Fortification iron as ferrous sulfate plus ascorbic acid is more rapidly absorbed than as sodium iron EDTA but neither increases serum nontransferrin-bound iron in women

The absorption profile of iron fortificants may be a determinant of their ability to generate nontransferrin-bound iron (NTBI) and, thus, their potential safety. Ferrous iron may be absorbed more rapidly than chelated ferric iron, but differences at the fortification level cannot be distinguished with nonisotopically labeled serum iron curves. Using stable isotope appearance curves (SIAC) in serum, we measured iron absorption profiles from FeSO(4) with ascorbic acid (AA) and from NaFeEDTA, as well as the serum hepcidin and NTBI response following the meals. Healthy women (n = 16) were given 6 mg oral iron as labeled FeSO(4) and NaFeEDTA with a maize porridge using a crossover design. SIAC, NTBI, and serum hepcidin were measured over 8 h after the meal. Iron from FeSO(4) plus AA was more rapidly absorbed, resulting in a 35% greater relative AUC during the first 2 h than for NaFeEDTA (P < 0.001). Median (95% CI) fractional iron absorption from the FeSO(4)- and NaFeEDTA-fortified meals was 15.2% (11.0-19.5) and 6.0% (5.0-9.2), respectively (P < 0.001). In response to the FeSO(4)-fortified meal, there was an ~60% increase in median serum hepcidin (P < 0.05) but no significant change in NTBI. There was no significant change in serum hepcidin or NTBI after the NaFeEDTA-fortified meal. SIAC are a useful new tool to compare iron absorption profiles from different iron compounds in fortified foods. Even with the use of a very well absorbed ferrous iron compound, iron fortification in this population does not increase NTBI, suggesting a low risk for adverse health consequences.     

The potential role of NaFeEDTA as an iron fortificant

Ethylene diamine tetraacetic acid (EDTA) is a hexadentate chelator, which can combine with virtually every metal in the periodic table. CaNa2EDTA and Na2EDTA (ADI 2.5 mg EDTA/kg body weight/day) are widely used as sequestering agents in canned products, while NaFeEDTA is a promising iron fortificant. Binding of EDTA with iron is favored in the acid milieu of the stomach, irrespective of whether the EDTA is administered as CaNa2EDTA, Na2EDTA, or NaFeEDTA, but in the more alkaline medium of the duodenum the iron is exchanged, in part, with other metals. The iron released from EDTA is absorbed by the normal physiological mechanisms. When NaFeEDTA is present in a meal, the iron moiety exchanges with the intrinsic food iron and the EDTA partially protects the iron in this common non-heme iron pool from the effects of inhibitors of iron absorption, such as phytates and polyphenols. When iron is added as NaFeEDTA to an inhibitory meal, it is two to three times better absorbed than is iron added as ferrous sulfate. It also has a similar effect on the intrinsic food iron in the meal. Fortification with NaFeEDTA is most efficacious when administered with cereal- and legume-based diets but offers no advantages over other fortificants when added to meals of high bioavailability. Its potential as a fortificant has been confirmed in five extended fortification trials carried out in developing countries. There is no evidence that NaFeEDTA in the dose range proposed for food fortificants (5 to 10 mg iron daily) will have any direct toxic effects. Na2EDTA and CaNa2EDTA have proved safe over a number of years, while the Joint FAO/WHO Expert Committee on Food Additives concluded in 1999 that NaFeEDTA "could be considered safe when used in supervised fortification programs". Animal and human studies, including the results of two fortification trials, suggest that NaFeEDTA has little or no effect on overall zinc metabolism. Indeed, if anything, it increases zinc and possibly copper absorption. Data on potentially toxic metals, such as lead mercury, aluminum, and manganese, are limited but the evidence that is available is uniformly negative thus far. Further studies in this field are desirable. The long-term potential of NaFeEDTA fortification to cause iron overload is conjectural but the available evidence suggests that homeostatic controls would prevent excess iron accumulation in the normal population. NaFeEDTA, which is pale yellow in color, causes fewer organoleptic changes in a number of stored vehicles, including cereals, than do other soluble iron salts. Other potential vehicles include condiments, several of which have been successfully used in fortification trials. What is currently lacking is a consolidated body of published evidence on the stability of NaFeEDTA during processing, storage, and household cooking in widely consumed food vehicles, coupled with standardized testing of consumer acceptance of each fortified vehicle. While NaFeEDTA seems to be an appropriate fortificant for developing countries, its cost is about six to eight times that of ferrous sulfate in terms of equivalent amounts of iron. Its better absorption (a factor of 2-3) might make it possible to halve the daily fortification level but, it still remains expensive and there is a pressing need for food grade NaFeEDTA at more affordable prices. Another possible option is the use of other salts of EDTA (Na2EDTA or Ca Na2EDTA) together with a soluble source of iron, such as ferrous sulfate. The combination has been shown to be as effective as NaFeEDTA when the EDTA:Fe molar ratio is between 1:2 and 1:1. This approach is, however, only feasible with vehicles that are stored for short periods because of ferrous sulfate's propensity to cause organoleptic changes. The search for an iron source that is more stable but at the same time available to combine with EDTA has been unsuccessful thus far. Target populations for fortification with NaFeEDTA include all those that subsist on cereal- and legume-based diets, with the most appropriate vehicles being cereal products and condiments. The fortification of infant milk and cereal formulas with NaFeEDTA does not seem appropriate, since the amounts of NaFeEDTA required for effective fortification would be close to the acceptable daily intake (ADI) of 2.5 mg EDTA/kg body weight/day.     

