to whether consumption of starchy staple foods in Africa together with micronutrient-dense and absorption enhancer-rich plant foods can enhance iron and zinc bioavailability in the diets of at-risk populations. While green leafy vegetables (GLVs) fortification of starchy staples can improve mineral contents, especially iron, it may not improve bioavailable iron and zinc, due to GLVs' high contents of mineral absorption inhibitors, notably polyphenols, phytate and calcium. Fruits, although low in minerals, could improve bioavailable iron and zinc in the staples because of their high ascorbic and citric acid and/or β-carotene contents, which can form soluble chelates with the minerals. More human studies are needed to establish whether such a technology or fortification strategy can improve bioavailable iron and zinc in African-type plant-based diets.
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Affiliation(s)
- Oluyimika Y Adetola
- Department of Consumer and Food Sciences, University of Pretoria, Hatfield, South Africa
| | - John R N Taylor
- Department of Consumer and Food Sciences, University of Pretoria, Hatfield, South Africa
| | - K G Duodu
- Department of Consumer and Food Sciences, University of Pretoria, Hatfield, South Africa
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Giorgetti A, Paganini D, Nyilima S, Kottler R, Frick M, Karanja S, Hennet T, Zimmermann MB. The effects of 2'-fucosyllactose and lacto-N-neotetraose, galacto-oligosaccharides, and maternal human milk oligosaccharide profile on iron absorption in Kenyan infants. Am J Clin Nutr 2023; 117:64-72. [PMID: 36789945 DOI: 10.1016/j.ajcnut.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 09/25/2022] [Accepted: 10/28/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Whether prebiotic human milk oligosaccharides (HMO), such as 2'-fucosyllactose (2'-FL) and lacto-N-neotetraose (LNnT), enhance iron absorption in infants is unknown. Moreover, whether maternal HMO profile affects absorption of iron fortificants or the effects of prebiotic galacto-oligosaccharides (GOS) and/or HMO on iron absorption is uncertain. OBJECTIVES The aim of this study was to test whether consumption of 3.0 g GOS or HMO enhances iron absorption from iron-fortified maize porridge in partially breastfed Kenyan infants and whether maternal HMO profile modulates these effects. METHODS In a randomized, prospective crossover study, 55 infants (aged 8-12 mo) were fed test meals fortified with 1 of the following: 1) 5.0 mg iron as 54Fe-labeled ferrous fumarate (FeFum); 2) 5.0 mg iron as 58FeFum and 3.0 g GOS (FeFum+GOS); and 3) 5.0 mg iron as 57FeFum and 2.0 g 2'-FL and 1.0 g LNnT (FeFum+HMO). Fractional iron absorption (FIA) was assessed by erythrocyte incorporation of iron isotopes. HMO profiles were determined by capillary gel electrophoresis with laser-induced florescence detection. Data were analyzed with mixed-effect models, and iron dialyzability was measured in vitro. RESULTS Of the 55 infants included, 49 were fed as instructed. FIA from the FeFum+GOS group [median (IQR) 22.2% (16.5%-25.9%)] was higher than that from the FeFum group [12.5% (9.5%-20.9%)] (P = 0.005). FIA from the FeFum+HMO group was 13.3% (7.1%-24.4%) and did not differ from the FeFum group (P = 0.923). Maternal HMO profile did not predict FIA or modulate the effects of GOS or HMO on FIA. Iron dialyzability ratios at pH 2 of FeFum+GOS to FeFum and FeFum+HMO to FeFum were 2.1 and 0.9 (P = 0.001 and P = 0.322), respectively. CONCLUSIONS In Kenyan infants consuming FeFum-fortified maize porridge, co-provision of 3.0 g GOS increased FIA by 78%, whereas co-provision of 3.0 g HMO did not affect FIA. Variations in maternal HMO profile, including secretor and Lewis phenotype, did not predict FIA. These data argue against a physiologic role for 2'-FL and LNnT in facilitating iron absorption in infancy. The study was registered at clinicaltrials.gov as NCT04163406 (https://clinicaltrials.gov/ct2/show/NCT04163406).
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Affiliation(s)
- Ambra Giorgetti
- Laboratory of Human Nutrition, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.
| | - Daniela Paganini
- Laboratory of Human Nutrition, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland; Department of Physiology and Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Suzane Nyilima
- Department of Medical Epidemiology, College of Health Sciences, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | | | | | - Simon Karanja
- Department of Medical Epidemiology, College of Health Sciences, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Thierry Hennet
- Department of Physiology and Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Michael B Zimmermann
- Laboratory of Human Nutrition, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland; MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
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Huey SL, Mehta NH, Konieczynski EM, Bhargava A, Friesen VM, Krisher JT, Mbuya MNN, Monterrosa E, Nyangaresi AM, Boy E, Mehta S. Bioaccessibility and bioavailability of biofortified food and food products: Current evidence. Crit Rev Food Sci Nutr 2022; 64:4500-4522. [PMID: 36384354 DOI: 10.1080/10408398.2022.2142762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Biofortification increases micronutrient content in staple crops through conventional breeding, agronomic methods, or genetic engineering. Bioaccessibility is a prerequisite for a nutrient to fulfill a biological function, e.g., to be bioavailable. The objective of this systematic review is to examine the bioavailability (and bioaccessibility as a proxy via in vitro and animal models) of the target micronutrients enriched in conventionally biofortified crops that have undergone post-harvest storage and/or processing, which has not been systematically reviewed previously, to our knowledge. We searched for articles indexed in MEDLINE, Agricola, AgEcon, and Center for Agriculture and Biosciences International databases, organizational websites, and hand-searched studies' reference lists to identify 18 studies reporting on bioaccessibility and 58 studies on bioavailability. Conventionally bred biofortified crops overall had higher bioaccessibility and bioavailability than their conventional counterparts, which generally provide more absorbed micronutrient on a fixed ration basis. However, these estimates depended on exact cultivar, processing method, context (crop measured alone or as part of a composite meal), and experimental method used. Measuring bioaccessibility and bioavailability of target micronutrients in biofortified and conventional foods is critical to optimize nutrient availability and absorption, ultimately to improve programs targeting micronutrient deficiency.
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Affiliation(s)
- Samantha L Huey
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
- Program in International Nutrition, Cornell University, Ithaca, New York, USA
- Center for Precision Nutrition and Health, Cornell University, Ithaca, New York, USA
| | - Neel H Mehta
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
| | | | - Arini Bhargava
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
| | | | - Jesse T Krisher
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
| | | | - Eva Monterrosa
- Global Alliance for Improved Nutrition, Geneva, Switzerland
| | | | - Erick Boy
- Harvest Plus, International Food Policy Research Institute, Washington, DC, USA
| | - Saurabh Mehta
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
- Program in International Nutrition, Cornell University, Ithaca, New York, USA
- Center for Precision Nutrition and Health, Cornell University, Ithaca, New York, USA
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9
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Hilaj N, Zimmermann MB, Galetti V, Zeder C, Murad Lima R, Hammer L, Krzystek A, Andlauer W, Moretti D. The effect of dechitinization on iron absorption from mealworm larvae (Tenebrio molitor) flour added to maize meals: stable-isotope studies in young females with low iron stores. Am J Clin Nutr 2022; 116:1135-1145. [PMID: 36100966 DOI: 10.1093/ajcn/nqac210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 07/28/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Edible insects have a low ecological footprint and could serve as an alternative dietary iron source. However, chitin, a major component of insects, avidly binds iron and might inhibit iron absorption. OBJECTIVES We aimed to measure fractional iron absorption (FIA) from Tenebrio molitor-based test meals with and without dechitinization, and to assess the effect of native and low chitin T. molitor on FIA from iron-fortified maize porridge. METHODS We measured iron absorption in young females with low iron stores (n = 21) from 1) labeled (54FeSO4) fortified maize porridge (maize alone); 2) intrinsically labeled (57Fe added during rearing) T. molitor larvae with native chitin content (NC) added to maize alone; and 3) dechitinized intrinsically labeled (57Fe) T. molitor larvae with low chitin content (LC) added to maize alone. We determined FIA using erythrocyte isotope incorporation and measured in vitro iron dialyzability from the 3 meals. RESULTS NC and LC T. molitor had similar mean ± SD iron content (12.0 ± 0.1 mg/100 g). Geometric mean (95% CI) FIAs from the 3 test meals were 1) maize alone: 5.8% (3.2%, 10.8%); 2) maize + NC T. molitor: 5.3% (2.5%, 11.3%) and 4.1% (1.9%, 8.7%); and 3) maize + LC T. molitor: 4.6% (2.0%, 10.3%) and 4.0% (1.8%, 9.2%), for extrinsic and intrinsic labels, respectively. FIA from NC and LC T. molitor did not significantly differ, and both were lower (P < 0.005) than FIA from the labeled maize porridge in the 3 meals, which did not significantly differ. The slopes of the relations between FIA and serum ferritin in the different meals and from the intrinsic and extrinsic labels did not significantly differ. CONCLUSIONS T. molitor biomass does not strongly affect iron absorption when added to maize porridge. Our data suggest T. molitor iron is absorbed from the common nonheme iron pool. Native T. molitor is high in iron which is moderately well absorbed, suggesting it could be a valuable dietary iron source.This trial was registered at clinicaltrials.gov as NCT04510831.
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Affiliation(s)
- Nikolin Hilaj
- Human Nutrition Laboratory, Departement of Health Sciences and Thechnology, ETH Zürich, Switzerland
| | - Michael B Zimmermann
- Human Nutrition Laboratory, Departement of Health Sciences and Thechnology, ETH Zürich, Switzerland
| | - Valeria Galetti
- Human Nutrition Laboratory, Departement of Health Sciences and Thechnology, ETH Zürich, Switzerland
| | - Christophe Zeder
- Human Nutrition Laboratory, Departement of Health Sciences and Thechnology, ETH Zürich, Switzerland
| | - Roberta Murad Lima
- Human Nutrition Laboratory, Departement of Health Sciences and Thechnology, ETH Zürich, Switzerland
| | - Laila Hammer
- Agroscope, Schwarzenburgstrasse 161, 3003 Bern, Switzerland.,Department of Health, Swiss Distance University of Applied Sciences (FFHS)/University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Zürich, Switzerland.,Division of Human Nutrition and Health, Wageningen University and Research, Stippeneng 4, 6708, WE, Wageningen, the Netherlands
| | - Adam Krzystek
- Human Nutrition Laboratory, Departement of Health Sciences and Thechnology, ETH Zürich, Switzerland
| | - Wilfried Andlauer
- Institute of Life Technologies, University of Applied Sciences and Arts Western Switzerland (HES-SO Valais Wallis), Sion, Switzerland
| | - Diego Moretti
- Human Nutrition Laboratory, Departement of Health Sciences and Thechnology, ETH Zürich, Switzerland.,Department of Health, Swiss Distance University of Applied Sciences (FFHS)/University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Zürich, Switzerland
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10
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Mwangi MN, Oonincx DGAB, Hummel M, Utami DA, Gunawan L, Veenenbos M, Zeder C, Cercamondi CI, Zimmermann MB, van Loon JJA, Dicke M, Melse-Boonstra A. Absorption of iron from edible house crickets: a randomized crossover stable-isotope study in humans. Am J Clin Nutr 2022; 116:1146-1156. [PMID: 36026477 PMCID: PMC9535517 DOI: 10.1093/ajcn/nqac223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 08/24/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Edible insects are a novel source of animal protein. Moreover, edible insects contain iron concentrations similar to meat, potentially making them a valuable iron source for human consumers. Yet, it is unknown to what extent iron from insects is absorbed in humans. OBJECTIVES In this exploratory study, we assessed fractional iron absorption from house crickets (Acheta domesticus) consumed with refined (low-phytate, noninhibiting) or nonrefined (high-phytate, inhibiting) meals. METHODS Intrinsically [57Fe]-labeled and control crickets were reared. Six iron-balanced experimental meals were randomly administered crossover to 20 iron-depleted females (serum ferritin <25 µg/L; 18-30 y old), in 2 time-blocks of 3 consecutive days, 2 wk apart. Three meals consisted of refined maize flour porridge with either [57Fe]-labeled crickets, [58Fe]SO4 (reference meal), or unlabeled crickets plus [54Fe]SO4. The other 3 meals consisted of nonrefined maize flour porridge with the same respective additions. Blood samples were drawn to assess the 14-d isotope enrichment in erythrocytes, and meal-specific fractional iron absorption was calculated. In vitro digestion was used to explore possible explanations for unexpected findings. RESULTS Mean fractional iron absorption from 57Fe-labeled house crickets with refined maize porridge (3.06%) and from refined maize porridge with unlabeled crickets (4.92%) was lower than from the reference meal (14.2%), with respective mean differences of -11.1% (95% CI: -12.6%, -9.68%) and -9.29% (95% CI: -10.8%, -7.77%). Iron absorption from all meals based on unrefined maize porridge was low (<3%), and did not differ for the 2 meals with crickets compared with the reference meal. In vitro digestion showed that chitin, chitosan, and calcium limited iron bioaccessibility to a large extent. CONCLUSIONS Iron absorption from house crickets and fortified maize porridge with crickets is low, which may be explained by the presence of chitin and other inhibitors in the cricket biomass.This trial was registered at https://www.trialregister.nl as NL6821.
