Iron fortification
Omni news flash (fwd) Michael H.N. Golden 04.08.97
Iron-EDTA Peter Ranum 01.11.97
Iron-EDTA Mike Golden 03.11.97
iron/caEDTA and zinc availability Colin Mills 11.11.97


Mon, 4 Aug 1997 12:29:35 +0100 (BST)

Subject: OMNI NEWS FLASH (fwd)

From: "Michael H.N. Golden" <m.goldenatabdn.ac.uk>

 

For those on the NGONUT who are not otherwise notified about OMNI publicaitons: they provide a very good and reliable service with very useful documents.

>From nullatlists.jsi.com Fri Aug 1 21:27 BST 1997

Date: Fri, 1 Aug 1997 16:06:15 -0400

From: Project OMNI <omni_projectatjsi.com>

Subject: OMNI NEWS FLASH

 

ITEMS INCLUDED IN THIS FLASH:

1. ANNOUNCING A NEW OMNI PUBLICATION, IMPROVING IRON STATUS THROUGH DIET: THE APPLICATION OF KNOWLEDGE CONCERNING DIETARY IRON BIOAVAILABILITY IN HUMANS

2. A REPORT PROVIDING GUIDELINES ON USING SODIUM IRON EDTA AS AN IRON FORTIFICANT: IRON EDTA FOR FOOD FORTIFICATION

3. TWO NEW PUBLICATIONS AVAILABLE FROM BASICS:

 

1. ANNOUNCING A NEW OMNI PUBLICATION, IMPROVING IRONSTATUS THROUGH DIET: THE APPLICATION OF KNOWLEDGE CONCERNING DIETARY IRON BIOAVAILABILITY IN HUMANS

A new publication, Improving Iron Status Through Diet: The Application of Knowledge Concerning Dietary Iron Bioavailability in Human Populations, by Lindsay H. Allen and Namanjeet Ahluwalia, is now available from OMNI. Worldwide, more than 500 million people suffer from iron deficiency anemia, and even more than that exhibit iron deficiency without anemia. This publication looks at significant factors affecting dietary iron bioavailability in humans, presenting the available information in a way that can assist researchers and program planners in designing effective and practical strategies to improve the absorption of iron from specific staple foods and diets. The report, primarily a scientific review, examines the many factors involved in improving iron status by modifying diets. It reviews enhancers and inhibitors of iron bioavailability, and the effects of diet and food processing on iron bioavailability. It discusses different approaches to measuring bioavailability, such as iron fortification, and the role of contaminant iron in the diet. A review of methods for estimating iron bioavailability from dietary data is also included. Extensive research on the bioavailability of iron in the diet is provided for both developed and developing countries.

Available in English. To obtain a complimentary copy contact OMNI (see end of FLASH for contact information).

2. A REPORT PROVIDING GUIDELINES ON USING SODIUM IRON EDTA AS AN IRON FORTIFICANT: IRON EDTA FOR FOOD FORTIFICATION

This publication on iron fortification discusses sodium iron ethylenediaminetetraacetic acid (EDTA) as an attractive compound to be used in food fortification, the most effective means for introducing iron into the diet. This report serves as a guide for food fortification with iron EDTA, and encourages more extensive evaluations of this compound. It includes a summary of iron EDTA properties and iron-free EDTA properties. Other information listed in this four-page report includes: insight into the advantages and limitations of using EDTA; a list of suitable and unsuitable food vehicles for iron fortification; and information on the commercial availability of the compound.

This brief was published by the International Life Sciences institute (ILSI), May 1997. To obtain a copy of the report please contact:

International Nutritional Anemia Consultative Group (INACG)
c/o ILSI Human Nutrition Institute
1126 16th Street, NW
Washington, DC 20036-4810, USA
Phone: 202-659-0789; Fax: 202-659-3617; e-mail: omniatdc.ilsi.org

3. TWO NEW PUBLICATIONS AVAILABLE FROM BASICS:

A) HEARTH NUTRITION MODEL: APPLICATIONS IN HAITI, VIETNAM, AND BANGLADESH

This new report published by BASICS and the World Relief Organization provides up-to-date information on the Hearth Nutrition Model, what it is and how it has worked thus far. The Hearth Nutrition Model was introduced in Haiti, Vietnam, and Bangladesh in the early 1990s. The model has evolved from earlier community-based approaches to alleviating childhood malnutrition. The focus is on energizing volunteer mothers to rehabilitate malnourished children using local, affordable, nutritious foods for two weeks in the context of a growth monitoring and counseling program. The visible change in the children is a powerful motivator for mothers to continue good feeding practices acquired through adult learning practices in the Hearth feeding sessions. Hearth programs are meant to be supported by other programs such as deworming, growth monitoring, income generation, and micronutrient supplementation. Findings indicate that the Hearth Nutrition Model can make a significant contribution in reducing malnutrition.

