In overweight and obese women, dietary iron absorption is reduced and the enhancement of iron absorption by ascorbic acid is one-half that in normal-weight women

Ana C. Cepeda-Lopez, Alida Melse-Boonstra, Michael B. Zimmermann, Isabelle Herter-Aeberli

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

© 2015 American Society for Nutrition. Background: Iron deficiency is common in overweight and obese individuals. This deficiency may be due to adiposity-related inflammation that increases serum hepcidin and decreases dietary iron absorption. Because hepcidin reduces iron efflux from the basolateral enterocyte, it is uncertain whether luminal enhancers of dietary iron absorption such as ascorbic acid can be effective in overweight and obese individuals. Objective: In this study, we compared iron absorption from a meal with ascorbic acid (+AA) and a meal without ascorbic acid (2AA) in women in a normal-weight group (NW) with those in overweight and obese groups combined (OW/OB). Design: Healthy, nonanemic women [n = 62; BMI (in kg/m2): 18.5- 39.9] consumed a stable-isotope-labeled wheat-based test meal 2AA and a wheat-based test meal +AA (31.4 mg ascorbic acid). We measured iron absorption and body composition with the use of dual-energy X-ray absorptiometry, blood volume with the use of a carbon monoxide (CO)-rebreathing method, iron status, inflammation, and serum hepcidin. Results: Inflammatory biomarkers (all P , 0.05) and hepcidin (P = 0.08) were lower in the NW than in the OW/OB. Geometric mean (95% CI) iron absorptions in the NW and OW/OB were 19.0% (15.2%, 23.5%) and 12.9% (9.7%, 16.9%) (P = 0.049), respectively, from -AA meals and 29.5% (23.3%, 38.2%) and 16.6% (12.8%, 21.7%) (P = 0.004), respectively, from +AA meals. Median percentage increases in iron absorption for 2AA to +AA meals were 56% in the NW (P , 0.001) and 28% in OW/OB (P = 0.006). Serum ferritin [R2 = 0.22; b = 20.17 (95% CI: 20.25, 20.09)], transferrin receptor [R2 = 0.23; b = 2.79 (95% CI: 1.47, 4.11)], and hepcidin [R2 = 0.13; b = 20.85 (95% CI: 21.41, 20.28)] were significant predictors of iron absorption. Conclusions: In overweight and obese women, iron absorption is two-thirds that in normal-weight women, and the enhancing effect of ascorbic acid on iron absorption is one-half of that in normalweight women. Recommending higher intakes of ascorbic acid (or other luminal enhancers of iron absorption) in obese individuals to improve iron status may have a limited effect. This trial was registered at clinicaltrials.gov as NCT01884506.
Original languageEnglish
Pages (from-to)1389-1397
Number of pages9
JournalAmerican Journal of Clinical Nutrition
Volume102
Issue number6
DOIs
Publication statusPublished - 1 Dec 2015

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Dietary Iron
Ascorbic Acid
Iron
Weights and Measures
Hepcidins
Meals
Triticum
Serum
Inflammation
Transferrin Receptors
Enterocytes
Photon Absorptiometry
Adiposity
Carbon Monoxide
Ferritins
Body Composition
Blood Volume
Isotopes

