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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(6):1521-1527AJ

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.

Authors+Show Affiliations

Department of Health Sciences and Technology, Laboratory of Human Nutrition, ETH Zürich, Zurich, Switzerland; and.Department of Health Sciences and Technology, Laboratory of Human Nutrition, ETH Zürich, Zurich, Switzerland; and diego.moretti@hest.ethz.ch.Department of Health Sciences and Technology, Laboratory of Human Nutrition, ETH Zürich, Zurich, Switzerland; and.Clinic for Gastroenterology and Hepatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.Department of Health Sciences and Technology, Laboratory of Human Nutrition, ETH Zürich, Zurich, Switzerland; and.

Pub Type(s)

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

Language

eng

PubMed ID

28468891

Citation

Monnard, Arnaud, et al. "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." The American Journal of Clinical Nutrition, vol. 105, no. 6, 2017, pp. 1521-1527.
Monnard A, Moretti D, Zeder C, et al. 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(6):1521-1527.
Monnard, A., Moretti, D., Zeder, C., Steingötter, A., & Zimmermann, M. B. (2017). 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. The American Journal of Clinical Nutrition, 105(6), pp. 1521-1527. doi:10.3945/ajcn.116.142976.
Monnard A, et al. 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(6):1521-1527. PubMed PMID: 28468891.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Monnard,Arnaud, AU - Moretti,Diego, AU - Zeder,Christophe, AU - Steingötter,Andreas, AU - Zimmermann,Michael B, Y1 - 2017/05/03/ PY - 2016/08/15/received PY - 2017/03/31/accepted PY - 2017/5/5/pubmed PY - 2017/8/2/medline PY - 2017/5/5/entrez KW - LNS KW - MNP KW - RUTF KW - iron absorption macronutrients KW - lipid KW - lipid-based nutrient supplements KW - micronutrient powder KW - ready-to-use therapeutic food SP - 1521 EP - 1527 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 105 IS - 6 N2 - 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. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/28468891/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_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.116.142976 DB - PRIME DP - Unbound Medicine ER -