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Bioavailability of Nutrients

Article · December 2016

DOI: 10.1016/B978-0-12-384947-2.00068-4

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Bioavailability of nutrients

Author and Co-author Contact Information

Hester Carina Schönfeldt

PO Box 35207, Menlopark, 0102, South Africa.

hettie.schonfeldt@up.ac.za

+27 12 361 2333

Beulah Pretorius

PO Box 35207, Menlopark, 0102, South Africa.

beulah.pretorius@up.ac.za

+27 12 361 2333

Nicolette Hall

PO Box 35207, Menlopark, 0102, South Africa

Nicolette.gibson@up.ac.za

+27 82 821 3131

Institute of Food, Nutrition and Wellbeing at the University of Pretoria, Pretoria, South Africa

Department of Animal and Wildlife Sciences, University of Pretoria, Pretoria, South Africa

Keywords

bioavailability, enhancers, human nutrition, inhibitors, iron, nutrients, nutrient absorption,

nutrient utilization, protein, vitamin A
Abstract / Synopsis

Bioavailability aims to describe the effect of a sequence of metabolic events on nutrient

utilization. The supply of nutrients to the human body not only depends on the amount of the
nutrient in a food, but also on its bioavailability. The bioavailability of nutrients is highly
variable and can be influenced by numerous factors. Different nutrients (including protein,
iron and vitamin A), and the forms in which they exist in the ingested medium, will react in
different ways to inhibitors and enhancers and the hosts’ nutritional status, all contributing to
the complex variability of nutrient bioavailability.

1 Background

The correct assessment of the adequacy of dietary intakes of nutrients requires not only
knowledge of the nutrient content of the foods ingested, but also the extent to which the
nutrient present in the diet is available for absorption and utilization in the human body.

Bioavailability is the technical term used to convey the fact that not 100% of nutrients
ingested will be absorbed, irrespective of whether consumed in the form of food or
supplements. Bioavailability aims to describe the effect of a sequence of metabolic events,
including digestion, solubilization, absorption, organ uptake and release, enzymatic
transformation, secretion and excretion, on nutrient utilization. The supply of nutrients to the
human body thus not only depends on the amount of the nutrient in a food, but also on its
bioavailability. Understanding nutrient bioavailability helps to optimize diets and set
appropriate nutrient recommendations.

The bioavailability of macronutrients, i.e. carbohydrates, proteins and fats, is usually high
with more than 90% of the amount ingested being absorbed and utilized in the human body.
On the other hand, micronutrients such as vitamins and minerals, and bioactive
phytochemicals such as flavonoids, carotenoids, can vary widely in the extent to which they
are absorbed and utilized after ingestion.

2 Defining bioavailability

Until a nutrient passes from the digestive system into the bloodstream, it has little or no
value. Bioavailability can be explained as the amount of a nutrient absorbed from the gut
which becomes available for normal physiological functions or storage.
3 The variability of nutrient bioavailability

The bioavailability of nutrients is highly variable and can be influenced by numerous factors,
including physiochemical properties such as chemical binding form; the matrix in which the
nutrient is incorporated; the presence or absence of other food components that enhances
or inhibits absorption; metabolization after absorption; host related factors (including state of
health, genetic factors, age and lifestyle); as well as other individual factors.

3.1 Enhancers and inhibitors

Nutrients can interact with one another or with other dietary components at the site of
absorption, resulting in either a change in bioavailability or – if enhancers and inhibitors
cancel each other out – a nil effect. Enhancers can act in different ways such as keeping a
nutrient soluble or protecting it from interaction with inhibitors. For example, since
carotenoids are fat-soluble, adding small quantities of fat or oil to the meal (3 to 5g per meal)
improves their bioavailability. Similarly, meat, fish and poultry, while containing highly
bioavailable iron themselves, are also known to enhance the absorption of iron from other
foods ingested at the same time. Although this ‘meat factor’ has yet to be identified, it has
been suggested that muscle protein exerts an influence.

