Background: Most dietary iron remains unabsorbed and hence may be available to participate in Fenton-driven free radical generation in conjunction with the colonic microflora, leading to the production of carcinogens or direct damage to colonocytes. Objective: Our aims were to measure the proportion of fecal iron available to participate in free radical generation and to determine the effect of an oral supplement of ferrous sulfate on free radical generation. Design: Eighteen healthy volunteers recorded their food intake and collected fecal samples before, during, and after 2 wk of supplementation (19 mg elemental Fe/d). Total, free, and weakly chelated fecal iron were measured and free radical production was determined by using an in vitro assay with dimethyl sulfoxide as a free radical trap. Results: Fecal iron increased significantly during the period of supplementation and returned to baseline within 2 wk. The concentration of weakly bound iron in feces (Ϸ1.3% of total fecal iron) increased from 60 mol/L before to 300 mol/L during supplementation, and the production of free radicals increased significantly (Ϸ40%). Higher-carbohydrate diets were associated with reduced free radical generation. Conclusion: Unabsorbed dietary iron may increase free radical production in the colon to a level that could cause mucosal cell damage or increased production of carcinogens.Am J Clin Nutr 1999;69:250-5.

High concentrations of iron in the diet have been shown to increase chemically induced colorectal tumors in rats. It is therefore important to understand the influence of dietary iron on the concentration of unabsorbed iron in the large intestine and its distribution between soluble and insoluble pools in the luminal compartment. We sought to investigate this issue and to establish whether iron modifies mucosal cell proliferation, which is thought to influence initiation and progression through the adenoma carcinoma sequence. In the first experiment, four groups of seven rats were fed diets at two concentrations of iron, 29 and 102 mg/kg, with or without the addition of 2.5 g phytic acid/kg. The concentrations of iron in the contents of the large bowel extractable with water ("free iron") or a buffered EDTA solution ("exchangeable iron") were determined. The concentration of freely soluble iron increased approximately 100% with iron supplementation in both the cecum and the colon, and there was an approximately five- to sixfold increase in exchangeable iron at both sites (P < 0. 05). In a second experiment with identical feeding conditions, there was a significantly greater number of cell divisions per crypt in the colon of the high iron group and a significantly greater number of cell divisions in the upper part of the crypt in the cecum. The concentrations of free and exchangeable iron observed in colonic contents in this study are consistent with those reported by others to increase free radical production in fecal material. Further studies are required to determine whether the small changes in crypt cytokinetics are a consequence of oxidative mucosal damage.

There is increasing evidence that excess dietary iron may be a risk factor for colorectal cancer. However, the majority of animal studies looking at possible mechanism have used unrealistically high concentrations of iron. The current study was designed to test whether chronic exposure to high levels of iron fortification affects the free radical generating capacity of the lumenal contents, mucosal lipid peroxidation and crypt cell proliferation. Rats were fed diets containing either 29 mg/kg or 102 mg/kg of elemental iron for 6 mo. The free radical generating capacity of lumenal contents was assessed using an in vitro assay. Crypt cell proliferation rate was measured in tissues taken from the cecum and colon, with the remaining tissue being used for the assessment of lipid peroxidation. Chronic feeding of iron did not increase crypt cell proliferation rate in either the colon or cecum, but it was associated with an increase in free radical generating capacity in the colon and increased lipid peroxidation, particularly in the cecum. These results may be relevant to epidemiological evidence showing that dietary iron is associated with the risk of proximal colon cancer in humans. J. Nutr. 131: 2928 -2931, 2001.