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Affiliation(s)
- Martin N Mwangi
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
- Training Research Unit of Excellence, Blantyre, Malawi
| | - Dennis G A B Oonincx
- Laboratory of Entomology, Wageningen University & Research, Wageningen, Netherlands
- Animal Nutrition Group, Wageningen University & Research, Wageningen, Netherlands
| | - Marijke Hummel
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
- Global Alliance for Improved Nutrition, Utrecht, Netherlands
| | - Dessy A Utami
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
- Faculty of Health Science, Esa Unggul University, Jakarta, Indonesia
| | - Lidyawati Gunawan
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
- Nutriolab, Jakarta, Indonesia
| | - Margot Veenenbos
- Laboratory of Entomology, Wageningen University & Research, Wageningen, Netherlands
- CLM Research and Advice, Culemborg, Netherlands
| | - Christophe Zeder
- Human Nutrition Laboratory, Institute of Food, Nutrition and Health, Swiss Federal Institute of Technology in Zürich (ETH Zürich), Zürich, Switzerland
| | - Colin I Cercamondi
- Human Nutrition Laboratory, Institute of Food, Nutrition and Health, Swiss Federal Institute of Technology in Zürich (ETH Zürich), Zürich, Switzerland
- Wyeth Nutrition Science Centre, Nestlé Nutrition Institute, Vevey, Switzerland
| | - Michael B Zimmermann
- Human Nutrition Laboratory, Institute of Food, Nutrition and Health, Swiss Federal Institute of Technology in Zürich (ETH Zürich), Zürich, Switzerland
| | - Joop J A van Loon
- Laboratory of Entomology, Wageningen University & Research, Wageningen, Netherlands
| | - Marcel Dicke
- Laboratory of Entomology, Wageningen University & Research, Wageningen, Netherlands
| | - Alida Melse-Boonstra
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
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11
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Scheuchzer P, Zimmerman MB, Zeder C, Sánchez-Ferrer A, Moretti D. Higher Extrusion Temperature Induces Greater Formation of Less Digestible Type V and Retrograded Starch in Iron-Fortified Rice Grains But Does Not Affect Iron Bioavailability: Stable Isotope Studies in Young Women. J Nutr 2022; 152:1220-1227. [PMID: 34967894 DOI: 10.1093/jn/nxab435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/22/2021] [Accepted: 12/21/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Hot extrusion is widely used to produce iron-fortified rice, but heating may increase resistant starch and thereby decrease iron bioavailability. Cold-extruded iron-fortified rice may have higher bioavailability but has higher iron losses during cooking. Thus, warm extrusion could have nutritional benefits, but this has not been tested. Whether the addition of citric acid (CA) and trisodium citrate (TSC) counteracts any detrimental effect of high-extrusion temperature on iron bioavailability is unclear. OBJECTIVES Our aim was to assess the effects of varying processing temperatures on the starch microstructure of extruded iron-fortified rice and resulting iron solubility and iron bioavailability. METHODS We produced extruded iron-fortified rice grains at cold, warm, and hot temperatures (40°C, 70°C, and 90°C), with and without CA/TSC at a molar ratio of iron to CA/TSC of 1:0.3:5.5. We characterized starch microstructure using small- and wide-angle X-ray scattering and differential scanning calorimetry, assessed color over 6 mo, and measured in vitro iron solubility. In standardized rice and vegetable test meals consumed by young women (n = 22; mean age: 23 y; geometric mean plasma ferritin: 29.3 μg/L), we measured iron absorption from the fortified rice grains intrinsically labeled with 57ferric pyrophosphate (57FePP), compared with ferrous sulfate (58FeSO4) solution added extrinsically to the meals. RESULTS Warm and hot extrusion altered starch morphology from native type A to type V and increased retrograded starch. However, extrusion temperature did not significantly affect iron solubility or iron bioavailability. The geometric mean fractional iron absorption of iron from fortified rice extruded with CA/TSC (8.2%; 95% CI: 7.9%, 11.0%) was more than twice that from extruded rice without CA/TSC (3.0%; 95% CI: 2.7%, 3.4%; P < 0.001). CONCLUSIONS Higher extrusion temperatures did not affect iron bioavailability from extruded rice in young women, but co-extrusion of CA/TSC with FePP sharply increased iron absorption independently from extrusion temperature. This trial is registered at www.clinicaltrials.gov as NCT03703726.
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Affiliation(s)
- Pornpimol Scheuchzer
- ETH Zürich, Department for Health Sciences and Technology (D-HEST), Institute of Food, Nutrition and Health (IFNH), Laboratory of Human Nutrition, Zurich, Switzerland
| | - Michael B Zimmerman
- ETH Zürich, Department for Health Sciences and Technology (D-HEST), Institute of Food, Nutrition and Health (IFNH), Laboratory of Human Nutrition, Zurich, Switzerland
| | - Christophe Zeder
- ETH Zürich, Department for Health Sciences and Technology (D-HEST), Institute of Food, Nutrition and Health (IFNH), Laboratory of Human Nutrition, Zurich, Switzerland
| | - Antoni Sánchez-Ferrer
- ETH Zürich, Department for Health Sciences and Technology (D-HEST), Institute of Food, Nutrition and Health (IFNH), Laboratory of Food & Soft Materials, Zurich, Switzerland.,Technical University of Munich, School of Life Sciences, Wood Research Munich (HFM), Munich, Germany
| | - Diego Moretti
- ETH Zürich, Department for Health Sciences and Technology (D-HEST), Institute of Food, Nutrition and Health (IFNH), Laboratory of Human Nutrition, Zurich, Switzerland.,Swiss Distance University of Applied Sciences (FFHS), Nutrition Group, Department of Health, Zurich, Switzerland
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12
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Iron and Zinc at a cross-road: a trade-off between micronutrients and anti-nutritional factors in pearl millet flour for enhancing the bioavailability. J Food Compost Anal 2022. [DOI: 10.1016/j.jfca.2022.104591] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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13
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Reddy BHR, Thankachan P, Hatakayama M, Hiremath N, Moretti D, Nanjareddy YA, Thumilan MB, Ravikumar RL, Phadnis S, Bose B, Poveda L, Kalaiah G, Zimmermann MB, Shimizu KK, Schlapbach R, Kurpad AV, Sreeman SM. A Natural Low Phytic Acid Finger Millet Accession Significantly Improves Iron Bioavailability in Indian Women. Front Nutr 2022; 8:791392. [PMID: 35402470 PMCID: PMC8988890 DOI: 10.3389/fnut.2021.791392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 11/12/2021] [Indexed: 12/05/2022] Open
Abstract
Iron deficiency and anemia are common in low- and middle-income countries. This is due to a poor dietary iron density and low iron absorption resulting from the high inhibitory phytic acid content in cereal and millet-based diets. Here, we report that a naturally occurring low phytic acid finger millet accession (571 mg 100 g−1), stable across three growing seasons with normal iron content (3.6 mg 100 g−1), increases iron absorption by 3-folds in normal Indian women. The accessions differing in grain phytic acid content, GE 2358 (low), and GE1004 (high) were selected from a core collection of 623 accessions. Whole genome re-sequencing of the accessions revealed significant single nucleotide variations segregating them into distinct clades. A non-synonymous mutation in the EcABCC phytic acid transporter gene between high and low accessions could affect gene function and result in phytic acid differences. The highly sensitive dual stable-isotope erythrocyte incorporation method was adopted to assess the fractional iron absorption. The low phytic acid accession resulted in a significantly higher iron absorption compared with the high phytic acid accession (3.7 vs. 1.3%, p < 0.05). The low phytic acid accession could be effective in preventing iron deficiency in regions where finger millet is habitually eaten. With its low water requirement, finger millet leaves low environmental footprints and hence would be an excellent sustainable strategy to mitigate iron deficiency.
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Affiliation(s)
- Bellam H. Rajashekar Reddy
- Division of Nutrition, St. John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, India
| | - Prashanth Thankachan
- Division of Nutrition, St. John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, India
| | - Masoami Hatakayama
- Department of Evolutionary Biology and Environmental Studies, University of Zurich, Zurich, Switzerland
- Functional Genomics Center Zurich, Zurich, Switzerland
| | - Netravati Hiremath
- All India Coordinated Research Project (Foods and Nutrition), University of Agricultural Sciences, Bengaluru, India
| | - Diego Moretti
- Laboratory for Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Yellodu A. Nanjareddy
- Department of Crop Physiology, University of Agricultural Sciences, Bengaluru, India
| | - Mathi B. Thumilan
- Department of Crop Physiology, University of Agricultural Sciences, Bengaluru, India
| | | | - Shamprasad Phadnis
- Department of Biotechnology, University of Agricultural Sciences, Bengaluru, India
| | - Beena Bose
- Division of Nutrition, St. John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, India
| | - Lucy Poveda
- Functional Genomics Center Zurich, Zurich, Switzerland
| | - Geetha Kalaiah
- All India Coordinated Research Project (Foods and Nutrition), University of Agricultural Sciences, Bengaluru, India
| | - Michael B. Zimmermann
- Laboratory for Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Kentaro K. Shimizu
- Department of Evolutionary Biology and Environmental Studies, University of Zurich, Zurich, Switzerland
| | | | - Anura V. Kurpad
- Division of Nutrition, St. John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, India
- Department of Physiology, St. John's Medical College, St. John's National Academy of Health Sciences, Bengaluru, India
| | - Sheshshayee M. Sreeman
- Department of Crop Physiology, University of Agricultural Sciences, Bengaluru, India
- *Correspondence: Sheshshayee M. Sreeman
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14
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Baumgartner J, Winkler HC, Zandberg L, Tuntipopipat S, Mankong P, Bester C, Hilty F, Zeevaart JR, Gowachirapant S, Zimmermann MB. Iron from nanostructured ferric phosphate: absorption and biodistribution in mice and bioavailability in iron deficient anemic women. Sci Rep 2022; 12:2792. [PMID: 35181698 PMCID: PMC8857185 DOI: 10.1038/s41598-022-06701-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 01/20/2022] [Indexed: 11/09/2022] Open
Abstract
Food fortification with iron nanoparticles (NPs) could help prevent iron deficiency anemia, but the absorption pathway and biodistribution of iron-NPs and their bioavailability in humans is unclear. Dietary non-heme iron is physiologically absorbed via the divalent metal transporter-1 (DMT1) pathway. Using radio- iron isotope labelling in mice with a partial knockdown of intestine-specific DMT1, we assessed oral absorption and tissue biodistribution of nanostructured ferric phosphate (FePO4-NP; specific surface area [SSA] 98 m2g-1) compared to to ferrous sulfate (FeSO4), the reference compound. We show that absorption of iron from FePO4-NP appears to be largely DMT1 dependent and that its biodistribution after absorption is similar to that from FeSO4, without abnormal deposition of iron in the reticuloendothelial system. Furthermore, we demonstrate high bioavailability from iron NPs in iron deficient anemic women in a randomized, cross-over study using stable-isotope labelling: absorption and subsequent erythrocyte iron utilization from two 57Fe-labeled FePO4-NP with SSAs of 98 m2g−1 and 188 m2g−1 was 2.8-fold and 5.4-fold higher than from bulk FePO4 with an SSA of 25 m2g−1 (P < 0.001) when added to a rice and vegetable meal consumed by iron deficient anemic women. The FePO4-NP 188 m2g-1 achieved 72% relative bioavailability compared to FeSO4. These data suggest FePO4-NPs may be useful for nutritional applications.
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Affiliation(s)
- Jeannine Baumgartner
- Laboratory of Human Nutrition, Department of Health Sciences and Technology, ETH Zurich, Schmelzbergstrasse 7, 8092, Zurich, Switzerland.,Center of Excellence in Nutrition, North-West University, Potchefstroom, South Africa
| | - Hans Christian Winkler
- Laboratory of Human Nutrition, Department of Health Sciences and Technology, ETH Zurich, Schmelzbergstrasse 7, 8092, Zurich, Switzerland
| | - Lizelle Zandberg
- Center of Excellence in Nutrition, North-West University, Potchefstroom, South Africa
| | | | - Phatchari Mankong
- Institute of Nutrition, Mahidol University, Salaya, Nakhon Pathom, 73170, Thailand
| | - Cor Bester
- DST/NWU Preclinical Drug Development Platform, North-West University, Potchefstroom, South Africa
| | - Florentine Hilty
- Laboratory of Human Nutrition, Department of Health Sciences and Technology, ETH Zurich, Schmelzbergstrasse 7, 8092, Zurich, Switzerland
| | - Jan Rijn Zeevaart
- DST/NWU Preclinical Drug Development Platform, North-West University, Potchefstroom, South Africa.,South African Nuclear Energy Corporation South Africa (Necsa), Pelindaba, South Africa
| | | | - Michael B Zimmermann
- Laboratory of Human Nutrition, Department of Health Sciences and Technology, ETH Zurich, Schmelzbergstrasse 7, 8092, Zurich, Switzerland.
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15
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Uyoga MA, Mzembe G, Stoffel NU, Moretti D, Zeder C, Phiri K, Sabatier M, Hays NP, Zimmermann MB, Mwangi MN. Iron Bioavailability from Infant Cereals Containing Whole Grains and Pulses: A Stable Isotope Study in Malawian Children. J Nutr 2021; 152:826-834. [PMID: 34958374 PMCID: PMC8891185 DOI: 10.1093/jn/nxab406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/29/2021] [Accepted: 11/30/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Compared with infant cereals based on refined grains, an infant cereal containing whole grains (WGs) and pulses with adequate amounts of ascorbic acid to protect against absorption inhibitors could be a healthier source of well-absorbed iron. However, iron absorption from such cereals is uncertain. OBJECTIVE We measured iron bioavailability from ferrous fumarate (Fefum) added to commercial infant cereals containing 1) refined wheat flour (reference meal), 2) WG wheat and lentil flour (WG-wheat-lentil), 3) WG wheat and chickpea flour (WG-wheat-chickpeas), and 4) WG oat flour (WG-oat) and from ferrous bisglycinate (FeBG) added to the same oat-based cereal (WG-oat-FeBG). METHODS In a prospective, single-blinded randomized crossover study, 6- to 14-mo-old Malawian children (n = 30) consumed 25-g servings of all 5 test meals containing 2.25 mg stable isotope-labeled iron and 13.5 mg ascorbic acid. Fractional iron absorption (FIA) was assessed by erythrocyte incorporation of isotopes after 14 d. Comparisons were made using linear mixed models. RESULTS Seventy percent of the children were anemic and 67% were iron deficient. Geometric mean FIA percentages (-SD, +SD) from the cereals were as follows: 1) refined wheat, 12.1 (4.8, 30.6); 2) WG-wheat-lentil, 15.8 (6.6, 37.6); 3) WG-wheat-chickpeas, 12.8 (5.5, 29.8); and 4) WG-oat, 9.2 (3.9, 21.5) and 7.4 (2.9, 18.9) from WG-oat-FeBG. Meal predicted FIA (P ≤ 0.001), whereas in pairwise comparisons, only WG-oat-FeBG was significantly different compared with the refined wheat meal (P = 0.02). In addition, FIAs from WG-wheat-lentil and WG-wheat-chickpeas were significantly higher than from WG-oat (P = 0.002 and P = 0.04, respectively) and WG-oat-FeBG (P < 0.001 and P = 0.004, respectively). CONCLUSION In Malawian children, when given with ascorbic acid at a molar ratio of 2:1, iron bioavailability from Fefum-fortified infant cereals containing WG wheat and pulses is ≈13-15%, whereas that from FeBG- and Fefum-fortified infant cereals based on WG oats is ≈7-9%.
