title: Orange but not apple juice enhances ferrous fumarate absorption in small children.
abstract: OBJECTIVE
  Ferrous fumarate is a common, inexpensive iron form increasingly used instead of ferrous sulfate as a food iron supplement. However, few data exist as to whether juices enhance iron absorption from ferrous fumarate.
  
  
  METHODS
  We studied 21 children, ages 4.0 to 7.9 years using a randomized crossover design. Subjects consumed a small meal including a muffin containing 4 mg Fe as ferrous fumarate and either apple (no ascorbic acid) or orange juice (25 mg ascorbic acid). They were separately given a reference dose of Fe (ferrous sulfate) with ascorbic acid.
  
  
  RESULTS
  Iron absorption increased from 5.5% +/- 0.7% to 8.2% +/- 1.2%, P < 0.001 from the muffins given with orange juice compared with muffins given with apple juice. The absorption of ferrous fumarate given with orange juice and enhancement of absorption by the presence of juice were significantly positively related to height, weight, and age (P < 0.01 for each). Although iron absorption from ferrous fumarate given with apple juice was significantly inversely associated with the (log transformed) serum ferritin, the difference in absorption between juice types was not (P > 0.9).
  
  
  CONCLUSIONS
  These data demonstrate an overall benefit to iron absorption from ferrous fumarate provided with orange juice. The effect was age related such that in children older than 6 years of age, there was a nearly 2-fold increase in iron absorption from ferrous fumarate given with orange juice.
authors.affiliation: Section of Neonatology, Department of Pediatrics, Children's Nutrition Research Center, Baylor College of Medicine and Texas Children's Hospital, Houston, TX 77030, USA.
authors.forename: Kimberly S
authors.initials: KS
authors.lastname: Balay
authors.forename: Keli M
authors.initials: KM
authors.lastname: Hawthorne
authors.forename: Penni D
authors.initials: PD
authors.lastname: Hicks
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Griffin
authors.forename: Zhensheng
authors.initials: Z
authors.lastname: Chen
authors.forename: Mark
authors.initials: M
authors.lastname: Westerman
authors.forename: Steven A
authors.initials: SA
authors.lastname: Abrams
mesh_terms: D001205:Ascorbic Acid; D001628:Beverages; D002648:Child; D002675:Child, Preschool; D032084:Citrus sinensis; D018592:Cross-Over Studies; D005260:Female; D005293:Ferritins / Q000097:blood; D005296:Ferrous Compounds / Q000493:pharmacokinetics*; D005638:Fruit; D006801:Humans; D007408:Intestinal Absorption; D007501:Iron / Q000493:pharmacokinetics*; D008297:Male; D027845:Malus; D028321:Plant Preparations / Q000494:pharmacology*
chemical_list: D005296:Ferrous Compounds; D028321:Plant Preparations; C020748:ferrous sulfate; D005293:Ferritins; D007501:Iron; D001205:Ascorbic Acid; C031621:ferrous fumarate