Central Idea

Iron is an essential mineral for bodily functions, but excessive intake can be harmful.
Fortification of food with iron is a suggested method for treating iron deficiency anemia.
Excess consumption of fortified foods or simultaneous consumption of multiple fortified foods can lead to excessive iron intake.

What is Iron Fortification?

Iron fortification refers to the process of adding iron to food products to increase their iron content.
It is done using various forms of iron, such as iron salts or iron powders, which are added to the food during processing.
It is a public health strategy employed to address iron deficiency, particularly in populations where inadequate iron intake is prevalent.
The goal is to provide a significant portion of the recommended daily iron intake through fortified foods, contributing to the prevention and treatment of iron deficiency anaemia.

Comorbidities: Iron overload conditions, such as thalassemia, hemochromatosis, and chronic liver disease, have impaired iron excretion mechanisms.
Blooding events: Iron absorption is balanced by steady and minimal excretion, except during bleeding events.
Menstrual bleeding: Women can excrete iron through menstrual bleeding, while men are less capable of iron excretion.
Oxidative stress: Increased iron intake can lead to oxidative stress, cellular damage, and impaired mitochondrial function.
Heart ailments: High serum ferritin levels (a marker of iron storage) are associated with an increased risk of chronic diseases such as high fasting serum glucose, high total cholesterol, high triglycerides, and hypertension.
Liver damage: Very high amounts of iron can activate hepatic stellate cells and cause excessive deposition of extracellular matrix in the liver. Prolonged liver iron overload can lead to liver fibrosis and cirrhosis.

Minimal absorption: Only a small percentage of ingested iron from fortified foods is absorbed, with the rest passing through the intestine.
Digestive issues: Unabsorbed iron can cause inflammation in the gastrointestinal lining and disrupt the colonic microbiota, leading to abdominal discomfort and gastrointestinal issues.
Issues with nutrition absorption: Excessive iron in the gastrointestinal tract can impair the absorption of other essential minerals like zinc and copper and potentially result in other deficiencies.

Implement individualized strategies for iron intake rather than mandatory fortification programs to avoid unsupervised high iron intake across diverse populations.
Ensure thorough monitoring and detection of adverse events related to iron intake.
Precision in public health approaches is necessary to prevent the risk of iron overload and potential long-term chronic illnesses associated with excess iron.
Evaluate the specific dietary iron needs of different population segments to avoid unnecessary excess iron consumption.