Sensitivity analyses and meta-regression for hemoglobin suggested a higher response with lower trial quality ( suboptimal allocation concealment and blinding ) , use of condiments , and sodium iron edetate and a lower response when adults were included .
Consumption of iron-fortified foods results in an improvement in hemoglobin , serum ferritin , and iron nutriture and a reduced risk of remaining anemic and iron deficient
BACKGROUND The utility of iron fortification of food to improve iron deficiency , anemia , and biological outcomes is not proven unequivocally .
The effects of iron fortification on the gut microbiota in African children: a randomized controlled trial in Cote d'Ivoire.
BACKGROUND Iron is essential for the growth and virulence of many pathogenic enterobacteria , whereas beneficial barrier bacteria , such as lactobacilli , do not require iron . Thus , increasing colonic iron could select gut microbiota for humans that are unfavorable to the host . OBJECTIVE The objective was to determine the effect of iron fortification on  gut microbiota and gut inflammation in African children . DESIGN In a 6-mo , r and omized , double-blind , controlled trial , 6 - 14-y-old Ivorian children ( n = 139 ) received iron-fortified biscuits , which contained 20 mg Fe/d , 4 times/wk as electrolytic iron or nonfortifoed biscuits . We measured changes in hemoglobin concentrations , inflammation , iron status , helminths , diarrhea , fecal calprotectin concentrations , and microbiota diversity and composition ( n = 60 ) and the prevalence of selected enteropathogens . RESULTS At baseline , there were greater numbers of fecal enterobacteria than of lactobacilli and bifidobacteria ( P < 0.02 ) . Iron fortification was ineffective ; there were no differences in iron status , anemia , or hookworm prevalence at 6 mo . The fecal microbiota was modified by iron fortification as shown by a significant increase in profile dissimilarity ( P < 0.0001 ) in the iron group as compared with the control group . There was a significant increase in the number of enterobacteria ( P < 0.005 ) and a decrease in lactobacilli ( P < 0.0001 ) in the iron group after 6 mo . In the iron group , there was an increase in the mean fecal calprotectin concentration ( P < 0.01 ) , which is a marker of gut inflammation , that correlated with the increase in fecal enterobacteria ( P < 0.05 ) . CONCLUSIONS Anemic African children carry an unfavorable ratio of fecal enterobacteria to bifidobacteria and lactobacilli , which is increased by iron fortification . Thus , iron fortification in this population produces a potentially more pathogenic gut microbiota profile , and this profile is associated with increased gut inflammation . This trial was registered at controlled-trials.com as IS RCT N21782274
Sensitivity analyses and meta-regression for hemoglobin suggested a higher response with lower trial quality ( suboptimal allocation concealment and blinding ) , use of condiments , and sodium iron edetate and a lower response when adults were included .
Consumption of iron-fortified foods results in an improvement in hemoglobin , serum ferritin , and iron nutriture and a reduced risk of remaining anemic and iron deficient
BACKGROUND The utility of iron fortification of food to improve iron deficiency , anemia , and biological outcomes is not proven unequivocally .