Improving iron absorption from a Peruvian school breakfast meal by adding ascorbic acid or Na(2)EDTA

Background: Iron-fortified school breakfasts have been introduced in Peru t o combat childhood iron deficiency. Objective: We evaluated whether iron absorption from a school breakfast mea l was improved by increasing the ascorbic acid content or by adding an alte rnative enhancer of iron absorption, Na(2)EDTA, Design: In a crossover design, iron absorption from test meals was evaluate d by erythrocyte incorporation of Fe-58 and Fe-57. The test meals (wheat br ead and a drink containing cereal, milk, and soy) contained 14 mgr added Fe (as ferrous sulfate) including 2.0-2.6 mg Fe-58 or 4.0-7.0 mg Fe-57. Results: Geometric mean iron absorption increased significantly from 5.1% t o 8.2% after the molar ratio of ascorbic acid to fortification iron was inc reased from 0.6:1 to 1.5:1 (P < 0.01; n = 9). Geometric mean iron absorptio n increased significantly from 2.9% to 3.8%, from 2.2% to 3.5%, and from 2. 4% to 3.7% after addition of Na(2)EDTA at molar ratios relative to fortific ation iron of 0.3:1, 0.7:1, and 1:1, respectively, compared with test meals containing no added enhancers (P < 0.01; n = 10 for all). Iron absorption after addition of ascorbic acid (molar ratio 0.6:1) was not significantly d ifferent from that after addition of Na(2)EDTA (molar ratio 0.7:1), Conclusions: Ascorbic acid and Na(2)EDTA did not differ significantly in th eir enhancing effects on iron absorption at molar ratios of 0.6:1 to 0.7:1 relative to fortification iron. Additional ascorbic acid (molar ratio 1.6:1 ) increased iron absorption significantly. Increasing the molar ratio of Na (2)EDTA to fortification iron from 0.3:1 to 1:1 had no effect on iron absor ption.