Optimizing iron adequacy and absorption to prevent iron deficiency anemia: The role of combination of fortified iron and vitamin C

Abstract

Iron is a vital nutrient to promote the availability of tissue oxygen, cell growth and control of differentiation, and energy metabolism. Preventing Iron Deficiency Anemia (IDA) is necessary because iron is vital to central nervous system growth and development especially in the first years of life. Iron-rich complementary foods are recommended in infants around 6 months of age because iron store is depleted. Better understanding of iron absorption process and factors affecting its absorption and bioavailability is necessary to prevent iron deficiency and can be a dietary strategy to mitigate iron deficiency. Meat and iron-fortified food are the main sources of iron in the diet, and it is essential to introduce supplementary food to improve iron absorption. Additional foods such as cereals, cow milk and soybeans such as phytate, polyphenol and calcium are inhibitors which require care to prevent IDA. Ascorbic acid is an effective iron-absorbing enhancer, which is useful to reduce the effects of any known nonheme iron inhibitor. In iron-fortified foods, Combination use of vitamin C (ascorbic acid) is recommended in molar ratio of 2:1 (with cow's milk and low-phytate cereal foods) and higher molar ratio of 4:1 (with higher phytate such as soybeans).

The Important Role of Iron, Protein and Vitamin C With the Incident of Anemia

“…There are two forms of iron in food: heme and nonheme. Iron found in animal meat such as beef, chicken and fish is the main source of heme iron, while nonheme iron can be found in cereals, nuts, fruits and vegetables (Basrowi & Dilantika, 2021).…”

Iron oxide nanoparticles carried by probiotics for iron absorption: a systematic review

“…Reducing agents, such as ascorbic acid, citric acid, other organic acids, and amino acids (cysteine and histidine), may increase endogenous stomach acid production, thus stimulating iron absorption [ 84 ]. Dietary nutrients such as ascorbic acid and meat improve non-heme iron absorption [ 85 ]; polyphenols, calcium, and phytic acid hinder it [ 8 ]. The duodenum and upper jejunum are significant areas for intestinal iron absorption (90%), whereas the stomach accounts for < 2% of this process [ 8 , 86 ].…”

Prioritizing strategies for wheat biofortification: Inspiration from underutilized species

“…To achieve the declared RDA, cereal grains must have an additional 40–60 mg kg −1 of Fe and Zn and around 50–100 mg kg −1 of AA [ 122 ]. The recommended molar ratio of AA to Fe in food was 2:1 [ 135 ]. However, increasing it to 4:1 ratio may be impractical for the cereal-based food due to instability of AA during cooking and processing and unwanted sensory changes [ 37 ].…”