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23.5.1 Product Fortification by Mineral
Fortification of infant food with iron, calcium, phosphorus, magnesium is considered to incorporate an adequate supply of these nutrients. Several factors must be
considered during this process in order to determine the appropriate amount of these
mineral in the fortified food. These factors include the amount of the nutrient needed
to prevent deficiency diseases, the cost and form of the fortified nutrients that will
yield the highest bioavailability and consideration of the safety of adding these minerals together such as potentially adverse nutrient interactions which can occur
between minerals (i.e. calcium and iron) (Abrams and Atkinson 2003).
23.5.1.1 Iron Fortification of Infant Formula
Iron is efficiently transported across the placenta during pregnancy so that healthy
babies born at term would have adequate iron stores mainly in circulating erythrocytes, the liver and reticuloendothelial tissues. In the first 6–8 weeks of life the high
hemoglobin level at birth which is 170 g/l falls to 125 g/l and after 2 months of age
erythropoiesis increases and total hemoglobin also increases as the infant grows
bigger. This high iron store at birth maintains iron supply during early age, between
births to the age of 4 months, therefore little need for additional iron to support the
synthesis of hemoglobin, myoglobin and iron bound enzymes. Iron deficiency is
uncommon during the early months unless different situation such as preterm,
excessive bleeding during neonatal or perinatal period occur (Moy 2000).
Iron is highly absorbed from breast milk than formula food. This may be due to
higher binding of breast milk to fat globules which increase the absorption of iron,
as compared to cow’s milk. Cow’s milk also contain high concentration of calcium
which decrease the absorption of iron. For this reason breast fed infants are rarely
develop anemia before 6 month of age. Infant formula contain lower iron and lower
absorption necessitates to fortify the infant formula with iron especially after
4 months of age (Moy 2000).
Fortification of infant formula with iron is the most challenging because the iron
compounds that have the best bioavailability interact most strongly with food constituents to produce undesirable organoleptic changes. During selection of iron
compound as a food fortificant bioavailability, unacceptable changes to the sensory
properties (i.e. taste, color, texture) of the food vehicle and costs are usually an
important consideration. Based on this iron compounds currently used as food fortificants are broadly divided into three categories. These are; water soluble, poorly
water soluble but soluble in dilute acid, water insoluble and poorly soluble in dilute
acid (Allen et al. 2006).
Water soluble compounds are highly soluble in gastric juices and highest relative
bioavailabilities than all the iron fortificants. However they are the most likely to
cause adverse effects on the organoleptic qualities of foods especially on colour and
flavor. During prolonged storage presence of iron in foods can cause rancidity and
23 Medical Foods and Infant Formulas
23.5.1 Product Fortification by Mineral
Fortification of infant food with iron, calcium, phosphorus, magnesium is considered to incorporate an adequate supply of these nutrients. Several factors must be
considered during this process in order to determine the appropriate amount of these
mineral in the fortified food. These factors include the amount of the nutrient needed
to prevent deficiency diseases, the cost and form of the fortified nutrients that will
yield the highest bioavailability and consideration of the safety of adding these minerals together such as potentially adverse nutrient interactions which can occur
between minerals (i.e. calcium and iron) (Abrams and Atkinson 2003).
23.5.1.1 Iron Fortification of Infant Formula
Iron is efficiently transported across the placenta during pregnancy so that healthy
babies born at term would have adequate iron stores mainly in circulating erythrocytes, the liver and reticuloendothelial tissues. In the first 6–8 weeks of life the high
hemoglobin level at birth which is 170 g/l falls to 125 g/l and after 2 months of age
erythropoiesis increases and total hemoglobin also increases as the infant grows
bigger. This high iron store at birth maintains iron supply during early age, between
births to the age of 4 months, therefore little need for additional iron to support the
synthesis of hemoglobin, myoglobin and iron bound enzymes. Iron deficiency is
uncommon during the early months unless different situation such as preterm,
excessive bleeding during neonatal or perinatal period occur (Moy 2000).
Iron is highly absorbed from breast milk than formula food. This may be due to
higher binding of breast milk to fat globules which increase the absorption of iron,
as compared to cow’s milk. Cow’s milk also contain high concentration of calcium
which decrease the absorption of iron. For this reason breast fed infants are rarely
develop anemia before 6 month of age. Infant formula contain lower iron and lower
absorption necessitates to fortify the infant formula with iron especially after
4 months of age (Moy 2000).
Fortification of infant formula with iron is the most challenging because the iron
compounds that have the best bioavailability interact most strongly with food constituents to produce undesirable organoleptic changes. During selection of iron
compound as a food fortificant bioavailability, unacceptable changes to the sensory
properties (i.e. taste, color, texture) of the food vehicle and costs are usually an
important consideration. Based on this iron compounds currently used as food fortificants are broadly divided into three categories. These are; water soluble, poorly
water soluble but soluble in dilute acid, water insoluble and poorly soluble in dilute
acid (Allen et al. 2006).
Water soluble compounds are highly soluble in gastric juices and highest relative
bioavailabilities than all the iron fortificants. However they are the most likely to
cause adverse effects on the organoleptic qualities of foods especially on colour and
flavor. During prolonged storage presence of iron in foods can cause rancidity and
23 Medical Foods and Infant Formulas