Iron deficiency is reported to be the most prevalent nutritional problem in the world today, with an estimated 2.5 to 4 billion people affected.
Novel strategies for food fortification need to be developed to increase the dietary intake of bioavailable iron. To establish a food fortification program, several important factors should be considered, including the choice of food vehicle and iron compound, and the fortification level and ways to enhance iron bioavailability from the fortified food. For example, industrially produced infant formulas are usually fortified with highly bioavailable water-soluble iron compounds such as ferrous sulfate, and they contain added ascorbic acid. However, cereal products are difficult to fortify with such compounds due to unacceptable organoleptic changes (rancidity flavor/color changes) that occur during storage and/or preparation. Consequently, less soluble, and therefore less bioavailable, iron compounds such as elemental iron powders and ferric pyrophosphate are commonly used.
SPECIFIC HEALTH BENEFITS
Iron fortification of the diet is an important approach to combating iron deficiency anemia. In a study published by M. Hoppe, et al., in the Nov. 21, 2005, issue of the European Journal of Nutrition, Swedish researchers assessed the bioavailability of seven elemental iron powders relative to a ferrous sulfate in humans. In these studies, subjects were served bread rolls fortified with various elemental iron powders. Blood samples were taken every hour during six hours following the meal to study the change in serum iron.
Overall, the findings from this study indicate that the elemental iron powders currently available for commercial use are absorbed significantly less than ferrous sulfate. The mean bioavailability of seven iron powder sources compared to ferrous sulfate is reported in "Different Sources, Different Bioavailability" (below). Although there are apparent differences in bioavailability between various iron powder sources, they were not statistically significant.
The investigators also tested whether addition of ascorbic acid to the test meal could increase iron bioavailability and found equal bioavailability with ferrous sulfate under these test conditions suggesting that co-fortification with both ascorbic acid and iron may be beneficial.
Walking unassisted is an important milestone in the development of children for a number of reasons, including an increased freedom for exploration and as a further stimulus in the development of visual perception. The ability to walk independently also influences a child’s interaction with its parents or other caregivers, which, in turn, can reinforce the child’s development. General malnutrition or deficiencies of micronutrients such as iron and zinc may rob a child of the energy and initiative to develop new skills and maintain those they have already acquired.
African and American researchers recently reported on the effects of providing a supplement containing iron and folic acid either with or without additional zinc in infants five to 11 months old in Zanzibar, which is located off the coast of mainland Tanzania in Africa. This work by D.K. Olney, et al., was published in the Journal of Nutrition of September 2006.
The main finding of the study was that children who received any ironcontaining supplement were able to walk unassisted sooner than those children who received no iron. On average, children receiving the iron supplement walked about one month earlier than those who received no iron. The study also found that there was a significantly greater reduction in the prevalence of anemia in children in the iron-plus-zinc group compared to children who only received placebo. The study is of interest because it suggests that the provision of iron to children living in areas with a high prevalence of iron deficiency can have an important effect on child development.
Iron deficiency in children can have adverse effects on developmental outcomes including cognitive function. A recent study in Greece was undertaken to assess whether iron supplementation would affect the ability for sustained attention and conceptual learning in children who were generally well nourished and healthy but also mildly iron-deficient anemic. Results were published by E. Metallinos-Katsaras, et al., in the November 2004 issue of the
The researchers found that the cognitive test scores indicated that anemic subjects given the iron supplement made significantly fewer errors, exhibited higher accuracy and were significantly more efficient than those given placebo. However, preschoolers with good iron status had no improvement in test response to iron supplementation. Overall, the researchers concluded that iron supplementation of iron-deficient anemic preschoolers results in an improvement in discrimination, specifically selective attention.
The incorporation of nutrients such as iron via nutrient premixes is an essential element in nutrition strategies to alleviate micronutrient deficiencies. It is a dynamic area developing in response to the needs of population groups and global industries. Efforts should continue to develop new systems of delivering micronutrients to target populations through appropriate fortification procedures. To facilitate this, those involved in the establishment of food fortification programs must have ready access to information concerning fortification techniques and procedures being used all over the world. A multi-disciplinary approach is essential for successful fortification with active collaboration with all parties involved. Adequate monitoring of food fortification is essential and should include both monitoring of critical control points in the production and distribution of fortified foods and the strict monitoring of micronutrient status for target populations.