Abstract
Even though iron is abundant in nature, it is estimated that two billion people are iron deficient. An important reason for this apparent paradox is the low bioavailability of many iron compounds, with bioavailability ranging from <2% for certain ferric compounds to 40% for heme iron. Dietary sources of iron include foods consumed daily (the common dietary sources of iron) but also foods intentionally enriched with iron (fortified foods), vitamin and mineral supplements containing iron, or foods or drinks contaminated with iron. In this chapter, we have given an overview of these different sources of iron intake and their relevance for human nutrition.
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References
Carpenter KJ. A short history of nutritional science: Part 1 (1785–1885). J Nutr. 2003;133:638–45.
Mackay HM. Anaemia in infancy: its prevalence and prevention. Arch Dis Child. 1928;3:117.
Gulec S, Anderson GJ, Collins JF. Mechanistic and regulatory aspects of intestinal iron absorption. American Journal of Physiology-Gastrointestinal and Liver. Physiology. 2014;307:G397–409.
Milman NT. Dietary iron intake in women of reproductive age in Europe: a review of 49 studies from 29 countries in the period 1993–2015. J Nutr Metab. 2019;2019:7631306.
Harika R, Faber M, Samuel F, Kimiywe J, Mulugeta A, Eilander A. Micronutrient status and dietary intake of iron, vitamin A, iodine, folate and zinc in women of reproductive age and pregnant women in Ethiopia, Kenya, Nigeria and South Africa: a systematic review of data from 2005 to 2015. Nutrients. 2017;9:1096.
Ferguson EL, Watson L, Berger J, Chea M, Chittchang U, Fahmida U, Khov K, Kounnavong S, Le BM, Rojroongwasinkul N. Realistic food-based approaches alone may not ensure dietary adequacy for women and young children in South-East Asia. Matern Child Health J. 2019;23:55–66.
Kongkachuichai R, Napatthalung P, Charoensiri R. Heme and nonheme iron content of animal products commonly consumed in Thailand. J Food Compos Anal. 2002;15:389–98.
Wang FS, Lin CW. The effects of heating and chemical treatment on the haem and non-haem iron content of heat-induced porcine blood curd. J Sci Food Agric. 1994;65:209–13.
Hurrell RF, Lynch SR, Trinidad TP, Dassenko SA, Cook JD. Iron absorption in humans: bovine serum albumin compared with beef muscle and egg white. Am J Clin Nutr. 1988;47(1):102–7.
Ziegler EE. Consumption of cow’s milk as a cause of iron deficiency in infants and toddlers. Nutr Rev. 2011;69(Suppl 1):S37–42.
Willett W, Rockström J, Loken B, Springmann M, Lang T, Vermeulen S, Garnett T, Tilman D, DeClerck F, Wood A, et al. Food in the Anthropocene: the EAT-Lancet Commission on healthy diets from sustainable food systems. Lancet (London, England). 2019;393:447–92.
Kawarazuka N, Béné C. Linking small-scale fisheries and aquaculture to household nutritional security: an overview. Food Security. 2010;2:343–57.
Roos N, Thorseng H, Chamnan C, Larsen T, Gondolf UH, Bukhave K, Thilsted SH. Iron content in common Cambodian fish species: perspectives for dietary iron intake in poor, rural households. Food Chem. 2007;104:1226–35.
Roos N, Wahab MA, Hossain MAR, Thilsted SH. Linking human nutrition and fisheries: incorporating micronutrient-dense, small indigenous fish species in carp polyculture production in Bangladesh. Food Nutr Bull. 2007;28:S280–S93.
Wheal MS, DeCourcy-Ireland E, Bogard JR, Thilsted SH, Stangoulis JC. Measurement of haem and total iron in fish, shrimp and prawn using ICP-MS: implications for dietary iron intake calculations. Food Chem. 2016;201:222–9.
Roos N, Islam MM, Thilsted SH. Small indigenous fish species in Bangladesh: contribution to vitamin A, calcium and iron intakes. J Nutr. 2003;133:4021S–6S.
Hicks CC, Cohen PJ, Graham NAJ, Nash KL, Allison EH, D’Lima C, Mills DJ, Roscher M, Thilsted SH, Thorne-Lyman AL, et al. Harnessing global fisheries to tackle micronutrient deficiencies. Nature. 2019;574:95–8.
Costello C, Cao L, Gelcich S, Cisneros-Mata MÁ, Free CM, Froehlich HE, Golden CD, Ishimura G, Maier J, Macadam-Somer I, et al. The future of food from the sea. Nature. 2020;588:95–100.
van Huis A. Edible insects are the future? Proc Nutr Soc. 2016;75:294–305.
