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Is a 40 % Absorption of Iron from a Ferrous Ascorbate Reference Dose Appropriate to Assess Iron Absorption Independent of Iron Status?

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Abstract

Although a 40 % absorption of a standard reference dose corresponds to iron (Fe) absorption in borderline Fe-deficient subjects, this percentage is currently applied to all subjects independent of Fe status: (a) to assess the use of the 40 % of Fe absorption of the reference dose (FeRD%) for subjects with iron-depleted stores (IDS), normal Fe status (NIS), Fe deficiency without anemia (IDWA), and Fe deficiency anemia (IDA) and (b) to explore relationships between Fe status biomarkers and FeRD%. Six hundred forty-six participants (582 women and 64 men) were selected from multiple Fe bioavailability studies and classified into four groups based on Fe status: NIS, IDS, IDWA, and IDA. All men were classified as normal. The absorption from FeRD% was calculated in each group and correlated with Fe status biomarkers. (a) Women with IDS absorbed 40 (18.9–84.7) % of the reference dose; (b) for male subjects with NIS, the absorption of the reference dose was 19 (9.8–36.1) %, while for females, absorption was observed as to be 34 (16.7–68.6)%. In the case of subjects with IDWA, a 43 (19.7–92.5) % absorption was observed, while subjects with IDA demonstrated 67 (45.2–98.6) % absorption. Serum ferritin (SF) had the strongest inverse correlation with FeRD% (r = −0.41, p < 0.001). A transferrin saturation (TS) <15 % increases the probability that the FeRD% will be highly elevated (OR, 5.05; 95 % CI, 2.73, 9.31; p < 0.001). A 40 % absorption as reference dose is only appropriate to assess Fe absorption in subjects with IDS and IDWA. SF had an inverse correlation with FeRD%, and TS increases the probability that the FeRD% will be elevated by over fivefold.

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Acknowledgments

CV, MO, and FP conceptualized and designed the study; MO and FP collected and analyzed the data; all authors interpreted the data; CV and AB wrote the manuscript. The authors gratefully acknowledge the technical assistance of María Angélica Letelier for her laboratory work and Juliana Haber and Sotiris Chaniotakis for their assistance in reviewing the English in this manuscript. All authors approved the final version of the manuscript. All authors declare no general, financial, or institutional competing interests.

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Authors and Affiliations

  1. Faculty of Veterinary and Animal Sciences, University of Chile, Santiago, Chile

    Carolina Valenzuela & Christopher Hamilton-West

  2. Micronutrients Laboratory, Institute of Nutrition and Food Technology (INTA), University of Chile, Avda El Libano 5524, Casilla, 13811, Santiago, Chile

    Manuel Olivares, Alex Brito & Fernando Pizarro

  3. United States Department of Agriculture, Western Human Nutrition Research Center, Davis, CA, USA

    Alex Brito

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  1. Carolina Valenzuela
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  2. Manuel Olivares
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  3. Alex Brito
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  4. Christopher Hamilton-West
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  5. Fernando Pizarro
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Correspondence to Fernando Pizarro.

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Valenzuela, C., Olivares, M., Brito, A. et al. Is a 40 % Absorption of Iron from a Ferrous Ascorbate Reference Dose Appropriate to Assess Iron Absorption Independent of Iron Status?. Biol Trace Elem Res 155, 322–326 (2013). https://doi.org/10.1007/s12011-013-9797-2

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  • DOI: https://doi.org/10.1007/s12011-013-9797-2

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