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Bioavailability of Nutrients

HC Schönfeldt, B Pretorius, and N Hall, University of Pretoria, Pretoria, South Africa


ã 2016 Elsevier Ltd. All rights reserved.

Background such as keeping a nutrient soluble or protecting it from inter-


action with inhibitors. For example, because carotenoids are
Correct assessment of the adequacy of nutrient intakes from fat-soluble, adding small quantities of fat or oil to a meal
the diet requires not only knowledge about nutrient content of (3–5 g) improves their bioavailability. Similarly, meat, fish,
ingested foods but also the extent to which the nutrient is and poultry, while containing highly bioavailable iron, are
available for absorption and utilization in the human body. also known to enhance the absorption of iron from other
Bioavailability is the technical term used to convey the fact foods ingested at the same time. Although this meat factor has
that not all of the nutrients ingested will be absorbed, yet to be identified, it has been suggested that muscle protein
irrespective of whether consumed in the form of food or sup- may exert an influence.
plements. Bioavailability aims to describe the effects of a Inhibitors, on the other hand, may reduce bioavailability
sequence of metabolic events, including digestion, solubili- by binding the nutrient in a form that is not recognized by
zation, absorption, uptake and release, enzymatic transforma- uptake systems on the surface of intestinal cells, rendering the
tion, secretion, and excretion, on nutrient utilization. Thus, the nutrient insoluble and, thus, unavailable for absorption, or by
supply of nutrients – and increasingly nonnutrient bioactive competing for the same uptake system. For example, phytic
compounds – to the human body depends not only on the acid is abundant in certain plant foods (e.g., pulses, whole-
amount in a food but also on its bioavailability. Understand- grain cereals, seeds, and nuts) and strongly binds minerals,
ing bioavailability helps to optimize diets and set appropriate such as calcium, iron, and zinc in soluble or insoluble com-
recommendations. plexes, which are unavailable for absorption. Ways to reduce
The bioavailability of macronutrients, that is, carbohy- phytic acid content of foods include fermentation (e.g., exten-
drates, proteins, and fats, is usually high with more than 90% sive leavening of whole-wheat bread dough) or the soaking
of the amount ingested being absorbed and utilized in the and germination of pulses.
body. On the other hand, for micronutrients, such as vitamins The inhibitory effect of food constituents can also be used
and minerals, and bioactive phytochemicals such as flavonoids advantageously, as in the case of phytosterols. These com-
and carotenoids, absorption and utilization can vary widely pounds can be extracted from certain plant foods and added
after ingestion. in higher doses (about 2 g per portion) to a variety of other
foods (e.g., spreads and fermented milk drinks) to reduce the
absorption of cholesterol, be it from dietary sources or pro-
Defining Bioavailability duced in the human body.

Until a nutrient passes from the digestive system into the


bloodstream, it has little or no value. Bioavailability can be Bioavailability of Specific Nutrients
explained as the amount of a nutrient absorbed from the gut
that becomes available for normal physiological functions or Protein–energy malnutrition, vitamin A, and iron deficiencies
storage. are some of the most common forms of malnutrition experi-
enced globally and often coexist. For effective intervention and
dietary guidelines, the bioavailability of these nutrients, as
The Variability of Nutrient Bioavailability supplied from different food sources, is particularly important.
The bioavailability of these nutrients is distinct and influenced
The bioavailability of nutrients is highly variable and can be by different factors, providing good examples of the complex-
influenced by numerous factors, including physiochemical ity of nutrient bioavailability.
properties, such as chemical binding form; the matrix in
which the nutrient is incorporated; the presence or absence of
other food components that enhance or inhibit absorption; Protein and Amino Acids
metabolization after absorption; host-related factors (includ- Although protein is a macronutrient that is easily absorbed by
ing state of health, genetic factors, age, and lifestyle); and other the human body, its bioavailability is directly linked to digest-
individual factors. ibility. 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.
Enhancers and Inhibitors
They are incorporated into various proteins and converted to
Nutrients can interact with one another and with other dietary metabolically essential compounds, such as nucleic acids,
components at the site of absorption, affecting a change in creatine, and porphyrins. Of the 20 amino acids in human
bioavailability or – if enhancers and inhibitors cancel each proteins, 12 can be made by the body and are known as non-
other out – a nil effect. Enhancers can act in different ways, essential amino acids. The remaining eight (8) (isoleucine,

