Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-22T18:13:10.777Z Has data issue: false hasContentIssue false

The impact of consuming iron from non-food sources on iron status in developing countries

Published online by Cambridge University Press:  02 January 2007

Philip WJ Harvey*
Affiliation:
Australian Centre for International and Tropical Health and Nutrition, now with MOST, The USAID Micronutrient Program, 1820, North Fort Myer Drive, Arlington, VA 22209, USA
Patricia B Dexter
Affiliation:
Institute of Food Science and Engineering, University of Arkansas, 272 Young Avenue, Fayetteville, AR 72704, USA
Ian Darnton-Hill
Affiliation:
Helen Keller International, 2nd floor, 90 West Street, New York, NY 10006, USA
*
*Corresponding author: 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.
Objective

To determine the impact of contaminant iron and geophagy on iron intake and status of persons living in developing countries.

Design

Literature for review was identified by searching Medline and Agricola, from appropriate other texts and from three reports from the Opportunities for Micronutrient Interventions (OMNI) Project of USAID.

Setting

The dietary intake of iron by people living in developing countries is generally high but iron deficiency remains prevalent. This apparent paradox is because the iron being consumed is predominantly in the non-haem form, which is poorly absorbed. Some of this non-haem iron is from contamination of food with iron from soil, dust and water; iron leaching into food during storage and cooking; contamination during food processing such as milling; and the practice of geophagy.

Results

Although the contribution of contaminant iron to overall iron intake is well documented, its absorption and thus its impact on iron status is not. To be available for absorption, contaminant iron must join the common non-haem pool, i.e. be exchangeable. The absorption of exchangeable contaminant iron is subject to the same interactions with other constituents in the diet as the non-haem iron that is intrinsic to food. The limited available evidence suggests wide variation in exchangeability. In situations where a significant fraction of the contaminating iron joins the pool, the impact on iron status could be substantial. Without a simple method for predicting exchangeability, the impact of contaminant iron on iron status in any particular situation is uncertain.

Conclusions

Interventions known to increase the absorption of iron intrinsic to foods will also increase absorption of any contaminant iron that has joined the common pool. Any positive effect of geophagy resulting from an increased intake of iron is highly unlikely, due to inhibiting constituents contained in soils and clays. The efficacy of approaches designed to increase the intake of contaminant iron remains encouraging but uncertain. An approach using multiple interventions will continue to be essential to reduce iron deficiency anaemia.

