Remember Me
Or use your Academic/Social account:


Or use your Academic/Social account:


You have just completed your registration at OpenAire.

Before you can login to the site, you will need to activate your account. An e-mail will be sent to you with the proper instructions.


Please note that this site is currently undergoing Beta testing.
Any new content you create is not guaranteed to be present to the final version of the site upon release.

Thank you for your patience,
OpenAire Dev Team.

Close This Message


Verify Password:
Verify E-mail:
*All Fields Are Required.
Please Verify You Are Human:
fbtwitterlinkedinvimeoflicker grey 14rssslideshare1
Christides, Tatiana; Wray, David; McBride, Richard; Fairweather, Rose; Sharp, Paul (2015)
Publisher: Springer-Verlag Berlin Heidelberg
Languages: English
Types: Article
Subjects: Q1, R1
Purpose: Iron deficiency anaemia (IDA) is a global public health problem. Treatment with the standard of care ferrous iron salts may be poorly tolerated, leading to non-compliance and ineffective correction of IDA. Employing supplements with higher bioavailability might permit lower doses of iron to be used with fewer side effects, thus improving treatment efficacy. Here, we compared the iron bioavailability of ferrous sulphate tablets with alternative commercial iron products, including three liquid-based supplements. \ud \ud Methods: Iron bioavailability was measured using Caco-2 cells with ferritin formation as a surrogate marker for iron uptake. Statistical analysis was performed using one-way ANOVA followed by either Dunnett’s or Tukey’s multiple comparisons tests. \ud \ud Results: Spatone Apple® (a naturally iron-rich mineral water with added ascorbate) and Iron Vital F® (a synthetic liquid iron supplement) had the highest iron bioavailability. There was no statistical difference between iron uptake from ferrous sulphate tablets, Spatone® (naturally iron-rich mineral water alone) and Pregnacare Original® (a multimineral/multivitamin tablet). \ud \ud Conclusion: In our in vitro model, naturally iron-rich mineral waters and synthetic liquid iron formulations have equivalent or better bioavailability compared with ferrous iron sulphate tablets. If these results are confirmed in vivo, this would mean that at-risk groups of IDA could be offered a greater choice of more bioavailable and potentially better tolerated iron preparations.
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • 1. McLean E, Cogswell M, Egli I, Wojdyla D, de Benoist B (2009) Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993-2005. Public Health Nutr 12 (4):444-454. doi:10.1017/S1368980008002401
    • 2. Shankar P, Boylan M, Sriram K (2010) Micronutrient deficiencies after bariatric surgery. Nutrition 26 (11-12):1031-1037. doi:10.1016/j.nut.2009.12.003
    • 3. Miller JL (2013) Iron deficiency anemia: a common and curable disease. Cold Spring Harb Perspect Med 3 (7). doi:10.1101/cshperspect.a011866
    • 4. Andrews NC (1999) Disorders of iron metabolism. New Engl J Med 341 (26):1986-1995. doi:10.1056/NEJM199912233412607
    • 5. Pavord S, Myers B, Robinson S, Allard S, Strong J, Oppenheimer C, British Committee for Standards in H (2012) UK guidelines on the management of iron deficiency in pregnancy. Brit J Haematol 156 (5):588-600
    • 6. Zhou SJ, Gibson RA, Crowther CA, Makrides M (2009) Should we lower the dose of iron when treating anaemia in pregnancy? A randomized dose-response trial. Eur J Clin Nutr 63 (2):183-190. doi:10.1038/sj.ejcn.1602926
    • 7. Hyder SM, Persson LA, Chowdhury AM, Ekstrom EC (2002) Do side-effects reduce compliance to iron supplementation? A study of daily- and weekly-dose regimens in pregnancy. J Health Popul Nutr 20 (2):175-179