Iron absorption from a breakfast cereal: effects of EDTA compounds and ascorbic acid

Sodium iron ethylenediaminetetracetic acid (NaFeEDTA) has been recommended for food fortification programmes to improve iron status but its performance in commercial products has not been evaluated. The effect of EDTA on iron absorption from fortified cornflakes, given as part of a typical Western breakfast, was determined in a double-blind randomised study with 20 non-anaemic female volunteers, using experimentally prepared iron compounds, enriched with 58Fe, and faecal monitoring. Five meals were compared: hydrogen reduced iron, hydrogen reduced iron plus Na2EDTA (molar ratio EDTA:Fe 1:2), hydrogen reduced iron plus NaFe(III)EDTA at two different molar ratios (EDTA:total Fe 1:3 and 1:2), and hydrogen reduced iron plus 15 mg ascorbic acid (ascorbic acid:Fe 1.3:1). The iron and EDTA compounds were accurately weighed into gelatine capsules and taken with unfortified cornflakes, semi-skimmed milk and tea on two consecutive days; the iron dose per meal was 3.75 mg. Iron absorption from all five test meals was measured in each volunteer with a minimum wash-out period of 2 weeks between tests. Geometric mean iron absorption (%) from the 5 tests was 14.1, 17.6, 20.6, 24.4 and 17.5 respectively (equivalent to 0.5-0.9 mg absorbed iron). There was a significantly higher iron absorption from the mixture of reduced iron and NaFe(III)EDTA (EDTA:Fe 1:2) than from reduced iron alone (p = 0.014). It is not known whether the higher absorption was from reduced iron or NaFeEDTA or both. Absorption was not increased significantly with NaFe(III)EDTA (EDTA:Fe 1:3), Na2EDTA (EDTA:Fe 1:2) or ascorbic acid (15 mg).     

