Daniela Paganini 1 , Mary A Uyoga 2 , Guus A M Kortman 3 , Colin I Cercamondi 1 , Diego Moretti 1 , Tanja Barth-Jaeggi 4 , Clarissa Schwab 1 , Jos Boekhorst 3 , Harro M Timmerman 3 , Christophe Lacroix 1 , Simon Karanja 2 , Michael B Zimmermann 1 Show Affiliations »
Abstract
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OBJECTIVE: Iron-containing micronutrient powders (MNPs ) reduce anaemia in African infants , but the current high iron dose (12.5 mg/day) may decrease gut Bifidobacteriaceae and Lactobacillaceae, and increase enteropathogens, diarrhoea and respiratory tract infections (RTIs ). We evaluated the efficacy and safety of a new MNP formula with prebiotic galacto-oligosaccharides (GOS) combined with a low dose (5 mg/day) of highly bioavailable iron . DESIGN: In a 4-month, controlled, double-blind trial, we randomised Kenyan infants aged 6.5-9.5 months (n=155) to receive daily (1) a MNP without iron (control); (2) the identical MNP but with 5 mg iron (2.5 mg as sodium iron ethylenediaminetetraacetate and 2.5 mg as ferrous fumarate ) (Fe group); or (3) the identical MNP as the Fe group but with 7.5 g GOS (FeGOS group). RESULTS: Anaemia decreased by ≈50% in the Fe and FeGOS groups (p<0.001). Compared with the control or FeGOS group, in the Fe group there were (1) lower abundances of Bifidobacterium and Lactobacillus and higher abundances of Clostridiales (p<0.01); (2) higher abundances of virulence and toxin genes (VTGs) of pathogens (p<0.01); (3 ) higher plasma intestinal fatty acid-binding protein (a biomarker of enterocyte damage) (p<0.05); and (4) a higher incidence of treated RTIs (p<0.05). In contrast, there were no significant differences in these variables comparing the control and FeGOS groups, with the exception that the abundance of VTGs of all pathogens was significantly lower in the FeGOS group compared with the control and Fe groups (p<0.01). CONCLUSION: A MNP containing a low dose of highly bioavailable iron reduces anaemia , and the addition of GOS mitigates most of the adverse effects of iron on the gut microbiome and morbidity in African infants . TRIAL REGISTRATION NUMBER: NCT02118402. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
RCT Entities: Population
Interventions
Outcomes
OBJECTIVE: Iron -containing micronutrient powders (MNPs) reduce anaemia in African infants , but the current high iron dose (12.5 mg/day) may decrease gut Bifidobacteriaceae and Lactobacillaceae, and increase enteropathogens, diarrhoea and respiratory tract infections (RTIs). We evaluated the efficacy and safety of a new MNP formula with prebiotic galacto-oligosaccharides (GOS ) combined with a low dose (5 mg/day) of highly bioavailable iron . DESIGN: In a 4-month, controlled, double-blind trial, we randomised Kenyan infants aged 6.5-9.5 months (n=155) to receive daily (1) a MNP without iron (control); (2) the identical MNP but with 5 mg iron (2.5 mg as sodium iron ethylenediaminetetraacetate and 2.5 mg as ferrous fumarate ) (Fe group); or (3) the identical MNP as the Fe group but with 7.5 g GOS (Fe GOS group). RESULTS: Anaemia decreased by ≈50% in the Fe and Fe GOS groups (p<0.001). Compared with the control or Fe GOS group, in the Fe group there were (1) lower abundances of Bifidobacterium and Lactobacillus and higher abundances of Clostridiales (p<0.01); (2) higher abundances of virulence and toxin genes (VTGs) of pathogens (p<0.01); (3) higher plasma intestinal fatty acid-binding protein (a biomarker of enterocyte damage) (p<0.05); and (4) a higher incidence of treated RTIs (p<0.05). In contrast, there were no significant differences in these variables comparing the control and Fe GOS groups, with the exception that the abundance of VTGs of all pathogens was significantly lower in the Fe GOS group compared with the control and Fe groups (p<0.01). CONCLUSION: A MNP containing a low dose of highly bioavailable iron reduces anaemia , and the addition of GOS mitigates most of the adverse effects of iron on the gut microbiome and morbidity in African infants . TRIAL REGISTRATION NUMBER: NCT02118402. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Entities: Chemical
Disease
Species
Keywords:
anemia; diarrhea; enteric pathogens; gut; infancy; iron deficiency; kenya; microbiome; micronutrient powder; prebiotic
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Year: 2017
PMID： 28774885 DOI： 10.1136/gutjnl-2017-314418
Source DB: PubMed Journal: Gut ISSN： 0017-5749 Impact factor: 23.059