Exploratory Study: Excessive Iron Supplementation Reduces Zinc Content in Pork without Affecting Iron and Copper.

The aim of this work was to determine in an exploratory manner the effect of excessive iron supplementation on iron, zinc, and copper contents in pork and pork offal. Pigs averaging 50 days in age and 15 ± 1.3 kg body weight were allocated to a control group (500 ppm dietary Fe) and a supplemental group (3000 ppm dietary Fe). After an iron supplementation period of 60 days, blood samples were analyzed to determine iron biomarkers, serum copper, and zinc contents. Animals were slaughtered to assess total iron, non-heme iron, heme iron, zinc, and copper contents in samples of nine meat cuts and some offal. Iron supplementation improved the iron status in pigs with increased hemoglobin and hematocrit, but did not affect serum levels of iron, zinc, and copper. Iron supplementation did not affect the heme and non-heme iron contents of the different meat cuts. Zinc contents decreased by 32-55% in meat cuts, where iron content increased in the liver, spleen, kidneys, and pancreas. No differences of zinc and copper were observed in offal samples. High concentrations of iron supplementation reduce zinc content in pork.

Zinc absorption and zinc status are reduced after either sleeve gastrectomy or Roux-en-Y gastric bypass in premenopausal women with severe obesity studied prospectively over 24 postoperative months.

BACKGROUND: Roux-en-Y gastric bypass (RYGBP) is known to reduce zinc absorption; the effects of vertical sleeve gastrectomy (SG) and its long-term implications on zinc absorption have not yet been studied. OBJECTIVE: The aim was to evaluate the effects of SG and RYGBP on zinc absorption and zinc status in premenopausal women with severe obesity up to 24 mo after surgery. METHODS: Twenty-six premenopausal women undergoing SG [BMI (in kg/m2): 37.3 ± 3.2] and 32 undergoing RYGBP (BMI: 42.0 ± 4.2) were studied. A series of anthropometric, dietary, and zinc status parameters (plasma and hair zinc), and the size of the exchangeable zinc pool (EZP), as well as percentage zinc absorption from a standardized dose using a stable isotope methodology were evaluated in the patients before the surgical procedure and at 12 and 24 mo after SG or RYGBP. SG patients received 15 mg and RYGBP received 25 mg of supplemental Zn/d. RESULTS: In premenopausal women, zinc absorption was decreased by 71.9% and 52.0% in SG and RYGBP, respectively, 24 mo postsurgery, compared with initial values. According to 2-factor repeated-measures ANOVA, time effect was significant (P = <0.0001), but not time × group interaction (P = 0.470). Plasma zinc below the cutoff point of 70 µg/dL increased from 0 to 15.4% and 38.1% in SG and RYGBP, respectively. Mean EZP was significantly reduced 24 mo after surgery, although no time × group interactions were observed. Hair zinc did not change across time or between groups. CONCLUSIONS: Both SG and RYGBP have profound effects on zinc absorption capacity, which are not compensated for after 24 mo. Although zinc absorption reduction was similar in both types of surgeries, plasma zinc was more affected in RYGBP than SG, despite greater zinc supplementation in RYGBP.This trial was registered at http://www.isrctn.com as ISRCTN31937503.

Effect of various calcium salts on non-heme iron bioavailability in fasted women of childbearing age.

