Efficacy of wheat-based biscuits fortified with microcapsules containing ferrous sulfate and potassium iodate or a new hydrogen-reduced elemental iron: a randomised, double-blind, controlled trial in Kuwaiti women.

Adverse sensory changes prevent the addition of highly bioavailable ferrous sulfate (FeSO4) to most wheat flours. Poorly absorbable reduced Fe powders are commonly used. Encapsulation of FeSO4 can overcome these sensory changes, but the particle size of commercial compounds is too large to be used by flour mills. The first objective of the study was to measure the efficacy in wheat flour of two newly developed Fe compounds, an H-reduced Fe powder (NutraFine RS; North America Höganäs High Alloys LLC, Johnstown, PA, USA) and small particle-sized (40 microm) encapsulated FeSO4. As a second objective, the microcapsules were evaluated as a vehicle for iodine fortification. A randomised, double-blind controlled intervention trial was conducted in Kuwaiti women (n 279; aged 18-35 years) with low body Fe stores (serum ferritin (SF) < 25 microg/l) randomly assigned to one of three groups (20 mg Fe as NutraFine RS, 10 mg Fe as encapsulated FeSO4 and 150 microg iodine, or no fortification Fe) who consumed wheat-based biscuits 5 d per week. At baseline and 22 weeks, Hb, SF, transferrin receptor, urinary iodine and body Fe stores were measured. Relative to control, mean SF in the encapsulated FeSO4 group increased by 88 % (P < 0.001) and body Fe stores increased from - 0.96 to 2.24 mg/kg body weight (P < 0.001), while NutraFine RS did not significantly increase SF or body Fe stores. The median urinary iodine concentration increased from 140 to 213 microg/l (P < 0.01). NutraFine RS added at double the amount of Fe as FeSO4 was not efficacious in improving Fe status. The newly developed microcapsules were highly efficacious in improving both Fe stores and iodine status.

[1]  L. Braverman,et al.  Ammonium persulfate: a new and safe method for measuring urinary iodine by ammonium persulfate oxidation. , 2009, Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association.

[2]  E. McLean,et al.  Iodine Deficiency in 2007: Global Progress since 2003 , 2008, Food and nutrition bulletin.

[3]  S. Lynch Influence of infection/inflammation, thalassemia and nutritional status on iron absorption. , 2007, International journal for vitamin and nutrition research. Internationale Zeitschrift fur Vitamin- und Ernahrungsforschung. Journal international de vitaminologie et de nutrition.

[4]  S. Lynch,et al.  A comparison of physical properties, screening procedures and a human efficacy trial for predicting the bioavailability of commercial elemental iron powders used for food fortification. , 2007, International journal for vitamin and nutrition research. Internationale Zeitschrift fur Vitamin- und Ernahrungsforschung. Journal international de vitaminologie et de nutrition.

[5]  Thomas Walczyk,et al.  Iron status and food matrix strongly affect the relative bioavailability of ferric pyrophosphate in humans , 2006, The American journal of clinical nutrition.

[6]  M. Zimmermann,et al.  Development, Stability, and Sensory Testing of Microcapsules Containing Iron, Iodine, and Vitamin A for Use in Food Fortification , 2006 .

[7]  M. Zimmermann,et al.  Comparison of the efficacy of wheat-based snacks fortified with ferrous sulfate, electrolytic iron, or hydrogen-reduced elemental iron: randomized, double-blind, controlled trial in Thai women. , 2005, The American journal of clinical nutrition.

[8]  I. Egli,et al.  Current global iodine status and progress over the last decade towards the elimination of iodine deficiency. , 2005, Bulletin of the World Health Organization.

[9]  M. Zimmermann,et al.  Triple fortification of salt with microcapsules of iodine, iron, and vitamin A. , 2004, The American journal of clinical nutrition.

[10]  M. Zimmermann The potential of encapsulated iron compounds in food fortification: a review. , 2004, International journal for vitamin and nutrition research. Internationale Zeitschrift fur Vitamin- und Ernahrungsforschung. Journal international de vitaminologie et de nutrition.

[11]  M. Zimmermann,et al.  Dual fortification of salt with iodine and micronized ferric pyrophosphate: a randomized, double-blind, controlled trial. , 2004, The American journal of clinical nutrition.

[12]  H. Mahmud,et al.  Helicobacter pylori infection, iron absorption, and gastric acid secretion in Bangladeshi children. , 2004, The American journal of clinical nutrition.

[13]  M. Zimmermann,et al.  Dual fortification of salt with iodine and encapsulated iron compounds: Stability and acceptability testing in Morocco and Cote d'Ivoire , 2003 .

[14]  J. Cook,et al.  The quantitative assessment of body iron. , 2003, Blood.

[15]  M. Zimmermann,et al.  Dual fortification of salt with iodine and microencapsulated iron: a randomized, double-blind, controlled trial in Moroccan schoolchildren. , 2003, The American journal of clinical nutrition.

[16]  J. Cook,et al.  The usefulness of elemental iron for cereal flour fortification: a SUSTAIN Task Force report. Sharing United States Technology to Aid in the Improvement of Nutrition. , 2002, Nutrition reviews.

[17]  R. Hurrell Fortification: overcoming technical and practical barriers. , 2002, The Journal of nutrition.

[18]  R. Jackson,et al.  Iron deficiency is a more important cause of anemia than hemoglobinopathies in Kuwaiti adolescent girls. , 2000, The Journal of nutrition.

[19]  L. Braverman,et al.  Ammonium persulfate: a safe alternative oxidizing reagent for measuring urinary iodine. , 1996, Clinical chemistry.

[20]  J. Cook,et al.  Iron fortification of infant cereals: a proposal for the use of ferrous fumarate or ferrous succinate. , 1989, The American journal of clinical nutrition.

[21]  L. Allen,et al.  Guidelines on food fortification with micronutrients , 2006 .

[22]  I. Egli,et al.  Iodine status worldwide: WHO Global Database on Iodine Deficiency , 2004 .

[23]  M. Haldimann,et al.  Improved measurement of iodine in food samples using inductively coupled plasma isotope dilution mass spectrometry. , 2000, The Analyst.

[24]  R. U. Mackower Extraction and determination of phytic acid in beans (Phaseolus vulgaris) , 1970 .