Encyclopedia of Food and Health http://dx.doi.org/10.1016/B978-0-12-384947-2.00068-4 401


402 Bioavailability of Nutrients

leucine, lysine, methionine, phenylalanine, threonine, trypto- Inhibitors


phan, and valine) must be obtained from the diet and, thus, Many foods contain bioactive (protein or nonprotein) sub-
are termed essential or indispensable amino acids. Sufficient stances that may inhibit amino acid bioavailability by affecting
intakes of essential amino acids and adequate amounts of either digestibility or utilization postabsorption. These inhibi-
nitrogen for the body to produce the nonessential amino tors may be naturally occurring (e.g., tannins, phytates, trypsin
acids are important for protein metabolism. inhibitors, glucosinolates, and isothiocyanates), formed dur-
ing processing (e.g., D-amino acids and lysinoalanine), or
formed during genetic modification of crops (e.g., lectins in
Protein quality lentils) (lectins suppress growth at low levels and are toxic at
The nutritional quality of food proteins varies, depending on high levels).
the 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- Vitamin A
quality proteins. Amino acids containing sulfur (including
Vitamin A is a generic term used for a group of structurally
methionine and cysteine) most commonly limit the nutri-
related chemical compounds known as retinoids, which may
tional value (quality) of proteins in the human diet. Concen- be naturally occurring or synthetic compounds with or without
trations of these sulfur-containing amino acids are, generally,
vitamin A biological activity. Figure 1 shows the chemical
considered lower in legumes and fruits than in food of animal
structures of some retinoids.
origin. The roles of these amino acids in the human body are Vitamin A is often used as a general term for all compounds
crucial as methionine is the amino acid initiating the synthesis
that exhibit the biological activity of retinol. Vitamin A activity
of almost all eukaryotic proteins and cysteine (due to its ability
in the diet derives from two sources: preformed vitamin A, such
to form sulfur bonds) has an important role in protein struc- as retinyl esters or retinoids, and provitamin A carotenoids,
ture. Other essential amino acids, lysine and tryptophan, are
such as b-carotene, a-carotene, and b-cryptoxanthin. Although
also consistently found at lower concentrations in plant-based
an essential nutrient, vitamin A is needed only in small
rather than animal-based foods; for example, tryptophan and amounts and is necessary for normal functioning of the visual
lysine are limiting in corn; lysine in wheat, sorghum, and other system, growth and development, and maintenance of epithe-
cereals; and methionine in soybeans and other legumes. For
lial cellular integrity, immune function, and reproduction.
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). Retinol (preformed vitamin A)
In addition to protein quality, digestibility (absorption), Vitamin A in vivo is, generally, found in the free alcohol form
chemical integrity, and inhibitors are three key properties of (retinol) or esterified with a fatty acid (retinyl ester). Available
foods that can influence the bioavailability of amino acids. in a 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
Amino acid digestibility adequate, more than 90% of the total body vitamin A is located
Amino acid digestibility explains the proportion of amino in the liver, which releases the nutrient into the circulation as
acids consumed that is absorbed. It is not a fixed value, but needed. The major dietary forms of vitamin A are long-chain
reflects the interaction between food and the host and, there- fatty acid esters of retinol, commonly found in foods of animal
fore, may be subject to individual variation. Although the origin, such as glandular meats, liver and fish liver oils (espe-
digestibility (absorption) of macronutrients, including pro- cially), egg yolk, and whole milk and dairy products.
tein, is relatively high, protein utilization is influenced by Preformed vitamin A is absorbed in the small intestine.
total dietary energy intake and the quality of protein in terms Generally, the bioavailability of retinol is high, ranging from
of meeting metabolic demand. 70% to 90%. Factors such as dietary fat and intestinal infec-
tions can affect the absorption of vitamin A. Products of fat
digestion (e.g., fatty acids, monoglycerides, cholesterol, and
Chemical integrity phospholipids) and secretions in bile (e.g., bile salts and
Chemical integrity describes the proportion of amino acids hydrolytic enzymes) are essential for the efficient solubili-
absorbed in a form that can be utilized. Some amino acids zation of retinol. The absorption of retinol appears to be
present in foods may be structurally unavailable (i.e., absorbed reduced in individuals with diarrhea and intestinal infections
in a form that cannot be utilized). This is most likely to be or infestations.
encountered in foods that are heat-treated, oxidized, or sub-
jected to other processes that limit amino acid bioavailability. Carotenoids
Heat treatment leads to the formation of Maillard compounds Carotenoids are lipid-soluble plant pigments found in photo-
and reduced lysine availability. Oxidization of sulfur- synthetic plants and animal tissues. About 600 carotenoids
containing amino acids reduced the bioavailability of have been isolated and characterized in nature, and about
tryptophan and threonine. High pH induces racemization of 10% of these can be metabolized to vitamin A in a variety of
L-amino acid residues to D-isomers and formation of cross- animal species, including humans. Both provitamin A carot-
linked amino acids, such as lysinoalanine, which also reduces enoids, such as a- and b-carotenes and cryptoxanthins, and
bioavailability. non-provitamin A carotenoids, such as lutein, zeaxanthin, and
Bioavailability of Nutrients 403

