Bioavailability of iron from fortified maize using stable isotope techniques

Abstract

Background: The high prevalence of iron deficiency and anaemia among South African children highlights the need for iron fortification, especially with a highly bioavailable iron compound. Fortification of staple foods is an adequate strategy to provide additional iron to populations at risk. In South Africa it is mandatory to fortify maize meal and wheat flour with iron, as well as other micronutrients. Elemental iron, specifically electrolytic iron, is currently the preferred choice but other compounds that might be more effective in alleviating iron deficiency are under consideration. Objectives: The objective of this study was to provide information about the bioavailability of ferrous fumarate and NaFeEDTA from maize meal porridge in young children, which would assist in selecting a bioavailable alternative to electrolytic iron in the South African National Food Fortification Programme, Methods: A randomized parallel study design was used, with each of the 2 groups further randomised to receive either one of two test regimens in a crossover design in which each child acted as his/her own control. Iron bioavailability was measured with a stable-isotope technique based on erythrocyte incorporation 15 days after intake. Results: The mean absorption of iron from NaFeEDTA and ferrous fumarate from the maize porridge meal was 11.5% and 9.29% respectively. NaFeEDTA and ferrous fumarate are both sufficiently bioavailable from a maize based meal rich in phytates. Conclusion: Both NaFeEDTA and ferrous fumarate would provide a physiologically important amount of iron should they replace electrolytic iron as fortificant in maize flour fortification. The final choice between ferrous fumarate and NaFeEDTA as when it comes to finding the alternative iron fortificant will depend on factors such as technical compatibility, bioavailability, relative cost and organoleptic characteristics.