A Narrative Review on the In Vivo Evaluation of Iron Bioavailability to Assess the Effectiveness of Food Fortification and Biofortification: Narrative Review on the In Vivo Evaluation of Iron Bioavailability in Food Fortification

Haneen Basori; Malvin Widyanto  Tjoa; Felycia Angellia; Gracia Angelina Wan; Rike Tri Kumala Dewi; Dwining Putri Elfriede

doi:10.36526/jipang.v8i1.8082

Authors

Haneen Basori Universitas Prasetiya Mulya
Malvin Widyanto Tjoa Universitas Prasetiya Mulya
Felycia Angellia Universitas Prasetiya Mulya
Gracia Angelina Wan Universitas Prasetiya Mulya
Rike Tri Kumala Dewi Universitas Prasetiya Mulya
Dwining Putri Elfriede Universitas Prasetiya Mulya

DOI:

https://doi.org/10.36526/jipang.v8i1.8082

Keywords:

Iron Bioavailability, In Vivo, Food Fortification, Biofortification, Anemia

Abstract

Iron deficiency anemia remains a major global health problem, with a prevalence reaching 40% among children aged 6–59 months, 37% among pregnant women, and 30% among women of reproductive age. Low iron bioavailability is a key limiting factor affecting the effectiveness of nutritional interventions. This review aimed to analyze various in vivo methods used to evaluate iron bioavailability from food sources and to assess the effectiveness of fortification, biofortification, and food processing modifications. A narrative review approach was conducted through literature searches in Google Scholar, ScienceDirect, Wiley, MDPI, and Garuda databases for original research articles published between January 2016 and March 2026, with March 2026 as the search cutoff to ensure inclusion of fully indexed publications only. Of the 24 identified articles, 8 met the inclusion criteria and were analyzed descriptively. The findings indicate that in vivo studies employed various parameters, including hemoglobin regeneration efficiency, relative biological value, fractional iron absorption, hemoglobin concentration, serum ferritin, and organ iron retention. Notably, iron bioavailability was not always proportional to total iron content in food, as biofortification and fermentation strategies improved physiological iron utilization primarily by reducing inhibitory compounds such as phytate, rather than by increasing total iron content. Food matrix, chemical form of iron, and physiological status of subjects were identified as the most critical determinants of iron absorption effectiveness.

References

Atkins, L. A., McNaughton, S. A., Spence, A. C., Evans, L. J., Leech, R. M., & Szymlek-Gay, E. A. (2024). Bioavailability of Australian pre-schooler iron intakes at specific eating occasions is low. European Journal of Nutrition, 63(7), 2587–2598. https://doi.org/10.1007/s00394-024-03441-8

Caballero Valcárcel, A. M., Martínez Graciá, C., Martínez Miró, S., et al. (2019). Iron bioavailability of four iron sources used to fortify infant cereals, using anemic weaning pigs as a model. European Journal of Nutrition, 58, 1911–1922. https://doi.org/10.1007/s00394-018-1742-x

Castro-Alba, V., Vargas, M., Sandberg, A.-S., Perez-Rea, D., Bergenståhl, B., Granfeldt, Y., & Lazarte, C. E. (2024). Fermented quinoa and canihua in plant-based diets increase iron and zinc bioavailability in growing rats. Food Science & Nutrition, 12(11), 9555–9565. https://doi.org/10.1002/fsn3.4514

de Souza Scherrer Medeiros, L., Grancieri, M., Sant’Ana, C. T., de Araujo Santiago, M. C. P., da Silva, L. B., Glahn, R. P., & Costa, N. M. B. (2024). The lower content of mineral-complexing compounds favored the in vitro and in vivo iron bioavailability of biofortified cowpeas. Journal of Functional Foods, 123, 106601. https://doi.org/10.1016/j.jff.2024.106601

Devi, R. M., Nuhriawangsa, A. M. P., & Rahardjo, S. S. (2024). Pengaruh pemberian serbuk daun salam (Syzygium polyanthum) terhadap kadar feritin pada tikus wistar model anemia. Media Penelitian dan Pengembangan Kesehatan, 34(3), 757. https://doi.org/10.34011/jmp2k.v34i3.2080

Ding, X., Xu, M., Li, H., Li, X., & Li, M. (2024). Improvement of in vivo iron bioavailability using mung bean peptide-ferrous chelate. Food Research International, 190, 114602. https://doi.org/10.1016/j.foodres.2024.114602

Fanzaga, M., Bollati, C., Ranaldi, G., Sucato, S., Fustinoni, S., Roda, G., & Lammi, C. (2023). Bioavailability assessment of an iron formulation using differentiated human intestinal Caco-2 cells. Foods, 12(16), 3016. https://doi.org/10.3390/foods12163016