H3C CH3 CH3 CH3

OH

CH3

all-trans retinol

O
H 3C CH3 CH3 CH3 O
R CH3
O
Acetate
R
CH3 O
retinyl ester
R CH2(CH2)13 CH3

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 1 mg 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, retinyl ester is formed for storage. 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, the 11-cis isomer, which is essential for the visual cycle. Reproduced from Packer, L.,
Kraemer, K., Obermüller-Jevic, U. and Sies, H. (eds.) (2005). Carotenoids and Retinoids: Molecular aspects and health issues, Illinois: AOCS Press.

lycopene, are present in the human blood and tissues and have Bioavailability of carotenoids
a variety of functions. The structures of these carotenoids are The main diet-related factors influencing carotenoid bioavail-
shown in Figure 2. Provitamin A carotenoids are an important ability are the food matrix, amounts ingested, and habitual diet
source of dietary vitamin A that are found primarily in dark- type. The nutritional status, health, and genetic characteristics
green leafy vegetables, such as spinach, and in orange and of human populations can also affect the absorption and bio-
yellow vegetables and fruit, such as carrots, mango, and availability of carotenoids.
papaya, although their bioavailability is significantly more Release of the carotenoids from the food matrix is important in
variable than that of preformed vitamin A (retinol). the absorption process. The rupture of the plant cell walls by
The bioavailability of carotenoids is affected by various processing (e.g., heating or pureeing) promotes the release of
factors. Different carotenoids have different levels of vitamin b-carotene from the cells before and during digestion and, there-
A activity depending upon the efficiency of their absorption and fore, facilitates solubilization and absorption. Generally, the
the rate of their conversion to vitamin A. Recent research has bioavailability of b-carotene from fruits is higher than for vegeta-
shown that the bioavailability of traditional dietary sources of bles, as the cell wall structure in fruits is usually weaker than in
b-carotene is considerably lower (around half to a quarter) than most vegetables and leaves. Furthermore, inhibitors of carotenoid
was previously assumed. Conversion factors for estimating vita- absorption present in fruit are also less than in leafy vegetables.
min A obtained from plant foods were revised from 6:1 to 12:1 The composition of the diet (due to nutrient-to-nutrient
(mg b-carotene–retinol activity equivalent (RAE)) and 24:1 for interactions) affects, to a large extent, the absorption of carot-
other provitamin A carotenoids in a mixed diet. There is also a enoids. The second step in absorption, which may affect bio-
wide variation in vitamin A equivalency ratios, which can be availability, involves the incorporation of carotenoids into
affected by food- and diet-related factors and health, nutri- mixed micelles. Among other factors, the formation of these
tional, and genetic characteristics among human populations. micelles is dependent on the presence of fat in the intestine.
Various diet- and host-related factors affect the bioavailabil- Therefore, ingestion of fat, along with carotenoids, is thought
ity of carotenoids. These factors have been evaluated and to be crucial although only a small amount of fat is necessary to
extensively reported by Castenmiller and West (1998), De enhance carotenoid absorption. As expected, fat-soluble com-
Pee et al. (1998), Van Het Hof et al. (2000), and Yeum and pounds that cannot be absorbed, such as sucrose polyester
Russell (2002). (a fat replacer), reduce carotenoid absorption. Also, as dietary
404 Bioavailability of Nutrients