INTRODUCTION: Micronutrient deficiencies are one of the most important public health issues worldwide and iron (Fe) deficiency anemia is the most prevalent micronutrient deficiency. Iron deficiency often coexists with calcium deficiency and iron and calcium supplementation often overlap. This has led to investigations into the interaction between these two minerals, and whether calcium may inhibit iron absorption in the gut. OBJECTIVE: To determine the effect of various calcium salts on non-heme iron bioavailability in fasted women of childbearing age. METHODS: A randomized and single blinded trial was conducted on 27 women of childbearing age (35-45 years old) divided into 2 groups (n1 = 13 and n2 = 14, respectively). On four different days, after an overnight fast, they received 5 mg of Fe as FeSO4 (labeled with 55Fe or 59Fe) with 800 mg of elemental calcium in the form of either calcium chloride, calcium gluconate, calcium citrate, calcium carbonate, calcium lactate, calcium sulfate or calcium phosphate. Calcium chloride was used as the control salt in both groups. Iron was labeled with the radioisotopes 59Fe or 55Fe, and the absorption of iron was measured by erythrocyte incorporation of radioactive Fe RESULTS: 800 mg of elemental calcium as calcium citrate produced a significant decrease in non-heme iron bioavailability (repeated measures ANOVA, F = 3.79, p = 0.018). CONCLUSION: Of the various calcium salts tested, calcium citrate was the only salt that decreased non-heme iron bioavailability relative to the calcium chloride control when taken on an empty stomach. These results suggest that inhibition of non-heme iron absorption in fasted individuals is dependent upon the calcium salt in question and not solely dependent on the presence of calcium.

Pectin Esterification Degree in the Bioavailability of Non-heme Iron in Women.

Pectins are a type of soluble fiber present in natural and processed foods. Evidence regarding the effect of esterification degree of pectins on iron absorption in humans is scarce. In the present study, the effect of pectins with different degrees of esterification on non-heme iron absorption in women was evaluated. A controlled experimental study was conducted with block design, involving 13 apparently healthy, adult women. Each subject received 5 mg Fe (FeSO4) without pectin (control) or accompanied by 5 g citrus pectin, two with a low degree of esterification (27 and 36%), and one with a high degree of esterification (67 to 73%), each on different days. Each day, the 5 mg Fe doses were marked with radioactive 59Fe or 55Fe. Radioactivity incorporated into erythrocytes was determined in blood samples 14 days after the marked Fe doses were consumed. On days 18 and 36 of study, 30 and 20 mL blood samples were obtained, respectively, and blood sample radioactivity incorporated into erythrocytes was determined. Body iron status was determined from blood taken on day 18. Whole body blood volume was estimated for calculate iron bioavailability; it was assumed that 80% of absorbed radioactivity was incorporated into the Hb. All women participants signed an informed consent of participation at baseline. Iron bioavailability (mean geometric ±1 SD) alone (control) was 18.2% (12.3-27.1%), iron + pectin27 was 17.2% (10.2-29.2%), iron + pectin36 was 15.3% (9.5-24.6%), and iron + pectin67 was 19.5% (10.0-38.0%). No statistically significant differences between iron bioavailability (repeated measures ANOVA, p = 0.22) were observed. Pectin esterification degree does not influence the bioavailability of non-heme iron in women.

Acute Copper and Ascorbic Acid Supplementation Inhibits Non-heme Iron Absorption in Humans.

The objective of the study is to determine the effect of copper (Cu) plus the reducing agent ascorbic acid (AA) on the absorption of non-heme iron (Fe). Experimental study with block design in which each subject was his own control. After signing an informed consent, 14 adult women using an effective method of contraception and negative pregnancy test received 0.5 mg Fe, as ferrous sulfate, alone or with Cu, as copper sulfate, plus ascorbic acid (AA/Cu 2/1 molar ratio) at 4/1; 6/1 and 8/1 Cu/Fe molar ratios as an aqueous solution on days 1, 2, 14, and 15 of the study. Fe absorption was assessed by erythrocyte incorporation of iron radioisotopes (55)Fe and (59)Fe. Geometric mean (range ± SD) absorption of Fe at 4/1 and 6/1 Cu/Fe molar ratios (and AA/Cu 2/1 molar ratio) and Fe alone was 57.4 % (35.7-92.1 %), 64.2 % (45.8-89.9 %), and 38.8 % (20.4-73.8 %), respectively (ANOVA for repeated measures p < 0.001; post hoc test Scheffé, p < 0.05). This is attributable to the enhancing effect of AA on non-heme Fe absorption; however, Fe absorption at Cu/Fe 8/1 molar ratio was 47.3 % (27.7-80.8) (p = NS compared with Fe alone). It was expected that Fe absorption would have been equal or greater than at 4/1 and 6/1 molar ratios. Copper in the presence of ascorbic acid inhibits non-heme Fe absorption at Cu/Fe 8/1 molar ratio.

