Applied nutritional investigation
Iron absorption from wheat ﬂour: effects of lemonade and
Manuel Olivares, M.D.
*, Fernando Pizarro, M.T.
, Eva Hertrampf, M.D., M.Sc.
Guillermo Fuenmayor, M.D., M.Sc.
, and Edmundo Estévez, M.D., M.Sc.
Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Santiago, Chile
Centro de Biomedicina de la Universidad Central del Ecuador, Quito, Ecudor
Instituto de Ciencia y Tecnología del Ministerio de Salud Pública del Ecuador, Quito, Ecudor
Manuscript received October 14, 2005; accepted April 19, 2006.
Abstract Objective: We measured iron bioavailability of meals based on wheat ﬂour consumed by a
vulnerable population in Latin America.
Methods: Bioavailability of iron (ferrous sulfate) from fortiﬁed noodles, noodle soup, noodle soup
eaten with lemonade sweetened with panela (unreﬁned whole cane sugar), bread alone, and bread
consumed with a chamomile infusion sweetened with panela was studied using the double isotopic
method in 13 women.
Results: Iron bioavailabilities from bread, noodles, and noodle soup were not signiﬁcantly different
(7.4%, 6.3%, and 6.0%, respectively). Iron absorption from noodle soup was signiﬁcantly higher
when given with lemonade (11.0%) compared with absorption of the same meal without lemonade
(P Ͻ 0.02) or with the absorption of noodles (P Ͻ 0.04). Iron absorption of bread given alone or
with chamomile infusion sweetened with panela (8%) was not signiﬁcantly different.
Conclusion: Iron bioavailability of meals based on wheat ﬂour, fortiﬁed with ferrous sulfate, is
improved when given with lemonade. The consumption of this beverage may be an alternative to
further increase the effectiveness of wheat ﬂour fortiﬁcation in preventing iron deﬁciency in
low-income Latin American populations. © 2007 Elsevier Inc. All rights reserved.
Keywords: Iron absorption; Wheat ﬂour; Ferrous sulfate; Ascorbic acid; Citric acid
Iron deﬁciency is the single most common nutritional
disorder worldwide. It is prevalent in most of the developing
world and it is probably the only nutritional deﬁciency of
consideration in industrialized countries . Because of
their high iron requirements, the most commonly affected
groups are infants, children, adolescents, and women of
child-bearing age. In the developing world the prevalence of
iron deﬁciency is due mainly to a low intake in bioavailable
Non-heme iron is the main form of dietary iron. Its
absorption is greatly affected by enhancers and inhibitors
contained within the diet . Most foods consumed in
undeveloped countries have a predominance of inhibitors of
non-heme iron absorption. The balance between enhancers
and inhibitors of non-heme absorption becomes the deter-
minant in the possibility of obtaining the required iron for
the vast majority of people in the world whose diet contains
very little or no heme iron. Therefore, knowledge of iron
absorption from various representative meals of vulnerable
populations is critical to the design of effective strategies to
combat iron deﬁciency. Two previous studies have studied
iron absorption from typical Latin American diets [4,5].
Staple foods such as wheat, corn, rice, or potatoes make
up the largest proportion of food supply in developing
countries. Some of these foods are suitable for iron fortiﬁ-
cation. However, they contain inhibitors of non-heme iron
absorption such as phytates, polyphenols, and tannins. The
proportion of absorbable iron can be increased by promot-
ing its consumption with foods rich in promoters of non-
heme absorption (i.e. ascorbic acid, citric acid, and meat).
This research was supported in part by the United Nations University.
* Corresponding author. Tel.: ϩ56-2-978-1482; fax: ϩ56-2-221-4030.
E-mail address: firstname.lastname@example.org (M. Olivares).
Nutrition 23 (2007) 296 –300
0899-9007/07/$ – see front matter © 2007 Elsevier Inc. All rights reserved.