Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-25T02:01:07.908Z Has data issue: false hasContentIssue false

Animal- and plant-food-based diets and iron status: benefits and costs

Published online by Cambridge University Press:  28 February 2007

Leif Hambræus*
Affiliation:
Department of Medical Science, Nutrition, Uppsala University, Dag Hammarskjölds väg 21, SE-752 37 Uppsala, Sweden
*
*Corresponding author: Professor Leif Hambraeus, fax +46 18 559505, email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Fe seems to be the only nutrient deficiency that industrialized and low-income countries have in common. Thus, Fe is one of the most critical nutrition requirements to be met in most diets in human subjects. Fe deficiency is caused not only by too low an intake, but is also the result of low bioavailability, as well as an increased Fe requirement due to physiological variables or clinical problems which are not met by an increased dietary intake of Fe. In low-income countries poor dietary quality rather than Fe intake seems to be the key determinant of impaired Fe status. Sometimes the Fe intake even exceeds that in populations of industrialized countries. The interaction of all enhancers (e.g. ascorbic acid and meat), as well as inhibitors (such as bran, polyphenols, egg yolk, soyabean products, Ca, Ca3(PO4)2 and phytic acid (or phytate)) is what determines the bioavailability of non-haem-Fe in the meal. Dietary composition seems to be particularly important when Fe reserves are low, or in the presence of Fe deficiency. Furthermore, the development of anaemia as a result of Fe deficiency, secondary to Fe-stress situations, is dependent on the Fe balance in the host. With respect to the dietary intake of Fe, other products in the food consumed as well as previous treatment of the product (e.g. heat treatment and processing) may also influence bioavailability. Despite all efforts to counteract Fe deficiency it still represents one of the dominant problems in the micronutrient sphere. It is apparent that there is no simple solution to the problem, and the fact that Fe deficiency still occurs in affluent societies consuming a mixed diet speaks for itself; a more holistic view of total dietary composition and the role of enhancers and inhibitors is needed.

Type
‘Meat or wheat for the next millennium?’ Plenary Lecture
Copyright
Copyright © The Nutrition Society 1999