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

@article{2700e6218f1d435a8c110d2f459e05f6,
title = "In overweight and obese women, dietary iron absorption is reduced and the enhancement of iron absorption by ascorbic acid is one-half that in normal-weight women",
abstract = "{\circledC} 2015 American Society for Nutrition. Background: Iron deficiency is common in overweight and obese individuals. This deficiency may be due to adiposity-related inflammation that increases serum hepcidin and decreases dietary iron absorption. Because hepcidin reduces iron efflux from the basolateral enterocyte, it is uncertain whether luminal enhancers of dietary iron absorption such as ascorbic acid can be effective in overweight and obese individuals. Objective: In this study, we compared iron absorption from a meal with ascorbic acid (+AA) and a meal without ascorbic acid (2AA) in women in a normal-weight group (NW) with those in overweight and obese groups combined (OW/OB). Design: Healthy, nonanemic women [n = 62; BMI (in kg/m2): 18.5- 39.9] consumed a stable-isotope-labeled wheat-based test meal 2AA and a wheat-based test meal +AA (31.4 mg ascorbic acid). We measured iron absorption and body composition with the use of dual-energy X-ray absorptiometry, blood volume with the use of a carbon monoxide (CO)-rebreathing method, iron status, inflammation, and serum hepcidin. Results: Inflammatory biomarkers (all P , 0.05) and hepcidin (P = 0.08) were lower in the NW than in the OW/OB. Geometric mean (95{\%} CI) iron absorptions in the NW and OW/OB were 19.0{\%} (15.2{\%}, 23.5{\%}) and 12.9{\%} (9.7{\%}, 16.9{\%}) (P = 0.049), respectively, from -AA meals and 29.5{\%} (23.3{\%}, 38.2{\%}) and 16.6{\%} (12.8{\%}, 21.7{\%}) (P = 0.004), respectively, from +AA meals. Median percentage increases in iron absorption for 2AA to +AA meals were 56{\%} in the NW (P , 0.001) and 28{\%} in OW/OB (P = 0.006). Serum ferritin [R2 = 0.22; b = 20.17 (95{\%} CI: 20.25, 20.09)], transferrin receptor [R2 = 0.23; b = 2.79 (95{\%} CI: 1.47, 4.11)], and hepcidin [R2 = 0.13; b = 20.85 (95{\%} CI: 21.41, 20.28)] were significant predictors of iron absorption. Conclusions: In overweight and obese women, iron absorption is two-thirds that in normal-weight women, and the enhancing effect of ascorbic acid on iron absorption is one-half of that in normalweight women. Recommending higher intakes of ascorbic acid (or other luminal enhancers of iron absorption) in obese individuals to improve iron status may have a limited effect. This trial was registered at clinicaltrials.gov as NCT01884506.",
author = "Cepeda-Lopez, {Ana C.} and Alida Melse-Boonstra and Zimmermann, {Michael B.} and Isabelle Herter-Aeberli",
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language = "English",
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pages = "1389--1397",
journal = "American Journal of Clinical Nutrition",
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In overweight and obese women, dietary iron absorption is reduced and the enhancement of iron absorption by ascorbic acid is one-half that in normal-weight women. / Cepeda-Lopez, Ana C.; Melse-Boonstra, Alida; Zimmermann, Michael B.; Herter-Aeberli, Isabelle.

In: American Journal of Clinical Nutrition, Vol. 102, No. 6, 01.12.2015, p. 1389-1397.

Research output: Contribution to journalArticle

TY - JOUR

T1 - In overweight and obese women, dietary iron absorption is reduced and the enhancement of iron absorption by ascorbic acid is one-half that in normal-weight women

AU - Cepeda-Lopez, Ana C.

AU - Melse-Boonstra, Alida

AU - Zimmermann, Michael B.