Iron Absorption from Two Milk Formulas Fortified with Iron Sulfate Stabilized with Maltodextrin and Citric Acid.

BACKGROUND: Fortification of milk formulas with iron is a strategy widely used, but the absorption of non-heme iron is low. The purpose of this study was to measure the bioavailability of two iron fortified milk formulas designed to cover toddlers´ nutritional needs. These milks were fortified with iron sulfate stabilized with maltodextrin and citric acid. METHODS: 15 women (33-47 years old) participated in study. They received on different days, after an overnight fast, 200 mL of Formula A; 200 mL of Formula B; 30 mL of a solution of iron and ascorbic acid as reference dose and 200 mL of full fat cow's milk fortified with iron as ferrous sulfate. Milk formulas and reference dose were labeled with radioisotopes (59)Fe or (55)Fe, and the absorption of iron measured by erythrocyte incorporation of radioactive Fe. RESULTS: The geometric mean iron absorption corrected to 40% of the reference dose was 20.6% for Formula A and 20.7% for Formula B, versus 7.5% of iron fortified cow's milk (p < 0.001). The post hoc Sheffé indeed differences between the milk formulas and the cow's milk (p < 0.001). CONCLUSION: Formulas A and B contain highly bioavailable iron, which contributes to covering toddlers´ requirements of this micronutrient.

Introduction: Prevalence of Micronutrient Deficiencies in Latin America and the Caribbean.

This Food and Nutrition Bulletin supplement summarizes updated prevalence data on micronutrient deficiencies in Latin America and the Caribbean (LAC). In order to provide an updated view of micronutrient status in LAC, systematic reviews were performed utilizing national health surveys and research-oriented studies focused on the prevalence of deficiencies of vitamin A, folate, anemia (as a proxy of iron deficiency), and zinc. Results show that the prevalence of vitamin A deficiency has been reduced in many countries, folate deficiency is now almost non-existent, low or marginal vitamin B12 status is still prevalent in most locations, anemia remains a public health problem among children under 6 years of age and women of childbearing age in most surveyed countries, and there is a high prevalence of zinc deficiency in children under 6 years of age and girls and women 12 to 49 years of age. Thus, regardless of improvements in the overall rates of economic growth in LAC, deficiencies of these micronutrients still remain a public health problem.

Effect of daily supplementation with iron and zinc on iron status of childbearing age women.

The objective was to determine the effect of daily supplementation with 30 mg of iron (Fe) plus 30 mg of zinc (Zn) for 3 months on Fe status of women of childbearing age. This was a randomized double-blind, placebo-controlled trial. Eighty-one women (18-45 years) were randomly assigned to receive either a daily single dose of 30 mg of Fe (group 1; n = 28) and 30 mg of Fe plus 30 mg of Zn (group 2; n = 26) or placebo (n = 27) for 3 months. Hemoglobin (Hb), mean corpuscular volume, serum Fe, total iron-binding capacity, transferrin saturation, erythrocyte Zn protoporphyrin, serum ferritin (SF), serum transferrin receptor (TfR), total body Fe, serum Zn, and high-sensitivity C-reactive protein were measured at baseline and at the end of the study. At baseline, 3.7, 28.4, and 3.7 % of women had iron-deficiency anemia (IDA), Fe deficiency without anemia, and depleted Fe stores, respectively. No significant differences on Fe status were found between groups before supplementation. After supplementation, group 2 showed a significant increase of Hb and total body Fe and a significant decrease of TfR compared with placebo (p < 0.05). Moreover, serum Zn increased significantly in group 2 compared with group 1 (p < 0.01) and placebo (p < 0.01). In conclusion, daily supplementation with 30 mg of Fe plus 30 mg of Zn for 3 months improved significantly the Fe and Zn status of women, compared with those who received placebo. The positive effect of Fe supplementation on Fe status is enhanced by combined Zn supplementation.

Effect of phytic acid, tannic acid and pectin on fasting iron bioavailability both in the presence and absence of calcium.

