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Enhancing the absorption of fortification iron. A SUSTAIN Task Force report.
Int J Vitam Nutr Res. 2004 Nov; 74(6):387-401.IJ

Abstract

Iron deficiency remains a major global health problem affecting an estimated 2 billion people. The World Health Organization ranked it as the seventh most important preventable risk for disease, disability, and death in 2002. Since an important factor in its causation is the poor bioavailability of iron in the cereal-based diets of many developing countries, SUSTAIN set up a Task Force, consisting of nutritional, medical, industry, and government experts to consider strategies for enhancing the absorption of fortification iron. This paper summarizes the findings of this Task Force. Detailed reviews of each strategy follow this overview. Highly soluble compounds of iron like ferrous sulfate are desirable food fortificants but cannot be used in many food vehicles because of sensory issues. Thus, potentially less well-absorbed forms of iron commonly are used in food fortification. The bioavailability of iron fortificants can, however, be enhanced with innovative ingredient technologies. Ascorbic acid, NaFeEDTA, ferrous bisglycinate, and dephytinization all enhance the absorption of fortification iron, but add to the overall costs of fortification. While all strategies cannot be recommended for all food fortification vehicles, individual strategies can be recommended for specific foods. For example, the addition of ascorbic acid is appropriate for dry blended foods such as infant foods and other dry products made for reconstitution that are packaged, stored, and prepared in a way that maximizes retention of this vitamin. NaFeEDTA can be recommended for fortification of fish sauce and soy sauce, whereas amino acid chelates may be more useful in milk products and beverages. With further development, dephytinization may be possible for low-cost, cereal-based complementary foods in developing countries. Encapsulation of iron salts in lipid coatings, while not an iron absorption-enhancing strategy per se, can prevent soluble forms of iron from interacting undesirably with some food vehicles and hence broaden the application of some fortificants. Research relevant to each of these strategies for enhancing the bioavailability or utility of iron food fortificants is reviewed. Individual strategies are evaluated in terms of enhancing effect and stability, organoleptic qualities, cost, and regulatory issues of interest to the nutrition community, industry, and consumers. Recommendations are made on potential usages and further research needs. Effective fortification depends on the selection of technically feasible and efficacious strategies. Once suitable strategies have been identified, cost becomes very important in selecting the best approach to implement. However it is essential to calculate cost in relation to the amount of bioavailable iron delivered. An approach to the calculation of cost using a conservative estimate of the enhancing effects of the innovative technologies discussed in the supplement is given in the final section.

Authors+Show Affiliations

Laboratory for Human Nutrition, Swiss Federal Institute of Technology Zurich, Rüschlikon, Switzerland. richard.hurrell@ilw.agrl.ethz.chNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

15743016

Citation

Hurrell, Richard F., et al. "Enhancing the Absorption of Fortification Iron. a SUSTAIN Task Force Report." International Journal for Vitamin and Nutrition Research. Internationale Zeitschrift Fur Vitamin- Und Ernahrungsforschung. Journal International De Vitaminologie Et De Nutrition, vol. 74, no. 6, 2004, pp. 387-401.
Hurrell RF, Lynch S, Bothwell T, et al. Enhancing the absorption of fortification iron. A SUSTAIN Task Force report. Int J Vitam Nutr Res. 2004;74(6):387-401.
Hurrell, R. F., Lynch, S., Bothwell, T., Cori, H., Glahn, R., Hertrampf, E., Kratky, Z., Miller, D., Rodenstein, M., Streekstra, H., Teucher, B., Turner, E., Yeung, C. K., & Zimmermann, M. B. (2004). Enhancing the absorption of fortification iron. A SUSTAIN Task Force report. International Journal for Vitamin and Nutrition Research. Internationale Zeitschrift Fur Vitamin- Und Ernahrungsforschung. Journal International De Vitaminologie Et De Nutrition, 74(6), 387-401.
Hurrell RF, et al. Enhancing the Absorption of Fortification Iron. a SUSTAIN Task Force Report. Int J Vitam Nutr Res. 2004;74(6):387-401. PubMed PMID: 15743016.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Enhancing the absorption of fortification iron. A SUSTAIN Task Force report. AU - Hurrell,Richard F, AU - Lynch,Sean, AU - Bothwell,Thomas, AU - Cori,Héctor, AU - Glahn,Ray, AU - Hertrampf,Eva, AU - Kratky,Zdenek, AU - Miller,Dennis, AU - Rodenstein,Mario, AU - Streekstra,Hugo, AU - Teucher,Birgit, AU - Turner,Elizabeth, AU - Yeung,C K, AU - Zimmermann,Michael B, AU - ,, PY - 2005/3/4/pubmed PY - 2005/5/6/medline PY - 2005/3/4/entrez SP - 387 EP - 401 JF - International journal for vitamin and nutrition research. Internationale Zeitschrift fur Vitamin- und Ernahrungsforschung. Journal international de vitaminologie et de nutrition JO - Int J Vitam Nutr Res VL - 74 IS - 6 N2 - Iron deficiency remains a major global health problem affecting an estimated 2 billion people. The World Health Organization ranked it as the seventh most important preventable risk for disease, disability, and death in 2002. Since an important factor in its causation is the poor bioavailability of iron in the cereal-based diets of many developing countries, SUSTAIN set up a Task Force, consisting of nutritional, medical, industry, and government experts to consider strategies for enhancing the absorption of fortification iron. This paper summarizes the findings of this Task Force. Detailed reviews of each strategy follow this overview. Highly soluble compounds of iron like ferrous sulfate are desirable food fortificants but cannot be used in many food vehicles because of sensory issues. Thus, potentially less well-absorbed forms of iron commonly are used in food fortification. The bioavailability of iron fortificants can, however, be enhanced with innovative ingredient technologies. Ascorbic acid, NaFeEDTA, ferrous bisglycinate, and dephytinization all enhance the absorption of fortification iron, but add to the overall costs of fortification. While all strategies cannot be recommended for all food fortification vehicles, individual strategies can be recommended for specific foods. For example, the addition of ascorbic acid is appropriate for dry blended foods such as infant foods and other dry products made for reconstitution that are packaged, stored, and prepared in a way that maximizes retention of this vitamin. NaFeEDTA can be recommended for fortification of fish sauce and soy sauce, whereas amino acid chelates may be more useful in milk products and beverages. With further development, dephytinization may be possible for low-cost, cereal-based complementary foods in developing countries. Encapsulation of iron salts in lipid coatings, while not an iron absorption-enhancing strategy per se, can prevent soluble forms of iron from interacting undesirably with some food vehicles and hence broaden the application of some fortificants. Research relevant to each of these strategies for enhancing the bioavailability or utility of iron food fortificants is reviewed. Individual strategies are evaluated in terms of enhancing effect and stability, organoleptic qualities, cost, and regulatory issues of interest to the nutrition community, industry, and consumers. Recommendations are made on potential usages and further research needs. Effective fortification depends on the selection of technically feasible and efficacious strategies. Once suitable strategies have been identified, cost becomes very important in selecting the best approach to implement. However it is essential to calculate cost in relation to the amount of bioavailable iron delivered. An approach to the calculation of cost using a conservative estimate of the enhancing effects of the innovative technologies discussed in the supplement is given in the final section. SN - 0300-9831 UR - https://www.unboundmedicine.com/medline/citation/15743016/Enhancing_the_absorption_of_fortification_iron__A_SUSTAIN_Task_Force_report_ L2 - https://econtent.hogrefe.com/doi/10.1024/0300-9831.74.6.387?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -