Sensitivity analyses and meta-regression for hemoglobin suggested a higher response with lower trial quality ( suboptimal allocation concealment and blinding ) , use of condiments , and sodium iron edetate and a lower response when adults were included .
Consumption of iron-fortified foods results in an improvement in hemoglobin , serum ferritin , and iron nutriture and a reduced risk of remaining anemic and iron deficient
BACKGROUND The utility of iron fortification of food to improve iron deficiency , anemia , and biological outcomes is not proven unequivocally .
Iron absorption: comparison of prediction equations and reality. Results from a feeding trial in the Philippines.
BACKGROUND A number of algorithms have been developed that seek to predict the bioavailability of iron from mixed meals and diets , but their direct validity in predicting change in iron status remains question able . Throughout the course of conducting a large feeding trial in convents in Manila , we collected weighed food-intake data and have the opportunity to directly compare the performance of these prediction equations . AIMS The specific aims of this particular analysis are as follows : ( a ) to determine habitual intakes of macro- and micronutrients  in religious sisters in Manila , ( b ) to determine the predicted efficiency of iron absorption from each of the published bioavailability algorithms ( Monsen , Hallberg , Reddy , Tseng , Barghava , and Du ) , and ( c ) to determine which of these equations best predicts the actual " gain " in iron in religious sisters over the duration of the trial . DESIGN The efficacy of consuming high-iron rice was tested during a nine-month feeding trial with a double-blinded dietary intervention ; these results have been published [ 7 ] . Religious sisters living in 10 convents around metropolitan Manila , the Philippines were r and omly assigned to consume either high-iron rice ( 3.21 mg/kg Fe ) or a local variety of control rice ( 0.57 mg/kg Fe ) within each convent . RESULTS Religious sisters in convents consumed a diet that appeared to be typical of habitual intakes of macro- and micronutrients in this part of the Philippines . The analysis of the six equations revealed highly significant differences in predicted efficiency of iron absorption . The Hallberg , Monsen , and Reddy equations all predicted similar median efficiency ( 6.88 , 7.92 , and 6.42 % ) . In contrast , Bhargava ( 4.68 % ) , Tseng ( 3.23 % ) , and Du ( 2.92 % ) were significantly lower . The correlation ( r = 0.98 ) of Monsen to Hallberg was highly significant and the slope was not different than unity . The median efficiency of absorption based on the gain in body iron in 114 subjects over nine months , combined with an estimate of daily iron requirements , was 17.2 % . Thus , none of these equations approximated the computed iron absorption based on improvement in serum ferritin and suggests alternative approaches to predicting iron accumulation from diet need to be formulated . CONCLUSIONS Inhibitory factors in the prediction equations either had little effect or had too large of an effect on apparent bioavailability as compared to median absorption over a nine-month period . The causes of the lack of agreement between computed iron gain and predicted absorption are open to discussion and will need to be resolved
Sensitivity analyses and meta-regression for hemoglobin suggested a higher response with lower trial quality ( suboptimal allocation concealment and blinding ) , use of condiments , and sodium iron edetate and a lower response when adults were included .
Consumption of iron-fortified foods results in an improvement in hemoglobin , serum ferritin , and iron nutriture and a reduced risk of remaining anemic and iron deficient
BACKGROUND The utility of iron fortification of food to improve iron deficiency , anemia , and biological outcomes is not proven unequivocally .