Hurrell, R., & Egli, I. (2010). Iron bioavailability and dietary reference values. The American Journal of Clinical Nutrition, 91(5), 1461S–1467S. https://doi.org/10.3945/ajcn.2010.28674F

Khan, A. S. (2025). Phytic acid: An optimal barrier to iron absorption. Biomedical Journal of Scientific & Technical Research, 62(4). https://doi.org/10.26717/BJSTR.2025.62.009773

Lin, J.-F., Wu, C.-C., Liao, Y.-J., Jakfar, S., Tang, Z.-B., Chen, J.-K., & Lin, F.-H. (2019). In vitro and in vivo evaluations of mesoporous iron particles for iron bioavailability. International Journal of Molecular Sciences, 20(21), 5291. https://doi.org/10.3390/ijms20215291

Nasruddin, H., Syamsu, R. F., & Permatasari, D. (2021). Angka kejadian anemia pada remaja di Indonesia. Cerdika: Jurnal Ilmiah Indonesia, 1(4), 357–364. https://doi.org/10.36418/cerdika.v1i4.66

Ośko, J., Nasierowska, K., & Grembecka, M. (2024). Application of in vitro digestion models in the evaluation of dietary supplements. Foods, 13(13), 2135. https://doi.org/10.3390/foods13132135

Pasricha, S. R., Tye-Din, J., Muckenthaler, M. U., & Swinkels, D. W. (2021). Iron deficiency. The Lancet, 397(10270), 233–248. https://doi.org/10.1016/S0140-6736(20)32594-0

Putri, S. K., Rukmana, E. N., & Saepudin, E. (2022). Narrative literature review penelitian perpustakaan digital sebagai sumber pembelajaran saat COVID-19 dalam database Google Scholar. Jurnal Perpustakaan Universitas Airlangga: Media Informasi dan Komunikasi Kepustakawan, 12(2), 90–101. https://doi.org/10.20473/jpua.v12i2.2022.90-101

Qi, Y., Xu, X., Mao, C., Chen, H., Tang, Y., & Lin, S. (2024). Evaluation of in vivo folic acid bioavailability in different mouse strains using enzymatic digestion combined with ultra performance liquid chromatography. Journal of Agricultural and Food Chemistry, 72(4), 2229–2239. https://doi.org/10.1021/acs.jafc.3c08632

Richards, J. D., Cori, H., Rahn, M., Finn, K., Bárcena, J., Kanellopoulos, A. K., Péter, S., & Spooren, A. (2025). Micronutrient bioavailability: Concepts, influencing factors, and strategies for improvement. Frontiers in Nutrition, 12, 1646750. https://doi.org/10.3389/fnut.2025.1646750

Sihag, M. K., Sharma, V., Goyal, A., Arora, S., & Kapila, R. (2016). In vivo assessment of iron bioavailability from fortified pearl millet based weaning food. Journal of the Science of Food and Agriculture, 96(13), 4410–4415. https://doi.org/10.1002/jsfa.7651

Stoffel, N. U., Zeder, C., & Zimmermann, M. B. (2024). Assessing human iron kinetics using stable iron isotopic techniques. Clinical Pharmacokinetics, 63(10), 1389–1405. https://doi.org/10.1007/s40262-024-01421-z

Sturza, R., Gudumac, V., Deseatnicova, O., & Ghendov-Mosanu, A. (2021). Dietary improvement of the iron statute of the rats with experimental anemia. One Health & Risk Management, 2(1), 13–21. https://doi.org/10.38045/ohrm.2021.1.02

Tako, E., Bar, H., & Glahn, R. P. (2016). The combined application of the Caco-2 cell bioassay coupled with in vivo (Gallus gallus) feeding trial represents an effective approach to predicting Fe bioavailability in humans. Nutrients, 8(11), 732. https://doi.org/10.3390/nu8110732

Uyoga, M. A., Mzembe, G., Stoffel, N. U., Moretti, D., Zeder, C., Phiri, K., Sabatier, M., Hays, N. P., Zimmermann, M. B., & Mwangi, M. N. (2022). Iron bioavailability from infant cereals containing whole grains and pulses: A stable isotope study in Malawian children. The Journal of Nutrition, 152(3), 826–834. https://doi.org/10.1093/jn/nxab406

World Health Organization. (2025). Anaemia. https://www.who.int/news-room/fact-sheets/detail/anaemia

World Health Organization. (2025). Anaemia in women and children. https://www.who.int/data/gho/data/themes/topics/anaemia_in_women_and_children

Yunadi, F. D., Faizal, I. A., & Septiyaningsih, R. (2020). Pemberdayaan kader dalam upaya pencegahan dan penanggulangan anemia ibu hamil. Jurnal Pengabdian Masyarakat Al-Irsyad (JPMA), 2(2), 144–153. https://doi.org/10.36760/jpma.v2i2.88