OBJECTIVE: To determine the effect of phytic acid, tannic acid and pectin on fasting non-heme iron bioavailability in both the presence and absence of calcium. RESEARCH METHODS: Twenty-eight apparently healthy adult females participated in two iron absorption studies using radioactive iron isotopes ((59)Fe and (55)Fe). One group received 5mg of iron (as FeSO4) alone (control), together with 10mg of phytic acid, 100mg of tannic acid and 250mg of pectin (study A), on different days. The second group received the same iron doses and compounds as the other group, plus 800mg of calcium (CaCl2) (study B). The compounds were administered after an overnight fast, and no food or beverages were consumed for the following 3h. Iron status and circulating radioactivity were measured in venous blood samples. RESULTS: The geometric means of iron bioavailability (range±1SD) for iron alone, iron with phytic acid, iron with tannic acid, and iron with citrus pectin were 25.0% (11.9-52.0); 18.9% (9.9-35.8); 16.8% (8.7-32.3); and 21.1% (10.2-43.9), respectively (repeated-measures ANOVA, p<0.02 (Dunnett's post hoc: control vs tannic acid p<0.05). When 800mg of calcium was added (study B), iron bioavailability was 16.7% (10.1-27.5); 13.2% (7.1-24.6); 14.8% (8.8-25.1); and 12.6% (5.5-28.8), respectively (repeated-measures ANOVA, NS). CONCLUSIONS: Tannic acid decreases the fasting bioavailability of non-heme iron, however this effect did not exist in the presence of calcium. No effect was observed by phytic acid or citrus pectin on fasting non-heme iron bioavailability in both the presence and absence of calcium.

Reducing iron deficiency anemia in Bolivian school children: calcium and iron combined versus iron supplementation alone.

OBJECTIVE: The aim of this study was to determine the effect of combined calcium and iron versus single iron supplementation on iron status in Bolivian schoolchildren. METHODS: Children ages 6 to 10 y old (N = 195), were randomly assigned to receive either 700 mg Ca (as calcium carbonate) plus 30 mg Fe (as ferrous sulfate) (Ca + Fe group) or 30 mg Fe (as ferrous sulfate) (Fe group). The doses were administered daily, from Monday to Friday, between meals at school over 3 mo. Iron status was assessed at baseline and after intervention. Additionally, overall nutritional status was assessed by anthropometry and an estimation of dietary intake. RESULTS: At baseline, the prevalence of anemia in the Ca + Fe group and the Fe group were 15% and 21.5%, respectively. After 3 mo follow-up, the prevalence of iron deficiency anemia dropped significantly (P < 0.001) to 3% in both groups (χ(2) = NS). Iron dietary intake was within recommended levels, but calcium intake only covered 39% of the Recommended Daily Intake. CONCLUSION: Combined calcium and iron supplementation is equally as effective as single iron supplementation in reducing the prevalence of iron deficiency anemia in Bolivian school children.

One-month of calcium supplementation does not affect iron bioavailability: a randomized controlled trial.

OBJECTIVES: Calcium (Ca) and iron (Fe) are essential minerals for normal growth and development. Although previous studies have shown that Ca inhibits acute Fe absorption, there is no evidence of the possible long- or medium-term effects of Ca supplementation on Fe bioavailability. The aim of this study was to determine the effect of 34 d of Ca supplementation on heme Fe and non-heme Fe bioavailability in non-pregnant women of ages 33 to 47 y. METHODS: This was a prospective, randomized, double-blind, placebo-controlled trial. Twenty-six healthy women (40 ± 5 y) were randomly assigned to receive either 600 mg of elemental Ca/d as CaCO3 (Ca group, n = 13) or a placebo (P group, n = 13) for 34 d. Heme Fe and non-heme Fe bioavailability were determined before and after treatment using (55)Fe and (59)Fe radioisotopes. A two-factor, repeated-measures analysis of variance was used to assess differences by treatment and timing. RESULTS: The geometric mean (range ± 1 SD) of heme Fe bioavailability before and after treatment was 16.5% (8.3-32.8) and 26% (15.5-43.6) for the Ca group and 21.8% (13.0-36.6) and 25.1% (16.5-38.3) for the P group. Non-heme Fe bioavailability before and after treatment was 39.5% (19.9-78.7) and 34.1% (19.1-60.6) for the Ca group, and 44.6% (24.9-79.7) and 39.3% (24.3-63.4) for the P group. There were no differences in either heme Fe or non-heme Fe bioavailability either at baseline or after treatment. CONCLUSION: The administration of calcium supplements for 34 d does not affect iron bioavailability. This trial is registered with Controlled-trials.gov, number ISRCTN 89888123.