Type
Research Article
Copyright
Copyright © CABI Publishing 2000

References

1FAO/WHO. Nutrition and Development: a Global Perspective. International Conference of NutritionRome FAO 1992.Google Scholar
2Beaton, GH. Epidemiology of iron deficiency. In: Jacobs, A, Worwood, M, eds. Iron in Biochemistry and Medicine. London: Academic Press, 1974; 477528.Google Scholar
3Bothwell, TH, Charlton, RW, Cook, JD, Finch, CA. Iron Metabolism in Man. Oxford: Blackwell Scientific Publications, 1979.Google Scholar
4Hallberg, L, Bjorn-Rasmussen, E, Rossander, L, et al. Iron absorption from some Asian meals containing contamination iron. Am. J. Clin. Nutr. 1983; 37: 272–7.CrossRefGoogle ScholarPubMed
5Hercberg, S, Galan, P, Dupin, H.Iron deficiency in Africa. World Rev. Nutr. Diet. 1987; 54: 201–36.CrossRefGoogle ScholarPubMed
6Galan, P, Cherouvrier, F, Zohoun, I, et al. Iron absorption from typical West African meals containing contaminant Fe. Br. J. Nutr. 1990; 64: 541–6.CrossRefGoogle ScholarPubMed
7Halsted, JA. Geophagia in man: its nature and nutritional effects. Am. J. Clin. Nutr. 1968; 21: 1384–93.CrossRefGoogle ScholarPubMed
8Danford, DE. Pica and nutrition. Annu. Rev. Nutr. 1982; 2: 303–22.CrossRefGoogle ScholarPubMed
9Talkington, KM, Gant, NF, Scott, DE, Pritchard, JA. Effect of ingestion of starch and some clays on iron absorption. Am. J. Obstet. Gynecol. 1970; 108(2): 262–7.CrossRefGoogle ScholarPubMed
10Vermeer, RE, Frate, DA. Geophagia in rural Mississippi: environmental and cultural contexts and nutritional implications. Am. J. Clin. Nutr. 1979; 32: 2129–35.CrossRefGoogle ScholarPubMed
11Kies, C. Nutritional Bioavailability of Iron. Washington, DC: American Chemical Society, 1992.Google Scholar
12Brock, JH, Halliday, JW, Pippard, MJ, Powell, LW, eds. Iron Metabolism in Health and Disease. London: WB Saunders, 1993.Google Scholar
13Allen, LH, Ahluwalia, N. Improving Iron Status through Diet: the Application of Knowledge concerning Dietary Iron Bioavailability in Human Populations. Washington, DC: John Snow Inc./OMNI/USAID, 1997.Google Scholar
14Henry, CJK, LaMont-Gregory, E. Non-Nutritional Sources of Iron: with Special to Geophagia. Draft Report Submitted to John Snow Inc./OMNI/USAID, 1996.Google Scholar
15Nestel, P, ed. Proceedings, Iron Interventions for Child Survival, 17–18 May 1995. London, UK: John Snow Inc./OMNI/USAID, 1995.Google Scholar
16Hazell, T.Chemical forms and bioavailability of dietary minerals. World Rev. Nutr. Diet. 1985; 46: 1123.CrossRefGoogle Scholar
17Cook, JD. Adaptation in iron metabolism. Am. J. Clin. Nutr. 1990; 51: 301–8.CrossRefGoogle ScholarPubMed
18Bothwell, TH. Overview and mechanisms of iron regulation. Nutr. Rev. 1995; 53: 237–45.CrossRefGoogle ScholarPubMed
19Baynes, RD. Iron deficiency. In: Brock, JH, Halliday, JW, Pippard, MJ, Powell, LW, eds. Iron Metabolism in Health and Disease. London: WB Saunders, 1994; 190225.Google Scholar
20Hallberg, L, Bjorn-Rasmussen, E.Measurement of iron absorption from meals contaminated with iron. Am. J. Clin. Nutr. 1981; 34: 2808–15.CrossRefGoogle ScholarPubMed
21Charlton, RW, Bothwell, TH, Seftel, HC. Dietary iron overload. Clin. Haematol. 1973; 2: 383403.Google Scholar
22Liu, D-Y, Chen, Z-G, Lei, H-Q, et al. Investigation of the amount of dissolved iron in food cooked in Chinese iron pots and estimation of daily iron intake. Biomed. Environ. Sci. 1990; 3: 276–80.Google ScholarPubMed
23Brittin, HC, Nossaman, CE. Iron content of food cooked in iron utensils. J. Am. Diet. Assoc. 1986; 86: 897901.CrossRefGoogle ScholarPubMed
24Zhou, Y-D, Brittin, HC. Increased iron content of some Chinese foods due to cooking in steel woks. J. Am. Diet. Assoc. 1994; 94(10): 1153–6.CrossRefGoogle ScholarPubMed
25Kollipara, UK, Brittin, HC. Increased iron content of some Indian foods due to cookware. J. Am. Diet. Assoc. 1996; 96: 508–10.CrossRefGoogle ScholarPubMed
26Adish, AA, Esrey, SA, Gyorkos, TW, Jean-Baptiste, JRojhani, A.Effect of consumption of food cooked in iron pots on iron status and growth of young children: a randomized trial. Lancet 1999; 353: 712–16.CrossRefGoogle Scholar
27Kuligowski, J, Halperin, KM. Stainless steel cookware as a significant source of nickel, chromium, and iron. Arch. Environ. Contam. Toxicol. 1992; 23: 211–15.CrossRefGoogle ScholarPubMed
28Kumar, R, Srivastava, PK, Srivastava, SP. Leaching of heavy metals (Cr, Fe, and Ni) from stainless steel utensils in food simulants and food materials. Bull. Environ. Contam. Toxicol. 1994; 53: 259–66.CrossRefGoogle ScholarPubMed
29Flint, GNPackirissrey, S.Systemic nickel: the contribution made by stainless-steel cooking utensils. Contact Dermatitis 1995; 32: 218–24.CrossRefGoogle ScholarPubMed
30Derman, DP, Bothwell, TH, Torrance, JD, et al. Iron absorption from maize (Zea mays) and sorghum (Sorghum vulgare) beer. Br. J. Nutr. 1980; 43: 271–9.CrossRefGoogle ScholarPubMed