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Affiliation(s)
| | - Glory Mzembe
- Training and Research Unit of Excellence (TRUE), Blantyre, Malawi,School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Nicole U Stoffel
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Diego Moretti
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland,Swiss Distance University of Applied Sciences, Zurich, Switzerland
| | - Christophe Zeder
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Kamija Phiri
- Training and Research Unit of Excellence (TRUE), Blantyre, Malawi,School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Magalie Sabatier
- Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé S.A., Vers-Chez-Les-Blanc, Lausanne, Switzerland
| | - Nicholas P Hays
- Nestlé Product Technology Center—Nutrition, Société des Produits Nestlé S.A., Vevey, Switzerland
| | - Michael B Zimmermann
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Martin N Mwangi
- Training and Research Unit of Excellence (TRUE), Blantyre, Malawi,School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
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16
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Anitha S, Kane-Potaka J, Botha R, Givens DI, Sulaiman NLB, Upadhyay S, Vetriventhan M, Tsusaka TW, Parasannanavar DJ, Longvah T, Rajendran A, Subramaniam K, Bhandari RK. Millets Can Have a Major Impact on Improving Iron Status, Hemoglobin Level, and in Reducing Iron Deficiency Anemia-A Systematic Review and Meta-Analysis. Front Nutr 2021; 8:725529. [PMID: 34722606 PMCID: PMC8551390 DOI: 10.3389/fnut.2021.725529] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 09/03/2021] [Indexed: 11/13/2022] Open
Abstract
The prevalence of iron deficiency anemia is highest among low and middle-income countries. Millets, including sorghum, are a traditional staple in many of these countries and are known to be rich in iron. However, a wide variation in the iron composition of millets has been reported, which needs to be understood in consonance with its bioavailability and roles in reducing anemia. This systematic review and meta-analysis were carried out to analyze the scientific evidence on the bioavailability of iron in different types of millets, processing, and the impact of millet-based food on iron status and anemia. The results indicated that iron levels in the millets used to study iron bioavailability (both in vivo and in vitro) and efficacy varied with the type and variety from 2 mg/100 g to 8 mg/100 g. However, not all the efficacy studies indicated the iron levels in the millets. There were 30 research studies, including 22 human interventions and 8 in vitro studies, included in the meta-analysis which all discussed various outcomes such as hemoglobin level, serum ferritin level, and absorbed iron. The studies included finger millet, pearl millet, teff and sorghum, or a mixture of millets. The results of 19 studies conducted on anaemic individuals showed that there was a significant (p < 0.01) increase in hemoglobin levels by 13.2% following regular consumption (21 days to 4.5 years) of millets either as a meal or drink compared with regular diets where there was only 2.7% increase. Seven studies on adolescents showed increases in hemoglobin levels from 10.8 ± 1.4 (moderate anemia) to 12.2 ± 1.5 g/dl (normal). Two studies conducted on humans demonstrated that consumption of a pearl millet-based meal significantly increased the bioavailable iron (p < 0.01), with the percentage of bioavailability being 7.5 ± 1.6, and provided bioavailable iron of 1 ± 0.4 mg. Four studies conducted on humans showed significant increases in ferritin level (p < 0.05) up to 54.7%. Eight in-vitro studies showed that traditional processing methods such as fermentation and germination can improve bioavailable iron significantly (p < 0.01) by 3.4 and 2.2 times and contributed to 143 and 95% of the physiological requirement of women, respectively. Overall, this study showed that millets can reduce iron deficiency anemia.
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Affiliation(s)
- Seetha Anitha
- Smart Food Initiative, International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), Patancheru, India
| | - Joanna Kane-Potaka
- Smart Food Initiative, International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), Patancheru, India
| | - Rosemary Botha
- Development Strategy and Governance Division, International Food Policy Research Institute (IFPRI), Lilongwe, Malawi
| | - D. Ian Givens
- Institute of Food, Nutrition and Health, University of Reading, Reading, United Kingdom
| | | | | | - Mani Vetriventhan
- Smart Food Initiative, International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), Patancheru, India
| | - Takuji W. Tsusaka
- Ostrom Center for Advanced Studies on Natural Resources Governance, Asian Institute of Technology, Pathumthani, Thailand
| | | | | | | | - Kowsalya Subramaniam
- Food Science and Nutrition, Avinashilingam Institute for Home Science and Higher Education for Women, Coimbatore, India
| | - Raj Kumar Bhandari
- National Technical Board of Nutrition, Government of India (GoI), New Delhi, India
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Shumoy H, Raes K. Dissecting the facts about the impact of contaminant iron in human nutrition: A review. Trends Food Sci Technol 2021. [DOI: 10.1016/j.tifs.2021.08.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Gannon BM, Glahn RP, Mehta S. Iron Bioavailability from Multiple Biofortified Foods Using an In Vitro Digestion, Caco-2 Assay for Optimizing a Cyclical Menu for a Randomized Efficacy Trial. Curr Dev Nutr 2021; 5:nzab111. [PMID: 34604692 PMCID: PMC8483813 DOI: 10.1093/cdn/nzab111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 06/28/2021] [Accepted: 08/27/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Inadequate nutritional status contributes to substantial losses in human health and productivity globally. A multiple biofortified food crop trial targeting iron, zinc, and vitamin A deficiencies among young children and their breastfeeding mothers is being conducted in India. OBJECTIVE We sought to determine the relative iron bioavailability from biofortified and conventional crops and crop combinations representative of a cyclical menu using crops targeted for inclusion in the feeding trial. METHODS Crops were procured from India, cooked, freeze-dried, and analyzed with an established in vitro digestion/Caco-2 iron bioavailability assay using a fixed sample weight. Crop proportions representative of meals planned for the human study were determined and combined such that samples included either all biofortified or all control crops. Crops were analyzed as single crops (n = 4) or crop combinations (n = 7) by variety (biofortified or control) in triplicate. The primary outcome was iron uptake measured by Caco-2 ferritin production normalized to total Caco-2 protein (nanograms of ferritin/milligrams of cell protein) analyzed for effects of crop variety and crop proportion using generalized linear models. RESULTS Biofortified pearl millet alone demonstrated higher iron uptake than conventional varieties (5.01 ± 1.66 vs. 2.17 ± 0.96; P = 0.036). Addition of sweet potato or sweet potato + pulse improved iron uptake for all proportions tested in control varieties and select proportions for biofortified varieties (P ≤ 0.05). Two multiple crop combinations demonstrated modestly higher iron uptake from biofortified crops. CONCLUSIONS Optimizing total iron delivery should consider matrix effects, processing, and promoters/inhibitors of iron absorption in addition to total iron concentration. Future directions include evaluating recipes as prepared for consumption and comparison against human iron bioavailability studies.
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Affiliation(s)
- Bryan M Gannon
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
- Institute for Nutritional Sciences, Global Health, and Technology (INSiGHT), Cornell University, Ithaca, NY, USA
| | - Raymond P Glahn
- USDA, Agricultural Research Service, Robert Holley Center for Agriculture and Health, Ithaca, NY, USA
| | - Saurabh Mehta
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
- Institute for Nutritional Sciences, Global Health, and Technology (INSiGHT), Cornell University, Ithaca, NY, USA
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Iron-biofortified pearl millet consumption increases physical activity in Indian adolescent schoolchildren after a 6-month randomised feeding trial. Br J Nutr 2021; 127:1018-1025. [PMID: 34078482 PMCID: PMC8924488 DOI: 10.1017/s000711452100180x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Fe deficiency has negative effects on voluntary physical activity (PA); however, the impact of consuming Fe-biofortified staple foods on voluntary PA remains unclear. This study compared the effects of consuming Fe-biofortified pearl millet or a conventional pearl millet on measures of voluntary PA in Indian schoolchildren (ages 12-16 years) during a 6-month randomised controlled feeding trial. PA data were collected from 130 children using Actigraph GT3X accelerometers for 6 d at baseline and endline. Minutes spent in light and in moderate-to-vigorous PA were calculated from accelerometer counts using Crouter's refined two-regression model for children. Mixed regression models adjusting for covariates were used to assess relationships between intervention treatment or change in Fe status and PA. Children who consumed Fe-biofortified pearl millet performed 22·3 (95 % CI 1·8, 42·8, P = 0·034) more minutes of light PA each day compared with conventional pearl millet. There was no effect of treatment on moderate-to-vigorous PA. The amount of Fe consumed from pearl millet was related to minutes spent in light PA (estimate 3·4 min/mg Fe (95 % CI 0·3, 6·5, P = 0·031)) and inversely related to daily sedentary minutes (estimate -5·4 min/mg Fe (95 % CI -9·9, -0·9, P = 0·020)). Consuming Fe-biofortified pearl millet increased light PA and decreased sedentary time in Indian schoolchildren in a dose-dependent manner.
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20
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Speich C, Mitchikpè CES, Cercamondi CI, Zeder C, Brittenham GM, Moretti D, Zimmermann MB. Direct assessment of body iron balance in women with and without iron supplementation using a long-term isotope dilution method in Benin and Switzerland. Am J Clin Nutr 2021; 113:1657-1669. [PMID: 33693464 DOI: 10.1093/ajcn/nqaa433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 12/16/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Long-term isotopic dilution measurements of body iron may allow quantification of basal body iron balance and iron gains during an iron intervention with higher precision and accuracy than conventional iron indices. OBJECTIVES We compared body iron balance before, during, and after oral iron supplementation in women in Benin and in Switzerland. METHODS In prospective studies, Beninese (n = 11) and Swiss (n = 10) women previously labeled with stable iron isotopes were followed preintervention for 90-120 d, then received 50-mg iron daily for 90-120 d and were followed postintervention for 90-120 d. We used changes in blood isotopic composition to calculate iron absorption (Feabs), iron loss (Feloss), and net iron balance (Fegain). RESULTS Compliance with supplementation was >90%. In Benin, during the preintervention, intervention, and postintervention periods, Fe means ± SDs were as follows: 1) Feabs: 0.92 ± 1.05, 3.75 ± 2.07, and 0.90 ± 0.93 mg/d; 2) Feloss: 1.46 ± 1.95, 1.58 ± 1.57, and 1.84 ± 1.61 mg/d; and 3) Fegain: -0.55 ± 1.56 mg/d, 2.17 ± 1.81 mg/d, and -0.94 ± 1.13 mg/d. In Switzerland, the corresponding values were: 1) 1.51 ± 0.37, 4.09 ± 1.52, and 0.97 ± 0.41 mg/d; 2) 0.76 ± 1.37, 2.54 ± 1.43, and 2.08 ± 1.05 mg/d; and 3) 0.75 ± 1.37, 1.55 ± 1.75, and -1.11 ± 1.06 mg/d. Inflammation was low in both settings, and isotopically calculated iron balance was comparable to that calculated from changes in conventional iron indices. CONCLUSION Without iron supplementation, Beninese women had lower long-term dietary iron absorption and higher iron losses in the preintervention period than Swiss women. During iron supplementation, both groups had high iron absorption and similar iron gains. However, there was a 3-fold increase in iron losses in the Swiss women during the supplementation and postintervention period compared with the preintervention period. Body iron isotope dilution is a promising new method for quantifying long-term body iron balance and for assessing the impact of iron interventions. The studies were registered at clinicaltrials.gov as NCT02979080 and NCT02979132, respectively.
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Affiliation(s)
- Cornelia Speich
- Laboratory of Human Nutrition, Institute of Food, Nutrition, and Health, ETH Zürich, Zurich, Switzerland
| | - Comlan Evariste S Mitchikpè
- Laboratory of Human Nutrition, Faculty of Agricultural Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - Colin I Cercamondi
- Laboratory of Human Nutrition, Institute of Food, Nutrition, and Health, ETH Zürich, Zurich, Switzerland
| | - Christophe Zeder
- Laboratory of Human Nutrition, Institute of Food, Nutrition, and Health, ETH Zürich, Zurich, Switzerland
| | - Gary M Brittenham
- Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, USA
| | - Diego Moretti
- Laboratory of Human Nutrition, Institute of Food, Nutrition, and Health, ETH Zürich, Zurich, Switzerland.,Nutrition and Dietetics Group, Health Department, Swiss Distance University of Applied Sciences, Regensdorf, Switzerland
| | - Michael B Zimmermann
- Laboratory of Human Nutrition, Institute of Food, Nutrition, and Health, ETH Zürich, Zurich, Switzerland
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21
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Mikulic N, Uyoga MA, Paganini D, Mwasi E, Stoffel NU, Zeder C, Karanja S, Zimmermann MB. Consumption of a Single Dose of Prebiotic Galacto-Oligosaccharides Does Not Enhance Iron Absorption from Micronutrient Powders in Kenyan Infants: A Stable Iron Isotope Study. J Nutr 2021; 151:1205-1212. [PMID: 33693741 DOI: 10.1093/jn/nxab007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/04/2020] [Accepted: 01/07/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Long-term feeding of prebiotic galacto-oligosaccharides (GOS) increases iron absorption in African infants, but the underlying mechanism and how long GOS need to be fed to infants to achieve an increase in absorption is uncertain. OBJECTIVES In Kenyan infants, we tested whether the addition of GOS to a single test meal would affect iron absorption from a micronutrient powder (MNP) containing ferrous sulfate (FeSO4) and another MNP containing ferrous fumarate (FeFum) and sodium iron ethylenediaminetetraacetate (NaFeEDTA). METHODS In a randomized-entry, prospective crossover study, iron deficient (87%) and anemic (70%) Kenyan infants (n = 23; mean ± SD age, 9.9 ± 2.1 months) consumed 4 stable iron isotope-labeled maize porridge meals fortified with MNPs containing 5 mg iron as FeFum + NaFeEDTA, or FeSO4, either without or with 7.5 g GOS. The primary outcome, fractional iron absorption (FIA), was assessed by erythrocyte incorporation of isotopic labels. Data were analyzed using a 2-way repeated-measures ANOVA. RESULTS There was no significant interaction between GOS and the iron compounds on FIA, and the addition of GOS did not have a significant effect on FIA. There was a statistically significant difference in FIA between the meals fortified with FeSO4 and with FeFum + NaFeEDTA (P < 0.001).Given with GOS, FIA from FeSO4 was 40% higher than from FeFum + NaFeEDTA (P < 0.001); given without GOS, it was 51% higher (P < 0.01). CONCLUSIONS The addition of GOS to a single iron-fortified maize porridge test meal in Kenyan infants did not significantly increase iron absorption, suggesting long-term feeding of GOS may be needed to enhance iron absorption at this age. This study was registered at clinicaltrials.gov as NCT02666417.