Inhibitors, on the other hand, may reduce nutrient bioavailability by binding the nutrient in
question into a form that is not recognized by the uptake systems on the surface of intestinal
cells, rendering the nutrient insoluble and thus unavailable for absorption, or competing for
the same uptake system. As an example, phytic acid is highly abundant in certain plant
foods (e.g. pulses, whole-grain cereals, seeds, nuts) and strongly binds minerals such as
calcium, iron and zinc in soluble or insoluble complexes that are unavailable for absorption.
Ways to reduce the phytic acid content of foods include fermentation (e.g. extensive
leavening of whole meal bread dough) or the soaking and germination of pulses.

The inhibitory effect of food constituents can also be used advantageously, as is done in the
case of phytosterols. These natural compounds are extracted from certain plant foods and
added in higher doses (about 2g per portion) to various other foods (for example enriched
spreads, fermented milk drinks) to lower the absorption of cholesterol, be it from dietary
sources or produced in the human body.

4 Bioavailability of specific nutrients

Protein-energy malnutrition, vitamin A and iron deficiencies are of the most common forms of
malnutrition experienced globally and often co-exist. For effective interventions and dietary
guidelines, consideration of the bioavailability of these nutrients as supplied from different
food sources is particularly important. The bioavailability of these nutrients is also distinct,
and influenced by different factors, which offers good examples of the complexity of nutrient
bioavailability.

4.1 Protein and amino acids

Although protein is a macronutrient which is considered to be easily absorbed into the

human body, its bioavailability is directly linked to its digestibility. To be most bioavailable, a
meal needs to supply all the required essential amino acids in the correct proportions.

Amino acids are the central units in protein metabolism. They are incorporated into various
proteins and converted to metabolically essential compounds such as nucleic acids, creatine
and porphyrins. Of the 20 amino acids building human proteins, 12 are manufactured by the
body and are known as nonessential amino acids. The remaining eight (8) (isoleucine,
leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine) must be
obtained from the diet and are thus termed essential or indispensable amino acids. A
sufficient intake of essential amino acids and adequate amount of nitrogen for the body to
produce the nonessential amino acids is important for protein metabolism.

4.1.1 Protein quality

The nutritional quality of food proteins varies and depends on essential amino acid
composition. Foods that contain essential amino acids at levels that facilitate tissue growth
and repair are known as complete protein foods, supplying high quality proteins. Amino
acids containing sulphur (including methionine and cysteine) most commonly limit the
nutritive values (quality) of proteins in the human diet. These sulphur containing amino acid
concentrations are generally considered lower in legumes and fruits than in animal foods.
The roles of these amino acids in the human body are crucial, as for example methionine is
the initiating amino acid in the synthesis of almost all eukaryotic proteins, and cysteine (due
to its ability to form sulphur bonds), plays an important role in protein structure. Other
indispensible amino acids, lysine and tryptophan, are also consistently found at lower
concentrations in plant-based foods, than in animal foods, e.g. tryptophan and lysine are
limiting in corn, lysine in wheat, sorghum and other cereals, and methionine is limiting in
soybeans and other legumes. For further reading on the global protein quality debate, refer
to the 2011 report of the FAO Expert Consultation on dietary protein quality evaluation in
human nutrition (FAO, 2011).
In addition to protein quality, digestibility (absorption), chemical integrity and inhibitors are
three key properties of food that can influence the bioavailability of amino acids.

4.1.2 Amino acid digestibility

Amino acid digestibility explains the proportion of consumed amino acids that is absorbed. It
is not a fixed attribute but reflects an interaction between the food and the host consuming it
and therefore may be subjected to individual variation. Although the digestibility (absorption)
of macronutrients, including protein, is relatively high, protein utilization is influenced by total
dietary energy intake and by the quality of the protein in terms of its ability to meet the
metabolic demand.

4.1.3 Chemical integrity

Chemical integrity describes the proportion of the amino acid that, if absorbed, is in an
utilizable form. Some amino acids present in foods may be in a structural form that is
unavailable (i.e. the amino acid may be absorbed in a form that cannot be utilized). This is
most likely to be encountered in foods that are heat-treated, oxidized or subjected to other
severe processes that can limit amino acid bioavailability. Heat treatment leads to the
formation of Maillard compounds and a loss of lysine availability. Oxidization leads to
oxidized sulphur containing amino acids and the subsequent loss of bioavailability of
tryptophan and threonine. High pH induces racemization of L-amino acid residues to D-
isomers and formation of cross-linked amino acids such as lysinoalanine, which also
reduces bioavailability.