Copper supplementation at 8 mg neither affects circulating lipids nor liver function in apparently healthy Chilean men.

UNLABELLED: Copper (Cu) deficiency has been reported to influence lipid metabolism, but the effects in humans are controversial. To evaluate the effects of 8 mg Cu/day supplementation (as copper sulfate) for 6 months on the lipid profile and hepatic function of apparently healthy men. The design was randomized double-blind placebo-controlled clinical trial. SUBJECTS AND METHODS: 60 apparently healthy males aged 18-51 years were randomly assigned to Cu supplementation (n = 30) or placebo (n = 30). There was a nonsignificant reduction of 17 % in total cholesterol in both groups after supplementation. A 23 % nonsignificant reduction was observed in LDL cholesterol levels in the supplemented group. There was a nonsignificant increase of HDL cholesterol of 47 and 66 % in the control and supplemented groups, respectively. Triglyceride levels over 150 mg/dl were found in 17 subjects supplemented and 13 controls at baseline and decreased after supplementation to seven and eight subjects, respectively. There were no effects on serum Cu concentration or ceruloplasmin (protein) and hepatic transaminases. Supplementation of 8 mg Cu for 6 months had no effect on lipid profile of apparently healthy Chilean men with adequate Cu status.

Effect of increasing levels of zinc fortificant on the iron absorption of bread co-fortified with iron and zinc consumed with a black tea.

Iron (Fe) and zinc's (Zn) interaction at the absorptive level can have an effect on the success of co-fortification of wheat flour with both minerals on iron deficiency prevention. The aim of the study was to determine the effect of increasing levels of zinc fortificant on the iron absorption of bread co-fortified with iron and zinc consumed with a black tea. Twelve women aged 33-42 years participated in the study. They received on four different days 200 mL of black tea and 100 g of bread made with wheat flour (70% extraction) fortified with either 30 mg Fe/kg alone, as ferrous sulfate (A), or with the same Fe-fortified flour, but with graded levels of Zn, as zinc sulfate: 30 mg/kg (B), 60 mg/kg (C), or 90 mg/kg (D). Fe radioisotopes ((59)Fe and (55)Fe) of high specific activity were used as tracers, and Fe absorption iron was measured by the incorporation of radioactive Fe into erythrocytes. The geometric mean and range of ±1 SD of Fe absorption were as follows: A = 6.5% (2.2-19.3%), B = 4.6% (1.0-21.0%), C = 2.1% (0.9-4.9%), and D = 2.2% (0.7-6.6%), respectively; ANOVA for repeated measures F = 10.9, p < 0.001 (Scheffè's post hoc test: A vs. C, A vs. D, B vs. C, and B vs. D; p < 0.05). We can conclude that Fe absorption of bread made from low-extraction flour fortified with 30 mg/kg of Fe, as ferrous sulfate, and co-fortified with zinc, as zinc sulfate consumed with black tea is significantly decreased at a zinc fortification level of ≥60 mg/kg flour.

Iron status biomarkers and C-reactive protein in children aged 19 to 72 months in Chile.

