Professional Documents
Culture Documents
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 CH3 CH3
H3C
CH3
CH3 CH3 CH3
CH3
b-Carotene
H3C
H3C CH3 CH3 H3C
H3C OH
H3C CH3 CH3 CH3
H3C OH
H3C CH3 CH3 CH3
H3C OH
H3C CH3 CH3 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.