References

Administrative Committee on Coordination/Sub-committee on Nutrition (1992) Second Report on the World Nutrition Situation, vol. 1, Global and Regional Results. New York: ACC/SCN.Google Scholar
Administrative Committee on Coordination/Sub-committee on Nutrition (1997) Major Issues in Developing Effective Approaches for the Prevention and Control of Iron Deficiency. New York: UNICEF.Google Scholar
Allen, LH & Ahluwalia, N (1997) Improving Iron Status Through Diet. The Application of Knowledge Concerning Dietary Iron Bioavailability in Human Populations. John Snow Inc/OMNI Project. Washington, DC: USAID.Google Scholar
Baynes, RD & Bothwell, TH (1990) Iron deficiency. Annual Review of Nutrition 10, 133148.CrossRefGoogle ScholarPubMed
Becker, W (1994) Befolkningens Kostvanor och Näringsintag i Sverige 1989 (Food Consumption and Nutrient Intake in Sweden 1989). Uppsala: Statens Livsmedelsverk.Google Scholar
Benito, P & Miller, D (1998) Iron absorption and bioavailability. An updated review. Nutrition Research 8, 561603.Google Scholar
Bothwell, TH, Baynes, RD, MacFarlane, BJ & MacPhail, AP (1989) Nutritional iron requirements and food iron absorption. Journal of Internal Medicine 226, 357365.CrossRefGoogle ScholarPubMed
British Nutrition Foundation (1995) Iron. Nutritional and Physiological Significance. The Report of the British Nutrition Foundation's Task Force. London: Chapman & Hall.Google Scholar
Brock, JH (1995) Iron in infection and immunity. In Iron Nutritional and Physiological Significance, pp. 5864 [British Nutrition Foundation, editors]. London: Chapman & Hall.Google Scholar
Chandra, RJ (1975) Impaired immunocompetence associated with iron deficiency. Journal of Pediatrics 86, 899902.CrossRefGoogle ScholarPubMed
Cook, JD (1990) Adaptation in iron metabolism. American Journal of Clinical Nutrition 51, 301308.CrossRefGoogle ScholarPubMed
Cook, JD, Dassenko, SA & Lynch, SR (1991) Assessment of the role of non-heme iron availability in iron balance. American Journal of Clinical Nutrition 54, 717722.CrossRefGoogle Scholar
Cook, JD, Layrisse, M, Martinez-Torres, L, Walker, R, Monsen, E & Finch, CA (1972) Food iron absorption measured by an extrinsic tag. Journal of Clinical Investigation 51, 805815.CrossRefGoogle ScholarPubMed
DeMayer, EM, Dallman, P, Gurney, JM, Hallberg, L, Sood, SK & Srikantia, SG (1989) Preventing and Controlling Iron Deficiency Anaemia Through Primary Health Care. A Guide for Health Administrators and Programme Managers. Geneva: WHO.Google Scholar
Department of Health and Human Services (1981) NHANES II (National Health and Nutrition Examination Survey, Second, 1976–1980). Haematology and Biochemistry, Age 6 months-74 years. Hyattsville, MD: US Department of Health and Human Services, National Center for Health Statistics.Google Scholar
De Sousa, M (1989) Immune cell function in iron overload. Clinical and Experimental Immunology 75, 16.Google ScholarPubMed
Food and Agriculture Organization (1990) Food Production Yearbook. Rome: FAO.Google Scholar
Food and Agriculture Organization/World Health Organization (1988) Requirements of Vitamin A, Iron, Folate, and Vitamin B12. Report of a Joint FAO/WHO Expert Consultation. FAO Food and Nutrition Series no. 23. Rome: FAO.Google Scholar
Hallberg, L & Björn-Rasmusson, E (1972) Determination of iron absorption from the whole diet. A new two-pool method using two radioiron isotopes given as haem and non-haem iron. Scandinavian Journal of Haematology 9, 193197.CrossRefGoogle Scholar
Hallberg, L, Brune, M & Rossander, L (1986) Iron bioavailability of carbonyl iron in man: Studies on iron fortification of wheat flour. American Journal of Clinical Nutrition 43, 5967.CrossRefGoogle ScholarPubMed
Hallberg, L & Hultén, L (1996) Iron requirements, iron balance and iron deficiency in menstruating and pregnant women. In Iron Nutrition in Health and Disease. Swedish Nutrition Foundation 20th International Symposium, pp. 165181 [Hallberg, L and Asp, N-G, editors]. London: John Libbey & Co.Google Scholar
Hallberg, L, Hultén, L & Gramatkovski, E (1997) Iron absorption from the whole diet in men: how effective is the regulation of iron absorption? American Journal of Clinical Nutrition 66, 347356.CrossRefGoogle ScholarPubMed
Hambraeus, L & Lönnerdal, B (1994) The physiological role of lactoferr In Proceedings of the IDF Seminar on Indigenous Antimicrobial Agents of Milk–Recent Developments, pp. 97107. Brussels: International Dairy Federation.Google Scholar
Hurrell, RF (1997) Bioavailability of iron. European Journal of Clinical Nutrition 51, Suppl. 1, S4S8.Google ScholarPubMed
Lynch, SR (1995) Iron overload: Prevalence and impact on health. Nutrition Reviews 53, 255260.CrossRefGoogle ScholarPubMed
Ministry of Agriculture, Fisheries and Food (1994) National Food Survey 1993. London: H. M. Stationery Office.Google Scholar
Martinez-Torres, C, Renzi, M & Layrisse, M (1976) Iron absorption by humans from haemosiderin and ferritin. Further studies. Journal of Nutrition 106, 128135.CrossRefGoogle ScholarPubMed
Murphy, SP, Beaton, GH & Calloway, DH (1992) Estimated mineral intakes of toddlers: Predicted prevalence of inadequacy in village populations in Egypt, Kenya and Mexico. American Journal of Clinical Nutrition 56, 565572.CrossRefGoogle ScholarPubMed
Murray, MJ, Murray, AB, Murray, NJ & Murray, MB (1975) Refeeding malaria and hyperferraemia. Lancet i, 653654.CrossRefGoogle Scholar
Murray, MJ, Murray, AB, Murray, NJ & Murray, MB (1978) The adverse effect of iron repletion on the course of certain infections. British Medical Journal 2, 11131115.CrossRefGoogle ScholarPubMed
Olssen, KS, Väisänen, M, Konar, J & Bruce, A (1997) The effect of withdrawal of food iron fortification in Sweden as studied with phlebotomy in subjects with genetic hemochromatosis. European Journal of Clinical Nutrition 51, 782786.CrossRefGoogle Scholar
Pawlowski, ZS, Schad, GA & Stott, GJ (1991) Hookworm Infection and Anaemia. Approaches to Prevention and Control. Geneva: WHO.Google Scholar
Reiter, B (1978) Review of the progress of dairy science: antimicrobial systems in milk. Journal of Dairy Research 45, 131147.CrossRefGoogle ScholarPubMed
Samuelson, G & Sjölin, S (1972) An epidemiological study on child health and nutrition in a Northern Swedish county. IV. Haematological investigation especially in regard to iron deficiency anaemia. Acta Paediatrica Scandinavica 61, 6373.CrossRefGoogle Scholar
Tidehag, P, Hallmans, G, Wing, K, Sjöström, R, Ågren, G, Lundin, E & Zhang, J (1996) A comparison of iron absorption from single meals and daily diets using radioFe (55Fe59Fe). British Journal of Nutrition 75, 281289.Google Scholar
Viteri, FE (1998) Prevention of iron deficiency. In Prevention of Micronutrient Deficiencies. Tools for Policymakers and Public Health Workers, pp. 45102 [Howson, CP, Kennedy, ET and Horwitz, A, editors]. Washington, DC: National Academy Press.Google Scholar
World Bank (1994) Enriching Lives. Overcoming Vitamin and Mineral Malnutrition in Developing Countries. Washington, DC: World Bank.Google Scholar
World Health Organization (1970) Requirements of Ascorbic Acid, Vitamin D, Vitamin B12, Folate and Iron. Technical Report Series no. 542. Geneva: WHO.Google Scholar
World Health Organization/United Nations Children's Fund/United Nations University (1998) Consultation on Iron Deficiency: Indicators and Strategies for Iron Deficiency Control Programmes. Geneva: WHO (In the Press).Google Scholar
Yip, R (1997) The challenge of improving iron nutrition: limitations and potentials of major intervention approaches. European Journal of Clinical Nutrition 51, S16S24.Google ScholarPubMed