BACKGROUND: The Chilean Ministry of Health has combated iron deficiency through the delivery of fortified milk by the National Complementary Feeding Program (NCFP). OBJECTIVE: To assess iron status and associations between biomarkers of iron status and serum C-reactive protein (CRP) in 218 beneficiaries of the NCFP aged 19 to 72 months in Santiago and Valparaiso, Chile. METHODS: Blood was collected from a cross-sectional representative sample. Iron status (measured by hemoglobin, zinc protoporphyrin, and serum ferritin levels) and inflammation (according to CRP level) were determined. RESULTS: Serum CRP level was positively associated with serum ferritin and zinc protoporphyrin levels (r = 0.16 and r = 0.15; p = .0168 and p = .0290, respectively). Serum ferritin was higher among children with high CRP (> 10 mg/dL) than among those with low CRP (< or = 10 mg/dL) (p = .003). After adjustment for 10, 6, and 5 mg/L CRP, the prevalence of low serum ferritin changed from 56.4% without adjustment to 60.6%, 61.5%, and 42.7%, respectively, and the prevalence of high zinc protoporphyrin changed from 22.9% to 21.6%, 17.4%, and 17.9%, respectively. There were no differences between regions in biomarkers of iron status. There was no association between consumption of fortified milk and the prevalence of abnormal serum ferritin (< 15 microg/L) after adjustment for sex, age, and breastfeeding (OR, 1.00; 95% CI, 0.99 to 1.01; p = .288). After adjustment for 10 mg/L CRP, 5.5% were classified as having iron-deficiency anemia, 42.7% as having iron-deficiency erythropoiesis, 17.9% as having depleted iron stores, and 35.8% as having normal iron status. CONCLUSIONS. CRP level was positively associated with: serum ferritin and zinc protoporphyrin levels. Chilean children aged 19 to 72 months from Santiago and Valparaiso who were beneficiaries of the NCFP had a low prevalence of iron-deficiency anemia, a high prevalence of iron-deficiency erythropoiesis, and a moderate prevalence of depleted iron stores.

Prevalencia y etiología de la anemia en Panamá

Desde 1998, el Ministerio de Salud de Panamá desarrolla un programa nacional de suplementación con hierro de forma preventiva en grupos de riesgo. El objetivo del estudio fue determinar las prevalencia total de anemia y de anemia ferropriva en una muestra representativa nacional de lactantes, preescolares, escolares y embarazadas, pertenecientes a distritos prioritarios y escolares de distritos prioritarios y no prioritarios. Se determinaron Hb, VCM, zinc-protoporfirina, ferritina sérica, proteína C reactiva (PCR) y solubilidad de hemoglobina. La Anemia ferropriva se definió como anemia con dos o más indicadores de nutrición de hierro alterados. Dado que un alto porcentaje de los sujetos presentó una PCR elevada, se utilizó un punto de corte para la ferritina de 50 ug/l. La prevalencia de anemia fue 66% en niños de 9 a 15 meses de edad, 41.8% en niños de 16 a 59 meses, 6.3% en escolares y 23.4% en embarazadas, mientras la prevalencia de anemia ferropriva fue 48.8%, 20.3%, 2.5% y 9.4%, respectivamente en embarazadas. La portación de drepanocitosis fue <2.5%. Conclusión: La anemia ferropriva tiene una alta prevalencia y es la principal causa de anemia en lactantes y preescolares. En embarazadas y escolares los procesos infecciosos constituirían la principal etiología de la anemia. La baja prevalencia de anemia ferropriva en escolares y embarazada es atribuible a la efectividad de la suplementación con hierro. Se requiere de la mejoría de la efectividad del programa nacional de suplementación y medidas destinadas a disminuir la incidencia de infecciones para reducir la prevalencia global de anemia en la población panameña.

From 1998, the Ministry of Health of Panama has a national program of prophylactic iron supplementation of risk groups. The objective of the study was to determine the prevalence anemia and of iron deficiency anemia (IDA) in a national representative sample of infants, preschool children and pregnant women from high-priority districts and scholar children from high-priority and not high-priority districts. Hb, MCV, zinc-protoporphyrin, serum ferritin, C reactive protein (CRP) and hemoglobin solubility were measured. IDA was defined as anemia plus two or more abnormal iron nutrition status. Since most of the subjects presented a high CRP, a 50 ug/l cutoff was used for serum ferritin. The prevalence of anemia was 66% in children from 9 to 15 months of age, 41.8% in children of 16 to 59 months, 6.3% in school children and 23.4% in pregnant women, whereas IDA prevalence was 48.8%, 20.3%, 2.5% and 9.4%, respectively. Sickle-cell trait was found in <2.5 % of the subjects. Conclusion, IDA was highly prevalent and the main cause of anemia in infants and preschool children. Infectious processes would constitute the main etiology of anemia in school children and pregnant women. The low prevalence of IDA in scholars and pregnant women is attributable to the effectiveness of the iron supplementation. The improvement of the effectiveness of the national iron supplementation program together with measures to diminish the incidence of infections are required to reduce the prevalence of anemia in the Panamanian population.

