Improving Iron Status Through Diet The Application of Knowledge Concerning Dietary Iron Bioavailability in Human Populations

Iron deficiency reflected in low concentrations of serum ferritin may have adverse effects on work performance even without anemia. Once anemia develops there are further impairments in cognitive performance and behavior as well as a risk of low birth weight due to prematurity and other pregnancy complications. In developing countries poor dietary quality rather than quantity is the key determinant of impaired micronutrient status. Even when the total iron intake of populations dependent on plant-based diets meets dietary recommendations the bioavailability of iron bound to plant constituents is usually poor. The key to the long-term prevention of iron deficiency and the resulting anemia is to increase the amount of dietary iron absorbed. The most commonly used strategies are the provision of iron supplements or the fortification of foods with iron. Parasite treatment can improve iron status by reducing intestinal blood loss and increasing iron absorption. Promotion of culturally acceptable changes in food choices represents another approach. This paper seeks to integrate the available information on iron bioavailability to facilitate the design of programs to improve the absorption of iron from specific staple foods and diets.