Fortifying brown bread with sodium iron EDTA, ferrous fumarate, or electrolytic iron does not affect iron status in South African schoolchildren

The choice of iron fortificant usually represents a balance between bioavailability of the compound and its tendency to cause organoleptic problems. The aim of this study was to evaluate the efficacy of sodium iron EDTA (NaFeEDTA) and ferrous fumarate at levels compatible with South African brown bread (10 mg/kg flour for NaFeEDTA and 20 mg/kg flour for ferrous fumarate) in a randomized controlled trial; electrolytic iron was evaluated at the level currently used in South Africa (35 mg/kg flour). Schoolchildren (n = 361), aged 6-11 y, from a low socioeconomic community with hemoglobin (Hb) < or = 125 g/L were randomly assigned to 1 of 4 groups that received 4 slices of brown bread supplying either: 1) no fortification iron 2) 2.35 mg iron as NaFeEDTA; 3) 4.70 mg iron as ferrous fumarate; and 4) 8.30 mg iron as electrolytic iron per intervention day. These amounts simulated a bread intake of 6 slices per day over the 34-wk study period at fortification levels of 0, 10, 20, and 35 mg/kg flour, respectively. Hb concentration and iron status were assessed at baseline and after 34 wk of intervention. The iron interventions did not affect Hb concentration, transferrin saturation, or serum ferritin, iron, or transferrin receptor concentrations relative to the control group. Our results suggest that electrolytic iron at the level currently used in South Africa is not effective in improving iron or Hb status. Neither do NaFeEDTA or ferrous fumarate appear to be suitable alternatives for the fortification of wheat flour when included at levels that do not cause color changes.     

乙二胺四乙酸铁钠强化酱油对学生贫血状况的改善

将 30 0名缺铁性贫血学生分为对照组 (未强化铁的酱油 )、低Fe剂量组 (5mg d)、高Fe剂量组(2 0mg d) ,观察乙二胺四乙酸铁钠 (NaFeEDTA)强化酱油对缺铁性贫血的干预效果。试验为期三个月 ,开始和结束时分别测定血红蛋白、血清铁、血清铁蛋白、原卟啉、总铁结合力、转铁蛋白 ,并每月测定血红蛋白一次。结果表明 ,对照组各项检验指标干预前后差异无显著性。低剂量组和高剂量组呈现出较为一致的变化 ,表现为血红蛋白、血清铁、血清铁蛋白、转铁蛋白含量的显著性增加和原卟啉、总铁结合力的显著性下降。低剂量组和高剂量组在干预前后未见明显差异。试验结果提示 ,采用乙二胺四乙酸铁钠强化酱油进行营养干预对缺铁性贫血学生的铁营养状况有改善。     

Effects of wheat flour fortified with different iron fortificants on iron status and anemia prevalence in iron deficient anemic students in Northern China

OBJECTIVES: To compare the effects of wheat flours fortified with NaFeEDTA, FeSO4 and elemental iron (electrolytic iron), in improving iron status in anemic students. METHODS: Four hundreds anemic students (11 to 18 years old) were divided into four groups and given wheat flour fortified with different iron fortificants at different concentrations: control group (no added iron); NaFeEDTA group (20 mg Fe/kg); FeSO4 group (30 mg Fe/kg); and elemental iron group (60 mg Fe/kg). The trial lasted for 6 months and the following parameters were examined every 2 months: whole blood hemoglobin, free erythrocyte protoporphyrin, serum ferritin, serum iron, total iron binding capacity and transferrin receptor. RESULTS: The flour consumption in the 4 groups was 300-400 g/person/day, accounted for 70% of total cereal consumption in the diets. There were no significant differences in flour consumption among the 4 groups. Blood hemoglobin level increased in all the 3 intervened groups, but the increment in the NaFeEDTA group was significantly higher and earlier than the other 2 groups; and only 1% of the subjected remained anemic at the end of the trial in the NaFeEDTA group, while 40% and 60% of the subjects in the FeSO4 and electrolytic iron group remained anemic, respectively. The order of improvements in free erythrocyte protoporphyrin, serum ferritin and transferring receptor levels were: NaFeEDTA > FeSO4 > electrolytic iron. No significant changes were found in the control group on all the tested parameters during the trial. CONCLUSIONS: The results indicated that even NaFeEDTA was added at a lower level, it has better effects than FeSO4 and elemental iron on controlling iron deficiency anemia and improving iron status in anemic children; while elemental iron was the least effective.     

