Nutritional Strategies for Managing Iron Deficiency in Adolescents: Approaches to a Challenging but Common Problem.
Study Goal
The researchers aimed to evaluate the prevention, recognition, and treatment of iron deficiency (ID) in adolescents, focusing on dietary habits, risk factors, and therapeutic approaches.
Results Summary
The study found that oral iron supplementation is effective for treating ID, with recommendations for once-daily dosing and avoidance of inhibitors. Intravenous iron is safe and effective for persistent ID, severe anemia, or chronic inflammatory conditions.
Population
Adolescents, particularly those with vegetarian/vegan diets, disordered eating, excessive menstrual blood loss, chronic health conditions, or athletic involvement.
Effective Dosage
Oral iron once daily, preferably in the morning; intravenous iron for specific cases (dosage not specified).
Duration
≥3 months for oral iron therapy.
Interactions
Avoid foods and drinks that inhibit iron absorption.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
plant-based, nonheme iron | decrease | bioavailability | Adolescents following vegetarian or vegan diets | - | has decreased bioavailability | #1 |
plant-based, nonheme iron | increase | total iron intake | Adolescents following vegetarian or vegan diets | - | requires increased total iron intake | #2 |
oral iron supplementation | neutral | Iron deficiency | - | - | is typically treated with | #3 |
oral iron therapy | increase | ferritin | in the setting of ID | 20 ng/mL | should be provided for ≥3 mo | #4 |
Intravenous iron | neutral | efficacy and safety | adolescents | - | has demonstrated efficacy and safety | #5 |
Iron deficiency (ID) is a common and challenging problem in adolescence. In order to prevent, recognize, and treat ID in this age range, it is critical to understand the recommended daily intake of iron in relation to an adolescent's activity, dietary habits, and basal iron losses. Adolescents following vegetarian or vegan diets exclusively rely on plant-based, nonheme iron, which has decreased bioavailability compared with heme iron and requires increased total iron intake. Individuals with disordered eating habits, excessive menstrual blood loss, and certain chronic health conditions (including inflammatory bowel disease and heart failure) are at high risk of ID and the development of symptomatic iron deficiency anemia (IDA). Adolescent athletes and those with sleep and movement disorders may also be more sensitive to changes in iron status. Iron deficiency is typically treated with oral iron supplementation. To maximize iron absorption, oral iron should be administered no more than once daily, ideally in the morning, while avoiding foods and drinks that inhibit iron absorption. Oral iron therapy should be provided for ≥3 mo in the setting of ID to reach a ferritin of 20 ng/mL before discontinuation. Intravenous iron is being increasingly used in this population and has demonstrated efficacy and safety in adolescents. It should be considered in those with persistent ID despite a course of oral iron, severe and/or symptomatic IDA, and chronic inflammatory conditions characterized by decreased gastrointestinal iron absorption.