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Affiliation(s)
- Nadja Mikulic
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, Swiss Federal Institute of Technology (ETH), Zurich, Switzerland
| | - Mary A Uyoga
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, Swiss Federal Institute of Technology (ETH), Zurich, Switzerland
| | - Daniela Paganini
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, Swiss Federal Institute of Technology (ETH), Zurich, Switzerland
| | - Edith Mwasi
- Pediatrics Department, Msambweni County Referral Hospital, Msambweni, Kenya
| | - Nicole U Stoffel
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, Swiss Federal Institute of Technology (ETH), Zurich, Switzerland
| | - Christophe Zeder
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, Swiss Federal Institute of Technology (ETH), Zurich, Switzerland
| | - Simon Karanja
- Public and Community Health Department, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Michael B Zimmermann
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, Swiss Federal Institute of Technology (ETH), Zurich, Switzerland
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Sedlander E, Long MW, Bingenheimer JB, Rimal RN. Examining intentions to take iron supplements to inform a behavioral intervention: The Reduction in Anemia through Normative Innovations (RANI) project. PLoS One 2021; 16:e0249646. [PMID: 33974640 PMCID: PMC8112683 DOI: 10.1371/journal.pone.0249646] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 03/23/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND More than half of women of reproductive age in India have anemia. Over the last decade, India has made some progress towards reducing anemia in pregnant women, but non-pregnant women, who make up the largest sub group of people with anemia, are largely disregarded. OBJECTIVES The objective of this paper is to examine intentions to take iron supplements and factors associated with intentions to inform a social norms-based behavioral intervention to increase uptake of iron supplements and reduce anemia in Odisha, India. METHODS We collected data from 3,914 randomly sampled non-pregnant women of reproductive age in 81 villages. We conducted a survey and took hemocue (anemia level) readings from each participant. We analyzed data using linear regression models beginning with demographics and social norms and adding other factors such as self-efficacy to take iron supplements, anemia risk perception, and knowledge about anemia in a subsequent model. RESULTS 63% of women in our sample were anemic but less than 5% knew they were anemic. Despite national guidelines that all women of reproductive age should take weekly iron supplements to prevent anemia, less than 3% of women in our sample were currently taking them. While actual use was low, intentions were rather high. On a five point Likert scale where higher numbers meant more intentions to take supplements, average intentions were above the midpoint (M = 3.48, SD = 1.27) and intentions and iron supplement use were significantly correlated (r = .10, p < .001). Both injunctive norms and collective norms were associated with intentions to take iron supplements but descriptive norms were not. Other significant factors included age, breastfeeding, knowledge, self-efficacy, and outcome expectations. The final model accounted for 74% of the variance in iron supplement intentions. CONCLUSIONS In this context, where the actual behavior is low but intentions to enact the behavior are high, starting an intervention with injunctive norms messaging (expectations around the behavior) and self-efficacy to enact the behavior is the step we recommend based on our results. As an intervention unfolds and iron supplement use increases, descriptive norms messaging (that people are indeed taking iron supplements) may add value.
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Affiliation(s)
- Erica Sedlander
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States of America
| | - Michael W. Long
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States of America
| | - Jeffrey B. Bingenheimer
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States of America
| | - Rajiv N. Rimal
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States of America
- Department of Health Behavior and Society, Johns Hopkins University, Baltimore, Maryland, United States of America
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Iron homeostasis during anemia of inflammation: a prospective study in patients with tuberculosis. Blood 2021; 138:1293-1303. [PMID: 33876222 DOI: 10.1182/blood.2020010562] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 04/02/2021] [Indexed: 11/20/2022] Open
Abstract
Anemia of inflammation is a hallmark of tuberculosis. Factors controlling iron metabolism during anemia of inflammation and its resolution are uncertain. Whether iron supplements should be given during anti-tuberculosis treatment to support Hb recovery is unclear. Before and during treatment of tuberculosis, we assessed iron kinetics, and changes in inflammation and iron metabolism indices. In a 26-wk prospective study, Tanzanian adults with tuberculosis (n=18) were studied before treatment and then every two weeks during treatment; oral and intravenous iron tracers were administered before treatment, after intensive phase (8/12 wk) and complete treatment (24 wk); no iron supplements were given. Before treatment, hepcidin and erythroferrone (ERFE) were greatly elevated, erythrocyte iron utilization was high (~80%) and iron absorption was negligible (<1%). During treatment, hepcidin and IL-6 decreased ~70% after only 2 wk (p<0.001); in contrast, ERFE did not significantly decrease until 8 wk (p<0.01). ERFE and IL-6 were the main opposing determinants of hepcidin (p<0.05) and greater ERFE was associated with reticulocytosis and hemoglobin (Hb) repletion (p<0.01). Dilution of baseline tracer concentration was 2.6-fold higher during intensive phase treatment (p<0.01) indicating enhanced erythropoiesis. After treatment completion, iron absorption increased ~20-fold (p<0.001); Hb increased ~25% (p<0.001). In tuberculosis-associated anemia of inflammation, our findings suggest elevated ERFE is unable to suppress hepcidin and iron absorption is negligible. During treatment, as inflammation resolves, ERFE may remain elevated, contributing to hepcidin suppression and Hb repletion. Iron is well-absorbed only after tuberculosis treatment and supplementation should be reserved for patients remaining anemic after treatment. (ClinicalTrials.gov Identifier:NCT02176772).
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Mikulic N, Uyoga MA, Mwasi E, Stoffel NU, Zeder C, Karanja S, Zimmermann MB. Iron Absorption is Greater from Apo-Lactoferrin and is Similar Between Holo-Lactoferrin and Ferrous Sulfate: Stable Iron Isotope Studies in Kenyan Infants. J Nutr 2020; 150:3200-3207. [PMID: 32886113 DOI: 10.1093/jn/nxaa226] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/14/2020] [Accepted: 07/09/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Whether lactoferrin (Lf) binds iron to facilitate its absorption or to sequester iron from potential enteropathogens remains uncertain. Bovine Lf is added to many infant formulas, but previous studies in infants reported that Lf had no effect on or inhibited iron absorption. The effects of the apo (iron-free) or the holo (iron-loaded) forms of Lf on iron absorption are unclear. OBJECTIVES Our objective was to compare iron absorption from a maize-based porridge containing: 1) labeled ferrous sulfate (FeSO4) alone; 2) labeled FeSO4 given with bovine apo-Lf; and 3) intrinsically labeled bovine holo-Lf. METHODS In a crossover study, we measured iron absorption in Kenyan infants (n = 25; mean ± SD age 4.2 ± 0.9 months; mean ± SD hemoglobin 109 ± 11 g/L) from maize-based test meals containing: 1) 1.5 mg of iron as 54Fe-labeled FeSO4; 2) 1.42 mg of iron as 58Fe-labeled FeSO4, given with 1.41 g apo-Lf (containing 0.08 mg iron); and 3) 1.41 g holo-Lf carrying 1.5 mg iron as 57Fe. The iron saturation levels of apo- and holo-Lf were 0.56% and 47.26%, respectively primary outcome was fractional iron absorption (FIA), assessed by erythrocyte incorporation of isotopic labels. RESULTS The FIA from the meal containing apo-Lf + FeSO4 (geometric mean, 9.8%; -SD and +SD, 5.4% and 17.5%) was higher than from the meals containing FeSO4 (geometric mean, 6.3%; -SD and +SD, 3.2% and 12.6%; P = 0.002) or holo-Lf (geometric mean, 5.0%; -SD and +SD, 2.8% and 8.9%; P <0.0001). There was no significant difference in FIA when comparing the meals containing holo-Lf versus FeSO4 alone (P = 0.24). CONCLUSIONS The amount of iron absorbed from holo-Lf was comparable to that of FeSO4, and the addition of apo-Lf to a test meal containing FeSO4 significantly increased (+56%) iron absorption. These findings suggest that Lf facilitates iron absorption in young infants. Because Lf binds iron with high affinity, it could be a safe way to provide iron to infants in low-income countries, where iron fortificants can adversely affect the gut microbiome and cause diarrhea. This study was registered at clinicaltrials.gov as NCT03617575.
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Affiliation(s)
- Nadja Mikulic
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, Swiss Federal Institute of Technology (ETH), Zurich, Switzerland
| | - Mary A Uyoga
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, Swiss Federal Institute of Technology (ETH), Zurich, Switzerland
| | - Edith Mwasi
- Pediatrics Department, Msambweni County Referral Hospital, Msambweni, Kenya
| | - Nicole U Stoffel
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, Swiss Federal Institute of Technology (ETH), Zurich, Switzerland
| | - Christophe Zeder
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, Swiss Federal Institute of Technology (ETH), Zurich, Switzerland
| | - Simon Karanja
- Public and Community Health Department, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Michael B Zimmermann
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, Swiss Federal Institute of Technology (ETH), Zurich, Switzerland
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25
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Hurrell RF. Iron Biofortified Potatoes; Every Little Bit Helps. J Nutr 2020; 150:3051-3052. [PMID: 33188426 DOI: 10.1093/jn/nxaa311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/11/2020] [Accepted: 09/16/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Richard F Hurrell
- Institute of Food, Nutrition, and Health, ETH Zurich, Zurich, Switzerland
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Jongstra R, Mwangi MN, Burgos G, Zeder C, Low JW, Mzembe G, Liria R, Penny M, Andrade MI, Fairweather-Tait S, Zum Felde T, Campos H, Phiri KS, Zimmermann MB, Wegmüller R. Iron Absorption from Iron-Biofortified Sweetpotato Is Higher Than Regular Sweetpotato in Malawian Women while Iron Absorption from Regular and Iron-Biofortified Potatoes Is High in Peruvian Women. J Nutr 2020; 150:3094-3102. [PMID: 33188398 PMCID: PMC7726126 DOI: 10.1093/jn/nxaa267] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/07/2020] [Accepted: 08/10/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Sweetpotato and potato are fast-maturing staple crops and widely consumed in low- and middle-income countries. Conventional breeding to biofortify these crops with iron could improve iron intakes. To our knowledge, iron absorption from sweetpotato and potato has not been assessed. OBJECTIVE The aim was to assess iron absorption from regular and iron-biofortified orange-fleshed sweetpotato in Malawi and yellow-fleshed potato and iron-biofortified purple-fleshed potato in Peru. METHODS We conducted 2 randomized, multiple-meal studies in generally healthy, iron-depleted women of reproductive age. Malawian women (n = 24) received 400 g regular or biofortified sweetpotato test meals and Peruvian women (n = 35) received 500 g regular or biofortified potato test meals. Women consumed the meals at breakfast for 2 wk and were then crossed over to the other variety. We labeled the test meals with 57Fe or 58Fe and measured cumulative erythrocyte incorporation of the labels 14 d after completion of each test-meal sequence to calculate iron absorption. Iron absorption was compared by paired-sample t tests. RESULTS The regular and biofortified orange-fleshed sweetpotato test meals contained 0.55 and 0.97 mg Fe/100 g. Geometric mean (95% CI) fractional iron absorption (FIA) was 5.82% (3.79%, 8.95%) and 6.02% (4.51%, 8.05%), respectively (P = 0.81), resulting in 1.9-fold higher total iron absorption (TIA) from biofortified sweetpotato (P < 0.001). The regular and biofortified potato test meals contained 0.33 and 0.69 mg Fe/100 g. FIA was 28.4% (23.5%, 34.2%) from the regular yellow-fleshed and 13.3% (10.6%, 16.6%) from the biofortified purple-fleshed potato meals, respectively (P < 0.001), resulting in no significant difference in TIA (P = 0.88). CONCLUSIONS FIA from regular yellow-fleshed potato was remarkably high, at 28%. Iron absorbed from both potato test meals covered 33% of the daily absorbed iron requirement for women of reproductive age, while the biofortified orange-fleshed sweetpotato test meal covered 18% of this requirement. High polyphenol concentrations were likely the major inhibitors of iron absorption. These trials were registered at www.clinicaltrials.gov as NCT03840031 (Malawi) and NCT04216030 (Peru).