H3C
H3C CH3 CH3 CH3

CH3 CH3 H3C CH3


CH3
a-Carotene

CH3
CH3 CH3 CH3
H3C

CH3
CH3 CH3 CH3

CH3
b-Carotene

H3C
H3C CH3 CH3 H3C

CH3 H3C H3C CH3


HO CH3
b-Cryptoxanthin

H3C OH
H3C CH3 CH3 CH3

CH3 CH3 H 3C CH3


HO CH3
Zeaxanthin

H3C OH
H3C CH3 CH3 CH3

CH3 CH3 H3C CH3


HO CH3
Lutein

H3C OH
H3C CH3 CH3 CH3

CH3 CH3 H 3C CH3


HO CH3

Lycopene
Figure 2 Chemical structures of major provitamin A carotenoids (a-carotene, b-carotene, and b-cryptoxanthin) and non-provitamin carotenoids
(lutein, zeaxanthin, and lycopene) found in food.

fiber content increases, the absorption of b-carotene decreases. b-carotene resulting in reduced bioavailability. It has also been
Dietary fiber reacts with bile acids and, thereby, decreases the found that with pharmaceutical doses of b-carotene, conver-
absorption of fat and fat-soluble nutrients. The presence of sion of b-carotene to vitamin A decreases as the oral dose of b-
dietary fiber in vegetables and fruits may explain in part the carotene increases. Further research is required to identify the
reduced bioavailability of carotenoids from plant foods. mechanisms behind these interactions.
Simultaneous ingestion of carotenoids may also reduce Furthermore, the absorption of carotenoids is highly likely
absorption of any of the carotenoids due to interactions at to be dependent on vitamin A status of the host. Consuming
the intestinal level. Studies on simultaneous ingestion of carot- b-carotene-rich foods leads to an increase in serum retinol
enoids indicate that lutein may interfere with the absorption of levels only when these are initially low. The serum response
Bioavailability of Nutrients 405