4.1.4 Inhibitors

Many foods contain bioactive (protein or non-protein) substances that may inhibit amino acid
bioavailability either by affecting digestibility or post-absorptive utilization. These inhibitors
may be naturally occurring (e.g. tannins, phytates, trypsin inhibitors, glucosinolates,
isothiocyanates), formed during processing (e.g. D-amino acids, lysinoalanine), or formed
during genetic modification of crops (e.g. lectins in lentils). (Lectins depressed growth at low
levels in the diet and are toxic at high levels).

4.2 Vitamin A

Vitamin A is a generic term used for a group of structurally related chemical compounds
known as retinoids. Retinoids refer to both naturally occurring and synthetic compounds
with, or without, the biological activity of vitamin A. Figure 1 shows the chemical structures of
some retinoids. The term vitamin A is often used as a general term for all compounds that
exhibit the biological activity of retinol.

Vitamin A activity in the diet derives from two sources: preformed vitamin A as retinyl esters
or retinoids and provitamin A carotenoids, such as β-carotene, α-carotene, and β-
cryptoxanthin. Although an essential nutrient needed in only small amounts, vitamin A is
necessary for normal functioning of the visual system; growth and development; and
maintenance of epithelial cellular integrity, immune function and reproduction.

4.2.1 Retinol (preformed vitamin A)

In vivo, vitamin A is generally found as the free alcohol form (retinol) or esterified with a fatty
acid (retinyl ester). The vitamin is available in pure form by chemical synthesis or as vitamin
A palmitate or acetate. It is a pale yellow solid, which dissolves freely in oils and fats, but is
insoluble in water. When vitamin A intake is adequate, more than 90% of total body vitamin
A is located in the liver, which releases the nutrient into the circulation as needed. The major
dietary forms of preformed vitamin A are long-chain fatty acid esters of retinol, commonly
found in foods of animal origin, such as glandular meats, liver and fish liver oils (especially),
egg yolk, and whole milk and dairy products.

Preformed vitamin A is absorbed in the small intestine. The bioavailability of retinol is

generally high, ranging from 70% to 90%. Factors such as dietary fat and intestinal infections
can affect the absorption of vitamin A by the body. Products of fat digestion (e.g., fatty acids,
monoglycerides, cholesterol, and phospholipids) and secretions in bile (e.g., bile salts and
hydrolytic enzymes) are essential for the efficient solubilization of retinol. Absorption of
retinol appears to be reduced in individuals with diarrhea, intestinal infections and
infestations.
H3C CH3 CH3 CH3

OH

CH3

all-trans retinol

O
H3C CH3 CH3 CH3 O
R CH3
O
Acetate
R
CH3
O
retinyl ester
R CH 2(CH 2)13 CH 3

Palmitate
H3C CH3 CH3

CH3 H3C

11-cis retinal N
CH3

Figure 1: Chemical structures of different retinoids. All-trans-retinol is by definition vitamin A,

and 1mg of all-trans retinol is equal to 1 retinol equivalent (RE). When a fatty acyl group is
esterified to the hydroxyl terminus of all-trans-retinol, a storage form of retinol, the retinyl
ester is formed. The most abundant retinyl esters are those of palmitic, oleic, stearic and
linoleic acids. Retinyl acetate and palmitate are often used as dietary supplements, but do
not occur naturally. Retinol can be reversibly oxidized to retinal, which as the 11-cis isomer
is essential for the visual cycle (Packer et al., 2005).

4.2.2 Carotenoids

Carotenoids are lipid-soluble plant pigments found in photosynthetic plants and animal
tissues. About 600 carotenoids have been isolated and characterized in nature, and about
10% of these can be metabolized to vitamin A in a variety of animal species, including
humans. Both provitamin A carotenoids such as α- and β-carotenes and cryptoxanthins and
nonprovitamin A carotenoids such as lutein, zeaxanthin, and lycopene are present in the
blood and tissues of humans and have a variety of functions. Structures of these carotenoids
are shown in Figure 2. Provitamin A carotenoids are an important source of dietary vitamin A
that are found primarily in dark-green leafy vegetables, such as spinach, and in orange and
yellow vegetables and fruit, such as carrots, mango, and papaya, although their
bioavailability is significantly more variable than that of preformed vitamin A (retinol).