31Gordeuk, VR, Mukiibi, J, Hasstedt, SJ, et al. Iron overload in Africa: interaction between a gene and dietary iron content. New Engl. J. Med. 1992; 326: 95100.CrossRefGoogle ScholarPubMed
32Moyo, VM, Mandishona, E, Hasstedt, SJ, et al. Evidence of genetic transmission in African iron overload. Blood 1998; 91: 1076–82.Google ScholarPubMed
33Derman, DP, Bothwell, TH, Torrance, JD, et al. Iron absorption from ferritin and ferric hydroxide. Scand. J. Haematol. 1982; 29: 1824.CrossRefGoogle ScholarPubMed
34Guiro, A, Hercberg, S.Iron exchangeability from pearl millet and Senegalese pearl millet meals. Nutr. Rep. Int. 1988; 38: 231–7.Google Scholar
35Guiro, AT, Galan, P, Cherouvrier, F, Sall, MG, Hercberg, S.Iron absorption from African millet and rice meals. Nutr. Res. 1991; 11: 885–93.CrossRefGoogle Scholar
36Hurrell, RF. Bioavailability of iron. Eur. J. Clin. Nutr. 1997; 51 (Suppl. 1): S48.Google ScholarPubMed
37Mistry, AN, Brittin, HCStoecker, BS. Availability of iron cooked in an iron utensil determined by an in vitro method. J. Food Sci. 1988; 53: 1546–8, 1573.CrossRefGoogle Scholar
38Martinez, FE, Vannucchi, H.Bioavailability of iron added to the diet by cooking food in an iron pot. Nutr. Res. 1986; 6: 421–8.CrossRefGoogle Scholar
39Reddy, MB, Cook, JD. Assessment of dietary determinants of nonheme-iron absorption in humans and rats Am J. Clin. Nutr. 1991; 54: 723–8.CrossRefGoogle ScholarPubMed
40Svanberg, U. Dietary interventions to prevent iron deficiency in preschool children. In: Nestel, P, ed. Proceedings, Iron Interventions for Child Survival, 17–18 May 1995. London, UK: John Snow Inc./OMNI/USAID, 1995; 3143.Google Scholar
41Derman, DP, Sayers, M, Lynch, SR, Charlton, RW, Bothwell, THMayet, F.Iron absorption from a cereal-based meal containing cane sugar fortified with ascorbic acid. Br. J. Nutr. 1977; 38: 261–9.CrossRefGoogle ScholarPubMed
42Reid, RM. Cultural and medical perspectives on geophagia. Med. Anthropol. 1992; 13: 337–51.CrossRefGoogle ScholarPubMed
43Prasad, AS, Halstead, JANadimi, M.Syndrome of iron deficiency anaemia, hepatosplenomegaly, hypogonadism, dwarfism and geophagia. Am. J. Med. 1961; 31: 532–46.CrossRefGoogle ScholarPubMed
44Minnich, V, Okcuoglu, A, Tarcon, Y, et al. Pica in Turkey. Am. J. Clin. Nutr. 1968; 21: 7886.CrossRefGoogle ScholarPubMed
45Federman, DG, Kerner, RS, Federman, GS. Pica: are you hungry for the facts? Community Med. 1997; 61: 207–9.Google ScholarPubMed
46Gutelius, ME, Millican, EK, Layman, EM, Cohen, GJDublin, CC. Nutritional studies of children with pica. Pediatrics 1962; 29: 1012–23.CrossRefGoogle ScholarPubMed
47Gutelius, ME, Millican, EK, Layman, EM, Cohen, GJDublin, CC. Treatment of pica with a vitamin and mineral supplement. Am. J. Clin. Nutr. 1963; 12: 388–93.CrossRefGoogle ScholarPubMed
48Sayetta, RB. Pica: an overview. Am. Fam. Physician 1986; 33: 181–5.Google ScholarPubMed
49Fairweather-Tait, SJ. Bioavailability of iron. In: Nestel, P, ed. Proceedings, Iron Interventions for Child Survival, 17–18 May 1995. London, UK: John Snow Inc./OMNI/USAID, 1995; 1329.Google Scholar
50Vermeer, RE, Ferrel, RE. Nigerian geographical clay: a traditional antidiarrheal pharmaceutical. Science 1985; 227: 634–6.CrossRefGoogle Scholar
51Johns, T, Duquette, M.Detoxification and mineral supplementation as functions of geophagy. Am. J. Clin. Nutr. 1991; 53: 448–56.CrossRefGoogle ScholarPubMed
52Geissler, PW, Mwaniki, D, Thiong'o, FFriis, H.Geophagy as a risk factor for geohelminth infections: a longitudinal study of Kenyan primary schoolchildren. Trans. R. Soc. Trop. Med. Hyg. 1998; 92: 711.CrossRefGoogle ScholarPubMed
53Wong, MS, Bundy, DAP, Golden, MHN. The rate of ingestion of Ascaris lumbricoides and Trichuris trichiura eggs and its relationship to infection in two children's homes in Jamaica. Trans. R. Soc. Trop. Med. Hyg. 1991; 85: 8991.CrossRefGoogle ScholarPubMed
54Lee, K. Iron chemistry and bioavailability in food processing. In: Kies, C, ed. Nutritional Bioavailability of Iron. Washington, DC: American Chemical Society, 1982: 2754.CrossRefGoogle Scholar
55Thomson, J.Anaemia in pregnant women in East Caprivi, Namibia. Bull. Trop. Med. Int. Health 1997; 5: 3.Google Scholar
56O'Rourke, DE, Quinn, JG, Nicholson, JO, Gibson, HH. Geophagia during pregnancy. Obstet. Gynecol. 1967; 29: 581–4.Google ScholarPubMed
57Mengel, CE, Carter, WA, Horton, ES. Geophagia with iron deficiency and hypokalemia. Arch. Intern. Med. 1964; 114: 470–4.CrossRefGoogle ScholarPubMed
58Darnton-Hill, I, Mora, JO, Weinstein, H, Wilbur, SNalubola, PR. Iron and folate fortification in the Americas to prevent and control micronutrient and malnutrition: an analysis. Nutr. Rev. 1999; 57: 2531.CrossRefGoogle ScholarPubMed