Chili, but not turmeric, inhibits iron absorption in young women from an iron-fortified composite meal

Chili and turmeric are common spices in indigenous diets in tropical regions. Being rich in phenolic compounds, they would be expected to bind iron (Fe)(3) in the intestine and inhibit Fe absorption in humans. Three experiments were conducted in healthy young women (n = 10/study) to assess the effect of chili and turmeric on Fe absorption from a rice-based meal containing vegetables and iron fortified fish sauce in vivo. Iron absorption was determined by erythrocyte incorporation of stable isotope labels ((57)Fe/(58)Fe) using a randomized crossover design. Addition of freeze-dried chili (4.2 g dry powder, 25 mg polyphenols as gallic acid equivalents) reduced Fe absorption from the meal by 38% (6.0% with chili vs. 9.7% without chili, P = 0.0017). Turmeric (0.5 g dry powder, 50 mg polyphenols as gallic acid equivalents) did not inhibit iron absorption (P = 0.91). A possible effect of chili on gastric acid secretion was indirectly assessed by comparing Fe absorption from acid soluble [(57)Fe]-ferric pyrophosphate relative to water soluble [(58)Fe]-ferrous sulfate from the same meal in the presence and absence of chili. Chili did not enhance gastric acid secretion. Relative Fe bioavailability of ferric pyrophosphate was 5.4% in presence of chili and 6.4% in absence of chili (P = 0.47). Despite the much higher amount of phenolics in the turmeric meal, it did not affect iron absorption. We conclude that both phenol quality and quantity determine the inhibitory effect of phenolic compounds on iron absorption.     

Iron absorption is more closely related to iron status than to daily iron intake in 12- to 48-mo-old children

Few studies have evaluated iron absorption in small children after the first year of life. Our objectives were to examine the relations among iron intake, iron absorption, and iron status in a group of healthy children. We studied 28 children, ages 12 to 48 mo, after a 7-d home adaptation to a diet representative of their usual daily mineral intake. A multi-tracer stable isotope study was performed to assess iron absorption both from a meal ((58)Fe) and from a reference iron dose ((57)Fe) given with ascorbic acid without a meal. Iron intake was 6.9 +/- 2.4 mg, approximately the 35th percentile of typical U.S. intakes. Absorption of (58)Fe was related to serum ferritin (r(2) = 0.319, P = 0.0018) and more so to reference dose iron absorption (r(2) = 0.653, P < 0.0001). Iron absorption was negatively correlated with zinc intake (r(2) = 0.090, P = 0.0049) but was not correlated with iron intake (P = 0.20). However, zinc intake was not correlated with measures of iron status, including reference dose iron absorption and serum ferritin (r(2) < 0.1, P > 0.25). Total absorbed iron was similar to needs estimated by the Institute of Medicine. We conclude that iron absorption in young children is more closely related to iron status than to iron intake. Reference dose iron absorption may be superior to serum ferritin as a surrogate measure for iron status in this age group. Although zinc intake may affect iron absorption from a meal, it does not appear to have a detectable effect on overall iron status in otherwise well-nourished children.     

Oral iron, dietary ligands and zinc absorption

The effect of iron on zinc absorption in humans was investigated by using 65Zn and whole-body counting after 2 wk. Increasing the molar ratio of ferrous iron (with ascorbic acid) to zinc from 1:1 to 2.5:1 did not affect absorption of zinc from water when given in a fasting state; 59 and 58% was absorbed, respectively. However, at an Fe:Zn ratio of 25:1, zinc absorption from water decreased significantly to 34%. When oral iron in the same ratio to zinc was given with a meal, no inhibitory effect was observed (25, 23 and 22%, respectively). Addition of the zinc ligand, histidine, to the water solution decreased the inhibitory effect of the higher dose of iron, resulting in a zinc absorption of 47%. Two weeks of iron preloading did not affect zinc absorption from water. The results demonstrate that when a multimineral supplement is taken on an empty stomach, excessive iron levels can negatively affect zinc absorption. Intake of the supplement with a meal or with a zinc ligand (such as histidine) may overcome this inhibitory effect.     

