Healthy Clinical Trial
Official title:
Can Prebiotics Support the Treatment of Mild Iron Deficiency by Iron Supplementation
The first aim of this study is to investigate if daily administration of the prebiotic Synergy-1 (a commercial product consisting of oligofructose-enriched inulin) together with a common iron supplement (ferrous sulphate) during 4 weeks, in premenopausal non-anaemic women with low ferritin levels, would mitigate the adverse effects of iron on the gut microbiota. The estimated absorption rate of the ferrous salts is 10-15%, therefore the unabsorbed iron will reach the colon where it could stimulate growth of non-beneficial bacterial species in the intestinal environment. By contrast, prebiotics function by specifically supporting growth of the typically-beneficial microorganism such as bifidobacteria. Inulin-type fructans (ITF) are well recognised in this way. The hypothesis to be tested is that prebiotic consumption will lead to a beneficial shift in the microbiota helping against the dysbiosis associated with iron supplementation.
This will be a crossover, placebo controlled, and randomised pilot study in 15 pre-menopausal
female individuals with ferritin levels below 40 mcg/l but normal hemoglobin (Hb) and C
reactive protein (CRP). The study will last 12 weeks and consist of two separated 4-week
randomised intervention treatment periods with a prebiotic (Synergy-1) or placebo
(Maltodextrin) in combination with an iron supplement (FeSO4) separated by a 4-week wash-out
period. Volunteers will take daily doses of an iron supplement and a prebiotic (Synergy-1) or
placebo (Maltodextrin) during the trial excepting in the washout period where the iron
supplement and prebiotic/placebo treatments will be discontinued.
This trial will investigate the effects of an iron supplement treatment in combination with a
prebiotic food supplement or placebo food supplement. Participants will be required to take
one daily tablet of a generic, iron supplement (200 mg FeSO4 equivalent to 65 mg iron)
(provided by pharmacy). In addition, participants will be required to take one of the
products (prebiotic or placebo) daily at the same time each day. The prebiotic food
supplement (supplied by the Beneo company) is a chicory inulin powder produced in Belgium. It
has been used in scores of human intervention studies with no adverse effects. Participants
will be required to take one 7 g sachet of prebiotic food supplement daily. This will be
reconstituted with water and participants will be encouraged to take the sachet at the same
time each day. The placebo control food supplement will be maltodextrin. Maltodextrin is a
standard placebo product for use in human studies involving prebiotics and has been used
safely at this dose, in many trials by ourselves for the last 20 years. The products will be
provided as a powder (served in sachets) and identical in texture and appearance. The Beneo
company will produce and provide barcoded sachets, blinded to the investigators and
volunteers. After all volunteers have completed their study visits and all samples have been
analysed by researchers, Beneo will provide information about barcoded sachets. Compliance to
food supplement (prebiotic or placebo) will be assessed by recording intake in
gastrointestinal (GI) diaries and participants will also be asked to return any unused
sachets to the researchers at the end of the each 4-week intervention periods. For
participants to be considered compliant and therefore included in the study, they will be
required to take the food supplement or placebo at least 6 out of every 7 days of the trial
for the week period and return completed questionnaires.
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