    • 8. Seck BC, Jackson RT (2008) Determinants of compliance with iron supplementation among pregnant women in Senegal. Public Health Nutr 11 (6):596- 605. doi:10.1017/S1368980007000924
    • 9. Habib F, Alabdin EH, Alenazy M, Nooh R (2009) Compliance to iron supplementation during pregnancy. J Obstet Gynaecol 29 (6):487-492. doi:10.1080/01443610902984961
    • 10. Keller J, Frederking D, Layer P (2008) The spectrum and treatment of gastrointestinal disorders during pregnancy. Nat Clin Pract Gastr 5 (8):430-443. doi:10.1038/ncpgasthep1197
    • 11. Bonapace ES, Jr., Fisher RS (1998) Constipation and diarrhea in pregnancy. Gastroenterol Clin N 27 (1):197-211
    • 12. Beard JL (2000) Effectiveness and strategies of iron supplementation during pregnancy. Am J Clin Nutr 71 (5 Suppl):1288S-1294S
    • 13. Ekstrom EC, Kavishe FP, Habicht JP, Frongillo EA, Jr., Rasmussen KM, Hemed L (1996) Adherence to iron supplementation during pregnancy in Tanzania: determinants and hematologic consequences. Am J Clin Nutr 64 (3):368-374
    • 14. Stoltzfus RJ (2011) Iron interventions for women and children in low-income countries. J Nutr 141 (4):756S-762S. doi:10.3945/jn.110.128793
    • 15. Worwood M, Evans WD, Villis RJ, Burnett AK (1996) Iron absorption from a natural mineral water (Spatone Iron-Plus). Clin Lab Haematol 18 (1):23-27
    • 16. Halksworth G, Moseley L, Carter K, Worwood M (2003) Iron absorption from Spatone (a natural mineral water) for prevention of iron deficiency in pregnancy. Clin Lab Haematol 25 (4):227-231
    • 17. Zariwala MG, Somavarapu S, Farnaud S, Renshaw D (2013) Comparison study of oral iron preparations using a human intestinal model. Sci Pharm 81 (4):1123-1139. doi:10.3797/scipharm.1304-03
    • 18. Glahn RP, Lee OA, Yeung A, Goldman MI, Miller DD (1998) Caco-2 cell ferritin formation predicts nonradiolabeled food iron availability in an in vitro digestion/Caco-2 cell culture model. J Nutr 128 (9):1555-1561
    • 19. Yun S, Habicht JP, Miller DD, Glahn RP (2004) An in vitro digestion/Caco-2 cell culture system accurately predicts the effects of ascorbic acid and polyphenolic compounds on iron bioavailability in humans. J Nutr 134 (10):2717-2721
    • 20. Caro I BX, Rousset M, Meunier V, Bourrie M, Julian B, Joyeux H, Roques C, Berger Y, Zweibaum A, Fabre G (1995) Characterisation of a newly isolated Caco-2 clone (TC-7), as a model of transport processes and biotransformation of drugs. Int J of Pharm 116:147-158
    • 21. Sharp P, Tandy S, Yamaji S, Tennant J, Williams M, Singh Srai SK (2002) Rapid regulation of divalent metal transporter (DMT1) protein but not mRNA expression by non-haem iron in human intestinal Caco-2 cells. FEBS letters 510 (1-2):71-76
    • 22. Christides T, Sharp P (2013) Sugars increase non-heme iron bioavailability in human epithelial intestinal and liver cells. PloS one 8 (12):e83031. doi:10.1371/journal.pone.0083031
    • 23. Glahn RP, Rassier M, Goldman MI, Lee OA, Cha J (2000) A comparison of iron availability from commercial iron preparations using an in vitro digestion/Caco-2 cell culture model. J Nutr Biochem 11 (2):62-68
    • 24. Motulsky H (2010) Intuitive Biostatistics. 2nd ed. Oxford University Press, Oxford, UK
    • 25. McKenna D, Spence D, Haggan SE, McCrum E, Dornan JC, Lappin TR (2003) A randomized trial investigating an iron-rich natural mineral water as a prophylaxis against iron deficiency in pregnancy. Clin Lab Haematol 25 (2):99-103
    • 26. Teucher B, Olivares M, Cori H (2004) Enhancers of iron absorption: ascorbic acid and other organic acids. Int J Vitam Nutr Res 74 (6):403-419