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Affiliation(s)
| | - Martin N Mwangi
- Training and Research Unit of Excellence (TRUE), College of Medicine, University of Malawi, Blantyre, Malawi
| | - Gabriela Burgos
- Genetics, Genomics, and Crop Improvement Program, International Potato Center, Lima, Peru
| | - Christophe Zeder
- ETH Zürich, Laboratory of Human Nutrition, Institute of Food, Nutrition, and Health, Department of Health Sciences and Technology, Zurich, Switzerland
| | - Jan W Low
- International Potato Center, Nairobi, Kenya
| | - Glory Mzembe
- Training and Research Unit of Excellence (TRUE), College of Medicine, University of Malawi, Blantyre, Malawi
| | - Reyna Liria
- Instituto de Investigación Nutricional, Lima, Peru
| | - Mary Penny
- Instituto de Investigación Nutricional, Lima, Peru
| | | | | | - Thomas Zum Felde
- Genetics, Genomics, and Crop Improvement Program, International Potato Center, Lima, Peru
| | - Hugo Campos
- Genetics, Genomics, and Crop Improvement Program, International Potato Center, Lima, Peru
| | - Kamija S Phiri
- Training and Research Unit of Excellence (TRUE), College of Medicine, University of Malawi, Blantyre, Malawi
| | - Michael B Zimmermann
- ETH Zürich, Laboratory of Human Nutrition, Institute of Food, Nutrition, and Health, Department of Health Sciences and Technology, Zurich, Switzerland
| | - Rita Wegmüller
- ETH Zürich, Laboratory of Human Nutrition, Institute of Food, Nutrition, and Health, Department of Health Sciences and Technology, Zurich, Switzerland,GroundWork, Fläsch, Switzerland
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Herter-Aeberli I, Fischer MM, Egli IM, Zeder C, Zimmermann MB, Hurrell RF. Addition of Whole Wheat Flour During Injera Fermentation Degrades Phytic Acid and Triples Iron Absorption from Fortified Tef in Young Women. J Nutr 2020; 150:2666-2672. [PMID: 32805002 DOI: 10.1093/jn/nxaa211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/18/2020] [Accepted: 06/30/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Iron deficiency is a major public health concern in Ethiopia, where the traditional diet is based on tef injera. Iron absorption from injera is low due to its high phytic acid (PA) content. OBJECTIVES We investigated ways to increase iron absorption from FeSO4-fortified tef injera in normal-weight healthy women (aged 21-29 y). METHODS Study A (n = 22) investigated the influence on fractional iron absorption (FIA) from FeSO4-fortified injera of 1) replacing 10% tef flour with whole wheat flour (a source of wheat phytase), or 2) adding an isolated phytase from Aspergillus niger. Study B (n = 18) investigated the influence on FIA of replacing FeSO4 in tef injera with different amounts of NaFeEDTA. In both studies, the iron fortificants were labeled with stable isotopes and FIA was calculated from erythrocyte incorporation of stable iron isotopes 14 d after administration. RESULTS In study A, the median (IQR) FIA from the 100% tef injera meal was 1.5% (0.7-2.8%). This increased significantly (P < 0.05) to 5.3% (2.4-7.1%) on addition of 10% whole wheat flour, and to 3.6% (1.6-6.2%) on addition of A. niger phytase. PA content of the 3 meals was 0.62, 0.20, and 0.02 g/meal, respectively. In study B, the median (IQR) FIA from the 100% tef injera meal was 3.3% (1.1-4.4%) and did not change significantly (P > 0.05) on replacing 50% or 75% of FeSO4 with NaFeEDTA. CONCLUSIONS FIA from tef injera by young women was very low. NaFeEDTA was ineffective at increasing iron absorption, presumably due to the relatively low EDTA:Fe molar ratios. Phytate degradation, however, greatly increased during tef fermentation on addition of native or isolated phytases. Replacing 10% tef with whole wheat flour during injera fermentation tripled FIA in young women and should be considered as a potential strategy to improve iron status in Ethiopia.
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Affiliation(s)
- Isabelle Herter-Aeberli
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Maren M Fischer
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Ines M Egli
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Christophe Zeder
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Michael B Zimmermann
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Richard F Hurrell
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
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Jeroense FMD, Zeder C, Zimmermann MB, Herter-Aeberli I. Acute Consumption of Prebiotic Galacto-Oligosaccharides Increases Iron Absorption from Ferrous Fumarate, but not from Ferrous Sulfate and Ferric Pyrophosphate: Stable Iron Isotope Studies in Iron-Depleted Young Women. J Nutr 2020; 150:2391-2397. [PMID: 32692367 DOI: 10.1093/jn/nxaa199] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/13/2020] [Accepted: 06/18/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Although acute consumption of high doses of prebiotic galacto-oligosaccharides (GOS) increases fractional iron absorption (FIA) from ferrous fumarate (FeFum), it is uncertain if low doses of GOS have this effect. Furthermore, whether GOS improve iron absorption from other commonly used iron compounds and whether ascorbic acid (AA) enhances the effect of GOS on iron absorption from FeFum is unclear. OBJECTIVES In iron-depleted women [serum ferritin (SF) <30 μg/L], we assessed: 1) whether the acute enhancing effect of GOS on FeFum is dose dependent; 2) if GOS would affect FIA from ferrous sulfate (FeSO4) or ferric pyrophosphate (FePP); and 3) if AA and GOS given together enhance FIA from FeFum to a greater extent compared with GOS alone. METHODS We recruited 46 women (mean age 22.0 y, mean BMI 21.3 kg/m2, median SF 17.1 μg/L), and measured FIA from 14 mg iron labeled with stable isotopes in the following conditions: 1) FIA from FeFum given with 3.5 g, 7 g GOS, and without GOS; 2) FIA from FeSO4 and FePP given with and without 15 g GOS; and 3) FIA from FeFum given with 7 g GOS with and without 93 mg AA. FIA was measured as erythrocyte incorporation of stable isotopes after 14 d. Comparisons were made using paired samples t-test or Wilcoxon rank sum test where appropriate. RESULTS Giving 7 g of GOS significantly increased FIA from FeFum (+26%; P = 0.039), whereas 3.5 g GOS did not (P = 0.130). GOS did not significantly increase FIA from FeSO4 (P = 0.998) or FePP (P = 0.059). FIA from FeFum given with GOS and AA was significantly higher compared with FeFum given with GOS alone (+30%; P <0.001). CONCLUSIONS In iron-depleted women, GOS does not increase FIA from FeSO4 or FePP, but it increases FIA from FeFum. Thus, a combination of FeFum and GOS may be a well-absorbed formula for iron supplements. The study was registered at clinicaltrials.gov as NCT03762148.
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Affiliation(s)
- Frederike M D Jeroense
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Christophe Zeder
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Michael B Zimmermann
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Isabelle Herter-Aeberli
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
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Dold S, Zimmermann MB, Jeroense F, Zeder C, Habeych E, Galaffu N, Grathwohl D, Tajeri Foman J, Merinat S, Rey B, Sabatier M, Moretti D. Iron bioavailability from bouillon fortified with a novel ferric phytate compound: a stable iron isotope study in healthy women (part II). Sci Rep 2020; 10:5339. [PMID: 32210349 PMCID: PMC7093532 DOI: 10.1038/s41598-020-62307-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 03/04/2020] [Indexed: 11/23/2022] Open
Abstract
Bouillon cubes are widely consumed and when fortified with iron could contribute in preventing iron deficiency. We report the development (part I) and evaluation (current part II) of a novel ferric phytate compound to be used as iron fortificant in condiments such as bouillon. Ferric pyrophosphate (FePP), is the compound of choice due to its high stability in foods, but has a modest absorption in humans. Our objective was to assess iron bioavailability from a novel iron fortificant consisting of ferric iron complexed with phytic acid and hydrolyzed corn protein (Fe-PA-HCP), used in bouillon with and without an inhibitory food matrix. In a randomised single blind, cross-over study, we measured iron absorption in healthy adult women (n = 22). In vitro iron bioaccessibility was assessed using a Caco-2 cell model. Iron absorption from Fe-PA-HCP was 1.5% and 4.1% in bouillon with and without inhibitory matrix, respectively. Relative iron bioavailability to FeSO4 was 2.4 times higher than from FePP in bouillon (17% vs 7%) and 5.2 times higher when consumed with the inhibitory meal (41% vs 8%). Similar results were found in vitro. Fe-PA-HCP has a higher relative bioavailability versus FePP, especially when bouillon is served with an inhibitory food matrix.
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Affiliation(s)
- Susanne Dold
- ETH Zurich, Laboratory of Human Nutrition, Zurich, Switzerland
| | | | | | | | - Edwin Habeych
- Nestlé Research, Société des Produits Nestlé SA, Lausanne, Switzerland
| | - Nicola Galaffu
- Nestlé Research, Société des Produits Nestlé SA, Lausanne, Switzerland
| | - Dominik Grathwohl
- Nestlé Research, Société des Produits Nestlé SA, Lausanne, Switzerland
| | | | - Sylvie Merinat
- Nestlé Research, Société des Produits Nestlé SA, Lausanne, Switzerland
| | - Brigitte Rey
- Nestlé Research, Société des Produits Nestlé SA, Lausanne, Switzerland
| | - Magalie Sabatier
- Nestlé Research, Société des Produits Nestlé SA, Lausanne, Switzerland
| | - Diego Moretti
- ETH Zurich, Laboratory of Human Nutrition, Zurich, Switzerland.
- Swiss Distance University of Applied Sciences, Nutrition Research, Health Department, Regensdorf, Zurich, Switzerland.
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Fairweather-Tait S, Speich C, Mitchikpè CES, Dainty JR. Dietary Iron Bioavailability: A Simple Model That Can Be Used to Derive Country-Specific Values for Adult Men and Women. Food Nutr Bull 2019; 41:121-130. [DOI: 10.1177/0379572119885482] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Reference intakes for iron are derived from physiological requirements, with an assumed value for dietary iron absorption. A new approach to estimate iron bioavailability, calculated from iron intake, status, and requirements was used to set European dietary reference values, but the values obtained cannot be used for low- and middle-income countries where diets are very different. Objective: We aimed to test the feasibility of using the model developed from United Kingdom and Irish data to derive a value for dietary iron bioavailability in an African country, using data collected from women of child-bearing age in Benin. We also compared the effect of using estimates of iron losses made in the 1960s with more recent data for whole body iron losses. Methods: Dietary iron intake and serum ferritin (SF), together with physiological requirements of iron, were entered into the predictive model to estimate percentage iron absorption from the diet at different levels of iron status. Results: The results obtained from the 2 different methods for calculating physiological iron requirements were similar, except at low SF concentrations. At a SF value of 30 µg/L predicted iron absorption from the African maize-based diet was 6%, compared with 18% from a Western diet, and it remained low until the SF fell below 25 µg/L. Conclusions: We used the model to estimate percentage dietary iron absorption in 30 Beninese women. The predicted values agreed with results from earlier single meal isotope studies; therefore, we conclude that the model has potential for estimating dietary iron bioavailability in men and nonpregnant women consuming different diets in other countries.
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Affiliation(s)
| | - Cornelia Speich
- Laboratory of Human Nutrition, Institute of Food Nutrition and Health, ETH Zürich, Zürich, Switzerland
| | | | - Jack R. Dainty
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
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Anselmo AC, Xu X, Buerkli S, Zeng Y, Tang W, McHugh KJ, Behrens AM, Rosenberg E, Duan AR, Sugarman JL, Zhuang J, Collins J, Lu X, Graf T, Tzeng SY, Rose S, Acolatse S, Nguyen TD, Le X, Guerra AS, Freed LE, Weinstock SB, Sears CB, Nikolic B, Wood L, Welkhoff PA, Oxley JD, Moretti D, Zimmermann MB, Langer R, Jaklenec A. A heat-stable microparticle platform for oral micronutrient delivery. Sci Transl Med 2019; 11:11/518/eaaw3680. [DOI: 10.1126/scitranslmed.aaw3680] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 09/16/2019] [Indexed: 12/30/2022]
Abstract
Micronutrient deficiencies affect up to 2 billion people and are the leading cause of cognitive and physical disorders in the developing world. Food fortification is effective in treating micronutrient deficiencies; however, its global implementation has been limited by technical challenges in maintaining micronutrient stability during cooking and storage. We hypothesized that polymer-based encapsulation could address this and facilitate micronutrient absorption. We identified poly(butylmethacrylate-co-(2-dimethylaminoethyl)methacrylate-co-methylmethacrylate) (1:2:1) (BMC) as a material with proven safety, offering stability in boiling water, rapid dissolution in gastric acid, and the ability to encapsulate distinct micronutrients. We encapsulated 11 micronutrients (iron; iodine; zinc; and vitamins A, B2, niacin, biotin, folic acid, B12, C, and D) and co-encapsulated up to 4 micronutrients. Encapsulation improved micronutrient stability against heat, light, moisture, and oxidation. Rodent studies confirmed rapid micronutrient release in the stomach and intestinal absorption. Bioavailability of iron from microparticles, compared to free iron, was lower in an initial human study. An organotypic human intestinal model revealed that increased iron loading and decreased polymer content would improve absorption. Using process development approaches capable of kilogram-scale synthesis, we increased iron loading more than 30-fold. Scaled batches tested in a follow-up human study exhibited up to 89% relative iron bioavailability compared to free iron. Collectively, these studies describe a broad approach for clinical translation of a heat-stable ingestible micronutrient delivery platform with the potential to improve micronutrient deficiency in the developing world. These approaches could potentially be applied toward clinical translation of other materials, such as natural polymers, for encapsulation and oral delivery of micronutrients.
