Iron nutrition and absorption: dietary factors which impact iron bioavailability

Iron deficiency is widely observed worldwide, yet, paradoxically, iron is the most plentiful heavy metal in the earth's crust. Although absorption of iron from the gastrointestinal tract is strictly controlled, excretion is limited to iron lost from exfoliation of skin and gastrointestinal cells, customary and abnormal blood loss, and menses. Individuals highly vulnerable to iron deficiency have high iron needs, as during growth or pregnancy; high iron loss, as during marked hemorrhage or excessive and/or frequent menstrual losses; or diets with low iron content or bioavailability. Food iron is classified as heme or nonheme. Approximately half of the iron in meat, fish, and poultry is heme iron. Depending on an individual's iron stores, 15% to 35% of heme iron is absorbed. Food contains more nonheme iron and, thus, it makes the larger contribution to the body's iron pool despite its lower absorption rate of 2% to 20%. Absorption of nonheme iron is markedly influenced by the levels of iron stores and by concomitantly consumed dietary components. Enhancing factors, such as ascorbic acid and meat/fish/poultry, may increase nonheme iron bioavailability fourfold.