B) GENDER BIAS IN HEALTH CARE AMONG CHILDREN 0-5 YEARS: OPPORTUNITIES FOR CHILD SURVIVAL

Are girls under five years of age treated with a bias in the developing world when it comes to nutrition and health care? That is what researchers Kathleen Kurz and Charlotte Johnson-Welch set to find out in a study they conducted with BASICS support. Read the results of their study in Gender Bias in Health Care Among Children 0-5 Years: Opportunities for Child Survival, a review of the literature on gender differences in health and nutrition among children under 5 years of age in the developing world. The study indicates that there is a scarcity of information on gender differences among children under the age of 5. It also stresses the importance of focusing on possible gender bias among young children so that child survival interventions benefit girls and boys equally.

For complimentary copies of either report mentioned above or for more information on BASICS, please contact:

Director of Information
BASICS Information Center
1600 Wilson Boulevard; Suite 300
Arlington, VA 22209
Phone: 703-312-6800; Fax: 703-312-6900; e-mail: infoctratbasics.org

OPPORTUNITIES FOR MICRONUTRIENT INTERVENTIONS (OMNI) is funded by the Office of Health and Nutrition of the U.S. Agency for International Development (USAID) in Washington, D.C. and managed by John Snow, Inc. OMNI's mission is accomplished by developing integrated, comprehensive programs and strategies to reduce and eliminate major micronutrient deficiencies throughout the developing world. Participating countries are based on their micronutrient malnutrition problems, commitment by local officials (public and private) to micronutrient activities, and their capacity to achieve and sustain a demonstrable impact.

OMNI is located at

1616 North Fort Myer Drive; Suite 1100
Arlington, Virginia 22209 USA
Tel: 703 528-7474; Fax: 703 528-7480
E-mail: omni_projectatjsi.com;
WWW: http://jsi.com/intl/omni/home

To subscribe: send message to list-mgratlists.jsi.com and type subscribe OMNIFLASH in the body of the message. To unsubscribe: send message to list-mgratlists.jsi.com and type leave OMNIFLASH in the body of the Message.

 

Best wishes,

Prof. Michael H.N.Golden


From: Peter Ranum Doughmaker <Doughmakerataol.com>

Date: Sat, 1 Nov 1997 11:31:55 EST

Subject: Iron-EDTA

 

Dear NGONUTs,

I would appreciate your comments and opinions regarding fortification of "atta" flour used in India and the Middle East with iron-EDTA.

As most of you are aware, India and many Middle East counties have problems with iron deficiency anemia and osteoporosis. Part of the reason is a high dependence on cereals along with high tea consumption and low meat consumption. Most of the wheat consumed in India is the high extraction "atta" flour containing high levels of phytic acid. This is then used to produce chapattis or other flat breads involving very little yeast fermentation, which would destroy the phytic acid were it used. Addition of normal sources of iron (eg ferrous sulfate) to such breads is not well absorbed because of it being tied up by the phytic acid. To make matters worse, the bread is often eaten along with tea, whose tannins further bind up added iron.

Since fortification of atta flour with normal iron sources does not appear to be an effective means of increasing absorbable iron in these diets, we propose to use iron EDTA (sodium iron ethylenediaminetetraacetic acid). The improved absorption of this form of iron has been well documented (Iron EDTA for Food Fortification, 1993, Nutrition Foundation).

Food grade iron EDTA has not been commercially available until just recently. There has been a lot of agricultural grade product used in fertilizer but no food grade. As a result, no countries have actually approved its use. One alternative is to use EDTA along with an iron salt, since it has been shown that EDTA will preferentially bind iron over any other mineral present including zinc and calcium. This would be less expensive and allow use of already approved ingredients: i.e. Calcium EDTA and ferrous sulfate.