The bioavailability of carotenoids is affected by various factors. Different carotenoids have

different levels of vitamin A activity depending upon the efficiency of their absorption and the
rate of their conversion to vitamin A. Recent research has shown that the bioavailability of
traditional dietary sources of ß-carotene is considerably lower (by one-half to one-fourth)
than was previously assumed. Conversion factors for estimating vitamin A obtained from
plant foods were revised from 6:1 to 12:1 (µg ß-carotene:retinol activity equivalent (RAE))
and 24:1 for other provitamin A carotenoids in a mixed diet. A wide variation in vitamin A
equivalency ratios are found and can be affected by food- and diet-related factors and
health, nutritional, and genetic characteristics of human populations.

There are various diet related and host related factors affecting the bioavailability of
carotenoids. These factors have been evaluated and extensively reported on by
Castenmiller and West, and De Pee et al. in 1998, Van Het Hof et al. in 2000, as well as
Yeum and Russell in 2002.
Figure 2: Chemical structures of major provitamin A carotenoids (α-carotene, ß-carotene and
ß-cryptoxanthin) and nonprovitamin carotenoids (lutein, zeaxanthin and lycopene) found in
food.
4.2.2.1 Bio-availability of carotenoids

The main diet-related factors that influence bioavailability are the food matrix in which ß-
carotene is incorporated, the amount ingested and the habitual diet type. The nutritional
status, health, and genetic characteristics of human populations can also affect the
absorption and bioavailability of carotenoids.

Release of the carotenoids from the food matrix is an important first step in the absorption
process. The rupture of the plant cell walls by processing (e.g. heating or pureeing)
promotes the release of ß-carotene from cells before and during digestion, and therefore it
facilitates solubilization and absorption. The bioavailability of ß-carotene from fruits is
generally higher than for vegetables, as the cell wall structure in fruits is usually weaker than
that in most vegetables and leaves. Furthermore, inhibitors of carotenoid absorption present
in fruit are also less than that of inhibitors present in leafy vegetables.

The composition of the diet (due to nutrient-to-nutrient interactions) affects to a large extent
the absorption of carotenoids. The second step in the absorption process that may affect
bioavailability involves the incorporation of released carotenoids into mixed micelles. Among
other factors, formation of these micelles is dependent on the presence of fat in the intestine.
Therefore, ingestion of fat along with carotenoids is thought to be crucial. It was found that
only a small amount of fat is sufficient to enhance carotenoid absorption. As expected,
unabsorbable fat-soluble compounds such as sucrose polyester (a fat replacer), reduces
carotenoid absorption. Also, as dietary fiber content increases, the absorption of ß-carotene
decreases. Dietary fiber reacts with bile acids and thereby decreases the absorption of fat
and fat soluble nutrients. The presence of dietary fiber in vegetables and fruits may explain
in part the lower bioavailability of carotenoids from plant foods.

Simultaneous ingestion of various carotenoids may also reduce absorption of either of the
carotenoids due to interactions at the intestinal level. Studies on simultaneous ingestion of
carotenoids indicate that lutein may interfere with absorption of ß-carotene resulting in
reduced bioavailability. It has also been found that with pharmaceutical doses of ß-carotene,
conversion of ß-carotene to vitamin A decreases as the oral dose of ß-carotene increases.
Further research is required to identify the mechanisms behind these interactions.

The absorption of carotenoids is furthermore highly likely to be dependent on vitamin A

status of the host. Feeding ß-carotene–rich foods to humans leads to an increase in serum
retinol levels only when these are initially low. The serum response to ß-carotene is higher in
women than in men; however, part of this effect could be attributed to differences in body
weight and body composition. Intestinal helminthic infections are associated with
malnutrition, and their effects are possibly mediated through impaired fat absorption and
reduced vitamin absorption, particularly of vitamin A.

