Ingesta de hierro y gen HFE en varones adultos de Buenos Aires / Iron intake and HFE gen in male adults from Buenos Aires

El consumo excesivo de hierro (Fe) en portadores de mutaciones en el gen HFE puede resultar en sobrecarga. Para evaluar el riesgo de sobrecarga de Fe fueron investigados 166 varones adultos donantes de sangre de la ciudad de Buenos Aires. Se estimó la ingesta diaria de Fe (IFe), de Fe hemínico y de Fe proveniente de harinas enriquecidas con SO4Fe. Se determinó ferritina sérica y porcentaje de saturación de transferrina (criterio de sobrecarga de Fe: ferritina sérica > 300 ng/ml y saturación de transferrina ≥ 50%). Las mutaciones C282Y, H63D y S65C fueron investigadas en sangre mediante PCR-RFLP. Todos los participantes cubrieron ampliamente el requerimiento estimado promedio de Fe (6 mg Fe/día) y 3.0% superó el máximo tolerable (45 mg Fe/día). El Fe hemínico correspondió al 9.4% de la IFe y el de harinas enriquecidas al 47.7%. Se observó una asociación entre el aumento de IFe y el de ferritina sérica (p = 0.0472), y el 2.3% de los donantes presentaron ferritina sérica > 300 ng/ml y saturación de transferrina ≥ 50%. El 29.3% de los donantes eran portadores de los genotipos H63D, S65C o C282Y, asociados a hemocromatosis hereditaria, y tenían valores de saturación de transferrina significativamente mayores a los de los donantes wild type (p = 0.0167). Si bien la incidencia clínica de hemocromatosis hereditaria fue baja en el grupo estudiado (1.2%), el consumo excesivo de Fe plantea un riesgo potencial para la salud de individuos que ignoran sus antecedentes familiares de sobrecarga de Fe.

Excess iron (Fe) intake in subjects carrying certain mutations in the HFE gene may result in Fe overload. To estimate risk of Fe overload, 166 male blood donors (19-65 years) from Buenos Aires city were investigated. Daily Fe intake (FeI), hem Fe intake, and Fe intake from SO4Fe enriched flours were estimated (SARA Computer Program and Food Composition Table, USDA). Serum ferritin and transferrin saturation were determined; criteria for Fe overload was serum ferritin > 300 ng/ml and transferrin saturation ≥ 50%. HFE genotypes C282Y, H63D and S65C were analyzed by PCR-RFLP in blood samples. No participant presented FeI lower than the estimated average requirement (6 mg Fe/day) and 3.0% was over the upper level (45 mg Fe/day). Hem Fe and Fe from flour enrichment were 9.4% and 47.7% of daily Fe intake, respectively. A significant association was observed between the increase in serum ferritin (ng/ml) and the increase in FeI (p = 0.0472); 2.3% of the donors presented serum ferritin > 300 ng/ml and transferrin saturation ≥ 50%. Genotypes associated with hereditary hemochromatosis (H63D, S65C and C282Y) were found in 29.3% of the donors. The percentage of transferrin saturation was higher in subjects carrying mutation than in wild type subjects (p = 0.0167). Although penetrance of hereditary hemochromatosis in the studied group was only 1.2%, an excessive Fe intake could enhance adverse effects in individuals unaware of any family history of Fe overload.

Study of EDTA intake of children for potential use of FeNaEDTA for breakfast cereal fortification

EDTA is used as disodium salt or disodiumcalcium in foods, to prevent lipid oxidation or as color and flavor stabilizer. In some countries, FeNaEDTA is also used as a source of iron for fortification. However, EDTA has an Acceptable Daily Intake (ADI) of 2.5 mg / kg/day. The aim of this study was to estimate the intake of EDTA in children of school age and the potential use of Fe- NaEDTA as iron source for breakfast cereal fortification. A qualitative-quantitative food frequency questionnaire was conducted on 225 schoolchildren of both sexes, aged between 4 and 13, from school canteens, public and private schools, from the city of Santa Fe (Argentina). Only those foods which EDTA addition is allowed in Argentina: packaged ice cream, soda, soft drinks and powdered soft drinks (upper limit of Na2EDTA o Na2CaEDTA: 35 mg/kg) and dressings and margarines (upper limit of Na2CaEDTA: 75 mg/kg) were considered. EDTA Average Daily Consumption (ADC) was 0.06 mg/kg/day with a median of 0.011 mg/kg/day, representing 2.4% of the ADI. In the hypothetical case that FeNaEDTA would be used as iron source for breakfast cereal fortification at level of 11 mg Fe%, the potential EDTA ADC would be 0.46 ± 0.32 mg/kg/day, representing 18.4% of the ADI (2.5 mg/kg/day). Results indicate that children from Santa Fe city have an EDTA ADC currently well below the maximum ADI of EDTA, which would remain low even if FeNaEDTA is used for breakfast cereal fortification.