The high cost of iron EDTA can be partially offset by being able to use a lower level of added iron due to its high bioavailability. A normal iron addition to flour in many cereal fortification programs is 30 ppm. It should be possible to match that with about 10 ppm iron as iron EDTA.

The problem with calcium is that its level in cereals is too low. This can be simply remedied by adding calcium, such as calcium carbonate or sulfate, to flour. The carbonate is preferred since its cost can be below that of wheat flour making it economically attractive to the millers.

We are, therefore, promoting that the commercial atta flour millers fortify their product with 500 ppm calcium and 10 ppm iron in the form of iron EDTA or as ferrous sulfate plus calcium EDTA. In India, they may consider adding 2 ppm folic acid and vitamin A as well. Mills would likely do this first on a voluntary basis, producing a special product aimed at women and children. We recognize that the bulk of the atta flour produced in India is made in the small "chuckie" mills where such fortification is not feasible, but you have to start somewhere.

Since this would start out as a voluntary program, millers and bakers would like to see some sort of endorsement on this from the medical and health community.

I would appreciate hearing NGONUT comments on this or other chelated forms of iron you may know about. It is also possible that such forms will be considered for use in fortified food aid commodities such as bulgur and wheat soy blend containing high levels of phytic acid.

 

Peter Ranum

SUSTAIN, 50 Amberwood

Grand Island, NY 14072

(716) 773-4742, fax: 775-1037


Date: Mon, 03 Nov 1997 10:58:55 +0000

From: Michael Golden <m.goldenatabdn.ac.uk>

Subject: Re: Iron-EDTA

 

As you know the original descriptions of human zinc deficiency came from the middle east where similar unleavened bread is the staple. We now know that zinc is frequently the limiting type II nutrient in growth and rehabilitation and that a low level is important in recuperation from diarrhoea. Addition of CaEDTA to a diet will affect zinc absorption as well as iron; particularly as the addition of calcium changes the relative affinity of phyate for iron and zinc strongly in favour of making zinc unavailable and rendering the bacterial breakdown of phytate/calcium/zinc complex much less efficient. I have sent a message to Britt-Marie Sandstrom in Denmark and to Colin Mills to ask about the magnitude of these effects.

We nutritionists have not focused upon another critical point about phytic acid, whilst we explore divalent metal availability. Phytic acid (inositol hexaphosphate) is the storage form of phosphorus for the plant. If phytic acid is unavailable then so is the phosphorus, even though other forms of PO4 are available and food composition tables suggest that PO4 should not be a problem. Several studies with severely malnourished children show that they have very low phosphorus levels and that they cannot tolerate food that generates a metabolic acid load because of this and readily develop a severe acidosis. A low available PO4 also has implications for almost all metabolic pathways and for bone metabolism. Thus, fermentation (or germination) technology, apart from making iron, zinc and calcium more available and affecting the thrixotropic properties of porridges through starch breakdown, makes the phsophorus available. So there are definite advanatages to the fermentation/germination approach over the simple fortification approach. However, this is not within many cultures. If calcium is to be fortified, I would strongly suggest that calcium phosphate is used instead of calcium carbonate or sulphate.

 

Best wishes,

Prof. Michael H.N.Golden


Date: Tue, 11 Nov 1997 16:31:02 +0000

From: cfmatrri.sari.ac.uk (Colin Mills)

Subject: iron/caEDTA and zinc availability

 

Mike,

I suspect that the increasein calcium intake likely to result from use of FeCaEDTA to fortify iron supply is hardly likely to have a significant effect on zinc utilisation, even if dietary phytate is high as for example with high cereal diets. Phytate markedly decreases Zn availability but only if dietary conditions favour the formation of insoluble ZnCa/phytate within the gut. Such conditions will certainly arise if contamination of cereal-rich foods with calcareous (chalky)soils occurs during food preparation.....not all that rarely !

But this results from a very much greater addition of reactive calcium than would be the case with the relatvely stable complex of Ca with EDTA.

The importance of correcting iron deficiency in a dietary environment which abounds with iron-binding substances is such that every encouragement should be given to the prophlactic (dietary) use of soluble complexes of iron of high bioavailability.......whether these be from natural sources or synthetic.