Sugar as a vehicle for iron fortification: further studies.

The data presented confirm the advantages of sugar as a vehicle for iron fortification over other vehicles used in the past. The absorption comparison between ferric and ferrous salts added to sugar demonstrated that Fe(III)-EDTA Complex and ferrous sulfate exhibited the highest absorption, while ferric ammonium citrate was poorly absorbed. It was also found that Fe(III)-EDTA reacts slowly with the tannin contained in tea; the color of the tea changes slightly in the first 2 hr after the addition of the fortified sugar. Iron absorption of sugar fortified with ferrous sulfate was tested in seven beverages. The mean absorption ratio from fortified sugar given with beverages to reference dose of iron ascorbate ranged between 0.42 and 0.70, that is, more than 4 times the absorption from fortified sugar when it is administered with a meal containing one or more vegetals. An absorption of between 0.25 and 0.80 mg of iron/soft drink sugar fortified with 3 mg of iron as ferrous sulfate can be expected in subjects with various degrees of iron deficiency. Thus, two soft drinks per day between meals would be enough to meet the iron requirement in more than 95% of menstruating women, even though the daily iron absorption from the diet is about 0.8 to 1.0 mg.     

乙二胺四乙酸铁钠强化酱油改善贫血效果观察

本研究比较了NaFeEDTA强化酱油、硫酸亚铁 (FeSO4)强化酱油对IDA改善效果。将 30 0名IDA学生分为对照组、NaFeEDTA强化酱油组Fe 5mg (人·日 )、FeSO4强化酱油组Fe5mg (人·日 ) ,比较新型铁强化剂 (NaFeEDTA)与传统铁剂 (FeSO4)对缺铁性贫血的改善作用。结果表明 ,对照组各项检验指标干预前后没有显著差异。其它各试验组呈现出较为一致的变化 ,表现为血红蛋白、血清铁、血清铁蛋白含量的显著性增加和原卟啉、总铁结合力、转铁蛋白的显著性下降。试验结果提示 ,乙二胺四乙酸铁钠与传统铁剂 (硫酸盐铁 )强化酱油均有改善学生贫血的作用 ,并且NaFeEDTA组的贫血改善率和Hb恢复水平优于FeSO4组。     

Competitive inhibition of iron absorption by manganese and zinc in humans

Zinc and manganese may interfere with iron absorption because of similar physicochemical properties and shared absorptive pathways. The effects of zinc and manganese on iron absorption were studied in human subjects by using paired observations and a dual-radioisotope method (55Fe and 49Fe). Manganese inhibited iron absorption both in solutions and in a hamburger meal. Fractional iron absorption is strongly dose dependent. Adding 2.99 mg Mn to 0.01 mg Fe reduced iron absorption to the same extent as increasing the iron dose 300-fold to 3 mg, strongly indicating a direct competitive inhibition of manganese on iron absorption. In the same experiment with zinc, no inhibitory effect was observed, suggesting different pathways for the absorption of zinc and iron. An intraluminal interaction may occur, because a fivefold excess of zinc to iron (15 mgZn/3 mg Fe) reduced iron absorption by 56% when given in a water solution but not when given with a hamburger meal.     