Estudio de la ingesta de EDTA en niños para la utilización potencial de FeNaEDTA en la fortificación de cereales para desayuno. El EDTA es utilizado en alimentos como sal disódica o disódica-cálcica, para prevenir la oxidación lipídica o como estabilizante del color y sabor. En algunos países, FeNaEDTA es también usado como una fuente de hierro para la fortificación de alimentos. Sin embargo, posee una Ingesta Diaria Admisible (IDA) de 2,5 mg/kg/día. El objetivo de este estudio fue estimar la ingesta de EDTA en niños y el potencial uso de FeNaEDTA como fuente de fortificación de hierro en cereales para desayuno (CPD). Se realizó un cuestionario de frecuencia alimentaria cuali-cuantitativo a niños de ambos sexos, en edades comprendidas entre 4 y 13 años, que asistían a comedores escolares, escuelas públicas y privadas de la Ciudad de Santa Fe, Argentina. Solo se evaluaron aquellos alimentos en los que se halla permitido el agregado de EDTA en Argentina: helados envasados, gaseosas, bebidas sin alcohol y jugos en polvo, aderezos y margarina. La Ingesta Diaria Promedio (IDP) de EDTA fue de 0,06 mg/Kg/día con una mediana de 0,011 mg/kg/día, lo que representa el 2,4% de la IDA. En el hipotético caso de que FeNaEDTA fuera usado como fuente de hierro para fortificación de CPD en un nivel de 11 mg Fe%, la potencial IDP de EDTA sería de 0,46 ± 0,32 mg/kg/día, lo que representa un 18,4 % de la IDA. Los resultados indican que la IDP de EDTA está muy por debajo de la IDA máxima, la cual seguiría siendo baja incluso si el FeNaEDTA se utilizara como fortificante de hierro en CPD.

Progress of prevention and treatment of iron deficiency / 国际儿科学杂志

Many countries have prevented and treated iron deficiency by more and more iron nutritional fortifiers. Although technical challenges limit the amount of bioavailable iron that can be added to many foods,evidence from controlled trials has shown that iron fortification can effectively control iron deficiency. Selective plant breeding and genetic engineering are promising new approaches to improve dietary iron bioavailability.However, a major challenge is to show that they can increase iron content to nutritionally useful levels and that the additional iron is bioavailable.

Estimated Iron Intakes from Simulated Fortification to Selected Grain Products in the Korea Food Supply / 대한지역사회영양학회지

Until now, South Korea does not have either fortification or enrichment program as intervention tools, although the addition of micronutrients to foods is for the most part not regulated. The aim of this study was to determine which scenario would most effectively reduce the proportion of the population with low iron intake while not putting other population groups at risk of excessive intakes. In order to investigate potential dietary consequences of iron fortification, we analyzed 2 day dietary record data (n=3,955) from the 2001 National Nutrition Surveys. The Proportion of the population consuming dietary iron less than the estimated average requirement (EAR) ranged from 12.4~87.5% depending upon gender and age group. Iron fortification at the level of 100% of Recommended Intake (RI) per 100g to breads and instant or dried noodles was estimated to result in a 15% decrease of proportion of those with iron less than EAR, while putting 1.4 % of the population greater than the Upper Limit (UL). Iron fortification appeared to be the most effective for the 15~19 year old age group, showing 39% reduction of iron intake insufficiency. The results suggest that carefully designed fortification or enrichment to staple foods may contribute to increase dietary iron intakes of Koreans, especially for the young population with a high prevalence of iron inadequacy. As the estimation in this study was based solely upon dietary intake data, iron intake from supplements should be considered in further studies.