Gold kiwifruit consumed with an iron-fortified breakfast cereal meal improves iron status in women with low iron stores: a 16-week randomised controlled trial

Abstract

Ascorbic acid, and more recently, the carotenoids lutein and zeaxanthin have been shown to enhance Fe absorption. However, it is not clear whether Fe status improves when foods high in ascorbic acid and carotenoids are consumed with Fe-fortified meals. The present study aimed to investigate whether consuming high v. low ascorbic acid-, lutein- and zeaxanthin-rich fruit (gold kiwifruit v. banana) with Fe-fortified breakfast cereal and milk improved Fe status in women with low Fe stores. Healthy women aged 18-44 years (n 89) with low Fe stores (serum ferritin≤25μg/l and Hb≥115g/l) were randomly stratified to receive Fe-fortified breakfast cereal (16mg Fe as ferrous sulfate), milk and either two gold kiwifruit or one banana (164mg v. not detectable ascorbic acid; 526 v. 22·90μg lutein and zeaxanthin, respectively) at breakfast every day for 16 weeks. Biomarkers of Fe status and dietary intake were assessed at baseline and end in the final sample (n 69). Median serum ferritin increased significantly in the kiwifruit group (n 33) compared with the banana group (n 36), with 10·0 (25th, 75th percentiles 3·0, 17·5) v. 1·0 (25th, 75th percentiles -2·8, 6·5) μg/l (P<0·001). Median soluble transferrin receptor concentrations decreased significantly in the kiwifruit group compared with the banana group, with -0·5 (25th, 75th percentiles -0·7, -0·1) v. 0·0 (25th, 75th percentiles -0·3, 0·4) mg/l (P=0·001). Consumption of an Fe-fortified breakfast cereal with kiwifruit compared with banana improved Fe status. Addition of an ascorbic acid-, lutein- and zeaxanthin-rich fruit to a breakfast cereal fortified with ferrous sulfate is a feasible approach to improve Fe status in women with low Fe stores.