Bioavailability of stabilised ferrous gluconate with glycine in fresh cheese matrix: a novel iron compound for food fortification.

Iron fortification of foods continues to be one of the preferred ways of improving the iron status of the population. Dairy product is a common product in the diet; therefore, it is a plausible vehicle for iron fortification. This study aims to investigate the bioavailability of ferrous gluconate stabilised with glycine (FGSG) in a fresh cheese fortified with zinc. The iron bioavailability of fresh cheese fortified with either FGSG and with or without zinc and FGSG in aqueous solution and a water solution of ferrous ascorbate (reference dose) was studied using double radio iron ((55)Fe and (59)Fe) erythrocyte incorporation in 15 male subjects. All subjects presented with normal values for iron status parameters. The geometric mean of iron bioavailability for the water solution of FGSG was 38.2 %, adjusted to 40 % from reference doses (N.S.). Iron bioavailability in fresh cheese fortified with Ca and Zn was 15.4 % and was 23.1 % without Zn, adjusted to 40 % from reference doses (N.S.). The results of the present study show that the novel iron compound ferrous gluconate stabilised with glycine in a fresh cheese matrix is a good source of iron and can be used in iron fortification programmes.

Effect of zinc sulfate fortificant on iron absorption from low extraction wheat flour co-fortified with ferrous sulfate.

UNLABELLED: The co-fortification of wheat flour with iron (Fe) and zinc (Zn) is a strategy used to prevent these deficiencies in the population. Given that Zn could interact negatively with Fe, the objective was to assess the effect of Zn on Fe absorption from bread prepared with wheat flour fortified with Fe and graded levels of Zn fortificant. Twelve women aged 30-43 years, with contraception and a negative pregnancy test, participated in the study. They received on four different days, after an overnight fast, 100 g of bread made with wheat flour (70 % extraction) fortified with 30 mg Fe/kg as ferrous sulfate (A) or prepared with the same Fe-fortified flour but with graded levels of Zn, as zinc sulfate: 30 mg/kg (B), 60 mg/kg (C), or 90 mg/kg (D). Fe radioisotopes ((59)Fe and (55)Fe) of high specific activity were used as tracers and Fe absorption iron was measured by the incorporation of radioactive Fe into erythrocytes. RESULTS: The geometric mean and range of ± 1 SD of Fe absorption were: A= 19.8 % (10.5-37.2 %), B = 18.5 % (10.2-33.4 %), C = 17.7 % (7.7-38.7 %), and D = 11.2 % (6.2-20.3 %), respectively; ANOVA for repeated measures F = 5.14, p < 0.01 (Scheffè's post hoc test: A vs D and B vs D, p < 0.05). We can conclude that Fe is well absorbed from low extraction flour fortified with 30 mg/kg of Fe, as ferrous sulfate, and up to 60 mg/kg of Zn, as Zn sulfate. A statistically significant reduction of Fe absorption was observed at a Zn fortification level of 90 mg Zn/kg.

Chilean complementary feeding program reduces anemia and improves iron status in children aged 11 to 18 months.