AU - Herter-Aeberli, Isabelle

PY - 2015/12/1

Y1 - 2015/12/1

N2 - © 2015 American Society for Nutrition. Background: Iron deficiency is common in overweight and obese individuals. This deficiency may be due to adiposity-related inflammation that increases serum hepcidin and decreases dietary iron absorption. Because hepcidin reduces iron efflux from the basolateral enterocyte, it is uncertain whether luminal enhancers of dietary iron absorption such as ascorbic acid can be effective in overweight and obese individuals. Objective: In this study, we compared iron absorption from a meal with ascorbic acid (+AA) and a meal without ascorbic acid (2AA) in women in a normal-weight group (NW) with those in overweight and obese groups combined (OW/OB). Design: Healthy, nonanemic women [n = 62; BMI (in kg/m2): 18.5- 39.9] consumed a stable-isotope-labeled wheat-based test meal 2AA and a wheat-based test meal +AA (31.4 mg ascorbic acid). We measured iron absorption and body composition with the use of dual-energy X-ray absorptiometry, blood volume with the use of a carbon monoxide (CO)-rebreathing method, iron status, inflammation, and serum hepcidin. Results: Inflammatory biomarkers (all P , 0.05) and hepcidin (P = 0.08) were lower in the NW than in the OW/OB. Geometric mean (95% CI) iron absorptions in the NW and OW/OB were 19.0% (15.2%, 23.5%) and 12.9% (9.7%, 16.9%) (P = 0.049), respectively, from -AA meals and 29.5% (23.3%, 38.2%) and 16.6% (12.8%, 21.7%) (P = 0.004), respectively, from +AA meals. Median percentage increases in iron absorption for 2AA to +AA meals were 56% in the NW (P , 0.001) and 28% in OW/OB (P = 0.006). Serum ferritin [R2 = 0.22; b = 20.17 (95% CI: 20.25, 20.09)], transferrin receptor [R2 = 0.23; b = 2.79 (95% CI: 1.47, 4.11)], and hepcidin [R2 = 0.13; b = 20.85 (95% CI: 21.41, 20.28)] were significant predictors of iron absorption. Conclusions: In overweight and obese women, iron absorption is two-thirds that in normal-weight women, and the enhancing effect of ascorbic acid on iron absorption is one-half of that in normalweight women. Recommending higher intakes of ascorbic acid (or other luminal enhancers of iron absorption) in obese individuals to improve iron status may have a limited effect. This trial was registered at clinicaltrials.gov as NCT01884506.

AB - © 2015 American Society for Nutrition. Background: Iron deficiency is common in overweight and obese individuals. This deficiency may be due to adiposity-related inflammation that increases serum hepcidin and decreases dietary iron absorption. Because hepcidin reduces iron efflux from the basolateral enterocyte, it is uncertain whether luminal enhancers of dietary iron absorption such as ascorbic acid can be effective in overweight and obese individuals. Objective: In this study, we compared iron absorption from a meal with ascorbic acid (+AA) and a meal without ascorbic acid (2AA) in women in a normal-weight group (NW) with those in overweight and obese groups combined (OW/OB). Design: Healthy, nonanemic women [n = 62; BMI (in kg/m2): 18.5- 39.9] consumed a stable-isotope-labeled wheat-based test meal 2AA and a wheat-based test meal +AA (31.4 mg ascorbic acid). We measured iron absorption and body composition with the use of dual-energy X-ray absorptiometry, blood volume with the use of a carbon monoxide (CO)-rebreathing method, iron status, inflammation, and serum hepcidin. Results: Inflammatory biomarkers (all P , 0.05) and hepcidin (P = 0.08) were lower in the NW than in the OW/OB. Geometric mean (95% CI) iron absorptions in the NW and OW/OB were 19.0% (15.2%, 23.5%) and 12.9% (9.7%, 16.9%) (P = 0.049), respectively, from -AA meals and 29.5% (23.3%, 38.2%) and 16.6% (12.8%, 21.7%) (P = 0.004), respectively, from +AA meals. Median percentage increases in iron absorption for 2AA to +AA meals were 56% in the NW (P , 0.001) and 28% in OW/OB (P = 0.006). Serum ferritin [R2 = 0.22; b = 20.17 (95% CI: 20.25, 20.09)], transferrin receptor [R2 = 0.23; b = 2.79 (95% CI: 1.47, 4.11)], and hepcidin [R2 = 0.13; b = 20.85 (95% CI: 21.41, 20.28)] were significant predictors of iron absorption. Conclusions: In overweight and obese women, iron absorption is two-thirds that in normal-weight women, and the enhancing effect of ascorbic acid on iron absorption is one-half of that in normalweight women. Recommending higher intakes of ascorbic acid (or other luminal enhancers of iron absorption) in obese individuals to improve iron status may have a limited effect. This trial was registered at clinicaltrials.gov as NCT01884506.

U2 - 10.3945/ajcn.114.099218

DO - 10.3945/ajcn.114.099218

M3 - Article

VL - 102

SP - 1389

EP - 1397

JO - American Journal of Clinical Nutrition

JF - American Journal of Clinical Nutrition

SN - 0002-9165

IS - 6

ER -