Iron absorption from NaFeEDTA is downregulated in iron-loaded rats

NaFeEDTA is a promising fortificant for use in plant foods, because it is less susceptible to iron absorption inhibitors and has fewer undesirable impacts on sensory quality than ferrous sulfate. However, the hypothesis that iron absorption from NaFeEDTA is effectively downregulated in iron-overload conditions has not been thoroughly tested. Therefore, the objective of this study was to compare downregulation of iron absorption from ferrous sulfate and NaFeEDTA in intact iron-loaded rats. Male Sprague-Dawley rats were fed diets containing either ferrous sulfate (35 mg Fe per 1 kg diet) or elemental iron (30,000 mg Fe per 1 kg diet) for 29 d to achieve basal or iron-loaded status. While body weights and hemoglobin concentrations were the same for basal and iron-loaded rats, nonheme-iron concentrations in liver, spleen, and kidney were all significantly higher in iron-loaded rats, indicating elevated iron status. Percentage of iron absorption from (59)Fe-labeled ferrous sulfate and NaFeEDTA, determined from whole-body retention of (59)Fe activity, was 64.7 and 49.4% in basal rats but decreased to 12.8 and 10.2% in iron-loaded rats, respectively. The reductions in percentage of iron absorption from both iron sources in rats as a result of iron loading were comparable (about -80% for both iron sources). Our results suggest that iron absorption from NaFeEDTA and ferrous sulfate is downregulated to a similar extent in iron-loaded rats. Hence, NaFeEDTA is no more likely than ferrous sulfate to exacerbate iron overload in subjects with adequate body iron stores.     

稳定性同位素示踪测定NaFeEDTA强化酱油中铁在人体中吸收率

采用铁稳定性同位素54Fe和58Fe分别标记FeSO4及NaFeEDTA并以稀土元素 (Dy)作为排泄物回收标记物。自愿受试人群为 18～ 2 2岁健康女性。采用我国典型城镇成年女性膳食模式。两种铁剂及Dy以酱油为食物载体一同分 2日 6次经口给入。实验其间每日留取受试人膳食样品并完全收集受试人在实验期的排泄物。采用原子吸收和ICP -MS分别检测膳食及排泄物中总铁含量和铁同位素比例 ,对两种铁剂中的铁的吸收率进行比较。结果表明 ,FeSO4中铁在人体中的平均吸收率为 4 73% ,NaFeEDTA为 10 5 1%。二者差异为极显著(P <0 0 1)。说明NaFeEDTA中铁的吸收率优于FeSO4。     

Iron absorption from fish sauce and soy sauce fortified with sodium iron EDTA

BACKGROUND: Fish sauce and soy sauce have been suggested as food vehicles for iron fortification in Asia. NaFeEDTA is a potentially useful fortificant because it can be added to these condiments without causing precipitation during storage. OBJECTIVES: The objectives were to evaluate iron absorption from NaFeEDTA-fortified fish sauce and soy sauce against a reference fortificant (FeSO(4)), to compare iron absorption from NaFeEDTA-fortified fish sauce and soy sauce, and to evaluate the influence of fish sauce and soy sauce per se on iron absorption. DESIGN: Five separate iron-absorption studies were made in adult women (10 women per study). Iron absorption was measured on the basis of erythrocyte incorporation of (57)Fe or (58)Fe 14 d after the intake of labeled meals of rice or rice and vegetables. Fish sauce or soy sauce (10 g) fortified with 5 mg Fe as NaFeEDTA or FeSO(4) was fed with selected meals. The results are presented as geometric means. RESULTS: Iron absorption from NaFeEDTA- and FeSO(4)-fortified fish sauce (3.3% and 3.1%, respectively) and soy sauce (6.1% and 5.6%, respectively) was not significantly different. No significant difference was observed when NaFeEDTA-fortified fish sauce and soy sauce were compared directly (6.7% and 7.9%, respectively). Soy sauce inhibited iron absorption from rice-based meals (8.5% without and 6.0% with soy sauce; P < 0.02), whereas fish sauce did not affect iron absorption significantly. CONCLUSION: The relatively high iron absorption from NaFeEDTA-fortified fish sauce and soy sauce and the acceptable organoleptic properties of NaFeEDTA indicate the potential usefulness of this iron fortificant in fish sauce and soy sauce fortification programs.     