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Affiliation(s)
- Aaron C. Anselmo
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Xian Xu
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Simone Buerkli
- Institute of Food Nutrition and Health, ETH Zürich, Zürich 8092, Switzerland
| | - Yingying Zeng
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Wen Tang
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Kevin J. McHugh
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Adam M. Behrens
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Evan Rosenberg
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Aranda R. Duan
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - James L. Sugarman
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Jia Zhuang
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Joe Collins
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Xueguang Lu
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Tyler Graf
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Stephany Y. Tzeng
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Sviatlana Rose
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Sarah Acolatse
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Thanh D. Nguyen
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Xiao Le
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Ana Sofia Guerra
- Department of Chemistry and Chemical Biology, Harvard University, Cambridge, MA 02138, USA
| | - Lisa E. Freed
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Shelley B. Weinstock
- Institute of Human Nutrition, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA
| | | | - Boris Nikolic
- Biomatics Capital, 1107 1st Avenue, Apartment 1305, Seattle, WA 98101, USA
| | - Lowell Wood
- Institute for Disease Modeling, Bellevue, WA 98005, USA
| | | | - James D. Oxley
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - Diego Moretti
- Institute of Food Nutrition and Health, ETH Zürich, Zürich 8092, Switzerland
| | | | - Robert Langer
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Ana Jaklenec
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
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Anitha S, Govindaraj M, Kane‐Potaka J. Balanced amino acid and higher micronutrients in millets complements legumes for improved human dietary nutrition. Cereal Chem 2019. [DOI: 10.1002/cche.10227] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Seetha Anitha
- International Crops Research Institute for the Semi‐Arid Tropics (ICRISAT) Patancheru India
| | - Mahalingam Govindaraj
- International Crops Research Institute for the Semi‐Arid Tropics (ICRISAT) Patancheru India
| | - Joanna Kane‐Potaka
- International Crops Research Institute for the Semi‐Arid Tropics (ICRISAT) Patancheru India
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Buerkli S, Fatou Ndiaye N, Cercamondi CI, Herter-Aeberli I, Moretti D, Zimmermann MB. Asymptomatic Helicobacter Pylori Infection in Preschool Children and Young Women Does Not Predict Iron Bioavailability from Iron-Fortified Foods. Nutrients 2019; 11:nu11092093. [PMID: 31487815 PMCID: PMC6770439 DOI: 10.3390/nu11092093] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 08/30/2019] [Accepted: 09/01/2019] [Indexed: 02/07/2023] Open
Abstract
Helicobacter pylori infection is common in low-income countries. It has been associated with iron deficiency and reduced efficacy of iron supplementation. Whether H. pylori infection affects iron absorption from fortified and biofortified foods is unclear. Our objective was to assess whether asymptomatic H. pylori infection predicts dietary iron bioavailability in women and children, two main target groups of iron fortification programs. We did a pooled analysis of studies in women of reproductive age and preschool children that were conducted in Benin, Senegal and Haiti using stable iron isotope tracers to measure erythrocyte iron incorporation. We used mixed models to assess whether asymptomatic H. pylori infection predicted fractional iron absorption from ferrous sulfate, ferrous fumarate or NaFeEDTA, controlling for age, hemoglobin, iron status (serum ferritin), inflammation (C-reactive protein), and test meal. The analysis included 213 iron bioavailability measurements from 80 women and 235 measurements from 90 children; 51.3% of women and 54.4% of children were seropositive for H. pylori. In both women and children, hemoglobin (Hb), serum ferritin (SF), and C-reactive protein (CRP) did not differ between the seropositive and seronegative groups. Geometric mean (95% CI) fractional iron absorption (%), adjusted for SF, was 8.97% (7.64, 10.54) and 6.06% (4.80, 7.67) in H. pylori positive and negative women (p = 0.274), and 9.02% (7.68, 10.59) and 7.44% (6.01, 9.20) in H. pylori positive and negative children (p = 0.479). Our data suggest asymptomatic H. pylori infection does not predict fractional iron absorption from iron fortificants given to preschool children or young women in low-income settings.
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Affiliation(s)
- Simone Buerkli
- Laboratory of Human Nutrition, Institute of Food Nutrition and Health, ETH Zurich, 8092 Zurich, Switzerland.
| | - Ndèye Fatou Ndiaye
- Laboratoire de Nutrition, Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta Diop de Dakar, 5005 Dakar-Fann, Senegal
| | - Colin I Cercamondi
- Laboratory of Human Nutrition, Institute of Food Nutrition and Health, ETH Zurich, 8092 Zurich, Switzerland
| | - Isabelle Herter-Aeberli
- Laboratory of Human Nutrition, Institute of Food Nutrition and Health, ETH Zurich, 8092 Zurich, Switzerland
| | - Diego Moretti
- Laboratory of Human Nutrition, Institute of Food Nutrition and Health, ETH Zurich, 8092 Zurich, Switzerland
| | - Michael B Zimmermann
- Laboratory of Human Nutrition, Institute of Food Nutrition and Health, ETH Zurich, 8092 Zurich, Switzerland
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Hama-Ba F, Mouquet-Rivier C, Diawara B, Weltzien E, Icard-Vernière C. Traditional African Dishes Prepared From Local Biofortified Varieties of Pearl Millet: Acceptability and Potential Contribution to Iron and Zinc Intakes of Burkinabe Young Children. Front Nutr 2019; 6:115. [PMID: 31475149 PMCID: PMC6702452 DOI: 10.3389/fnut.2019.00115] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 07/11/2019] [Indexed: 11/17/2022] Open
Abstract
Biofortification is among the food-based strategies, recently implemented and still in development, to fight micronutrient deficiencies. Three cereal-based traditional dishes of Sub-Saharan Africa (tô paste, pancakes, and gruel) prepared from one local (Gampela), or two biofortified (GB 8735 and Tabi) varieties of millet were assessed for their (i) acceptability by local consumers, (ii) iron and zinc absorption predicted by phytate-to-mineral molar ratios and (iii) contribution to the iron and zinc requirements of young children. Tasters preferred the color, texture, and taste of dishes prepared with the local variety, whether or not the grains were decorticated. Hedonic and preference tests showed no significant difference between the two biofortified varieties, but the cooks reported different behaviors during processing. Biofortified millet contained up to two times more iron than the local variety, reaching 6.5 mg iron/100 g dry matter. Iron and zinc contents remained higher in biofortified varieties even after decortication. Iron content in the dishes was highly variable, depending on iron loss and potential contamination during processing. The phytate-to-mineral molar ratios of all dishes indicated low iron absorption, independent of the millet variety, but improved zinc absorption in dishes prepared with biofortified varieties. The contribution of a dish prepared with one of the two biofortified millet varieties to the recommended iron and zinc intakes for 6–11-month-old children was estimated to be about 5 and 7%, respectively, compared to 2 and 4% for the same dish prepared with local millet. For 12–23-month-old children, the contribution to the recommended intakes was estimated to be about 14 and 12% with biofortified millet, respectively, and about 6 and 7% with local millet. The use of biofortified millet varieties could be complementary to food diversification strategies to increase iron and zinc intakes. As in Ouagadougou, cereals are eaten in different forms by young children several times per day, iron and zinc intakes could be improved in the long term by using the biofortified varieties of pearl millet.
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Affiliation(s)
- Fatoumata Hama-Ba
- Département de Technologie Alimentaire, IRSAT, Ouagadougou, Burkina Faso
| | | | - Bréhima Diawara
- Département de Technologie Alimentaire, IRSAT, Ouagadougou, Burkina Faso
| | - Eva Weltzien
- Honorary Fellow, Agronomy Department, University of Wisconsin-Madison, Madison, AL, United States
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MCCORMICK RACHEL, MORETTI DIEGO, MCKAY ALANNAHKA, LAARAKKERS COBYM, VANSWELM RACHEL, TRINDER DEBBIE, COX GREGORYR, ZIMMERMAN MICHAELB, SIM MARC, GOODMAN CARMEL, DAWSON BRIAN, PEELING PETER. The Impact of Morning versus Afternoon Exercise on Iron Absorption in Athletes. Med Sci Sports Exerc 2019; 51:2147-2155. [DOI: 10.1249/mss.0000000000002026] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Jeroense FMD, Michel L, Zeder C, Herter-Aeberli I, Zimmermann MB. Consumption of Galacto-Oligosaccharides Increases Iron Absorption from Ferrous Fumarate: A Stable Iron Isotope Study in Iron-Depleted Young Women. J Nutr 2019; 149:738-746. [PMID: 31004135 DOI: 10.1093/jn/nxy327] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 10/24/2018] [Accepted: 12/31/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Animal studies suggest prebiotics can increase iron absorption, but results from human studies are equivocal. OBJECTIVES In iron-depleted women, before (baseline) and after daily consumption of galacto-oligosaccharides (GOS) for 4 wk, we sought to assess fractional iron absorption (FIA) from an iron supplement given with and without single doses of GOS in test meals or water. METHODS In all women (n = 34; median serum ferritin concentration = 16.4 µg/L), FIA from doses of 14 mg iron labeled with stable isotopes was measured in the following conditions at baseline: 1) FIA from ferrous fumarate (FeFum) in water given with and without 15 g GOS; 2) FIA from FeFum in a test meal given with and without 15 g GOS; 3) FIA from ferrous sulfate (FeSO4) in a test meal given without 15 g GOS. All subjects then consumed ∼15 g GOS daily for 4 wk. Then the following conditions were tested: 4) FIA from FeFum in a test meal with and without 15 g GOS; and 5) FIA from FeSO4 in a test meal with 15 g GOS. FIA was measured as erythrocyte incorporation of stable isotopes. RESULTS At baseline, GOS significantly increased FIA from FeFum when given with water (+61%; P < 0.001) and the meal (+28%; P = 0.002). After 4 wk of GOS consumption, GOS again significantly increased FIA from FeFum in the meal (+29%; P = 0.044). However, compared with baseline, consumption of GOS for 4 wk did not significantly enhance absorption from FeFum in the meal given without GOS. FIA from FeSO4 given with GOS in a meal after 4 wk of GOS consumption was not significantly greater than FIA from FeSO4 in a meal without GOS at baseline. CONCLUSIONS In iron-depleted women, GOS given with FeFum increases FIA, but 4 wk of GOS consumption did not enhance this effect. The study was registered at clinicaltrials.gov as NCT03325270.
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Affiliation(s)
- Frederike M D Jeroense
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Ladina Michel
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Christophe Zeder
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Isabelle Herter-Aeberli
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Michael B Zimmermann
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
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Eilander A, Funke OM, Moretti D, Zimmermann MB, Owojuyigbe TO, Blonk C, Murray P, Duchateau GS. High Bioavailability from Ferric Pyrophosphate-Fortified Bouillon Cubes in Meals is Not Increased by Sodium Pyrophosphate: a Stable Iron Isotope Study in Young Nigerian Women. J Nutr 2019; 149:723-729. [PMID: 31004134 PMCID: PMC6499105 DOI: 10.1093/jn/nxz003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 12/03/2018] [Accepted: 01/08/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND It is challenging to find an iron compound that combines good bioavailability with minimal sensory changes when added to seasonings or condiments. Ferric pyrophosphate (FePP) is currently used to fortify bouillon cubes, but its bioavailability is generally low. Previously, the addition of a stabilizer, sodium pyrophosphate (NaPP), improved iron bioavailability from a bouillon drink. OBJECTIVE We assessed whether there is a dose-response effect of added NaPP on iron bioavailability from local meals prepared with intrinsically labeled FePP-fortified bouillon cubes in young Nigerian women using iron stable isotope techniques. METHODS In a double-blind, randomized, cross-over trial, women (n = 24; aged 18-40 y; mean BMI 20.5 kg/m2) consumed a Nigerian breakfast and lunch for 5 d prepared with bouillon cubes containing 2.5 mg 57Fe (as FePP) and 3 different molar ratios of NaPP: 57Fe (0:1, 3:1, and 6:1). Iron bioavailability was assessed by measuring 57Fe incorporation into erythrocytes 16 d after each 5 d NaPP: 57Fe feeding period. Data were analyzed using a linear regression model of log iron absorption on NaPP ratio, with body weight and baseline body iron stores as covariates and subject as a random intercept. RESULTS Of the women included, 46% were anemic and 26% were iron deficient. Iron bioavailability was 10.8, 9.8, and 11.0% for the 0:1, 3:1, and 6:1 NaPP:57Fe treatments, respectively. There was no dose-response effect of an increasing NaPP:57Fe ratio (β ± SE: 0.003 ± 0.028, P = 0.45). CONCLUSIONS In this study, the addition of NaPP did not increase iron bioavailability from FePP-fortified bouillon cubes. However, iron bioavailability from the Nigerian meals prepared with FePP-fortified bouillon cubes was higher than expected. These results are encouraging for the potential of bouillon cubes as a fortification vehicle. Further studies are needed to assess the effect of FePP-fortified bouillon cubes on improving iron status in low-income populations. This trial was registered at clinicaltrials.gov as NCT02815449.
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Affiliation(s)
- Ans Eilander
- Unilever R&D Vlaardingen, South Holland, The Netherlands
| | | | - Diego Moretti
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Michael B Zimmermann
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | | | - Cor Blonk
- Unilever R&D Vlaardingen, South Holland, The Netherlands
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Hackl LS, Abizari AR, Speich C, Zungbey-Garti H, Cercamondi CI, Zeder C, Zimmermann MB, Moretti D. Micronutrient-fortified rice can be a significant source of dietary bioavailable iron in schoolchildren from rural Ghana. SCIENCE ADVANCES 2019; 5:eaau0790. [PMID: 30944850 PMCID: PMC6436922 DOI: 10.1126/sciadv.aau0790] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 02/04/2019] [Indexed: 05/05/2023]
Abstract
Iron deficiency and anemia are prominent contributors to the preventable disease burden worldwide. A substantial proportion of people with inadequate dietary iron rely on rice as a staple food, but fortification efforts are limited by low iron bioavailability. Furthermore, using high iron fortification dosages may not always be prudent in tropical regions. To identify alternative fortification formulations with enhanced absorption, we screened different iron compounds for their suitability as rice fortificants, measured in vitro gastric solubility, and assessed dietary iron bioavailability using stable isotopic labels in rural Ghanaian children. Isotopic incorporation in red blood cells indicates that in the two age groups of children investigated (4 to 6 and 7 to 10 years), formulations provided 36 and 51% of the median daily requirement in absorbed iron, respectively. We describe approaches to enhancing iron bioavailability from fortified rice, which can substantially contribute to the prevention of iron deficiency in rice-eating populations.
