Background: Iron deficiency anemia (IDA) is highly prevalent in the Cote d’Ivoire and has severe health and economic consequences. In this paper, we apply a health economic model to quantify the burden of IDA, and the contribution of nationwide mandatory iron fortification of wheat flour and voluntary iron fortification of condiments to the reduction of this burden.Methods: The analysis for the population from 6 months to 64 years builds on published reviews and publicly available datasets and is stratified by age-groups and socioeconomic strata using comparative risk assessment model.Results: Without the impact of these fortification strategies, the annual burden of IDA is estimated at 242,100 disability adjusted life years (DALYs) and 978.1 million USD. Wheat flour and condiment fortification contributed to a reduction of the IDA burden by approximately 5% each.Conclusion: In places with high prevalence of malaria and other infectious diseases, such as the Côte D’Ivoire, food fortification as a nutritional intervention should be accompanied with infectious disease prevention and control. The findings of this study provide additional input for policy makers about the magnitude of the impact and can support the conception of future fortification strategies.

An adequate mineral supply to preterm infants is essential for normal growth and development. This study aimed to compare the mineral contents of human milk (HM) from healthy mothers of preterm (28–32 weeks) and full term (>37 weeks) infants. Samples were collected weekly for eight weeks for the term group (n = 34) and, biweekly up to 16 weeks for the preterm group (n = 27). Iron, zinc, selenium, copper, iodine, calcium, magnesium, phosphorus, potassium, and sodium were quantitatively analyzed by Inductively Coupled Plasma-Mass Spectrometry. The mineral contents of both HM showed parallel compositional changes over the period of lactation, with occasional significant differences when compared at the same postpartum age. However, when the comparisons were performed at an equivalent postmenstrual age, preterm HM contained less zinc and copper from week 39 to 48 (p < 0.002) and less selenium from week 39 to 44 (p < 0.002) than term HM. This translates into ranges of differences (min–max) of 53% to 78%, 30% to 72%, and 11% to 33% lower for zinc, copper, and selenium, respectively. These data provide comprehensive information on the temporal changes of ten minerals in preterm HM and may help to increase the accuracy of the mineral fortification of milk for preterm consumption.

A new iron–casein complex (ICC) has been developed for iron (Fe) fortification of dairy matrices. The objective was to assess the impact of ascorbic acid (AA) on its in vitro bioavailability in comparison with ferrous sulfate (FeSO₄) and ferric pyrophosphate (FePP). A simulated digestion coupled with the Caco-2 cell culture model was used in parallel with solubility and dissociation tests. Under diluted acidic conditions, the ICC was as soluble as FeSO₄, but only part of the iron was found to dissociate from the caseins, indicating that the ICC was an iron chelate. The Caco-2 cell results in milk showed that the addition of AA (2:1 molar ratio) enhanced iron uptake from the ICCs and FeSO₄ to a similar level (p = 0.582; p = 0.852) and to a significantly higher level than that from FePP (p < 0.01). This translated into a relative in vitro bioavailability to FeSO₄ of 36% for FePP and 114 and 104% for the two ICCs. Similar results were obtained from water. Increasing the AA to iron molar ratio (4:1 molar ratio) had no additional effect on the ICCs and FePP. However, ICC absorption remained similar to that from FeSO₄ (p = 0.666; p = 0.113), and was still significantly higher than that from FePP (p < 0.003). Therefore, even though iron from ICC does not fully dissociate under gastric digestion, iron uptake suggested that ICCs are absorbed to a similar amount as FeSO₄ in the presence of AA and thus provide an excellent source of iron.

It is generally considered that the absorption of Mg is inversely related to the ingested dose. The objective of the present study was to determine if the mode of administration (bolus v. consumption throughout the day) could influence Mg bioavailability from Mg-rich natural mineral water comparing the same nutritional Mg amount (126 mg). Using a 2 d cross-over design, twelve healthy men were asked to drink 1·5 litres Mg-rich mineral water either as 2 × 750 ml or 7 × 212 ml throughout the day. Two stable isotopes (²⁵Mg and ²⁶Mg) were used to label the water in order to distinguish both regimens. Fractional apparent Mg absorption was determined by faecal monitoring and Mg retention was determined by measuring urinary excretion of Mg isotopes. Higher Mg absorption (50·7 (sd 12·7) v. 32·4 (sd 8·1) %; P = 0·0007) and retention (47·5 (sd 12·9) v. 29·0 (sd 7·5) %; P = 0·0008) from Mg-rich mineral water were observed when it was consumed in seven servings compared with larger servings. Thus, regular water consumption throughout the day is an effective way to increase Mg bioavailability from Mg-rich mineral water.

Plant-based foods can offer sustainable and healthy dietary choices. Soybeans and derivatives (for example, flour, concentrate, or isolate) are the primary protein source for plant-based products, including meat analogs, and are naturally rich in iron. To investigate the nutritional contribution of iron naturally present in soy, this narrative review presents iron bioavailability data from isotope studies in humans aged >3 y. To allow interstudy comparison, we adjusted mean iron absorption for iron status (that is, serum ferritin of 15 μg/L), quantified native iron absorbed, and compared with daily human requirements for absorbed iron where possible. Adjusted iron absorption from soybeans served as part of meals varied widely (4.1%-22.2%), translating to contributions of 13%-70% and 10%-40% to the daily requirements for absorbed iron in adult males and females, respectively. Similar results were found for meals prepared with soy flour (full fat, defatted, and texturized) and soy protein concentrates, whereas iron bioavailability from soy protein isolates may be reduced. Within a meal, partial substitution (≤30%) of meat with soy concentrates and isolates did not meaningfully impair total iron absorption. In all conditions, low phytic acid levels and co-ingestion of ascorbic acid improved the absorption of iron naturally present in soy. Available evidence suggests that soy-based products can provide a meaningful contribution to daily requirements for absorbed iron, especially if phytic acid is below defined thresholds to optimize absorption and/or if products include iron absorption enhancers such as ascorbic acid. Further research is needed to understand the factors affecting iron bioavailability from these products, especially the soy cultivar, the roles of phytoferritin and the protein profiles of different soy protein ingredients, as well as the processes to produce them. Long-term assessments of the impact of soybean-based products on iron status are also warranted.