to b-carotene is higher in women than in men; however, this Phytate and polyphenols in plant-based diets are the main
could in part be attributed to differences in body weight and inhibitors of nonheme iron absorption. The negative effect of
composition. Intestinal helminthic infections are associated phytate on iron bioavailability is dose-dependent, and any
with malnutrition, which may be mediated through impaired food processing and preparation methods, such as milling,
fat absorption and reduced vitamin absorption, particularly of heating, soaking, germination, and fermentation, which
vitamin A. degrade phytate to varying extents, will have a positive effect
on iron absorption. Controversies exist on the inhibitory effect
of oxalic acid in spinach and cabbage and nondigestible car-
Iron
bohydrates in beans on iron absorption, as these foods are also
Minerals (and other nutrients) exist in different chemical forms good sources of ascorbic acid, which enhances iron absorption.
in food, which can influence bioavailability. Iron is a classic Calcium and dairy products have also been shown to have a
example: there are two primary forms of dietary iron, namely, negative effect on nonheme iron absorption, but what separates
heme and nonheme. The former is only found in animal these from other inhibitors is the ability to also inhibit heme
products, such as red meat, fish, and poultry. The heme iron iron absorption. Single-meal studies show a negative effect of
content of animal sourced foods is estimated at 40% of the calcium on iron absorption, but multimeal studies, with a vari-
total iron, but data suggest that a portion of red meat provides ety of other inhibitors and enhancers, indicate calcium has only
considerably more heme iron than a portion of white fish, for limited impact on iron absorption. In a recent study, the two
example. Heme iron is a component from hemoglobin and major milk protein fraction (casein and whey) and egg protein
myoglobin (see Figure 3), which explains why it is only found (albumin) were reported to have a negative effect on iron
in animal tissue. Nonheme iron is found mostly in plant-based absorption in humans. Although phytate has been shown to
foods and makes up the remaining estimated 60% of iron be the major inhibitor in soy, even after complete phytate
found in animal products. digestion in soy protein isolates, significant inhibition of iron
The types of iron (heme or nonheme) notably influence absorption can be observed. Thus, in soy, it was concluded that
bioavailability. Approximately 90% of dietary iron is con- both phytate and a protein fraction inhibit iron absorption.
sumed in the nonheme form. However, due to low bioavail- Ascorbic acid has been shown convincingly to enhance iron
ability, it constitutes only approximately half the iron absorbed bioavailability in a dose-dependent manner. This effect is
by the body. The absorption of nonheme iron is usually much largely due to its ability to reduce ferric to ferrous iron. Ascorbic
lower than heme iron. In general, the rate of nonheme iron acid has also been shown, at least partially, to counteract the
absorption is related to its solubility in the upper part of the inhibitory effects of both phytate and polyphenols on non-
small intestine. The presence of soluble enhancers, such as heme iron absorption.
ascorbic acid, and inhibitors, such as phytates, polyphenols, Small amounts of meat are recognized to enhance the
and calcium, consumed in the same meal will have a notable absorption of nonheme iron from plant foods, although the
effect on the amount of nonheme iron absorbed. Heme iron is mechanism(s) is unknown. Studies also support the enhancing
much less affected by other dietary factors and contributes effect of cysteine-containing peptides following the proteolysis
more significantly to absorbable iron. of meat muscle.
Vitamin A and b-carotene can enhance nonheme iron
Inhibitors and enhancers of iron bioavailability absorption and increase hemoglobin levels, although several
Nonheme iron that enters the common iron pool in the diges- studies suggest this is only observed in iron-deficient individ-
tive tract is absorbed to the same extent, depending on the uals. Host-related factors that influence the absorption of heme
balance between inhibitors and enhancers and the iron status and nonheme iron include mainly iron status, other nutritional
of the individuals. deficiencies, infection, genetic disorders, and physiological state.
As with inhibitors and enhancers, the iron status of an
individual mainly influences the absorption of nonheme
OH
iron, while heme iron absorption is less affected. There is an
O inverse relationship between iron status and iron absorption.
Protein–energy malnutrition, riboflavin, and vitamin A defi-
CH3 ciencies have also been shown to impair iron metabolism and
absorption; correction of these nutritional deficiencies will
O
improve iron absorption.
N CH3 Iron deficiency often coexists in a burden of disease in
HO
seemingly well-fed, overweight populations, due in part to
N- Fe2+ N-
CH2 iron absorption being reduced by the peptide, hepcidin. Hep-
H3C N cidin is a regulatory hormone secreted by the liver, which
inhibits iron absorption. It secretion is increased in chronic
inflammation and obesity.
CH3 Achlorhydria might also be a substantial cause of iron
deficiency, mainly in elderly people, among whom atrophic
CH2
gastritis is common and gastric acid secretion is low. Gastric
Figure 3 Chemical structure of heme iron as found in food from animal acid is needed to maintain ferric iron in solution and make it
sources. bioavailable. However, heme iron does not appear to be
406 Bioavailability of Nutrients

