Iron-deficiency Clinical Trial
Official title:
Effect of Prebiotics on Iron Absorption in Women With Low Iron Stores
Rationale:
According to the WHO, iron deficiency is still the most common and widespread nutritional
disorder in the world. Current iron supplements have limitations in terms of bioavailability
and tolerability. Prebiotic fibers, such as galacto-oligosaccharides (GOS), selectively
enhance growth of beneficial colonic bacteria. Prebiotics in general enhance the production
of short-chain fatty acids (SCFAs) and thereby decrease luminal pH. Through the reduction in
colonic pH, prebiotics can enhance absorption of minerals such as calcium and magnesium and
they have been proposed to potentially improve iron absorption as well.
The primary objective of this study is to investigate the effect of an addition of GOS to an
iron supplement on iron absorption in iron deplete, healthy, normal weight women.
Iron deficiency is still the most common and widespread nutritional disorder in the world
according to WHO. It does not only affect large numbers of women and children in the
developing world, but also in industrialized countries. The current estimation is that 2
billion people, or around 30% of the world's population, are anemic, of which around 50% is
caused by iron deficiency. In industrialized countries, ID remains a public health concern in
young women, affecting 16% of females between the ages of 12-49y in the United states.
Iron supplementation has been recommended by the WHO as an approach to improve iron status in
varying age and risk groups. Iron supplementation can be practical for high-risk groups such
as pregnant women and has been proven effective for increasing hemoglobin levels in women.
However, iron absorption from supplements is generally low and epigastric side effects reduce
compliance. With the high global burden of iron deficiency and anemia, improved products
which allow better absorption and reduce side effects are urgently needed.
Targeted iron supplementation in high risk groups is the preferred way to treat iron
deficiency. However, the recommendation is to consume iron supplements away from food in
order to increase bioavailability which often causes nausea and epigastric pain and thus
reduces compliance. Taken together with food, bioavailability of most supplements is reduced
by about two thirds. Thus, a lot of unabsorbed iron passes into the colon where it can
increase the abundance of enteropathogens.
Prebiotic fibers, such as galacto-oligosaccharides (GOS), selectively enhance growth of
beneficial colonic bacteria. GOS are enzymatically produced from lactose and are a mixture of
glucose- and galactose- based di- and oligosaccharides of varying structure and seem to have
an increased selectivity towards Bifidobacterium spp compared to other prebiotics. Prebiotics
in general enhance the production of short-chain fatty acids (SCFAs) and thereby decrease
luminal pH, which may reduce growth of enteropathogens. Through the reduction in colonic pH,
prebiotics can enhance absorption of minerals such as calcium and magnesium and they have
been proposed to potentially improve iron absorption, by reducing ferric to ferrous iron in
the colon. Even though colonic absorption is minimal compared to absorption in the duodenum
in healthy humans, it may become more important in iron deficiency or anemia as demonstrated
in animal studies.
The primary objective of this study is to investigate the effect of an addition of GOS to an
iron supplement on iron absorption in iron deplete, healthy, normal weight women.
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