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Inhibition of iron absorption by calcium is modest in an iron-fortified, casein- and whey-based drink in Indian children and is easily compensated for by addition of ascorbic acid.
J Nutr. 2014 Nov; 144(11):1703-9.JN

Abstract

BACKGROUND

Calcium inhibits and ascorbic acid (AA) enhances iron absorption from iron-fortified foods. Absorption efficiency depends on iron status, although the interaction is unclear.

OBJECTIVE

We investigated the ability of AA to overcome calcium-induced inhibition of iron absorption in children differing in iron status.

METHODS

The effect of calcium (0, 100, and 200 mg/test meal) on iron absorption in the absence and presence of AA (0, 42.5, and 85 mg/test meal) from a casein/whey-based drink fortified with ferrous sulfate was assessed in a series of randomized crossover studies both in iron-replete (IR) Indian schoolchildren and in children with iron deficiency anemia (IDA) (6-11 y; n = 14-16/group) by using stable isotopes.

RESULTS

In the absence of calcium and AA, iron absorption from the casein/whey-based drink was 20% lower in IR children than in children with IDA. The addition of calcium reduced mean iron absorption by 18-27%, with the effect being stronger for high added calcium (P < 0.01). AA at a 2:1 or 4:1 molar ratio enhanced iron absorption by a factor of 2-4 and greatly overcompensated for the inhibitory effect of calcium on iron absorption in a dose-dependent manner (P < 0.001). The dose-response effect tended to be stronger (P < 0.1) in the IDA group, and iron status was of far less influence on iron absorption than the enhancing effect of AA.

CONCLUSION

When adding AA to iron-fortified milk products, care should be taken not to provide absorbable iron in excess of needs.

Authors+Show Affiliations

Laboratory for Human Nutrition, Swiss Federal Institute of Technology (ETH) Zurich, Zurich, Switzerland; Departments of Chemistry (Science) and Biochemistry (Medicine), National University of Singapore, Singapore; walczyk@nus.edu.sg.Division of Nutrition, St. John's Research Institute, Bangalore, India; and.Laboratory for Human Nutrition, Swiss Federal Institute of Technology (ETH) Zurich, Zurich, Switzerland;Division of Nutrition, St. John's Research Institute, Bangalore, India; and.Unilever Research and Development, Vlaardingen, The Netherlands.Unilever Research and Development, Vlaardingen, The Netherlands.Division of Nutrition, St. John's Research Institute, Bangalore, India; and.Division of Nutrition, St. John's Research Institute, Bangalore, India; and.Laboratory for Human Nutrition, Swiss Federal Institute of Technology (ETH) Zurich, Zurich, Switzerland;

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25332469

Citation

Walczyk, Thomas, et al. "Inhibition of Iron Absorption By Calcium Is Modest in an Iron-fortified, Casein- and Whey-based Drink in Indian Children and Is Easily Compensated for By Addition of Ascorbic Acid." The Journal of Nutrition, vol. 144, no. 11, 2014, pp. 1703-9.
Walczyk T, Muthayya S, Wegmüller R, et al. Inhibition of iron absorption by calcium is modest in an iron-fortified, casein- and whey-based drink in Indian children and is easily compensated for by addition of ascorbic acid. J Nutr. 2014;144(11):1703-9.
Walczyk, T., Muthayya, S., Wegmüller, R., Thankachan, P., Sierksma, A., Frenken, L. G., Thomas, T., Kurpad, A., & Hurrell, R. F. (2014). Inhibition of iron absorption by calcium is modest in an iron-fortified, casein- and whey-based drink in Indian children and is easily compensated for by addition of ascorbic acid. The Journal of Nutrition, 144(11), 1703-9. https://doi.org/10.3945/jn.114.193417
Walczyk T, et al. Inhibition of Iron Absorption By Calcium Is Modest in an Iron-fortified, Casein- and Whey-based Drink in Indian Children and Is Easily Compensated for By Addition of Ascorbic Acid. J Nutr. 2014;144(11):1703-9. PubMed PMID: 25332469.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Inhibition of iron absorption by calcium is modest in an iron-fortified, casein- and whey-based drink in Indian children and is easily compensated for by addition of ascorbic acid. AU - Walczyk,Thomas, AU - Muthayya,Sumithra, AU - Wegmüller,Rita, AU - Thankachan,Prashanth, AU - Sierksma,Aafje, AU - Frenken,Leon G J, AU - Thomas,Tinku, AU - Kurpad,Anura, AU - Hurrell,Richard F, Y1 - 2014/09/03/ PY - 2014/10/22/entrez PY - 2014/10/22/pubmed PY - 2014/12/23/medline SP - 1703 EP - 9 JF - The Journal of nutrition JO - J Nutr VL - 144 IS - 11 N2 - BACKGROUND: Calcium inhibits and ascorbic acid (AA) enhances iron absorption from iron-fortified foods. Absorption efficiency depends on iron status, although the interaction is unclear. OBJECTIVE: We investigated the ability of AA to overcome calcium-induced inhibition of iron absorption in children differing in iron status. METHODS: The effect of calcium (0, 100, and 200 mg/test meal) on iron absorption in the absence and presence of AA (0, 42.5, and 85 mg/test meal) from a casein/whey-based drink fortified with ferrous sulfate was assessed in a series of randomized crossover studies both in iron-replete (IR) Indian schoolchildren and in children with iron deficiency anemia (IDA) (6-11 y; n = 14-16/group) by using stable isotopes. RESULTS: In the absence of calcium and AA, iron absorption from the casein/whey-based drink was 20% lower in IR children than in children with IDA. The addition of calcium reduced mean iron absorption by 18-27%, with the effect being stronger for high added calcium (P < 0.01). AA at a 2:1 or 4:1 molar ratio enhanced iron absorption by a factor of 2-4 and greatly overcompensated for the inhibitory effect of calcium on iron absorption in a dose-dependent manner (P < 0.001). The dose-response effect tended to be stronger (P < 0.1) in the IDA group, and iron status was of far less influence on iron absorption than the enhancing effect of AA. CONCLUSION: When adding AA to iron-fortified milk products, care should be taken not to provide absorbable iron in excess of needs. SN - 1541-6100 UR - https://www.unboundmedicine.com/medline/citation/25332469/Inhibition_of_iron_absorption_by_calcium_is_modest_in_an_iron_fortified_casein__and_whey_based_drink_in_Indian_children_and_is_easily_compensated_for_by_addition_of_ascorbic_acid_ L2 - https://academic.oup.com/jn/article-lookup/doi/10.3945/jn.114.193417 DB - PRIME DP - Unbound Medicine ER -