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Moustarah F, Mohiuddin SS.2024 Dietary iron

Jun 12, 2025

Overview

This lecture covers dietary iron, including its physiological roles, sources, absorption, regulation, factors influencing requirements, and deficiency risks.

Iron Functions in the Body

  • Iron is vital for oxygen transport via hemoglobin in red blood cells.
  • Iron is essential for myoglobin, which stores and releases oxygen in muscles.
  • It acts as a cofactor in enzymes for energy production, DNA/amino acid synthesis, hormone production, and immune function.
  • Most body iron is found in hemoglobin, myoglobin, cytochromes, and storage proteins like ferritin and hemosiderin.

Iron Absorption and Regulation

  • Iron is mainly absorbed in the duodenum and upper jejunum of the small intestine.
  • Once absorbed, iron mostly binds to transferrin for transport to bone marrow.
  • The liver stores excess iron as ferritin.
  • Hepcidin, a liver-produced peptide, regulates absorption: more hepcidin means less absorption and more storage.
  • The body controls iron levels by adjusting absorption, not excretion.

Dietary Iron Types and Sources

  • Heme iron (from animal foods) is absorbed more efficiently (≈25%) than non-heme iron (from plants, ≈17% or less).
  • Main heme sources: red meat, poultry, fish, shellfish.
  • Main non-heme sources: legumes, dark greens, nuts, seeds, whole grains, fortified foods, eggs.
  • Cooking in iron pots increases food iron content.

Factors Affecting Iron Absorption

  • Vitamin C and the "MFP factor" (meat, fish, poultry) enhance non-heme iron absorption.
  • Phytates (grains, legumes), polyphenols (tea, coffee, red wine), and calcium (dairy) inhibit iron absorption.
  • Iron absorption from non-heme sources increases when iron stores are low.
  • Plant-based diets require higher iron intake due to lower absorption.

Iron Requirements and Special Populations

  • RDA varies: 0.27 mg/day for infants, 8 mg for adult men/postmenopausal women, 18 mg for menstruating women, 27 mg in pregnancy.
  • Breastfed infants may need iron supplements starting at 4 months.
  • Iron needs rise during growth spurts, menstruation, pregnancy, and in some health conditions.
  • Malabsorptive disorders and GI surgeries can increase iron requirements.

Clinical Significance and Deficiency

  • Iron deficiency affects over 1.6 billion globally, leading to anemia if severe.
  • Risk is higher in women of childbearing age, children, and resource-limited regions.
  • Iron toxicity is rare from food but possible from supplements or genetic disorders.

Key Terms & Definitions

  • Heme Iron — Iron from animal sources, highly bioavailable.
  • Non-Heme Iron — Iron from plant sources, less efficiently absorbed.
  • Transferrin — Protein that transports iron in the blood.
  • Ferritin — Protein that stores iron in cells.
  • Hepcidin — Liver hormone that regulates iron absorption.
  • RDA (Recommended Dietary Allowance) — Amount of nutrient needed daily for health.

Action Items / Next Steps

  • Review iron-rich foods and dietary sources.
  • Study factors that enhance or inhibit iron absorption.
  • Check individual iron needs based on age, sex, and health status.