affected by the lack of acid and is normally absorbed in indi- Dary O and Mora JO (2002) Food fortification to reduce vitamin a deficiency:
viduals with atrophic gastritis. international Vitamin A consultative group recommendations. Journal of Nutrition
132: 2927S–2933S.
Other common causes of reduced iron absorption and/or
De Pee S, West CE, Permaesih D, Martuti S, Muhilal, and Hautvast JGAJ (1998) Orange
iron deficiency are mucosal atrophy in celiac disease and, fruit is more effective than are dark-green leafy vegetables in increasing serum
possibly, Helicobacter pylori infection, although no consensus concentrations of retinol and ß-carotene in schoolchildren in Indonesia. American
has been reached. For further reading on iron bioavailability, Journal of Clinical Nutrition 68: 1058–1067.
refer to Heath and Fairweather-Tait (2002), Zimmermann and 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
Hurrell (2007), and Hurrell and Egli (2010). 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.
Conclusions Harrison EH (2012) Mechanisms involved in the intestinal absorption of dietary
vitamin A and provitamin A carotenoids. Biochimica et Biophysica Acta
Nutrients react differently once ingested and absorption can be 1821: 70–77.
Haskell MJ (2012) The challenge to reach nutritional adequacy for vitamin A: ß-carotene
influenced by a variety of factors, including quality of the food
bioavailability and conversion – evidence in humans. American Journal of Clinical
source and the matrix in which it is consumed; the composi- Nutrition 96(Suppl): 1193S–1203S.
tion of the whole meal, inhibitors, and enhancers; and the Heath A-L and Fairweather-Tait SJ (2002) Clinical implications of changes in the
status of the host. Although bioavailability is only a partial modern diet: iron intake, absorption and status. Best Practice & Research. Clinical
measure of the benefit from a nutrient, this factor quantifies Haematology 15(2): 225–241.
Hurrell R and Egli I (2010) Iron bioavailability and dietary reference values. American
the amount entering the bloodstream. Once in the blood- Journal of Clinical Nutrition 91(Suppl): 1461S–1467S.
stream, the nutrient must cross cell membranes before it can Millward DJ, Layman DK, Tomé D, and Schaafsma G (2008) Protein quality
nourish cells. In addition to nutrient content of foods, nutrient assessment: impact of understanding of protein and amino acid needs for
bioavailability should also be taken into consideration when optimal health. American Journal of Clinical Nutrition 87(Suppl):
1576S–1581S.
nutrition-sensitive policies, nutrition interventions, and die-
Otten JJ, Hellwig JP, and Meyers LD (2006) Dietary reference intakes: the essential
tary guidelines are developed. However, it should be noted guide to nutrient requirements. Washington: Institute of Medicine, ISBN 0-309-
that bioavailability is not a constant value and needs to be 10091-7.
considered with caution in the context of multiple factors, Packer L, Kraemer K, Obermüller-Jevic U, and Sies H (eds.) (2005) Carotenoids and
both intrinsic and extrinsic, which can affect the bioavailability retinoids: molecular aspects and health issues Illinois: AOCS Press.
van het Hof KH, West CE, Weststrate JA, and Hauvast JGAJ (2000) Dietary factors
from food- and nonfood sources of nutrients. that affect the bioavailability of carotenoids. Journal of Nutrition 130(3):
503–506.
Yeum KJ and Russell RM (2002) Carotenoids bioavailability and bioconversion. Annual
See also: Amino Acids: Metabolism; Ascorbic Acid: Physiology and Review of Nutrition 22: 483–504.
Health Effects; Carotenoids: Occurrence, Properties and Determination; Zimmermann MB and Hurrell RF (2007) Nutritional iron deficiency. Lancet
Carotenoids: Physiology; Iron: Biosynthesis and Significance of Heme; 370: 511–520.
Protein: Digestion, Absorption and Metabolism; Retinol: Physiology;
Retinol: Properties and Determination.

Relevant Websites
Further Reading http://www.eufic.org/article/en/artid/Nutrient-bioavailability-food/ – European Food
Information Council.
Castenmiller JJM and West CE (1998) Bioavailability and bioconversion of carotenoids. http://www.fao.org – Food and Agricultural Organization of the United Nations .
Annual Review of Nutrition 18: 19–38. http://www.harvestplus.org – HarvestPlus.
Castenmiller JJM, West CE, Linssen JPH, van het Hof KH, and Voragen AGJ (1999) The http://www.ifpri.org – International Food Policy Research Institute.
food matrix of spinach is a limiting factor in determining the bioavailability of ß-carotene http://www.usda.gov – United States Department of Agriculture.
and to a lesser extent of lutein in humans. Journal of Nutrition 129: 349–355. http://www.who.org – World Health Organization.

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