4.3 Iron

Minerals (and other nutrients) exist in different chemical forms in food and this can influence
their bioavailability. A classic example is iron. There are two primary forms of dietary iron,
namely heme and non-heme iron. The former is only found in animal products such as red
meat, fish and poultry. The heme iron content of animal source foods is estimated at 40% of
total iron, but data suggest that considerably more heme iron is provided by a portion of red
meat than by a portion of white fish for example. Heme iron is a component from hemoglobin
and myoglobin (see Figure 3) which explains why it is only found in animal tissue. Non-heme
iron is found mostly in plant-based foods, and makes up the remaining estimated 60% of iron
found in animal products.

The type of iron (heme or non-heme) notably influences bioavailability. Approximately 90%
of dietary iron is consumed in the non-heme form, however, due to a low bioavailability it
constitutes only approximately 50% of iron actually absorbed into the human body.

The absorption of non-heme iron is usually much lower than that of heme iron. In general,
the rate of non-heme iron absorption is related to its solubility in the upper part of the small
intestine. The presence of soluble enhancers such as ascorbic acid and inhibitors such as
phytates, polyphenols and calcium, consumed during the same meal will have a notable
effect on the amount of non-heme iron absorbed. Heme iron is much less affected by other
dietary factors and contributes more significantly to absorbable iron.

Figure 3: Chemical structure of heme iron as found in food from animal sources.
4.3.1 Inhibitors and enhancers of iron bioavailability

Non-heme food iron that enters the common iron pool in the digestive tract is absorbed to
the same extent, which depends on the balance between the absorption inhibitors and
enhancers and the iron status of the individuals.

Phytate and polyphenols in plant-based diets is the main inhibitors of non-heme iron
absorption. The negative effect of phytate on iron bioavailability is dose-dependent and any
food processing and preparation methods, such as milling, heating, soaking, germination
and fermentation that degrade phytate to a varying extent, will have a positive effect on iron
absorption. Controversies exist on the inhibitory effect of oxalic acid in spinach and cabbage
and non-digestible carbohydrates in beans on iron absorption, as these foods are also good
sources of ascorbic acid which enhances iron absorption.

Calcium and dairy products have also been shown to have a negative effect on non-heme
iron absorption, but what separates it from other inhibitors is its ability to also inhibit heme
iron absorption. Single meal studies show a negative effect of calcium on iron absorption,
but multi-meal studies with a variety of other inhibitors and enhancers indicate that calcium
has only a limited negative effect on iron absorption. In a recent study the two major milk
protein fraction, casein and whey, and egg protein, albumin, were reported to have a
negative effect on iron absorption in humans. Although phytate was shown to be the major
inhibitor in soy, even after complete phytate digestion in soy protein isolates significant
inhibition of iron absorption was still observed. It was concluded that both phytate and a
protein fraction were the main inhibitors of iron absorption in soy.

Ascorbic acid has convincingly been shown to enhance iron bioavailability in a dose-
dependent manner. This effect is largely due to ascorbic acid’s ability to reduce ferric to
ferrous iron. Ascorbic acid has also been shown to, at least partially counteract the inhibitory
effect of both phytate and polyphenols on non-heme iron absorption.

Small amounts of meat are recognised to enhance the absorption of non-heme iron from
plant foods, although the mechanism for the enhancing effect of meat on non-heme iron
absorption is unknown. Studies support the enhancing effect of cysteine-containing peptides
following the proteolysis of meat muscle.

Vitamin A and β-carotene can also enhance non-heme iron absorption and improve
hemoglobin levels, although several studies suggest that it is only observed in iron deficient
individuals. Host related factors that influence the absorption of heme and non-heme iron
includes mainly iron status, other nutritional deficiencies, infection, genetic disorders and
physiological state.

As with inhibitors and enhancers, the iron status of an individual mainly influences on the
absorption of non-heme iron, while heme iron absorption is less affected. There is an inverse
relationship between iron status and iron absorption. Protein-energy malnutrition, riboflavin
and vitamin A deficiencies have also been shown to impair iron metabolism and absorption.
The correction of nutritional deficiency will improve iron absorption.

Iron deficiency often co-exists in a double burden of disease in seemingly well-fed,

overweight populations. This can be partially due to iron absorption being decreased by the
peptide, hepcidin. Hepcidin secretion is increased due to chronic inflammation and obesity. It
is a regulatory hormone secreted by the liver and inhibits iron absorption.