    • 27. Olivares M, Pizarro F, Ruz M, de Romana DL (2012) Acute inhibition of iron bioavailability by zinc: studies in humans. Biometals 25 (4):657-664. doi:10.1007/s10534-012-9524-z
    • 28. Scholl TO (2005) Iron status during pregnancy: setting the stage for mother and infant. Am J Clin Nutr 81 (5):1218S-1222S
    • 29. CDC (1998) Recommendations to prevent and control iron deficiency in the United States. MMWR Recomm Rep, vol 47. Centers for Disease Control and Prevention
    • 30. WHO (World Health Oreganization)(2012) Guideline: Daily iron and folic acid supplementation in pregnant women. Geneva, World Health Organization
    • 31. WHO (World Health Organization)(2012) Guideline: Intermittent iron and folic acid supplementation in non-anaemic pregnant women. Geneva, World Health Organization
    • 32. NICE (2008) Antenatal care: Routine care for the healthy pregnant woman. National Institute for Clinical Excellence, London
    • 33. Fenton V, Cavill I, Fisher J (1977) Iron stores in pregnancy. Brit J Haematol 37 (1):145-149
    • 34. Cuervo LG, Mahomed K (2001) Treatments for iron deficiency anaemia in pregnancy. Cochrane DB Syst Rev (2):CD003094. doi:10.1002/14651858.CD003094
    • 35. Pena-Rosas JP, Viteri FE (2009) Effects and safety of preventive oral iron or iron+folic acid supplementation for women during pregnancy. Cochrane DB Syst Rev (4):CD004736. doi:10.1002/14651858.CD004736.pub3
    • 36. Krafft A (2013) Iron supplementation in pregnancy. Brit Med J 347:f4399. doi:10.1136/bmj.f4399
    • 37. Pena-Rosas JP, De-Regil LM, Dowswell T, Viteri FE (2012) Daily oral iron supplementation during pregnancy. Cochrane DB Syst Rev 12:CD004736. doi:10.1002/14651858.CD004736.pub4
    • 38. Haider BA, Olofin I, Wang M, Spiegelman D, Ezzati M, Fawzi WW, Nutrition Impact Model Study G (2013) Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis. Brit Med J 346:f3443. doi:10.1136/bmj.f3443
    • 39. Jauregui-Lobera I (2013) Iron deficiency and bariatric surgery. Nutrients 5 (5):1595-1608. doi:10.3390/nu5051595
    • 40. Bal BS, Finelli FC, Shope TR, Koch TR (2012) Nutritional deficiencies after bariatric surgery. Nat Rev Endocrinol 8 (9):544-556. doi:10.1038/nrendo.2012.48
    • 41. Stein J, Stier C, Raab H, Weiner R (2014) Review article: the nutritional and pharmacological consequences of obesity surgery. Aliment Pharm Ther 40 (6):582- 609. doi:10.1111/apt.12872
    • 42. Sawaya RA, Jaffe J, Friedenberg L, Friedenberg FK (2012) Vitamin, mineral, and drug absorption following bariatric surgery. Curr Drug Metab 13 (9):1345-1355
    • 43. Gasteyger C, Suter M, Gaillard RC, Giusti V (2008) Nutritional deficiencies after Roux-en-Y gastric bypass for morbid obesity often cannot be prevented by standard multivitamin supplementation. Am J Clin Nutr 87 (5):1128-1133
    • 44. Gesquiere I, Lannoo M, Augustijns P, Matthys C, Van der Schueren B, Foulon V (2014) Iron deficiency after Roux-en-Y gastric bypass: insufficient iron absorption from oral iron supplements. Obes Surg 24 (1):56-61. doi:10.1007/s11695-013-1042-8
    • 45. Clements RH, Katasani VG, Palepu R, Leeth RR, Leath TD, Roy BP, Vickers SM (2006) Incidence of vitamin deficiency after laparoscopic Roux-en-Y gastric bypass in a university hospital setting. Am Surgeon 72 (12):1196-1202; discussion 1203- 1194
    • 46. Netto BD, Moreira EA, Patino JS, Beninca JP, Jordao AA, Frode TS (2012) Influence of Roux-en-Y gastric bypass surgery on vitamin C, myeloperoxidase, and
  • No related research data.
  • No similar publications.

Share - Bookmark

Cite this article