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Minerals, trace elements, vitamin D and bone health

A mathematical model for the hemoglobin response to iron intake, based on iron absorption measurements from habitually consumed Indian meals

European Journal of Clinical Nutrition volume 66, pages 481–487 (2012)Cite this article

Abstract

Background/Objectives:

The prevalence of iron deficiency (ID) and iron deficiency anemia (IDA) is high in India and appear unchanging over decades. To understand the persistence of these disorders, it is critical to measure iron (Fe) absorption from cereal-based Indian meals, its modulation by ID and the time-course of the response of hemoglobin (Hb) to Fe intake.

Subjests/Methods:

Fe absorption from rice-based meals was measured by the erythrocyte incorporation of the stable isotope label at 14 days in IDA (N=15) and Fe replete (IR) women (N=15). Hb level was used as surrogate for Fe status, and a response curve for Fe absorption versus the Hb level for a rice-based meal was constructed from measured data. This relationship was used as input for a mathematical model that examined the Hb response to different Fe intakes in normal and anemic women.

Results:

The mean fractional Fe absorption from a rice-based meal in IR and IDA women was 2.7% and 8.3%, respectively. The model predicted that Fe intakes between 20 and 55 mg/day in low-bioavailability diets would result in stable, non-anemic levels of Hb in women over a 1-year period.

Conclusion:

This mathematical model suggests that with a Fe intake of 20–30 mg/day and a dietary bioavailability of 3–5%, Hb concentration would hover around 12 g/dl with a variability of 0.5 g/dl in pre-menopausal adult women.

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Acknowledgements

This study was supported by the Department of Biotechnology, Government of India. ALH was supported by the Harvard Nutrition and Global Health Program. We thank Shanthi Chellan, Charles Milton, Grace, Sunil, Stella, Leena Sebastian and Kiran Babu for their assistance in screening, biochemical analysis, sample preparation and TIMS measurements. We are most grateful to the management and employees of Sun & Ski Garment factory, Bangalore for their keen interest, participation and support during the study.

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Authors and Affiliations

  1. Division of Nutrition, St John's Research Institute, St John's National Academy of Health Sciences, Bangalore, India

    P Thankachan, S Kalasuramath, T Thomas, K Bhat & A V Kurpad

  2. Program in Biophysics and Harvard-MIT Division of Health Sciences and Technology, Harvard University, Cambridge, MA, USA

    A L Hill

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  1. P Thankachan
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  2. S Kalasuramath
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  3. A L Hill
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  4. T Thomas
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Corresponding author

Correspondence to P Thankachan.

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Competing interests

AVK is a member of the Kraft Health and Wellness Advisory Board; the other authors declare no conflict of interest.

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Supplementary Information accompanies the paper on European Journal of Clinical Nutrition website

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Thankachan, P., Kalasuramath, S., Hill, A. et al. A mathematical model for the hemoglobin response to iron intake, based on iron absorption measurements from habitually consumed Indian meals. Eur J Clin Nutr 66, 481–487 (2012). https://doi.org/10.1038/ejcn.2011.169

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