BACKGROUND: Iron deficiency is the most prevalent nutritional deficiency in the world, primarily affecting infants, young children, and women of childbearing age. OBJECTIVE: To evaluate the impact of the National Complementary Feeding Program (NCFP) on anemia and iron status in Chilean children aged 11 to 18 months. METHODS: Two studies were performed. The first study was performed at one public outpatient health center in Santiago, using data collected in 1999 (n = 128) and 2000 (n = 125), before and after the national introduction of iron-fortified milk. Subsequently, a study of a representative sample (n = 320) from the two most populated areas of the country was performed in 2009. RESULTS: One year after fortification, the prevalence of anemia was 9%; significantly lower (p < .001) than the 27% prevalence observed 1 year before. Ten years after fortification, 14% of children were anemic and 77% of children with anemia (12% of all children) suffered from iron-deficiency anemia. In 2009, 11% of children consuming iron-fortified milk delivered by the NCFP (73%) were anemic, significantly lower (p = .028) than the 21% prevalence of anemia observed in children without consumption. Consumption of iron-fortified milk was positively associated with hemoglobin concentration (r = 0.28, p = .022) and was associated with a lower prevalence of anemia after adjusting for confounding factors (odds ratio, 0.50; 95% CI, 0.26 to 0.96). CONCLUSIONS: In Chile, the NCFP has had an impact on the reduction of anemia and improved the iron status of children aged 11 to 18 months. Increasing the consumption of this iron-fortified milk could enhance the impact of the NCFP.

Folatos y vitamina B12 en la salud humana / Folate, vitamin B12 and human health

During the past decade the role of folate and vitamin B12 in human nutrition have been under constant re-examination. Basic knowledge on the metabolism and interactions between these essential nutrients has expanded and multiple complexities have been unraveled. These micronutrients have shared functions and intertwined metabolic pathways that define the size of the "methyl donor" pool utilized in multiple metabolic pathways; these include DNA methylation and synthesis of nucleic acids. In Chile, folate deficiency is virtually nonexistent, while vitamin B12 deficiency affects approximately 8.5-51% depending on the cut-off value used to define deficiency. Folate is found naturally mainly in vegetables or added as folic acid to staple foods. Vitamin B12 in its natural form is present only in foods of animal origin, which is why deficit is more common among strict vegetarians and populations with a low intake of animal foods. Poorfolate status in vulnerable women of childbearing age increases the risk of neural tube birth defects, so the critical time for the contribution of folic acid is several months before conception since neural tube closure occurs during the first weeks of life. The absorption of vitamin B12 from food is lower in older adults, who are considered to have higher risk of gastric mucosa atrophy, altered production of intrinsic factor and acid secretion. Deficiency of these vitamins is associated with hematological disorders. Vitamin B12 deficiency can also induce clinical and sub-clinical neurological and of other disorders. The purpose of this review is to provide an update on recent advances in the basic and applied knowledge of these vitamins relative to human health.

Heme- and nonheme-iron absorption and iron status 12 mo after sleeve gastrectomy and Roux-en-Y gastric bypass in morbidly obese women.

BACKGROUND: The effect of bariatric surgery on iron absorption is only partially known. OBJECTIVE: The objective was to study the effects of sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGBP) on heme- and nonheme-iron absorption and iron status. DESIGN: Fifty-eight menstruating women were enrolled in this prospective study [mean (±SD) age: 35.9 ± 9.1 y; weight: 101.7 ± 13.5 kg; BMI (in kg/m²): 39.9 ± 4.4]. Anthropometric, body-composition, dietary, and hematologic indexes and heme- and nonheme-iron absorption-using a standardized meal containing 3 mg Fe-were determined before and 12 mo after surgery. Forty-three subjects completed the 12-mo follow-up. Iron supplements were strictly controlled. RESULTS: Heme-iron absorption was 23.9% before and 6.2% 12 mo after surgery (P < 0.0001). Nonheme-iron absorption decreased from 11.1% to 4.7% (P < 0.0001). No differences were observed by type of surgery. Iron intakes from all sources of supplements were 27.9 ± 6.2 mg/d in the SG group and 63.2 ± 21.1 mg/d in the RYGBP group (P < 0.001). Serum ferritin and total-body iron decreased more after RYGBP than after SG. CONCLUSIONS: Iron (heme and nonheme) absorption is markedly reduced after SG and RYGBP. The magnitude of the decrease in heme-iron absorption is greater than that of nonheme iron. The amounts suggested as iron supplements may need to be increased to effectively prevent iron-status impairment.