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Improving iron absorption from a Peruvian school breakfast meal by adding ascorbic acid or Na₂EDTA^1,2,3

¹ From the Laboratory for Human Nutrition, Institute of Food Science, Swiss Federal Institute of Technology, Rüschlikon, Switzerland, and Instituto de Investigacion Nutricional, Lima, Peru.

Background: Iron-fortified school breakfasts have been introduced in Peru to combat childhood iron deficiency.

Objective: We evaluated whether iron absorption from a school breakfast meal was improved by increasing the ascorbic acid content or by adding an alternative enhancer of iron absorption, Na₂EDTA.

Design: In a crossover design, iron absorption from test meals was evaluated by erythrocyte incorporation of ⁵⁸Fe and ⁵⁷Fe. The test meals (wheat bread and a drink containing cereal, milk, and soy) contained 14 mg added Fe (as ferrous sulfate) including 2.0–2.6 mg ⁵⁸Fe or 4.0–7.0 mg ⁵⁷Fe.

Results: Geometric mean iron absorption increased significantly from 5.1% to 8.2% after the molar ratio of ascorbic acid to fortification iron was increased from 0.6:1 to 1.6:1 (P < 0.01; n = 9). Geometric mean iron absorption increased significantly from 2.9% to 3.8%, from 2.2% to 3.5%, and from 2.4% to 3.7% after addition of Na₂EDTA at molar ratios relative to fortification iron of 0.3:1, 0.7:1, and 1:1, respectively, compared with test meals containing no added enhancers (P < 0.01; n = 10 for all). Iron absorption after addition of ascorbic acid (molar ratio 0.6:1) was not significantly different from that after addition of Na₂EDTA (molar ratio 0.7:1).

Conclusions: Ascorbic acid and Na₂EDTA did not differ significantly in their enhancing effects on iron absorption at molar ratios of 0.6:1 to 0.7:1 relative to fortification iron. Additional ascorbic acid (molar ratio 1.6:1) increased iron absorption significantly. Increasing the molar ratio of Na₂EDTA to fortification iron from 0.3:1 to 1:1 had no effect on iron absorption.

Key Words: Iron • iron absorption • stable isotope • food fortification • iron fortification • children • ascorbic acid • vitamin C • Na₂EDTA • Peru • childhood anemia • iron deficiency • pediatric nutrition

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