I have been concerned about iron intake because of the high incidence of iron deficiency in Aboriginal children in our area. After reading Stanley Zlotkin's article,1 I thought it might be a good idea to recommend that parents start giving their children Cheerios (General Mills) on a regular basis. According to Table 4 of Zlotkin's article1 this breakfast cereal has 8.1 mg of iron in a 30-g serving, which is almost 100% of the recommended dietary allowance (RDA) of this mineral (as illustrated in Table 2 of the same article). I then went to my own children's cereal cupboard, where I found a box of Shreddies (Post, division of Kraft Foods); the side panel of the box stated that there was 29% of the RDA of iron in a 30-g serving. These numbers were very encouraging, especially given Zlotkin's strong endorsement of these ready-to-eat cereals.1
Unfortunately, it all sounded too good to be true. Many of my pediatric patients are already eating Count Chocula (General Mills), which has a stated 45% of the iron RDA per 30-g serving, or similar cereals, yet they are still anemic. A quick check in a standard nutritional text2 revealed that the form of iron that is typically added to cereals is poorly absorbed. Flour and cereals are “fortified” with finely powdered metallic iron, which must be oxidized to ferric (trivalent) iron and then reduced to ferrous (divalent) iron before it can be absorbed in the gastrointestinal tract. The food industry is well aware that this added iron is poorly absorbed.2 I would be interested in Zlotkin's comments on the bioavailability of iron in flour and cereals.
John O'Brien Family Physician Tofino, BC
Footnotes
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Competing interests: None declared.