Achlorhydria might also be a substantial cause of iron deficiency, mainly in elderly people in
whom atrophic gastritis is common, and gastric acid secretion is low. Gastric acid is needed
to maintain ferric iron forms in solution and bioavailable. However, heme iron does not
appear to be affected by lack of acid and is normally absorbed in individuals with atrophic
gastritis. Other common causes of lowered iron absorption and iron deficiency are mucosal
atrophy in coeliac disease and, possibly, Helicobacter Pylori infection, although no
consensus has been reached.

For further reading on iron bioavailability, refer to Heath and Fairweather (2002),
Zimmerman and Hurrel (2007), and Hurrel and Egli (2010).

5 Conclusions

Different nutrients react differently once ingested into the human gastro-intestinal tract, and
can be influenced by various factors including the quality of the food source and the matrix in
which it is consumed, the composition of the whole meal, inhibitors, enhancers and the
status of the host. Although bioavailability is only a partial measure of the body’s ability to
benefit from a nutrient, this factor quantifies the amount of a substance that successfully
enters the bloodstream. Once in the bloodstream, the nutrient must cross cellular
membranes before it can nourish body cells.

In addition to considering the nutrient content of foods, nutrient bioavailability should also be
taken into consideration when nutrition-sensitive policies, nutrition interventions and dietary
guidelines are developed. It should however be noted that bioavailability can’t attain a
constant calculated value, and needs to be considered with caution as multiple factors, both
intrinsic and extrinsic, can notably affect the bioavailability of nutrients present in food-, and
non-food sources of nutrients.

6 Further Reading

Castenmiller, J.J.M. and West, C.E. (1998). Bioavailability and bioconversion of carotenoids.
Annual Review of Nutrition 18, 19-38.

Castenmiller, J.J.M., West, C.E., Linssen, J.P.H., van het Hof, K.H. and Voragen, A.G.J.
(1999). The food matrix of spinach is a limiting factor in determining the bioavailability of ß-
carotene and to a lesser extent of lutein in humans. Journal of Nutrition 129, 349-355.

Dary, O. and Mora, J.O. (2002). Food fortification to reduce vitamin A deficiency:
International Vitamin A Consultative Group Recommendations. Journal of Nutrition 132,
2927S-2933S.

De Pee, S., West, C.E., Permaesih, D., Martuti, S., Muhilal and Hautvast, J.G.A.J. (1998).
Orange fruit is more effective than are dark-green leafy vegetables in increasing serum
concentrations of retinol and ß-carotene in schoolchildren in Indonesia. American Journal of
Clinical Nutrition 68, 1058-1067.

FAO. (2011). Dietary protein quality evaluation in human nutrition. Report of an FAO Expert
Consultation. 31 March - 2 April, Auckland, New Zealand. FAO Food and Nutrition Paper
92', Food and Agricultural Organisation, Rome.

Friedman, M. (1996). Nutritional value of proteins from different food sources. Journal of
Agricultural and Food Chemistry 44, 6-29.

Harrison, E.H. (2012). Mechanisms involved in the intestinal absorption of dietary vitamin A
and provitamin A carotenoids. Biochimica et Biophysica Acta 1821, 70-77.

Haskell, M.J. (2012).The challenge to reach nutritional adequacy for vitamin A: ß-carotene
bioavailability and conversion - evidence in humans. American Journal of Clinical Nutrition
96(suppl), 1193S-1203S.

Millward, D.J., Layman, D.K., Tomé, D. and Schaafsma, G. (2008). Protein quality
assessment: impact of understanding of protein and amino acid needs for optimal health.
American Journal of Clinical Nutrition 87(suppl), 1576S-1581S.

Packer, L., Kraemer, K., Obermüller-Jevic, U. and Sies, H. (ed.) (2005). Carotenoids and
Retinoids: Molecular aspects and health issues, Illinois: AOCS Press.
Otten, J.J., Hellwig, J.P. and Meyers, L.D. (2006). Dietary Reference Intakes: The essential
guide to nutrient requirements, Institute of Medicine. ISBN 0-309-10091-7, Washington.

van het Hof, K.H., West, C.E., Weststrate, J.A. and Hauvast, J.G.A.J. (2000). Dietary factors
that affect the bioavailability of carotenoids. Journal of Nutrition 130(3), 503-506.

