Effect of probiotic and prebiotics supplementation on hemoglobin levels and iron absorption among women of reproductive age and children: a systematic review and meta-analysis.
Study Goal
The researchers aimed to assess whether oral administration of prebiotics (and/or probiotics) improves intestinal iron absorption, hemoglobin, and ferritin levels in children and women of reproductive age.
Results Summary
Prebiotics/probiotics showed a modest improvement in iron absorption and ferritin levels in women but no significant effect on hemoglobin levels in women or children. The evidence for these effects varied from low to moderate certainty.
Population
Children and women of reproductive age (WRA).
Effective Dosage
Major interventions included galacto-oligosaccharide, inulin, and specific probiotic strains (e.g., Lactobacillus plantarum 299v, Lactobacillus reuteri, Lactobacillus acidophilus), but exact dosages were not specified.
Duration
Not specified in the abstract.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
oral administration of probiotics and/or prebiotics | increase | intestinal iron absorption, hemoglobin, and ferritin levels | children and women of reproductive age (WRA) | - | improve | #1 |
prebiotics and/or probiotics with or without iron | no change | hemoglobin | WRA | - | associated with little or no effect | #2 |
prebiotics and/or probiotics with or without iron | increase | fractional absorption of iron | - | mean increase 0.74%, 95%CI-0.11-1.38, p = 0.02 | led to improvement | #3 |
prebiotics and/or probiotics with or without iron | increase | ferritin levels | WRA | mean increase 2.45 ng/ml, 95% CI 0.61-4.3, p = 0.009, n = 320 | led to a significant increase | #4 |
prebiotics and/or probiotics with or without iron | no change | hemoglobin, ferritin and fractional iron absorption | children | - | did not result in any significant change | #5 |
prebiotics or probiotics (especially Lp299v and GOS) with or without oral iron | increase | iron absorption | women | - | can improve | #6 |
prebiotics or probiotics (especially Lp299v and GOS) with or without oral iron | increase | ferritin levels | women | - | lead to improvement | #7 |
prebiotics or probiotics (especially Lp299v and GOS) with or without oral iron | no change | hemoglobin levels | women and children | - | does not conclusively show the benefit | #8 |
BACKGROUND: This review aims to assess the effect of oral administration of probiotics and/or prebiotics in children and women of reproductive age (WRA) to improve intestinal iron absorption, hemoglobin, and ferritin levels. METHODS: Randomized controlled trials from published literature on probiotics and or prebiotics for prevention or treatment of anemia as a supplement or fortification in children or WRA till Jan 31, 2023, were included. Studies on probiotics and prebiotics in patients with anemia due to other causes were excluded. Screening and data extraction was done using Distiller SR and meta-analysis was performed using Revman 5.4.1. RESULTS: A total of 1925 records were identified from Pubmed, Embase, and Cochrane, of which 29 were included in the systematic review (14 supplementation and 15 fortification studies; 15 studies in children and 14 studies in WRA). The major interventions included galacto-oligosaccharide, inulin, heat-killed H61, Lactobacillus plantarum 299v, Lactobacillus reuteri, Lactobacillus acidophilus. Meta-analysis of 5 studies in WRA showed that the use of prebiotics and/or probiotics with or without iron was associated with little or no effect on hemoglobin. However, there is low certainty of evidence that the intervention led to improvement in fractional absorption of iron as compared to placebo or iron [8 studies, n = 335, mean increase 0.74%, 95%CI-0.11-1.38, p = 0.02]. Meta-analysis of 6 studies in WRA using prebiotics and/or probiotics with or without iron led to a significant increase in ferritin levels in WRA (mean increase 2.45 ng/ml, 95% CI 0.61-4.3, p = 0.009, n = 320) [Moderate certainty of evidence]. In children, meta-analysis of up to 8 studies did not result in any significant change in hemoglobin, ferritin and fractional iron absorption [low or very low certainty of evidence]. CONCLUSION: There is some evidence to show that the use of prebiotics or probiotics (especially Lp299v and GOS) with or without oral iron can improve iron absorption in women and lead to improvement in ferritin levels in women. However, the current evidence does not conclusively show the benefit of these interventions in improving hemoglobin levels in women and children.