Iron deficiency anemia: A comprehensive review on iron absorption, bioavailability and emerging food fortification approaches

Anemia, a morbid condition, is a global concern that affects people of all age groups. This scenario has attracted the attention of several government organizations for implementing strict regulations to provide nutritional security. Iron fortification and supplementation has been in practice from the past decades. However, there is a need for determining an effective strategy to address this rising concern among the vulnerable population. Among the existing approaches, iron fortification of foods remains to be cheaper and effective in targeting large-scale population without the intervention of pharmaceutical drugs. The key challenge is the bioavailability of iron from fortified foods. Thus, this work presents a comprehensive review of morbidities of anemia, causes, the significance of haem and non-haem iron, absorption, and bioavailability, in context with different iron fortification approaches. Apart from the nutritional deficit, anemia is also associated with a sedentary lifestyle linked with obesity and diabetes. The complex interaction of elemental iron and its physiology have been highlighted in consideration with potential iron enhancers and inhibitors. It was found that the incorporation of haem iron would complement the effectiveness of non-haem iron through fortification. Several iron fortification techniques focused on combating iron deficiency have been described. Food fortification is a promising strategy for reducing the prevalence of anemia. Food vehicles must be designed considering its synergistic effects with iron complexes for effective absorption and bioavailability. However, the scalability, cost economics, safety concerns and acceptability of the iron-fortified foods remain as constraints that have to be addressed. Further, the application of novel food processing techniques with food fortification can result in the emergence of novel approaches for addressing iron deficiency and anemia.