Why is Vitamin C: Iron molar ratio of 2:1 critical for infant health?

Why is Vitamin C: Iron molar ratio of 2:1 critical for infant health?

Almost 67.1% Indian infants under 5 years of age are anemic¹ and more than 50% of that is attributed to iron deficiency.²

While it is important to provide iron, it is equally important to ensure iron bioavailability as well. One such enhancer of iron bioavailability is Vitamin C.³

Vitamin C (ascorbic acid) has been scientifically shown to promote the absorption of nonheme iron in humans⁴ Nonheme iron is the type of iron found in plant-based foods (such as grains, legumes, and vegetables) and iron supplements. When you consume nonheme iron along with vitamin C, it significantly improves your body's ability to absorb more iron from these sources.

Mechanism of action of how vitamin C supports iron absorption⁵

The ferric form (Fe³⁺) of iron from dietary sources is reduced to ferrous form (Fe²⁺) by ferric reductase (Dcytb) in the presence of ascorbic acid (Vitamin C). The reduced Fe²⁺ is transported into intestinal absorptive cells by Divalent metal transporter (DMT-1). The transported iron ions are either stored in iron storage protein or transported into blood vessel to be carried to other parts of body.

Vitamin C also helps to overcome the adverse effects of some anti-nutritional factors like oxalates, phytates, tannins and polyphenols which may inhibit nonheme iron absorption.⁶

Practical Implication

Combining vitamin C-rich foods (such as citrus fruits, amla, strawberries, capsicum)⁷with iron-containing meals can improve iron absorption.⁶

In summary, ensuring an adequate vitamin C intake alongside iron-rich foods or supplements can optimize iron absorption and contribute to overall health and well-being of infants and children.

References

1. International Institute for Population Sciences (IIPS) and ICF. 2017. National Family Health Survey (NFHS-4), 2015-16: India. Mumbai: IIPS. 2. International Institute for Population Sciences (IIPS) and ICF. 2021.National Family Health Survey (NFHS-5), 2019-21: India. Mumbai: IIPS.
2. Ministry of Health and Family Welfare (MoHFW), Government of India,UNICEF and Population Council. 2019. Comprehensive National Nutrition Survey (CNNS) National Report. New Delhi.
3. Vitolo MR, Bortolini GA. Jornal de pediatria. 2007;83:33-8.
4. Li N, Zhao G, Wu W, et al.. JAMA Netw Open. 2020;3(11):e2023644.
5. Ganasen, M., Togashi, H., Takeda, H. et al. Structural basis for promotion of duodenal iron absorption by enteric ferric reductase with ascorbate. Commun Biol 1, 120 (2018).
6. Kamp F, Jandel D, Hoenicke I, et al. Food and nutrition bulletin. 2003;24(3_suppl_1):S20-6
7. ICMR, 2020
8. WHO / FAO (2006) - Guidelines on food fortification with micronutrients – Eds. Edited by Lindsay Allen L, Bruno de Benoist B, Dary O, Hurrell R. WHO Press, Geneva, Switizerland.

For the use of healthcare professionals only. CVM code -1709898164065