Köhler R, Kariuki L, Lambert C, Biesalski H. Protein, amino acid and mineral composition of some edible insects from Thailand. J Asia Pac Entomol. 2019;22:372–8.
Latunde-Dada GO, Yang W, Vera Aviles M. In vitro iron availability from insects and sirloin beef. J Agric Food Chem. 2016;64:8420–4.
Imathiu S. Benefits and food safety concerns associated with consumption of edible insects. NFS J. 2020;18:1–11.
Cherry P, O’Hara C, Magee PJ, McSorley EM, Allsopp PJ. Risks and benefits of consuming edible seaweeds. Nutr Rev. 2019;77:307–29.
García-Casal MN, Pereira AC, Leets I, Ramírez J, Quiroga MF. High iron content and bioavailability in humans from four species of marine algae. J Nutr. 2007;137:2691–5.
Rao PS, Mantri VA, Ganesan K. Mineral composition of edible seaweed Porphyra vietnamensis. Food Chem. 2007;102:215–8.
Gutiérrez-Salmeán G, Fabila-Castillo L, Chamorro-Cevallos G. Aspectos nutricionales y toxicológicos de Spirulina (arthrospira). Nutr Hosp. 2015;32:34–40.
Gençcelep H, Uzun Y, Tunçtürk Y, Demirel K. Determination of mineral contents of wild-grown edible mushrooms. Food Chem. 2009;113:1033–6.
Haider LM, Schwingshackl L, Hoffmann G, Ekmekcioglu C. The effect of vegetarian diets on iron status in adults: a systematic review and meta-analysis. Crit Rev Food Sci Nutr. 2018;58:1359–74.
Clarys P, Deliens T, Huybrechts I, Deriemaeker P, Vanaelst B, De Keyzer W, Hebbelinck M, Mullie P. Comparison of nutritional quality of the vegan, vegetarian, semi-vegetarian, pesco-vegetarian and omnivorous diet. Nutrients. 2014;6(3):1318–32.
Mohammed SH, Taye H, Larijani B, Esmaillzadeh A. Food taboo among pregnant Ethiopian women: magnitude, drivers, and association with anemia. Nutr J. 2019;18(1):19.
Cao C, Fleming MD. The placenta: the forgotten essential organ of iron transport. Nutr Rev. 2016;74(7):421–31.
Domellöf M, Lönnerdal B, Dewey KG, Cohen RJ, Hernell O. Iron, zinc, and copper concentrations in breast milk are independent of maternal mineral status. Am J Clin Nutr. 2004;79(1):111–5.
Cerami C. Iron nutriture of the fetus, neonate, infant, and child. Ann Nutr Metab. 2017;71(Suppl 3):8–14.
Chantry CJ, Howard CR, Auinger P. Full breastfeeding duration and risk for iron deficiency in U.S. infants. Breastfeed Med. 2007;2(2):63–73.
Dewey KG, Brown KH. Update on technical issues concerning complementary feeding of young children in developing countries and implications for intervention programs. Food Nutr Bull. 2003;24(1):5–28.
Wieringa FT, Berger J, Dijkhuizen MA, Hidayat A, Ninh NX, Utomo B, Wasantwisut E, Winichagoon P. Sex differences in prevalence of anaemia and iron deficiency in infancy in a large multi-country trial in South-East Asia. Br J Nutr. 2007;98:1070–6.
Domellöf M, Lönnerdal B, Dewey KG, Cohen RJ, Rivera LL, Hernell O. Sex differences in iron status during infancy. Pediatrics. 2002;110:545–52.
Peña-Rosas JP, De-Regil LM, Garcia-Casal MN, Dowswell T. Daily oral iron supplementation during pregnancy. Cochrane Database Syst Rev. 2015;2015(7):CD004736.
Viteri FE, Berger J. Importance of pre-pregnancy and pregnancy iron status: can long-term weekly preventive iron and folic acid supplementation achieve desirable and safe status? Nutr Rev. 2005;63:S65–76.
Sazawal S, Black RE, Ramsan M, Chwaya HM, Stoltzfus RJ, Dutta A, Dhingra U, Kabole I, Deb S, Othman MK, et al. Effects of routine prophylactic supplementation with iron and folic acid on admission to hospital and mortality in preschool children in a high malaria transmission setting: community-based, randomised, placebo-controlled trial. Lancet (London, England). 2006;367:133–43.
