Wheat Flour Fortified with Elemental Iron or FeSO4 Provides Bioavailable Iron to Pakistani Children

Abstract

Iron fortification of wheat flour is an accepted long term strategy to combat iron deficiency anemia worldwide. It is necessary to determine the relative bioavailability of various iron fortificants in local available flour prior to making any recommendation for wheat flour fortification. Relative bioavailability of various iron fortificants in 85% extraction wheat flour was evaluated. 54 school children, ages 5 to 10 years, were randomized in three groups, in order to receive a breakfast containing a wheat-based product, labeled with either 1) elemental ⁵⁸Fe, 2) ⁵⁸FeSO₄, or 3) ⁵⁸FeSO₄ + Na₂EDTA (1:1 molar ratio). Forty subjects successfully completed the trial. Using stable isotope methodology, the absorption of ⁵⁸Fe was determined. Overall, the two groups receiving ⁵⁸FeSO₄ had significantly higher absorption (7.0%±3.8) than the group receiving elemental ⁵⁸Fe (4.1%±1.7). There was no significant difference found in the percent absorption of ⁵⁸Fe between the groups receiving ⁵⁸FeSO₄ (7.4%±3.4) and those receiving ⁵⁸FeSO₄ + Na₂EDTA (6.4%±4.4). Estimated absorbed iron from 300 g of wheat fortified at the tested concentrations would be approximately 730 μg, 670 μg and 380 μg from elemental Fe, FeSO₄ and FeSO₄ + Na₂EDTA respectively. Overall, iron absorption was in the range expected although the lack of efficacy of Na₂EDTA was unexpected.