The effect of gold kiwifruit consumed with an iron fortified breakfast cereal meal on iron status in women with low iron stores: A 16 week randomised controlled intervention study

Kathryn Beck,Rozanne Kruger,Cathryn Conlon,Jane Coad,Welma Stonehouse

doi:10.1186/1471-2458-10-36

Abstract

BackgroundDietary treatment is often recommended as the first line of treatment for women with mild iron deficiency. Although it is well established that ascorbic acid enhances iron absorption, it is less clear whether the consumption of ascorbic acid rich foods (such as kiwifruit) with meals fortified with iron improves iron status. The aim of this study is to investigate whether the consumption of ZESPRI® GOLD kiwifruit (a fruit high in ascorbic acid and carotenoids) with an iron fortified breakfast cereal meal increases iron status in women with low iron stores.Methods/DesignEighty nine healthy women aged 18-44 years with low iron stores (serum ferritin (SF) ≤ 25 μg/L, haemoglobin (Hb) ≥ 115 g/L) living in Auckland, New Zealand were randomised to receive an iron fortified breakfast cereal (16 mg iron per serve) and either two ZESPRI® GOLD kiwifruit or a banana (low ascorbic acid and carotenoid content) to eat at breakfast time every day for 16 weeks. Iron status (SF, Hb, C-reactive protein (CRP) and soluble transferrin receptor (sTfR)), ascorbic acid and carotenoid status were measured at baseline and after 16 weeks. Anthropometric measures, dietary intake, physical activity and blood loss were measured before and after the 16 week intervention.DiscussionThis randomised controlled intervention study will be the first study to investigate the effect of a dietary based intervention of an iron fortified breakfast cereal meal combined with an ascorbic acid and carotenoid rich fruit on improving iron status in women with low iron stores.Trial registrationACTRN12608000360314

Highlights

Dietary treatment is often recommended as the first line of treatment for women with mild iron deficiency
It is well known that non haem iron absorption is enhanced by the addition of ascorbic acid to meals [10,11]
Lutein and zeaxanthin have recently been shown to increase iron absorption when added to meals [12]

Summary

Introduction

Dietary treatment is often recommended as the first line of treatment for women with mild iron deficiency. A study in eleven iron depleted women found that providing 500 mg ascorbic acid with three meals per day for five and a half weeks improved haemoglobin levels but not serum ferritin levels [15]. No changes in serum ferritin levels were seen in fourteen vegetarian subjects who consumed tofu alone or tofu and orange juice for 30 days in a cross over study [16] Limitations of these studies include small sample sizes, three of the studies being of less than six weeks duration, and in some cases, the use of subjects with normal iron stores or whose iron levels was not reported. Ascorbic acid may be more likely to improve iron status if consumed with meals containing substantial amounts of fortificant iron [20]

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