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Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc (2001)
Food and Nutrition Board (FNB)
Institute of Medicine (IOM)

Citation Manager

. "9 Iron." Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: The National Academies Press, 2001.

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Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc

containing porphyrin ring functioning to reduce ferric iron to ferrous iron. Cytochromes act as electron carriers. The 40 different proteins that constitute the respiratory chain contain six different heme proteins, six with iron sulfur centers, two with copper centers, and ubiquinone to connect nicotinamide adenine dinucleotide hydride to oxygen.

Physiology of Absorption, Metabolism, and Excretion

Absorption

The iron content of the body is highly conserved. In the absence of bleeding (including menstruation) or pregnancy, only a small quantity is lost each day (Bothwell et al., 1979). Adult men need to absorb only about 1 mg/day to maintain iron balance. The average requirement for menstruating women is somewhat higher, approximately 1.5 mg/day. There is, however, a marked interindividual variation in menstrual losses, and a small proportion of women must absorb as much as 3.4 mg/day. Towards the end of pregnancy, the absorption of 4 to 5 mg/day is necessary to preserve iron balance. Requirements are also higher in childhood, particularly during periods of rapid growth in early childhood (6 to 24 months), and adolescence.

In the face of these varying requirements, iron balance is maintained by the regulation of absorption in the upper small intestine (Bothwell et al., 1979). There are two pathways for the absorption of iron in humans. One mediates the uptake of the small quantity of heme iron derived primarily from hemoglobin and myoglobin in meat. The other allows for the absorption of nonheme iron, primarily as iron salts, that can be extracted from plant and dairy foods and rendered soluble in the lumen of the stomach and duodenum. Absorption of nonheme iron is enhanced by substances, such as ascorbic acid, that form low molecular weight iron chelates. Most of the iron consumed by humans is in the latter nonheme form.

Heme iron is highly bioavailable and little affected by dietary factors. Nonheme iron absorption depends on the solubilization of predominately ferric food iron in the acid milieu of the stomach (Raja et al., 1987; Wollenberg and Rummel, 1987) and reduction to the ferrous form by compounds such as ascorbic acid or a ferri-reductase present at the musosal surfaces of cells in the duodenum (Han et al., 1995; Raja et al., 1993). This bioavailable iron is then absorbed in a three-step process in which the iron is taken up by the enterocytes across the cellular apical membrane by an energy-

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Front Matter (R1-R24)
Summary (1-28)
1 Introduction to Dietary Reference Intakes (29-43)
2 Overview and Methods (44-59)
3 A Model for the Development of Tolerable Upper Intake Levels (60-81)
4 Vitamin A (82-161)
5 Vitamin K (162-196)
6 Chromium (197-223)
7 Copper (224-257)
8 Iodine (258-289)
9 Iron (290-393)
10 Manganese (394-419)
11 Molybdenum (420-441)
12 Zinc (442-501)
13 Arsenic, Boron, Nickel, Silicon, and Vanadium (502-553)
14 Uses of Dietary Reference Intakes (554-579)
15 A Research Agenda (580-586)
Appendix A Origin and Framework of the Development of Dietary Reference Intake (587-590)
Appendix B Acknowledgments (591-593)
Appendix C Dietary Intake Data from the Third National Health and Nutrition Examination Survey (NHANES III), 1988-1994 (594-643)
Appendix D Dietary Intake Data from the Continuing Survey of Food Intakes by Individuals (CSFII), 1994-1996 (644-653)
Appendix E Dietary Intake Data from the U.S. Food and Drug Administration Total Diet Study, 1991-1997 (654-673)
Appendix F Canadian Dietary Intake Data, 1990 (674-679)
Appendix G Biochemical Indicators for Iron, Vitamin A, and Iodine from the Third National Health and Nutrition Examination Survey (NHANES III), 1988-1994 (680-691)
Appendix H Comparison of Vitamin A and Iron Intake and Biochemical Indicators from the Third National Health and Nutrition Examination Survey (NHANES III), 1988-1994 (692-696)
Appendix I Iron Intakes and Estimated Percentile of the Distribution of Iron Requirements from the Continuing Survey of Food Intakes by Individuals (CSFII), 1994-1996 (697-703)
Appendix J Glossary and Acronyms (704-708)
Appendix K Conversion of Units (709-709)
Appendix L Options for Dealing with Uncertainties (710-714)
Appendix M Biographical Sketches of Panel and Subcommittee Members (715-728)
Index (729-769)
Summary Table, Dietary Reference Intakes: Recommended Intakes for Individuals, Vitamins (770-771)
Summary Table, Dietary Reference Intakes: Recommended Intakes for Individuals, Elements (772-773)