Iron‐fortified Bread

The increase in serum iron two hours after test‐meals in fasting subjects was taken as an expression of iron absorption in three series of experiments. All the individuals, most of them young, healthy, female nurses acted as their own controls. Tests were performed with white wheaten and wholemeal bread fortified with ferrous sulphate or ferrum reductum to 40 mg iron per 100 g. Some experiments with unenriched white bread were also included. It was found that ferrous sulphate gave a more pronounced increase in serum iron than ferrum reductum. The increase was higher after fortified white bread than after fortified wholemeal bread. This was probably due to the inhibitory effect, although only partial, of dietary phytate on iron absorption. Because of the relative uncertainty of the performed absorption experiments, a controlled clinical trial with ferrous‐sulphate‐enriched white and wholemeal bread to 8 mg iron per 100 g was conducted in 146 adult female patients of a mental hospital. The 12 weeks' trial was completed in 77 subjects in the experimental group and in only 20 in the control group. In the experimental group the mean Hb value showed a significant increase to 14.32 g%, which is equivalent to the mean optimal value for adult Norwegian women. A concomitant rise in the mean Hct and MCHC values was recorded. The results in the control group are difficult to interpret. The mean increase in Hb concentration after 12 weeks, however, was not statistically significant. The present study indicates that ferrous sulphate baked into bread is better absorbed than ferrum reductum, and is easily available for hemoglobin synthesis. A long‐term community‐based feeding trial, however, may be necessary before a final conclusion regarding the future Norwegian iron‐fortification policy is reached.