Factors affecting iron absorption and the role of fortification in enhancing iron levels

• Published in: Nutrition bulletin Vol. 48; no. 4; pp. 442 - 457
• Main Authors: Perera, Dipun Nirmal, Palliyaguruge, Chathurangi Lakshika, Eapasinghe, Dasuni Dilkini, Liyanage, Dilmi Maleesha, Seneviratne, R. A. C. Haily, Demini, S. M. D., Jayasinghe, J. A. S. M., Faizan, Mishal, Rajagopalan, Umapriyatharshini, Galhena, B. Prasanna, Hays, Hasi, Senathilake, Kanishka, Tennekoon, Kamani H., Samarakoon, Sameera R.
• Format: Journal Article
• Language: English
• Published: Oxford Wiley Subscription Services, Inc 01-12-2023
• Subjects: Anemia; Bioavailability; Calcium absorption; Ferritin; Food; Hemoglobin; Iron; Iron deficiency; Menstruation; Nutrient deficiency; Organic acids; Organoleptic properties; Polyphenols; Shelf life
• ISSN: 1471-9827; 1467-3010
• DOI: 10.1111/nbu.12643

Abstract
Iron is an important micronutrient required for a number of biological processes including oxygen transport, cellular respiration, the synthesis of nucleic acids and the activity of key enzymes. The World Health Organization has recognised iron deficiency as the most common nutritional deficiency globally and as a major determinant of anaemia. Iron deficiency anaemia affects 40% of all children between the ages of 6 and 59 months, 37% of mothers who are pregnant and 30% of women between the ages of 15 and 49 years worldwide. Dietary iron exists in two main forms known as haem iron and non‐haem iron. Haem iron is obtained from animal sources such as meat and shows higher bioavailability than non‐haem iron, which can be obtained from both plant and animal sources. Different components in food can enhance or inhibit iron absorption from the diet. Components such as meat proteins and organic acids increase iron absorption, while phytate, calcium and polyphenols reduce iron absorption. Iron levels in the body are tightly regulated since both iron overload and iron deficiency can exert harmful effects on human health. Iron is stored mainly as haemoglobin and as iron bound to proteins such as ferritin and hemosiderin. Iron deficiency affects individuals at increased risk due to factors such as age, pregnancy, menstruation and various diseases. Different solutions for iron deficiency are applied at individual and community levels. Iron supplements and intravenous iron can be used to treat individuals with iron deficiency, while various types of iron‐fortified foods and biofortified crops can be employed for larger communities. Foods such as rice, flour and biscuits have been used to prepare fortified iron products. However, it is important to ensure the fortification process does not exert significant negative effects on organoleptic properties and the shelf life of the food product.