Suchdev PS, Jefferds MED, Ota E, da Silva LK, De-Regil LM. Home fortification of foods with multiple micronutrient powders for health and nutrition in children under two years of age. Cochrane Database Syst Rev. 2020;2(2):CD008959.
Paganini D, Zimmermann MB. The effects of iron fortification and supplementation on the gut microbiome and diarrhea in infants and children: a review. Am J Clin Nutr. 2017;106(Suppl 6):1688S–93S.
Dijkhuizen MA, Greffeille V, Roos N, Berger J, Wieringa FT. Interventions to improve micronutrient status of women of reproductive age in Southeast Asia: a narrative review on what works, what might work, and what doesn’t work. Matern Child Health J. 2019;23(Suppl 1):18–28.
Van Thuy P, Berger J, Nakanishi Y, Khan NC, Lynch S, Dixon P. The use of NaFeEDTA-fortified fish sauce is an effective tool for controlling iron deficiency in women of childbearing age in rural Vietnam. Nutrition. 2005;135(11):2596–601.
Peña-Rosas JP, Mithra P, Unnikrishnan B, Kumar N, De-Regil LM, Nair NS, Garcia-Casal MN, Solon JA. Fortification of rice with vitamins and minerals for addressing micronutrient malnutrition. Cochrane Database Syst Rev. 2019;2019:CD009902. https://doi.org/10.1002/14651858.CD009902.pub2.
Friesen VM, Mbuya MN, Aaron GJ, Pachón H, Adegoke O, Noor RA, Swart R, Kaaya A, Wieringa FT, Neufeld LM. Fortified foods are major contributors to apparent intakes of vitamin A and iodine, but not iron, in diets of women of reproductive age in 4 African countries. J Nutr. 2020;150(8):2183–90.
Majumder S, Datta K, Datta SK. Rice biofortification: high iron, zinc, and vitamin-A to fight against “hidden hunger”. Agronomy. 2019;9:803.
Athe R, Dwivedi R, Pati S, Mazumder A, Banset U. Meta-analysis approach on iron fortification and its effect on pregnancy and its outcome through randomized, controlled trials. J Family Med Primary Care. 2020;9:513–9.
WHO. WHO guidelines approved by the guidelines review committee. guideline: intermittent iron and folic acid supplementation in menstruating women. Geneva: World Health Organization; 2011.
Ziauddin Hyder SM, Haseen F, Khan M, Schaetzel T, Jalal CSB, Rahman M, Lönnerdal B, Mannar V, Mehansho H. A multiple-micronutrient-fortified beverage affects hemoglobin, iron, and vitamin A status and growth in adolescent girls in Rural Bangladesh. J Nutr. 2007;137:2147–53.
Tam E, Keats EC, Rind F, Das JK, Bhutta AZA. Micronutrient supplementation and fortification interventions on health and development outcomes among children under-five in low- and middle-income countries: a systematic review and meta-analysis. Nutrients. 2020;12:289.
Waller AW, Andrade JE, Mejia LA. Performance factors influencing efficacy and effectiveness of iron fortification programs of condiments for improving anemia prevalence and iron status in populations: a systematic review. Nutrients. 2020;12:275.
Connorton JM, Balk J. Iron biofortification of staple crops: lessons and challenges in plant genetics. Plant Cell Physiol. 2019;60:1447–56.
Mutwiri LN, Kyallo F, Kiage B, Van der Schueren B, Matthys C. Can improved legume varieties optimize iron status in low- and middle-income countries? A systematic review. Adv Nutr. 2020;11:1315–24.
Afify AE-MM, El-Beltagi HS, Abd El-Salam SM, Omran AA. Bioavailability of iron, zinc, phytate and phytase activity during soaking and germination of white sorghum varieties. PLoS One. 2011;6:e25512.
Baye K, Mouquet-Rivier C, Icard-Vernière C, Picq C, Guyot J-P. Changes in mineral absorption inhibitors consequent to fermentation of Ethiopian injera: implications for predicted iron bioavailability and bioaccessibility. Int J Food Sci Technol. 2014;49:174–80.
Proulx AK, Reddy MB. Fermentation and lactic acid addition enhance iron bioavailability of maize. J Agric Food Chem. 2007;55:2749–54.
Chawla P, Bhandari L, Sadh PK, Kaushik R. Impact of solid-state fermentation (Aspergillus oryzae) on functional properties and mineral bioavailability of black-eyed pea (Vigna unguiculata) seed flour. Cereal Chem. 2017;94:437–42.
Gabaza M, Muchuweti M, Vandamme P, Raes K. Can fermentation be used as a sustainable strategy to reduce iron and zinc binders in traditional African fermented cereal porridges or gruels? Food Rev Intl. 2017;33:561–86.