Cross References

Castenmiller, J.J.M. and West, C.E. (1998). Bioavailability and bioconversion of carotenoids.
Annual Review of Nutrition 18, 19-38.

De Pee, S., West, C.E., Permaesih, D., Martuti, S., Muhilal and Hautvast, J.G.A.J. (1998).
Orange fruit is more effective than are dark-green leafy vegetables in increasing serum
concentrations of retinol and ß-carotene in schoolchildren in Indonesia. American Journal of
Clinical Nutrition 68, 1058-1067.

Heath, A.-L. and Fairweather-Tait, S.J. (2002). Clinical implications of changes in the
modern diet: iron intake, absorption and status. Best Practice & Research Clinical
Haematology 15(2), 225-241.

Hurrell, R. and Egli, I. (2010). Iron bioavailability and dietary reference values. American
Journal of Clinical Nutrition 91(suppl), 1461S-1467S.

van het Hof, K.H., West, C.E., Weststrate, J.A. and Hauvast, J.G.A.J. (2000). Dietary factors
that affect the bioavailability of carotenoids. Journal of Nutrition 130(3), 503-506.

Yeum, K.J. and Russell, R.M. (2002). Carotenoids bioavailability and bioconversion. Annual
Reviews of Nutrition 22, 483-504.

Zimmermann, M.B. and Hurrell, R.F. (2007). Nutritional iron deficiency. Lancet 370, 511-520.
Biography and photo

Professor Hettie Schonfeldt, is a rated and registered scientist

and mentor in the fields of human nutrition and food composition.
She is a Professor extraordinaire in the Faculty of Natural and
Agricultural Sciences and an Associate of the Institute of Food,
Nutrition and Well-being at the University of Pretoria. She is an
invited Scientific Advisor for the Food and Agriculture Organization
of the United Nations International Network of Food Data Systems,
and has been tasked to evaluate FAO’s Role and Work on
Nutrition. She recently conducted a review of the nutrition-sensitivity of the South African
agriculture and food system for the United Nations Standing Committee of Nutrition. She is
an invited member of the International Food Monitoring Group collaborative project which
tracks the nutritional composition of fast foods globally as part of Salt Watch. She was
elected President of the International Life Sciences Institute (ILSI) South Africa in 2014. She
is currently a member of the Scientific Advisory Committee of the South African Department
of Health Codex Committee on Nutrition and Foods for Special Dietary Uses, member of the
International Meat Secretariat (IMS) Nutrition and Health Committee and the International
Dairy Federations’ (IDF) Standing Committee on Nutrition and Health.

Dr Beulah Pretoris obtained her work experience at the Agricultural

Research Council. In 1998 she became a SANAS technical
signatory for the ARC-Irene Analytical Laboratory and in 2009 she
became Head of Laboratory. Since March 2011, she was appointed
as nutrition consultant at the University of Pretoria. She obtained her
PhD Nutrition in September 2011 focusing on the “Vitamin A content
and bio-availability of South African maize meal”. Apart from over
1400 laboratory reports to clients, she was supervisor of three Nat
Dip Chemistry students and one M.Sc Biochemistry student. She has authored three and co-
authored six peer-reviewed scientific articles. Recently she has been asked by the
International INFOODS Group (International Network of Food Data Systems) to represent
them on a global committee advising Codex. Beulah is a member of the South African
Consultative Working Group on Micronutrient Control Interventions, as well as, the Technical
Working Group on Food Based Dietary Guidelines.
 Nicolette Hall is a young researcher with an MSc degree (Cum
Laude) in human nutrition and a BSc Honours degree in Nutrition
and Food Sciences. She is currently completing her PhD degree in
Human Nutrition at the University of Pretoria, on the sustainability
of the South African red meat industry from a nutrition perspective,
focused on nutrient composition. Her research focus is on nutrient
composition of animal products and the role thereof in human
nutrition, as well as the extrapolation of research findings into
consumer friendly messages. Apart from numerous popular outputs as part of the consumer
education campaign of Lamb and Mutton South Africa, she has published more than 15 peer
reviewed scientific articles in accredited journals, published a peer-reviewed book, and two
chapters in books. She has presented more than 40 national and international conference
contributions, and won two conference contribution awards in 2013.

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