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Iron deficiency (ID) is a major public health problem worldwide and oral iron supplementation can be an effective strategy to treat and prevent ID. To maximize iron bioavailability form oral iron supplements the simultaneous intake of the iron absorption enhancer ascorbic acid (AA) is recommended, and the simultaneous intake of coffee or tea containing the iron absorption inhibitors polyphenols should be avoided. Also, oral iron supplements are recommended to be taken on an empty stomach in the morning and without a meal to avoid any interaction with phytic acid, another iron absorption inhibitor present in many foods. However, the effects of these iron absorption enhancers and inhibitors have only been shown on iron absorption from dietary iron (up to 10mg). Also, the effect of the diurnal hepcidin increase on absorption from an iron supplement given in the afternoon without a preceding morning dose is unclear. Whether AA also increases iron bioavailability from a supplemental iron dose and whether a cup of coffee, a breakfast or iron administration in the afternoon decreases iron bioavailability from a supplemental dose is uncertain.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Reference | Active Comparator | Ferrum Hausmann 100 mg is consumed with 200 mL nanopure water with labelled ferrous fumarate (3 mg 54Fe). |
|
| Ascorbic acid (AA) 500 mg | Experimental | Ferrum Hausmann 100 mg is consumed with 200 mL nanopure water with labelled ferrous fumarate (3 mg 57Fe) and 500 mg AA. |
|
| Ascorbic acid (AA) 80 mg | Experimental | Ferrum Hausmann 100 mg is consumed with 200 mL nanopure water with labelled ferrous fumarate (3 mg 58Fe) and 80 mg AA. |
|
| Coffee | Experimental | Ferrum Hausmann 100 mg is consumed with 200 mL nanopure water with labelled ferrous fumarate (3 mg 54Fe) and 150 mL coffee. |
|
| Breakfast | Experimental | Ferrum Hausmann 100 mg is consumed with 200 mL nanopure water with labelled ferrous fumarate (3 mg 57Fe) and 1 bread roll (~100 g) with butter and honey, 1 cup of plain yoghurt (180 mL), 1 cup of coffee (150 mL) and 1 glass of orange juice (250 mL). |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Reference | Other | Ferrum Hausmann 100 mg + 200 mL nanopure water with 3 mg 54Fe isotopes |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Fractional iron absorption [percent] | Fractional iron absorption will be calculated based on the shift of the iron isotope ratios in the collected blood samples after the administration of the intervention products. Fractional iron absorption will be measured as erythrocyte incorporation of the naturally occurring iron forms with different masses used to label the iron supplements. | Day 22 |
| Fractional iron absorption [percent] | Fractional iron absorption will be calculated based on the shift of the iron isotope ratios in the collected blood samples after the administration of the intervention products. Fractional iron absorption will be measured as erythrocyte incorporation of the naturally occurring iron forms with different masses used to label the iron supplements. | Day 43 |
| Total iron absorption [mg] | Total iron absorption will be calculated based on the shift of the iron isotope ratios in the collected blood samples after the administration of the intervention products. Total iron absorption will be measured as erythrocyte incorporation of the naturally occurring iron forms with different masses used to label the iron supplements. | Day 22 |
| Total iron absorption [mg] | Total iron absorption will be calculated based on the shift of the iron isotope ratios in the collected blood samples after the administration of the intervention products. Total iron absorption will be measured as erythrocyte incorporation of the naturally occurring iron forms with different masses used to label the iron supplements. | Day 43 |
| Measure | Description | Time Frame |
|---|---|---|
| Hemoglobin (Hb) | Iron status marker | Day 1, 22, 26 and 43 |
| Serum ferritin (SF) | Iron status marker | Day 1, 22, 26 and 43 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Nicole Stoffel, Dr. | Human Nutrition Laboratory, ETH Zuerich | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| ETH Zurich; Human Nutrition Laboratory; Institute of Food, Nutrition and Health | Zurich | 8092 | Switzerland |
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| ID | Term |
|---|---|
| D018798 | Anemia, Iron-Deficiency |
| D000090463 | Iron Deficiencies |
| ID | Term |
|---|---|
| D000747 | Anemia, Hypochromic |
| D000740 | Anemia |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
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| ID | Term |
|---|---|
| D001205 | Ascorbic Acid |
| D003069 | Coffee |
| D062408 | Breakfast |
| ID | Term |
|---|---|
| D013400 | Sugar Acids |
| D000144 | Acids, Acyclic |
| D002264 | Carboxylic Acids |
| D009930 | Organic Chemicals |
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| Afternoon | Experimental | Ferrum Hausmann 100 mg is consumed with 200 mL nanopure water with labelled ferrous fumarate (3 mg 58Fe) in the afternoon . |
|
| Ascorbic acid (AA) 500 mg |
| Other |
Ferrum Hausmann 100 mg + 200 mL nanopure water with 3 mg 57Fe isotopes + 500 mg AA |
|
| Ascorbic acid (AA) 80 mg | Other | Ferrum Hausmann 100 mg + 200 mL nanopure water with 3 mg 58Fe + 80 mg AA |
|
| Coffee | Other | Ferrum Hausmann 100 mg + 200 mL nanopure water with 3 mg 54Fe isotopes + 150 mL coffee |
|
| Breakfast | Other | Ferrum Hausmann 100 mg + 200 mL nanopure water with 3 mg 57Fe isotopes + 1 bread roll (~100 g) with butter and honey + 1 cup of plain yoghurt (180 mL) + 1 cup of coffee (150 mL) + 1 glass of orange juice (250 mL) |
|
| Afternoon | Other | Ferrum Hausmann 100 mg + 200 mL nanopure water with 3 mg 58Fe isotopes administered in the afternoon |
|
| Serum transferrin receptor (sTfR) | Iron status marker | Day 1, 22, 26 and 43 |
| Serum iron (SFe) | Iron status marker | Day 1, 22, 26 and 43 |
| Total iron binding capacity (TIBC) | Iron status marker | Day 1, 22, 26 and 43 |
| Hepcidin | Iron regulatory protein | Day 1, 22 and 26 |
| C-reactive protein (CRP) | Inflammation marker | Day 1, 22, 26 and 43 |
| Alpha-1-acid-glycoprotein (AGP) | Inflammation marker | Day 1, 22, 26 and 43 |
| D019189 |
| Iron Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D006880 |
| Hydroxy Acids |
| D002241 | Carbohydrates |
| D028321 | Plant Preparations |
| D001688 | Biological Products |
| D045424 | Complex Mixtures |
| D001628 | Beverages |
| D000066888 | Diet, Food, and Nutrition |
| D010829 | Physiological Phenomena |
| D019602 | Food and Beverages |
| D062407 | Meals |
| D005502 | Food |