Adish AA, Esrey SA, Gyorkos TW, Jean-Baptiste J, Rojhani A. Effect of consumption of food cooked in iron pots on iron status and growth of young children: a randomised trial. Lancet. 1999;353(9154):712–6.
Harvey PW, Dexter PB, Darnton-Hill I. The impact of consuming iron from non-food sources on iron status in developing countries. Public Health Nutr. 2000;3(4):375–83.
Alves CA-O, Saleh A, Alaofè H. Iron-containing cookware for the reduction of iron deficiency anemia among children and females of reproductive age in low- and middle-income countries: a systematic review. PLoS One. 2019;14(9):e0221094.
Sharieff W, Dofonsou J, Zlotkin S. Is cooking food in iron pots an appropriate solution for the control of anaemia in developing countries? A randomised clinical trial in Benin. Public Health Nutr. 2008;11(9):971–7.
Bothwell T, Seftel H, Jacobs P, Torrance J, Baumslag N. Iron overload in Bantu subjects: studies on the availability of iron in Bantu beer. Am J Clin Nutr. 1964;14:47–51.
Choma S, Alberts M, Urdal P. Effect of traditional beer consumption on the iron status of a rural South African population. South Afr J Clin Nutr. 2007;20:62–8.
Charles CV, Summerlee AJ, Dewey CE. Iron content of Cambodian foods when prepared in cooking pots containing an iron ingot. Tropical Med Int Health. 2011;16(12):1518–24.
Rappaport AA-O, Whitfield KC, Chapman GE, Yada RY, Kheang KM, Louise J, Summerlee AJ, Armstrong GR, Green TJ. Randomized controlled trial assessing the efficacy of a reusable fish-shaped iron ingot to increase hemoglobin concentration in anemic, rural Cambodian women. Am J Clin Nutr. 2017;106(2):667–74.
Galan P, Cherouvrier F, Zohoun I, Zohoun T, Chauliac M, Hercberg S. Iron absorption from typical West African meals containing contaminating Fe. Br J Nutr. 1990;64:541–6.
Greffeuille V, Polycarpe Kayodé AP, Icard-Vernière C, Gnimadi M, Rochette I, Mouquet-Rivier C. Changes in iron, zinc and chelating agents during traditional African processing of maize: effect of iron contamination on bioaccessibility. Food Chem. 2011;126:1800–7.
Young SL. Pica in pregnancy: new ideas about an old condition. Annu Rev Nutr. 2010;30:403–22.
Seim GL, Ahn CI, Bodis MS, Luwedde F, Miller DD, Hillier S, Tako E, Glahn RP, Young SL. Bioavailability of iron in geophagic earths and clay minerals, and their effect on dietary iron absorption using an in vitro digestion/Caco-2 cell model. Food Funct. 2013;4:1263–70.
Karakochuk CD, Murphy HM, Whitfield KC, Barr SI, Vercauteren SM, Talukder A, Porter K, Kroeun H, Eath M, McLean J, et al. Elevated levels of iron in groundwater in Prey Veng province in Cambodia: a possible factor contributing to high iron stores in women. J Water Health. 2014;13:575–86.
Wieringa FT, Dahl M, Chamnan C, Poirot E, Kuong K, Sophonneary P, Sinuon M, Greuffeille V, Hong R, Berger J. The high prevalence of anemia in Cambodian children and women cannot be satisfactorily explained by nutritional deficiencies or hemoglobin disorders. Nutrients. 2016;8:348.
Ahmed F, Khan MR, Shaheen N, Ahmed KMU, Hasan A, Chowdhury IA, Chowdhury R. Anemia and iron deficiency in rural Bangladeshi pregnant women living in areas of high and low iron in groundwater. Nutrition. 2018;51:46–52.
Palanog AD, Calayugan MIC, Descalsota-Empleo GI, Amparado A, Inabangan-Asilo MA, Arocena EC, Cruz PC, Borromeo TH, Lalusin A, Hernandez JE, et al. Zinc and iron nutrition status in the Philippines population and local soils. Front Nutr. 2019;6:81.
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Wieringa, F.T., Dijkhuizen, M.A., Berger, J. (2022). Sources of Iron: Diet, Supplemental, and Environmental. In: Karakochuk, C.D., Zimmermann, M.B., Moretti, D., Kraemer, K. (eds) Nutritional Anemia. Nutrition and Health. Springer, Cham. https://doi.org/10.1007/978-3-031-14521-6_10
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