A mathematical model for the hemoglobin response to iron intake, based on iron absorption measurements from habitually consumed Indian meals

Abstract

Background/Objectives: The prevalence of iron deficiency (ID) and iron deficiency anemia (IDA) is high in India and appear unchanging over decades. To understand the persistence of these disorders, it is critical to measure iron (Fe) absorption from cereal-based Indian meals, its modulation by ID and the time-course of the response of hemoglobin (Hb) to Fe intake. Subjests/Methods: Fe absorption from rice-based meals was measured by the erythrocyte incorporation of the stable isotope label at 14 days in IDA (N ¼ 15) and Fe replete (IR) women (N ¼ 15). Hb level was used as surrogate for Fe status, and a response curve for Fe absorption versus the Hb level for a rice-based meal was constructed from measured data. This relationship was used as input for a mathematical model that examined the Hb response to different Fe intakes in normal and anemic women. Results: The mean fractional Fe absorption from a rice-based meal in IR and IDA women was 2.7% and 8.3%, respectively. The model predicted that Fe intakes between 20 and 55 mg/day in low-bioavailability diets would result in stable, non-anemic levels of Hb in women over a 1-year period.Conclusion: This mathematical model suggests that with a Fe intake of 20-30 mg/day and a dietary bioavailability of 3-5%, Hb concentration would hover around 12 g/dl with a variability of 0.5 g/dl in pre-menopausal adult women.

Non-Heme Iron Absorption and Utilization from Typical Whole Chinese Diets in Young Chinese Urban Men Measured by a Double-Labeled Stable Isotope Technique

“…A report showed mean iron absorption was low (4.6%) from the millet, but was increased from rice (8.3%) and wheat (11.2%)-based meals in the iron deficiency healthy young Indian women [ 48 ]. Iron absorption from a rice-based meal was low in iron replete (2.7%) but was higher in iron deficiency anemia Indian adult women (2.7% versus 8.3%) [ 59 ]. Further studies need to be carried out to observe the iron absorption and utilization from other staple foods (e.g.…”

A Survey of Plant Iron Content—A Semi-Systematic Review

“…Dietary sulfur amino-acids, as provided by a diet rich in shallot ( Allium ascalonicum ) and leek ( Allium tuberosum ) were shown in vitro to increase the iron availability of cereals and pulses with 10%–67% and 10%–38%, respectively [ 89 ]. A mathematical modeling based on data on iron absorption from a rice-based meal in Indian female subjects with iron deficiency and iron deficiency anemia has predicted that iron intakes of 20–55 mg per day are sufficient in (plant based) low-bioavailability diets to ensure stable, non-anemic levels of Hb in women [ 90 ].…”

Food system strategies for preventing micronutrient malnutrition

“…Figure 2 illustrates how the addition of selected foods to a rice-based diet can achieve nutritional adequacy for those micronutrients that are most commonly deficient in populations around the world. The foods selected for the diets are representative of foods that are commonly included in South Indian rice-based meals (Thankachan et al, 2012). All diets in the figure meet the calorie needs of a physically active woman aged 19-30 (2350 kcal).…”