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Affiliation(s)
- L. S. Hackl
- Laboratory for Human Nutrition, Institute of Food, Nutrition and Health, ETH Zürich, Zurich, Switzerland
| | - A. R. Abizari
- Department of Community Nutrition, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - C. Speich
- Laboratory for Human Nutrition, Institute of Food, Nutrition and Health, ETH Zürich, Zurich, Switzerland
| | - H. Zungbey-Garti
- Department of Community Nutrition, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - C. I. Cercamondi
- Laboratory for Human Nutrition, Institute of Food, Nutrition and Health, ETH Zürich, Zurich, Switzerland
| | - C. Zeder
- Laboratory for Human Nutrition, Institute of Food, Nutrition and Health, ETH Zürich, Zurich, Switzerland
| | - M. B. Zimmermann
- Laboratory for Human Nutrition, Institute of Food, Nutrition and Health, ETH Zürich, Zurich, Switzerland
| | - D. Moretti
- Laboratory for Human Nutrition, Institute of Food, Nutrition and Health, ETH Zürich, Zurich, Switzerland
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Lockyer S, White A, Buttriss JL. Biofortified crops for tackling micronutrient deficiencies - what impact are these having in developing countries and could they be of relevance within Europe? NUTR BULL 2018. [DOI: 10.1111/nbu.12347] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
| | - A. White
- British Nutrition Foundation; London UK
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41
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Tan GZH, Das Bhowmik SS, Hoang TML, Karbaschi MR, Long H, Cheng A, Bonneau JP, Beasley JT, Johnson AAT, Williams B, Mundree SG. Investigation of Baseline Iron Levels in Australian Chickpea and Evaluation of a Transgenic Biofortification Approach. FRONTIERS IN PLANT SCIENCE 2018; 9:788. [PMID: 29963065 PMCID: PMC6010650 DOI: 10.3389/fpls.2018.00788] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 05/24/2018] [Indexed: 05/25/2023]
Abstract
Iron deficiency currently affects over two billion people worldwide despite significant advances in technology and society aimed at mitigating this global health problem. Biofortification of food staples with iron (Fe) represents a sustainable approach for alleviating human Fe deficiency in developing countries, however, biofortification efforts have focused extensively on cereal staples while pulses have been largely overlooked. In this study we describe a genetic engineering (GE) approach to biofortify the pulse crop, chickpea (Cicer arietinum L.), with Fe using a combination of the chickpea nicotianamine synthase 2 (CaNAS2) and soybean (Glycine max) ferritin (GmFER) genes which function in Fe transport and storage, respectively. This study consists of three main components: (1) the establishment for baseline Fe concentration of existing germplam, (2) the isolation and study of expression pattern of the novel CaNAS2 gene, and (3) the generation of GE chickpea overexpressing the CaNAS2 and GmFER genes. Seed of six commercial chickpea cultivars was collected from four different field locations in Australia and assessed for seed Fe concentration. The results revealed little difference between the cultivars assessed, and that chickpea seed Fe was negatively affected where soil Fe bioavailability is low. The desi cultivar HatTrick was then selected for further study. From it, the CaNAS2 gene was cloned and its expression in different tissues examined. The gene was found to be expressed in multiple vegetative tissues under Fe-sufficient conditions, suggesting that it may play a housekeeping role in systemic translocation of Fe. Two GE chickpea events were then generated and the overexpression of the CaNAS2 and GmFER transgenes confirmed. Analysis of nicotianamine (NA) and Fe levels in the GE seeds revealed that NA was nearly doubled compared to the null control while Fe concentration was not changed. Increased NA content in chickpea seed is likely to translate into increased Fe bioavailability and may thus overcome the effect of the bioavailability inhibitors found in pulses; however, further study is required to confirm this. This is the first known example of GE Fe biofortified chickpea; information gleaned from this study can feed into future pulse biofortification work to help alleviate global Fe deficiency.
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Affiliation(s)
- Grace Z. H. Tan
- Centre for Tropical Crops and Biocommodities, Queensland University of Technology, Brisbane, QLD, Australia
| | - Sudipta S. Das Bhowmik
- Centre for Tropical Crops and Biocommodities, Queensland University of Technology, Brisbane, QLD, Australia
| | - Thi M. L. Hoang
- Centre for Tropical Crops and Biocommodities, Queensland University of Technology, Brisbane, QLD, Australia
| | - Mohammad R. Karbaschi
- Centre for Tropical Crops and Biocommodities, Queensland University of Technology, Brisbane, QLD, Australia
| | - Hao Long
- Centre for Tropical Crops and Biocommodities, Queensland University of Technology, Brisbane, QLD, Australia
| | - Alam Cheng
- Centre for Tropical Crops and Biocommodities, Queensland University of Technology, Brisbane, QLD, Australia
| | - Julien P. Bonneau
- School of Biosciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Jesse T. Beasley
- School of Biosciences, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Brett Williams
- Centre for Tropical Crops and Biocommodities, Queensland University of Technology, Brisbane, QLD, Australia
| | - Sagadevan G. Mundree
- Centre for Tropical Crops and Biocommodities, Queensland University of Technology, Brisbane, QLD, Australia
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Lowe NM, Khan MJ, Broadley MR, Zia MH, McArdle HJ, Joy EJM, Ohly H, Shahzad B, Ullah U, Kabana G, Medhi R, Afridi MZ. Examining the effectiveness of consuming flour made from agronomically biofortified wheat (Zincol-2016/NR-421) for improving Zn status in women in a low-resource setting in Pakistan: study protocol for a randomised, double-blind, controlled cross-over trial (BiZiFED). BMJ Open 2018; 8:e021364. [PMID: 29666141 PMCID: PMC5905768 DOI: 10.1136/bmjopen-2017-021364] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 02/16/2018] [Accepted: 03/05/2018] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Dietary zinc (Zn) deficiency is a global problem, particularly in low-income and middle-income countries where access to rich, animal-source foods of Zn is limited due to poverty. In Pakistan, Zn deficiency affects over 40% of the adult female population, resulting in suboptimal immune status and increased likelihood of complications during pregnancy. METHODS AND ANALYSIS We are conducting a double-blind, randomised controlled feeding study with cross-over design in a low-resource setting in Pakistan. Households were provided with flour milled from genetically and agronomically biofortified grain (Zincol-2016/NR-421) or control grain (Galaxy-2013). Fifty households were recruited. Each household included a woman aged 16-49 years who is neither pregnant nor breastfeeding, and not currently consuming nutritional supplements. These women were the primary study participants. All households were provided with control flour for an initial 2-week baseline period, followed by an 8-week intervention period where 25 households receive biofortified flour (group A) and 25 households receive control flour (group B). After this 8-week period, groups A and B crossed over, receiving control and biofortified flour respectively for 8 weeks. Tissue (blood, hair and nails) have been collected from the women at five time points: baseline, middle and end of period 1, and middle and end of period 2. ETHICS AND DISSEMINATION Ethical approval was granted from the lead university (reference no. STEMH 697 FR) and the collaborating institution in Pakistan. The final study methods (including any modifications) will be published in peer-reviewed journals, alongside the study outcomes on completion of the data analysis. In addition, findings will be disseminated to the scientific community via conference presentations and abstracts and communicated to the study participants through the village elders at an appropriate community forum. REGISTRATION DETAILS The trial has been registered with the ISRCTN registry, study ID ISRCTN83678069.
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Affiliation(s)
- Nicola M Lowe
- International Institute of Nutritional Sciences and Applied Food Safety Studies, Faculty of Health and Wellbeing, University of Central Lancashire, Preston, UK
| | - Muhammad Jaffar Khan
- Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Martin R Broadley
- School of Biosciences, University of Nottingham, Sutton Bonnington Campus, Leicestershire, UK
| | - Munir H Zia
- Research and Development Department, Fauji Fertilizer Company Limited, Rawalpindi, Punjab, Pakistan
| | - Harry J McArdle
- School of Biosciences, University of Nottingham, Sutton Bonnington Campus, Leicestershire, UK
| | - Edward J M Joy
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Heather Ohly
- International Institute of Nutritional Sciences and Applied Food Safety Studies, Faculty of Health and Wellbeing, University of Central Lancashire, Preston, UK
| | - Babar Shahzad
- Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Ubaid Ullah
- Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Pakistan
| | | | | | - Mukhtiar Zaman Afridi
- Division of Medicine, Medical Teaching Institution, Lady Reading Hospital, Peshawar, Pakistan
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Hackl L, Speich C, Zeder C, Sánchez-Ferrer A, Adelmann H, de Pee S, Tay F, Zimmermann MB, Moretti D. Cold Extrusion but Not Coating Affects Iron Bioavailability from Fortified Rice in Young Women and Is Associated with Modifications in Starch Microstructure and Mineral Retention during Cooking. J Nutr 2017; 147:2319-2325. [PMID: 29046406 DOI: 10.3945/jn.117.259085] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 08/18/2017] [Accepted: 09/19/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Rice can be fortified with the use of hot or cold extrusion or coating, but the nutritional qualities of the resulting rice grains have never been directly compared.Objective: Using fortified rice produced by coating or hot or cold extrusion, we compared 1) iron and zinc absorption with the use of stable isotopes, 2) iron and zinc retention during cooking, and 3) starch microstructure.Methods: We conducted 2 studies in young women: in study 1 [n = 19; mean ± SD age: 26.2 ± 3.4 y; body mass index (BMI; in kg/m2): 21.3 ± 1.6], we compared the fractional iron absorption (FAFe) from rice meals containing isotopically labeled ferric prophosphate (57FePP), zinc oxide (ZnO), citric acid, and micronutrients fortified through hot extrusion (HER1) with rice meals fortified through cold extrusion containing 57FePP, ZnO, citric acid, and micronutrients (CER); in study 2 (n = 22; age: 24 ± 4 y; BMI: 21.2 ± 1.3), we compared FAFe and fractional zinc absorption (FAZn) from rice meals fortified through hot extrusion (HER2) compared with rice meals fortified through coating containing 57FePP, ZnO, a citric acid and trisodium cirate mixture (CA/TSC), and micronutrients (COR) relative to rice meals extrinsically fortified with ferrous sulfate (reference). Rice types HER1 and CER contained citric acid, whereas types HER2 and COR contained CA/TSC. We assessed retention during standardized cooking experiments and characterized the rice starch microstructure.Results: FAFe (95% CI) was greater from CER [2.2% (1.4%, 3.4%)] than from HER1 [1.2% (0.7%, 2.0%)] (P = 0.036). There was no difference in FAFe between HER2 [5.1% (3.7%, 7.1%)] and COR [4.0% (2.9%, 5.4%)] (P = 0.14), but FAFe from COR was lower than that from the reference meal [6.6% (4.9%, 9.0%)] (P = 0.003), and the geometric mean FAZn (95% CI) did not differ between HER2 [9.5% (7.9%, 11.6%)] and COR [9.6% (8.7%, 10.7%)] (P = 0.92). Cooking in a rice-to-water ratio of 1:2 resulted in iron and zinc retentions >80%, and cooking in excess water did not affect iron retention from hot-extruded rice but caused iron losses of 25% from CER and COR. Distinct variations in starch microstructure were found in CER and HER1.Conclusions: Iron absorption was 64% higher from CER than from hot-extruded rice, with no difference between COR compared with hot-extruded rice. Lower extrusion temperatures may generate a more readily digestible starch structure, allowing for greater iron release in vivo but lower mineral retention during cooking. This trial was registered at clinicaltrials.gov as NCT02176759.
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Affiliation(s)
| | | | | | - Antoni Sánchez-Ferrer
- Laboratory of Food and Soft Materials, Institute of Food, Nutrition and Health, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Horst Adelmann
- Laboratory of Food and Soft Materials, Institute of Food, Nutrition and Health, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | | | - Fabian Tay
- Clinical Trials Center, University Hospital Zurich, Zurich, Switzerland
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Krishnan R, Meera MS. Assessment of inhibitory factors on bioaccessibility of iron and zinc in pearl millet ( Pennisetum glaucum (L.) R. Br.) cultivars. Journal of Food Science and Technology 2017; 54:4378-4386. [PMID: 29184244 DOI: 10.1007/s13197-017-2911-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 09/21/2017] [Accepted: 09/28/2017] [Indexed: 10/18/2022]
Abstract
The variations in iron and zinc bioaccessibility as influenced by inhibitory factors in 13 pearl millet cultivars were evaluated. The results indicated that iron and zinc contents ranged between 5.59-13.41 and 2.11-5.19 mg/100 g. Polyphenols, flavonoids and phytic acid were highest in GHB744 (781 mg/100 g), HHB223 (116 mg/100 g) and HHB226 (1.080 g/100 g) respectively. Insoluble fiber content range from 9.36 to 12.89 g/100 g. Iron and zinc bioaccessibility was the highest in local Anantapur (17.95%) and GHB744 (15.19%) cultivar with low phytic acid. HHB226 exhibited high β-carotene and phytase activity. In this study, the cultivars with high iron and zinc content also possessed high inhibitory factors which affected bioaccessibility. However, the bioaccessibility of iron did not seem to depend on the phytic acid: iron ratio alone. Further, a trend was observed in cultivars with low iron: zinc ratio had increased iron bioaccessibility. On the contrary, phytic acid: zinc ratio appears to play a significant role in zinc bioaccessibility. Certain cultivars with high iron content also had high phytase activity and β-carotene content which could be exploited for further technological treatments to enhance the bioaccessibility of iron and zinc.
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Affiliation(s)
- Rateesh Krishnan
- Department of Grain Science and Technology, CSIR-Central Food Technological Research Institute, Mysore, 570 020 India
| | - M S Meera
- Department of Grain Science and Technology, CSIR-Central Food Technological Research Institute, Mysore, 570 020 India
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Stoffel NU, Cercamondi CI, Brittenham G, Zeder C, Geurts-Moespot AJ, Swinkels DW, Moretti D, Zimmermann MB. Iron absorption from oral iron supplements given on consecutive versus alternate days and as single morning doses versus twice-daily split dosing in iron-depleted women: two open-label, randomised controlled trials. LANCET HAEMATOLOGY 2017; 4:e524-e533. [PMID: 29032957 DOI: 10.1016/s2352-3026(17)30182-5] [Citation(s) in RCA: 243] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Revised: 09/07/2017] [Accepted: 09/08/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Current guidelines to treat iron deficiency recommend daily provision of ferrous iron divided through the day to increase absorption. However, daily dosing and split dosing might increase serum hepcidin and decrease iron absorption from subsequent doses. Our study aim was to compare iron absorption from oral iron supplements given on consecutive versus alternate days and given as single morning doses versus twice-daily split dosing. METHODS We did two prospective, open-label, randomised controlled trials assessing iron absorption using (54Fe)-labelled, (57Fe)-labelled, or (58Fe)-labelled ferrous sulfate in iron-depleted (serum ferritin ≤25 μg/L) women aged 18-40 years recruited from ETH Zurich and the University of Zurich, Switzerland. In study 1, women were randomly assigned (1:1) to two groups. One group was given 60 mg iron at 0800 h (±1 h) on consecutive days for 14 days, and the other group was given the same doses on alternate days for 28 days. In study 2, women were assigned to two groups, stratified by serum ferritin so that two groups with similar iron statuses could be formed. One group was given 120 mg iron at 0800 h (±1 h) and the other was given the dose split into two divided doses of 60 mg at 0800 h (±1 h) and 1700 h (±1 h) for three consecutive days. 14 days after the final dose, the groups were each crossed over to the other regimen. Within-individual comparisons were done. The co-primary outcomes in both studies were iron bioavailability (total and fractional iron absorption), assessed by measuring the isotopic label abundance in erythrocytes 14 days after administration, and serum hepcidin. Group allocations in both studies were not masked and primary and safety analyses were done on an intention-to-treat basis. The studies were registered at ClinicalTrials.gov, numbers NCT02175888 (study 1) and NCT02177851 (study 2) and are complete. FINDINGS For study 1, 40 women were enrolled on Oct 15-29, 2015. 21 women were assigned to the consecutive-day group and 19 to the alternate-day group. At the end of treatment (14 days for the consecutive-day group and 28 days for the alternate-day group), geometric mean (-SD, +SD) cumulative fractional iron absorptions were 16·3% (9·3, 28·8) in the consecutive-day group versus 21·8% (13·7, 34·6) in the alternate-day group (p=0·0013), and cumulative total iron absorption was 131·0 mg (71·4, 240·5) versus 175·3 mg (110·3, 278·5; p=0·0010). During the first 14 days of supplementation in both groups, serum hepcidin was higher in the consecutive-day group than the alternate-day group (p=0·0031). In study 2, 20 women were enrolled between Aug 13 and 18, 2015. Ten women were assigned to receive once-daily dosing and ten were assigned to receive twice-daily divided dosing. No significant differences were seen in fractional (day 1-3 geometric mean: 11·8% [7·1, 19·4] once daily vs 13·1% [8·2, 20·7] twice daily; p=0·33) or total iron absorption (day 1-3: 44·3 mg [29·4, 66·7] once daily vs 49·4 [35·2, 69·4] twice daily; p=0·33) between the two dosing regimens. Twice-daily divided doses resulted in a higher serum hepcidin concentration than once-daily dosing (p=0·013). No grade 3 or 4 adverse events were reported in either study. INTERPRETATION In iron-depleted women, providing iron supplements daily as divided doses increases serum hepcidin and reduces iron absorption. Providing iron supplements on alternate days and in single doses optimises iron absorption and might be a preferable dosing regimen. These findings should be confirmed in iron-deficient anaemic patients. FUNDING Swiss National Science Foundation, Bern, Switzerland.
