Iron bioavailability and dietary reference values

Iron differs from other minerals because iron balance in the human body is regulated by absorption only because there is no physiologic mechanism for excretion. On the basis of intake data and isotope studies, iron bioavailability has been estimated to be in the range of 14-18% for mixed diets and 5-12% for vegetarian diets in subjects with no iron stores, and these values have been used to generate dietary reference values for all population groups. Dietary factors that influence iron absorption, such as phytate, polyphenols, calcium, ascorbic acid, and muscle tissue, have been shown repeatedly to influence iron absorption in single-meal isotope studies, whereas in multimeal studies with a varied diet and multiple inhibitors and enhancers, the effect of single components has been, as expected, more modest. The importance of fortification iron and food additives such as erythorbic acid on iron bioavailability from a mixed diet needs clarification. The influence of vitamin A, carotenoids, and nondigestible carbohydrates on iron absorption and the nature of the "meat factor" remain unresolved. The iron status of the individual and other host factors, such as obesity, play a key role in iron bioavailability, and iron status generally has a greater effect than diet composition. It would therefore be timely to develop a range of iron bioavailability factors based not only on diet composition but also on subject characteristics, such as iron status and prevalence of obesity.