Iron absorption from soybean ferritin in nonanemic women

BACKGROUND: Dietary ferritin, a protein cage around an iron mineral, is an underestimated source of bioavailable iron. Plant ferritin, the most common dietary ferritin, has not been studied. Iron from animal ferritin is absorbed as well as is iron from FeSO4 in women. OBJECTIVE: The objective was to examine iron absorption from purified soybean ferritin. DESIGN: Healthy, nonanemic women (n = 16) were fed a standardized meal (bagel, cream cheese, and apple juice) containing 1 microCi 59Fe/meal as FeSO4 or (extrinsically labeled) as iron-free soybean ferritin reconstituted with the high phosphate characteristic of plant ferritin (iron:phosphorus = 4:1). Iron-free, apo-soybean ferritin was prepared (with the use of thioglycolic acid and extensive dialysis) from purified ferritin. In a randomized crossover design, the other labeled meal, which contained FeSO4 or ferritin, was given after 4 wk. The subjects received 140 microg Fe as ferritin (2.5 mg) or as FeSO4. After 28 d, whole-body 59Fe and 59Fe in red blood cells were measured before and after dosing. RESULTS: There was no significant difference in whole-body iron absorption from soybean ferritin (29.9 +/- 19.8%) and that from FeSO4 (34.3 +/- 23.6%) or in iron absorption calculated from red blood cell incorporation (33.0 +/- 20.1% for soybean ferritin and 35.3 +/- 23.4% for FeSO4), which confirmed previous results with animal ferritin that was mineralized and labeled similarly. An inverse relation was observed between serum ferritin and iron absorption from both ferritin and FeSO4, which suggested that sensors regulating iron absorption respond similarly to iron provided as ferrous salts or as ferritin mineral. CONCLUSION: Iron from soybean ferritin is well absorbed and may provide a model for novel, utilizable, plant-based forms of iron for populations with a low iron status.     

Na2EDTA enhances the absorption of iron and zinc from fortified rice flour in Sri Lankan children

Rice flour was proposed as a vehicle for iron and zinc fortification in Sri Lanka. Although widely consumed, rice flour has not been evaluated as a fortified food, and the absorption of minerals including iron and zinc from this flour is unknown. Determination of the bioavailability of these nutrients is a critical step before commencing a fortification program. We randomly divided 53 Sri Lankan schoolchildren ages 6-10 y into 4 groups that consumed a local dish prepared with 25 g of fortified rice flour labeled with one of the following: 1) (58)FeSO(4) 2) (58)FeSO(4) + Na(2)EDTA 3) (58)FeSO(4) + (67)ZnO or, 4) (58)FeSO(4) + Na(2)EDTA + (67)ZnO. The levels of iron and zinc were 60 mg/kg; the rice flour also contained folate at 2 mg/kg in each group. Na(2)EDTA was added at a Fe:Na(2)EDTA, 1:1 molar ratio. A total of 48 children completed the trial. Absorption of (58)Fe from a meal was significantly greater (P < 0.01) in the groups administered FeSO(4) + Na(2)EDTA (4.7 +/- 3.6%) than in those administered FeSO(4) without Na(2)EDTA (2.2 +/- 1.3%). Fractional absorption of zinc was 13.5 +/- 6.0% in the FeSO(4) + Na(2)EDTA group and 8.8 +/- 2.0% in the FeSO(4) group (P = 0.037). Although zinc absorption was low, our results demonstrated a benefit in using Na(2)EDTA to improve both iron and zinc absorption. We conclude that the fortification of rice flour is feasible, although additional strategies such as dephytinization or an increase in the level of iron and zinc fortification should be considered to obtain a higher proportion of the daily requirement of total absorbed iron and zinc.     