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Affiliation(s)
- Nicole U Stoffel
- Department of Health Science and Technology, ETH Zürich, Zürich, Switzerland
| | - Colin I Cercamondi
- Department of Health Science and Technology, ETH Zürich, Zürich, Switzerland
| | - Gary Brittenham
- Department of Pediatrics, Columbia University, College of Physicians and Surgeons, New York, NY, USA
| | - Christophe Zeder
- Department of Health Science and Technology, ETH Zürich, Zürich, Switzerland
| | | | - Dorine W Swinkels
- Department of Laboratory Medicine, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Diego Moretti
- Department of Health Science and Technology, ETH Zürich, Zürich, Switzerland
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Dwivedi SL, Lammerts van Bueren ET, Ceccarelli S, Grando S, Upadhyaya HD, Ortiz R. Diversifying Food Systems in the Pursuit of Sustainable Food Production and Healthy Diets. TRENDS IN PLANT SCIENCE 2017; 22:842-856. [PMID: 28716581 DOI: 10.1016/j.tplants.2017.06.011] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 06/09/2017] [Accepted: 06/13/2017] [Indexed: 05/19/2023]
Abstract
Increasing demand for nutritious, safe, and healthy food because of a growing population, and the pledge to maintain biodiversity and other resources, pose a major challenge to agriculture that is already threatened by a changing climate. Diverse and healthy diets, largely based on plant-derived food, may reduce diet-related illnesses. Investments in plant sciences will be necessary to design diverse cropping systems balancing productivity, sustainability, and nutritional quality. Cultivar diversity and nutritional quality are crucial. We call for better cooperation between food and medical scientists, food sector industries, breeders, and farmers to develop diversified and nutritious cultivars that reduce soil degradation and dependence on external inputs, such as fertilizers and pesticides, and to increase adaptation to climate change and resistance to emerging pests.
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Affiliation(s)
- Sangam L Dwivedi
- International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), Patancheru 502324, India
| | - Edith T Lammerts van Bueren
- Louis Bolk Institute, Hoofdstraat 24, 3972 LA Driebergen, The Netherlands; Wageningen University and Research, PO Box 386, 6700 AJ Wageningen, The Netherlands
| | | | - Stefania Grando
- International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), Patancheru 502324, India
| | - Hari D Upadhyaya
- International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), Patancheru 502324, India
| | - Rodomiro Ortiz
- Swedish University of Agricultural Sciences, Department of Plant Breeding, Sundsvagen, 14 Box 101, 23053 Alnarp, Sweden.
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Dias DM, Costa NMB, Nutti MR, Tako E, Martino HSD. Advantages and limitations of in vitro and in vivo methods of iron and zinc bioavailability evaluation in the assessment of biofortification program effectiveness. Crit Rev Food Sci Nutr 2017; 58:2136-2146. [PMID: 28414527 DOI: 10.1080/10408398.2017.1306484] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Biofortification aims to improve the micronutrient concentration of staple food crops through the best practices of breeding and modern biotechnology. However, increased zinc and iron concentrations in food crops may not always translate into proportional increases in absorbed zinc (Zn) and iron (Fe). Therefore, assessing iron and zinc bioavailability in biofortified crops is imperative to evaluate the efficacy of breeding programs. This review aimed to investigate the advantages and limitations of in vitro and in vivo methods of iron and zinc bioavailability evaluation in the assessment of biofortification program effectiveness. In vitro, animal and isotopic human studies have shown high iron and zinc bioavailability in biofortified staple food crops. Human studies provide direct knowledge regarding the effectiveness of biofortification, however, human studies are time consuming and are more expensive than in vitro and animal studies. Moreover, in vitro studies may be a useful preliminary screening method to identify promising plant cultivars, however, these studies cannot provide data that are directly applicable to humans. None of these methods provides complete information regarding mineral bioavailability, thus, a combination of these methods should be the most appropriate strategy to investigate the effectiveness of zinc and iron biofortification programs.
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Affiliation(s)
- Desirrê Morais Dias
- a Department of Nutrition and Health , Federal University of Viçosa , Viçosa , Minas Gerais , Brazil
| | - Neuza Maria Brunoro Costa
- b Department of Pharmacy and Nutrition , Center for Exact, Natural and Health Sciences, Federal University of Espírito Santo, Alto Universitario , Alegre , ES , Brazil
| | - Marilia Regini Nutti
- c EMBRAPA Food Technology , Rio de Janeiro, Brazil-Leader of the Brazilian Biofortification Network
| | - Elad Tako
- d USDA/ARS , Robert W. Holley Center for Agriculture and Health, Cornell University , Ithaca , New York , USA
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Monnard A, Moretti D, Zeder C, Steingötter A, Zimmermann MB. The effect of lipids, a lipid-rich ready-to-use therapeutic food, or a phytase on iron absorption from maize-based meals fortified with micronutrient powders. Am J Clin Nutr 2017; 105:1521-1527. [PMID: 28468891 DOI: 10.3945/ajcn.116.142976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 03/31/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Ready-to-use-therapeutic foods (RUTFs) high in lipid, protein, and iron are used to treat malnutrition. Lipids increase gastric residence time, which could increase iron absorption, particularly from poorly soluble iron compounds and in combination with phytase.Objectives: The objectives were to 1) assess the effect on iron absorption of a lipid emulsion given 20 min before or together with an iron-fortified maize meal and 2) assess iron absorption from a micronutrient powder (MNP) given with a nutrient-dense RUTF and/or a microbial phytase.Design: A total of 41 women participated in 3 studies. They consumed a maize meal fortified with isotopically labeled ferrous sulfate (FeSO4; study 1) or ferric pyrophosphate (FePP; study 2). In studies 1 and 2, a lipid emulsion was given with or 20 min before the meal. In study 3, with the use of a 2 × 2 factorial design, subjects consumed a maize meal fortified with an MNP containing labeled FeSO4 (MNP) given with an RUTF (MNP+RUTF), with a phytase (MNP+phytase), or both (MNP+RUTF+phytase). Iron absorption was assessed by isotope incorporation in erythrocytes 14 d after the test meals.Results: The lipid emulsion given either before or with the meal significantly increased iron absorption from FePP by 2.55-fold (95% CI: 1.48-, 4.37-fold; P = 0.001) but not from FeSO4 There was a trend to increase iron absorption with the MNP+RUTF meal, which did not reach significance (1.21-fold; 95% CI: 0.92-, 1.61-fold; P = 0.060). The addition of phytase to MNP and MNP+RUTF significantly increased iron absorption by 1.85-fold (95% CI: 1.49-, 2.29-fold; P < 0.001), with no interaction between phytase and RUTF.Conclusions: In iron-fortified maize-based meals, the addition of lipids more than doubles iron absorption from FePP. Our results suggest the possibility of an enhancing effect on iron absorption of lipid-rich RUTFs, but more research is needed to determine this. This trial was registered at clinicaltrials.gov as NCT01991626.
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Affiliation(s)
- Arnaud Monnard
- Department of Health Sciences and Technology, Laboratory of Human Nutrition, ETH Zürich, Zurich, Switzerland; and
| | - Diego Moretti
- Department of Health Sciences and Technology, Laboratory of Human Nutrition, ETH Zürich, Zurich, Switzerland; and
| | - Christophe Zeder
- Department of Health Sciences and Technology, Laboratory of Human Nutrition, ETH Zürich, Zurich, Switzerland; and
| | - Andreas Steingötter
- Clinic for Gastroenterology and Hepatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Michael B Zimmermann
- Department of Health Sciences and Technology, Laboratory of Human Nutrition, ETH Zürich, Zurich, Switzerland; and
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Vinoth A, Ravindhran R. Biofortification in Millets: A Sustainable Approach for Nutritional Security. FRONTIERS IN PLANT SCIENCE 2017; 8:29. [PMID: 28167953 PMCID: PMC5253353 DOI: 10.3389/fpls.2017.00029] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 01/05/2017] [Indexed: 05/04/2023]
Abstract
Nutritional insecurity is a major threat to the world's population that is highly dependent on cereals-based diet, deficient in micronutrients. Next to cereals, millets are the primary sources of energy in the semi-arid tropics and drought-prone regions of Asia and Africa. Millets are nutritionally superior as their grains contain high amount of proteins, essential amino acids, minerals, and vitamins. Biofortification of staple crops is proved to be an economically feasible approach to combat micronutrient malnutrition. HarvestPlus group realized the importance of millet biofortification and released conventionally bred high iron pearl millet in India to tackle iron deficiency. Molecular basis of waxy starch has been identified in foxtail millet, proso millet, and barnyard millet to facilitate their use in infant foods. With close genetic-relatedness to cereals, comparative genomics has helped in deciphering quantitative trait loci and genes linked to protein quality in finger millet. Recently, transgenic expression of zinc transporters resulted in the development of high grain zinc while transcriptomics revealed various calcium sensor genes involved in uptake, translocation, and accumulation of calcium in finger millet. Biofortification in millets is still limited by the presence of antinutrients like phytic acid, polyphenols, and tannins. RNA interference and genome editing tools [zinc finger nucleases (ZFNs), transcription activator-like effector nucleases (TALENs), and clustered regularly interspaced short palindromic repeats (CRISPR)] needs to be employed to reduce these antinutrients. In this review paper, we discuss the strategies to accelerate biofortification in millets by summarizing the opportunities and challenges to increase the bioavailability of macro and micronutrients.
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Affiliation(s)
- A Vinoth
- T. A. Lourdusamy Unit for Plant Tissue Culture and Molecular Biology, Department of Plant Biology and Biotechnology, Loyola College Chennai, India
| | - R Ravindhran
- T. A. Lourdusamy Unit for Plant Tissue Culture and Molecular Biology, Department of Plant Biology and Biotechnology, Loyola College Chennai, India
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Tan GZH, Das Bhowmik SS, Hoang TML, Karbaschi MR, Johnson AAT, Williams B, Mundree SG. Finger on the Pulse: Pumping Iron into Chickpea. FRONTIERS IN PLANT SCIENCE 2017; 8:1755. [PMID: 29081785 PMCID: PMC5646179 DOI: 10.3389/fpls.2017.01755] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 09/25/2017] [Indexed: 05/21/2023]
Abstract
Iron deficiency is a major problem in both developing and developed countries, and much of this can be attributed to insufficient dietary intake. Over the past decades several measures, such as supplementation and food fortification, have helped to alleviate this problem. However, their associated costs limit their accessibility and effectiveness, particularly amongst the financially constrained. A more affordable and sustainable option that can be implemented alongside existing measures is biofortification. To date, much work has been invested into staples like cereals and root crops-this has culminated in the successful generation of high iron-accumulating lines in rice and pearl millet. More recently, pulses have gained attention as targets for biofortification. Being secondary staples rich in protein, they are a nutritional complement to the traditional starchy staples. Despite the relative youth of this interest, considerable advances have already been made concerning the biofortification of pulses. Several studies have been conducted in bean, chickpea, lentil, and pea to assess existing germplasm for high iron-accumulating traits. However, little is known about the molecular workings behind these traits, particularly in a leguminous context, and biofortification via genetic modification (GM) remains to be attempted. This review examines the current state of the iron biofortification in pulses, particularly chickpea. The challenges concerning biofortification in pulses are also discussed. Specifically, the potential application of transgenic technology is explored, with focus on the genes that have been successfully used in biofortification efforts in rice.
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Affiliation(s)
- Grace Z. H. Tan
- Centre for Tropical Crops and Biocommodities, Queensland University of Technology, Brisbane, QLD, Australia
| | - Sudipta S. Das Bhowmik
- Centre for Tropical Crops and Biocommodities, Queensland University of Technology, Brisbane, QLD, Australia
| | - Thi M. L. Hoang
- Centre for Tropical Crops and Biocommodities, Queensland University of Technology, Brisbane, QLD, Australia
| | - Mohammad R. Karbaschi
- Centre for Tropical Crops and Biocommodities, Queensland University of Technology, Brisbane, QLD, Australia
| | | | - Brett Williams
- Centre for Tropical Crops and Biocommodities, Queensland University of Technology, Brisbane, QLD, Australia
| | - Sagadevan G. Mundree
- Centre for Tropical Crops and Biocommodities, Queensland University of Technology, Brisbane, QLD, Australia
- *Correspondence: Sagadevan G. Mundree
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