Mixture of ferric sodium ethylenediaminetetraacetate (NaFeEDTA) and ferrous sulfate: An effective iron fortificant for complementary foods for young Chinese children

Background. Ferric sodium ethylenediaminetetraacetate (NaFeEDTA) enhances iron absorption in the presence of phytate. However, the amount of NaFeEDTA that would have to be added to a complementary food to provide the necessary intake of iron for an infant or young child if NaFeEDTA were the sole iron fortificant exceeds the Acceptable Daily Intake (ADI) of EDTA for this age group. EDTA increases iron absorption at a molar ratio EDTA:iron of less than 1:1. Objective. To determine whether iron absorption is enhanced with a mixture of ferrous sulfate (FeSO4) and NaFeEDTA. Methods. Two studies with a crossover design were conducted in separate groups of 14 and 15 children aged 24 to 31 months. A complementary food consisting of millet porridge with cabbage, tofu, and pork-filled wheat flour dumplings was fortified with 2 mg iron as either FeSO4 or NaFeEDTA (study 1) or 4 mg iron as FeSO4 or a mixture of 2 mg each of FeSO4 and NaFeEDTA (study 2). Iron absorption was determined based on erythrocyte incorporation of stable iron isotopes. Results. In study 1, the geometric mean (+/- SD) iron absorption was 8.0% (3.1, 20.8) and 9.2% (3.1, 27.0) from food fortified with FeSO4 and NaFeEDTA, respectively. In study 2, iron absorption was significantly higher from food fortified with 4 mg iron as 1:1 mixture of FeSO4/NaFeEDTA than from food fortified with FeSO4; the geometric mean iron absorption was 6.4% (3.0, 13.5) and 4.1% (1.9, 8.9), respectively. Conclusions. The enhancing effect of EDTA on iron absorption is less strong in composite meals containing enhancers; nevertheless, the equal mixture of FeSO4 and NaFeEDTA significantly enhanced iron absorption and can be a strategy to ensure adequate iron absorption from phytate-containing complementary foods.