铁强化中国酱油的研究——Ⅱ、铁强化酱油的人体铁吸收试验

31名健康成年自愿者,男11名,年龄18—48岁,女20名,年龄34—52岁 (均系采取节育措施的育龄妇女),用同位素~(55)Fe和~(59)Fe外标食物,分两批作人体铁吸收试验。其结果为:上海生产出口的海鸥牌瓶装酱油,原有铁(15.8mg铁/100ml)的吸收率几何均数(下同)为6.95％,酱油强化铁量为121mg铁/100ml时的铁吸收率为4.36％,该种铁强化酱油再强化维生素C(按铁:维生素C=1:2克分子量)则铁的吸收率为8.25％,几乎增加一倍。以7.5ml(一餐用量)的铁强化酱油(75mg铁/100ml)含铁量为5.6mg进行烹调蔬菜,以大米为主食,该餐中总铁量为8.9mg,铁的吸收率为5.65％,铁的吸收量为0.5mg;该餐另加瘦猪肉100g,则铁的吸收率为9.69％,铁的吸收量为1.08mg,肉能促进铁吸收一倍;但在该蔬菜餐后饮用龙井绿茶150ml(1.5g干茶叶泡成)其铁的吸收率降至3.09％,铁的吸收量为0.27mg,降低近一半。因此,应用加铁量为75mg铁/100ml的铁强化酱油,如按每人每天平均酱油的消耗量为15—20ml铁吸收率为5.65％计算,则铁的吸收量为0.63—0.85mg,可以基本满足一般人群每天对铁的需要量要求。如该种铁强化酱油同时强化维生素C,以铁吸收率增加一倍计算,则可满足孕妇、乳母、月经过多妇女及正在生长发育的儿童青少年对铁的特殊需要。     

Serum iron curves can be used to estimate dietary iron bioavailability in humans

Erythrocyte incorporation of isotopic iron (Fe) is the standard method for assessing iron bioavailability, but the process is expensive, technically difficult, and gives no information on the kinetics of absorption. The main objective of this study was to validate serum Fe curves as measures of dietary iron absorption because previous work demonstrated that serum iron curves can be generated with iron doses as low as 5-20 mg and that up to 20 mg iron can be added to meals without affecting relative absorption. In 3 studies, groups (n = 10, 10, 21) of Fe-deficient, mildly anemic women consumed meals of varying calculated Fe bioavailability, with and without added ferric chloride (10 mg Fe). Blood samples were collected at baseline and every 30 min for 4 h after the meal. Serum Fe concentrations were measured. Areas under the serum Fe curves and peak concentrations were used in different models to estimate Fe absorption and uptake. In 21 subjects, (58)Fe-enriched ferric chloride was added to the meals, and blood was taken 2 wk later to calculate red cell isotope incorporation. The addition of 10 mg Fe to test meals produced measurable serum iron curves even when the meal Fe bioavailability was low. Serum Fe curves were highly reproducible and were affected as expected by food composition. Even the single measurement at the estimated time of peak iron concentration was correlated significantly with erythrocyte incorporation of (58)Fe (r = 0.72, P < 0.0001). Hence the extent and rate of absorption of nonheme iron from meals, rather than in individuals, can be investigated with such subjects without the need for isotopes.     

NaFeEDTA强化酱油对铁缺乏的防治效果——人群干预试验

在过去研究人体铁吸收率和对贫血儿童的治疗试验的基础上 ,观察NaFeEDTA强化酱油在自然高危人群中纠正铁缺乏的效果及可接受性。在贵州省毕节市海子街镇用双盲安慰剂对照法 ,在 14 0 0 0名 3岁以上人群中进行为期 18个月的NaFeEDTA强化酱油 (Fe 2 96mg铁 L)干预试验。观察指标包括 :血红蛋白、红细胞压积、血浆铁蛋白和维生素A、膳食、体格测量、智力发育和身体耐力。干预组平均每人每天消费 16 5ml酱油 ,其中含 4 9mg来自NaFeEDTA的铁。与对照人群相比 ,干预人群中各年龄 -性别组的血红蛋白水平明显升高、贫血率明显下降、血浆铁蛋白明显升高 ;3～ 6岁儿童身高和体重明显改善。而同时 ,两组食物消费与试验前无明显差别。NaFeEDTA强化酱油对于纠正铁缺乏、降低贫血率以及改善儿童生长发育有明显效果。同时 ,试验参加者一致反映铁强化酱油的感官性状良好 ,可接受性良好。