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Title: Iron deficiency, but not anemia, upregulates iron absorption in breast-fed Peruvian infants

Author
item HICKS, PENNI - BAYLOR COLLEGE MED
item ZAVALETA, NELLY - LIMA, PERU
item CHEN, ZHENSHENG - BAYLOR COLLEGE MED
item Abrams, Steven
item LONNERDAL, BO - UNIV CALIFORNIA AT DAVIS

Submitted to: Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/26/2006
Publication Date: 9/28/2006
Citation: Hicks, P.D., Zavaleta, N., Chen, Z., Abrams, S.A., Lonnerdal, B. 2006. Iron deficiency, but not anemia, upregulates iron absorption in breast-fed Peruvian infants. Journal of Nutrition. 136(9):2435-2438.

Interpretive Summary: Iron absorption in adults is controlled by methods that decrease absorption when iron status is high. There are few data, however, regarding the existence of a similar regulation in infants. We studied two groups of human milk-fed infants at 5-6 months of age and 9-10 months using a safe type of iron called a stable isotope. One isotope was given without any milk and the other was given at the time of a breast milk feeding. This was done to determine whether healthy infants at risk for iron deficiency would regulate their iron absorption based on their iron status. We found that iron absorption in infants is related to iron status as assessed by serum ferritin but not hemoglobin concentration. Infants with low iron status increase iron absorption from breast milk at both 5-6 and 9-10 months of age.

Technical Abstract: Iron absorption in adults is regulated by homeostatic mechanisms that decrease absorption when iron status is high. There are few data, however, regarding the existence of a similar homeostatic regulation in infants. We studied 2 groups of human milk-fed infants using (57)Fe (given as ferrous sulfate without any milk) and (58)Fe (given at the time of a breast-milk feeding) stable isotopes to determine whether healthy infants at risk for iron deficiency would regulate their iron absorption based on their iron status. We studied 20 Peruvian infants at 5-6 mo of age and 18 infants at 9-10 mo of age. We found no effect of infant hemoglobin concentration on iron absorption with 5- to 6-mo-old infants absorbing 19.2 +/- 2.1% and 9- to 10-mo-old infants absorbing 25.8 +/- 2.6% of the (57)Fe dose. For (58)Fe, 5- to 6-mo-old infants absorbed 42.6 +/- 5.0% and 9- to 10-mo-old infants absorbed 51.9 +/- 10.3%. Following log transformation, iron absorption from (57)Fe (r = -0.61, P = < 0.001) and (58)Fe (r = -0.61, P = < 0.001) were inversely correlated to serum ferritin (S-Ft). For both the (57)Fe and (58)Fe doses, infants with S-Ft <12 mg/L (n = 11) had significantly higher iron absorption than those with S-Ft >12 mg/L. We concluded that iron absorption in infants is related to iron status as assessed by serum ferritin but not hemoglobin concentration. Infants with low iron status upregulate iron absorption from breast milk at both 5-6 and 9-10 mo of age.