A mathematical model for the hemoglobin response to iron intake, based on iron absorption measurements from habitually consumed Indian meals

• Published in: European journal of clinical nutrition Vol. 66; no. 4; pp. 481 - 487
• Main Authors: Thankachan, P, Kalasuramath, S, Hill, A L, Thomas, T, Bhat, K, Kurpad, A V
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-04-2012; Nature Publishing Group
• Subjects: Absorption; Adolescent; Adult; Anemia; Anemia, Iron-Deficiency - blood; Anemia, Iron-Deficiency - epidemiology; Anemias. Hemoglobinopathies; Bioavailability; Biological and medical sciences; Biological Availability; Biomathematics; Clinical Nutrition; Diet; Diseases of red blood cells; Edible Grain - chemistry; Energy Intake; Epidemiology; Erythrocytes; Feeding Behavior; Feeding. Feeding behavior; Female; Food consumption; Fundamental and applied biological sciences. Psychology; Health aspects; Hematologic and hematopoietic diseases; Hemoglobin; Hemoglobins; Humans; India - epidemiology; Internal Medicine; Iron; Iron deficiency; Iron in the body; Iron, Dietary - administration & dosage; Iron, Dietary - blood; Mathematical analysis; Mathematical models; Meals; Medical sciences; Medicine; Medicine & Public Health; Menopause; Metabolic Diseases; Metals (hemochromatosis...); Models, Theoretical; Nutrient deficiency; original-article; Other metabolic disorders; Physiological aspects; Premenopause; Prevalence; Public Health; Rice; Socioeconomic Factors; Stable isotopes; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Womens health; Young Adult; Asia; India; iron absorption; mathematical modeling; iron deficiency; bioavailability; hemoglobin response; anemia; Consumption; Iron deficiency anemia; Meal; Metabolic diseases; Hemopathy; Iron; Bioavailability; Inorganic element; Absorption; Hemoglobin; Indian; Sideropenia; Mathematical model
• ISSN: 0954-3007; 1476-5640
• DOI: 10.1038/ejcn.2011.169

Background/Objectives:
The prevalence of iron deficiency (ID) and iron deficiency anemia (IDA) is high in India and appear unchanging over decades. To understand the persistence of these disorders, it is critical to measure iron (Fe) absorption from cereal-based Indian meals, its modulation by ID and the time-course of the response of hemoglobin (Hb) to Fe intake.
Subjests/Methods:
Fe absorption from rice-based meals was measured by the erythrocyte incorporation of the stable isotope label at 14 days in IDA (
N
=15) and Fe replete (IR) women (
N
=15). Hb level was used as surrogate for Fe status, and a response curve for Fe absorption versus the Hb level for a rice-based meal was constructed from measured data. This relationship was used as input for a mathematical model that examined the Hb response to different Fe intakes in normal and anemic women.
Results:
The mean fractional Fe absorption from a rice-based meal in IR and IDA women was 2.7% and 8.3%, respectively. The model predicted that Fe intakes between 20 and 55 mg/day in low-bioavailability diets would result in stable, non-anemic levels of Hb in women over a 1-year period.
Conclusion:
This mathematical model suggests that with a Fe intake of 20–30 mg/day and a dietary bioavailability of 3–5%, Hb concentration would hover around 12 g/dl with a variability of 0.5 g/dl in pre-menopausal adult women.