Fortification with iron

Kurtz, F. E., Tamsma, A. and Pallansch, J. 1973. Effect of fortification with iron on susceptibility of skim milk and nonfat dry milk to oxidation. J. Dairy Sci. 56, 1139-1143. 

Iron-deficiency anaemia is one result of the advanced-stage of iron deficiency. For food fortification with iron, many compounds of iron and elemental iron are used. In the evaluation of the biological value of the individual compounds, the increased level of haemoglobin (which cannot be formed in iron deficiency) in experimental animals on an iron dose is used as a criterion. Ferrous sulfate is used as a reference compound. Compared with ferrous sulfate, the usable forms of iron can be divided into three groups ... 

Although the benefits of many functional ingredients have yet to be proven, there is a possibility for new health problems to arise if the market for fortified functional foods continues to expand. Some consumers may ingest excessive amounts of certain nutritional food additives such as iron, which could lead to an increased incidence of hemachromatosis in genetically predisposed people. Fortification with specific carotenoids may competitively inhibit the bioavailability of other carotenoids, perhaps leading to adverse physiological consequences. 

Perales, S., Barbera, R., Lagarda, M. J., and Parre, R. (2006). Fortification of milk with calcium Effect on calcium bioavailability and interactions with iron and zinc. /. Agric. Food Chem. 54, 4901 906. 

Edmondson et al (1971), who studied the enrichment of whole milk with iron, found that ferrous compounds normally caused a definite oxidized flavor when added before pasteurization. Aeration before addition of the iron reduced the off-flavor. The authors recommended the addition of ferric ammonium citrate followed by pasteurization at 81 °C. Kurtz et al. (1973) reported that iron salts can be added in amounts equivalent to 20 mg iron per liter of skim milk with no adverse flavor effects when iron-fortified dry milk is reconstituted to skim milk or used in the preparation of 2% milk. Hegenauer et al. (1979A) reported that emulsification of milk fat prior to fortification greatly reduced lipid peroxidation by all metal complexes. These researchers (Hegenauer et al. 1979B) concluded that chelated iron and copper should be added after homogenization but before pasteurization by a high-temperature-short-time process. 

In Norway we have no fortification of flour, a conclusion drawn long after discussions and some years with iron fortification in some areas. 

Dangers of Therapeutic Administration of Iron Good Food Sources of Iron Factors Affecting the Utilization of Iron in Foods Enrichment and Fortification of Foods with Iron Enrichment Fortification... 

From time to time, the Food and Drug Administration (FDA) has been pressured to promulgate new standards for the fortification of grain products and flour with iron. Present practices, however, should be examined before new measures are considered. These follow. 

FORTIFICATION. This means the addition to food of nutrients in such amounts that their finai ieveis in the food are greater than those that were naturaiiy present Some of the common foods which are presently fortified with iron are commercial infant formulas, infant cereals, and breakfast cereals. 

From such early beginnings as the iodine fortification of salt in the 1920s, and the enrichment of flour and bread with iron and vitamins in the 1930s, the addition of essential minerals has been extended to both traditional foods and new items which have been recently concocted by food technologists. Therefore, it is important to be knowledgeable relative to the following items that may be enriched or fortified with minerals ... 

Iron-deficiency anaemia results from a discrepancy between iron availability and the amount required for production of red blood cells. The causes of acquired iron deficiency in so-called underdeveloped and developed countries must be differentiated. In underdeveloped countries, the main causes of iron deficiency are (a) the poor availability of iron in the diet due to low haem and high fibre and phytate content (D Souza et ah, 1987), and (b) chronic blood loss due to hookworm, schistosomiasis and malaria (Stoltzfus et ah, 1997 Olsen et ah, 1998 Dreyfuss et ah, 2000). Inflammation and vitamin A deficiency often interfere with the above causes of iron deficiency, causing a mixed type of anaemia. In underdeveloped countries diet improvement, iron fortification of natural foods and eradication of parasites will have a much higher impact than will refinement of diagnostic procedures and therapy of iron-deficiency anaemia. 

Iron is an essential element, for humans and for many forms of life, but even a modest excess can be toxic as the human body does not have an effective iron excretion mechanism. It is therefore necessary to maintain an appropriate level of iron in the body, to supply iron in absorbable form if it is deficient (anemia) and to remove iron if present in excess. Inorganic coordination chemistry plays an important role in dealing with these complementary conditions of deficiency and of excess. The latter condition is much more common than often supposed, for there are a number of conditions, such as hemochromatosis and thallasemia, where the build-up of iron in essential organs is eventually lethal. Mild iron poisoning is not infrequent in children, while even iron fortification of foodstuffs can have adverse effects. Mild iron poisoning can be treated with bicarbonate or phosphate, which presumably complex and precipitate the iron. ... 

Much of the current research has centered upon the role of phytic acid on zinc and iron bioavailability (110-124). Work performed at the authors institution with several different types of soy foods suggests that phytic acid is a major factor affecting availability of zinc from foods derived from the legume (110-114). In addition, it appears that endogenous zinc in high-phytate foods may be a limiting factor in optimal utilization of these foods for man. We have found that fortification of soy foods (under proper conditions) with zinc, iron, magnesium, or calcium results in excellent... 

For prevention of disease in the elderly, the pregnant, or other susceptible groups, national fortification of food with vitamin B12 appears sensible and inexpensive but at present is not used and, in the absence of population screening s unlikely to be mandated by governmental edict. In general terms, the hematological manifestations of vitamin B12 deficiency are rapidly and fully correctable, although deficiencies of other micronutrients such as iron, folic acid, pyridoxine, copper, or vitamin C may be unmasked in the process and may limit the bone marrow s response until they are also corrected. 

Iron within a food matrix provides an extremely reactive vehicle for complexation with a great number of chemical compounds. In fact, it is this very reactivity which makes some of the most bioavailable forms of iron so objectionable to the food processor since the chemical reactions which occur can drastically affect quality. Conversely, the most functionally suitable forms of iron are often not very bioavailable. This nutritional/functional campatability, although not a subject of focus here, should be mentioned since any fortification program must consider this campatability factor or it will be doomed to failure. This problem has been discussed in some detail by Lee and Clydesdale and Zoller et al ... 

Ascorbic acid has also been shown to interact with therapeutic iron. Derman, et al., have reported that ascorbic acid increases absorption of various iron fortification compounds in infant formulas in cereals this three-fold increase in iron absorption induced by ascorbic acid was observed in multiparous women (16). El-Hawary, et al., studied 97 infants and young children and observed that ascorbic acid increased absorption from a four mg iron supplement as ferrous sulfate (17). 

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