Iron content, bioavailability & factors affecting iron status of Indians

Repeated surveys have shown that the magnitude of nutritional anaemia is of public health concern in India. Though reduced intake of iron is a major aetiological factor, low intake or an imbalance in the consumption of other haematopoietic nutrients, their utilization; increased nutrient loss and/or demand also contribute to nutritional anaemia. In India, cereals and millets form the bulk of the dietaries and are major sources of non-haeme iron. According to the current estimates, the intake of iron is less than 50 per cent of the recommended dietary allowance (RDA) and iron density is about 8.5 mg/1000 Kcal. It is now well established that iron bioavailability from habitual Indian diets is low due to high phytate and low ascorbic acid/iron ratios. These factors determine iron bioavailability and the RDA. There are striking differences in the iron RDAs among the physiological groups, which need to be validated. The other dietary factors affecting iron status are inadequate intake of folic acid and vitamins B₁₂, A, C and other vitamins of the B-complex group. Chronic low grade inflammation and infections, and malaria also contribute significantly to iron malnutrition. Recent evidence of the interaction of hepcidin (iron hormone) and inflammatory stimuli on iron metabolism has opened new avenues to target iron deficiency anaemia. Food-based approaches to increase the intake of iron and other haematopoietic nutrients through dietary diversification and provision of hygienic environment are important sustainable strategies for correction of iron deficiency anaemia.