No Difference Between Iron Supplementation Only and Iron Supplementation with Synbiotic Fermented Milk on Iron Status, Growth, and Gut Microbiota Profile in Elementary School Children with Iron Deficiency

Author(s): Siti Helmyati*, Endang Sutriswati Rahayu, Bernadette Josephine Istiti Kandarina, Mohammad Juffrie

Journal Name: Current Nutrition & Food Science

Volume 16 , Issue 2 , 2020

Become EABM
Become Reviewer

Graphical Abstract:


Abstract:

Background: Iron deficiency may inhibit the height increase and weight gain of children. On the other hand, the supplementation of iron causes gut microbiota imbalance which leads to inflammation and diarrhea. The addition of synbiotic fermented milk is expected to have beneficial effects on iron supplementation. This study aimed to determine the effects of iron supplementation only and its administration with synbiotic fermented milk on iron status, body height and weight, and gut microbiota profile of iron deficient elementary school children.

Methods: This research was an experimental study with pre and post test conducted on 59 irondeficient children. Subjects were given iron supplementation in syrups (IS group) or given iron supplementation in syrup with fermented milk (containing synbiotic Lactobacillus plantarum Dad 13 and fructo-oligosaccharide) (ISFM group) for 3 months. The body weight and height, hemoglobin and serum ferritin levels, and total number of Lactobacilli, Enterobacteria, Bifidobacteria, and Escherichia coli were measured at the beginning and the end of the study.

Results: The body height in the ISFM group increased significantly than that in IS group after the intervention (1.67 vs. 2.42, p<0.05). The hemoglobin and serum ferritin levels in IS and ISFM groups were improved significantly (p<0.05) although the difference between the two groups was not significant (p>0.05). The results showed no significant difference of gut microbiota profile between the IS and ISFM groups (p>0.05).

Conclusion: There is no difference on the iron status, height, weight, and gut microbiota profile of iron-deficient primary school children received iron supplementation only or iron supplementation with synbiotic fermented milk.

Keywords: Child growth, fermented milk, gut microbiota, iron deficiency, iron supplementation, synbiotic.

[1]
Rahbar A, Hajian A. On the prevalence of iron deficiency in children and adolescents with growth retardation. Biosci Biotech Res Comm 2017; 10: 592-6.
[http://dx.doi.org/10.21786/bbrc/10.3/38]
[2]
Stoltzfus RJ. Iron deficiency: Global prevalence and consequences. Food Nutr Bull 2003; 24(4): S99-S103.
[http://dx.doi.org/10.1177/15648265030244S206] [PMID: 17016951]
[3]
Burke RM, Leon JS, Suchdev PS. Identification, prevention and treatment of iron deficiency during the first 1000 days. Nutrients 2014; 6(10): 4093-114.
[http://dx.doi.org/10.3390/nu6104093] [PMID: 25310252]
[4]
Ministry of Health of Republic Indonesia. Basic health research 2013.
[5]
Widjaja IR, Widjaja FF, Santoso LA, Wonggokusuma E. Anemia among children and adolescents in a rural area. Paediatr Indones 2014; 54: 88-93.
[http://dx.doi.org/10.14238/pi54.2.2014.88-93]
[6]
Motadi SA, Mbhenyane XG, Mbhatsani HV, Mabapa NS, Mamabolo RL. Prevalence of iron and zinc deficiencies among preschool children ages 3 to 5y in Vhembe district, Limpopo province, South Africa. Nutrition 2015; 31(3): 452-8.
[http://dx.doi.org/10.1016/j.nut.2014.09.016] [PMID: 25701334]
[7]
Yip R. Iron deficiency. Bull World Health Organ 1998; 76(Suppl. 2): 121-3.
[PMID: 10063687]
[8]
Zimmermann MB, Chassard C, Rohner F, et al. The effects of iron fortification on the gut microbiota in African children: a randomized controlled trial in Cote d’Ivoire. Am J Clin Nutr 2010; 92(6): 1406-15.
[http://dx.doi.org/10.3945/ajcn.110.004564] [PMID: 20962160]
[9]
World Health Organization. Strategies to prevent anaemia: recommendations from an expert group consultation World Heal Organ. Geneva 2016.
[10]
Helmyati S, Juffrie M, Rahayu ES, Kandarina BJI. A comparative study of gut microbiota profiles of children living in Kulon Progo and West Lombok. Pak J Nutr 2015; 14: 762-4.
[http://dx.doi.org/10.3923/pjn.2015.762.764]
[11]
Paganini D, Uyoga MA, Zimmermann MB. Iron fortification of foods for infants and children in low-income countries: effects on the gut microbiome, gut inflammation, and diarrhea. Nutrients 2016; 8(8): 1-6.
[http://dx.doi.org/10.3390/nu8080494] [PMID: 27529276]
[12]
Yeung CK, Glahn RP, Welch RM, Miller DD. Prebiotics and iron bioavailability - Is there a connection? J Food Sci 2005; 70: R88-92.
[http://dx.doi.org/10.1111/j.1365-2621.2005.tb09984.x]
[13]
Roberfroid MB. Prebiotics and probiotics: are they functional foods? Am J Clin Nutr 2000; 71(6)(Suppl.): 1682S-7S.
[http://dx.doi.org/10.1093/ajcn/71.6.1682S] [PMID: 10837317]
[14]
Pandey KR, Naik SR, Vakil BV. Probiotics, prebiotics and synbiotics- A review. J Food Sci Technol 2015; 52(12): 7577-87.
[http://dx.doi.org/10.1007/s13197-015-1921-1] [PMID: 26604335]
[15]
Toi M, Hirota S, Tomotaki A, et al. Probiotic beverage with soy isoflavone consumption for breast cancer prevention: a case-control study. Curr Nutr Food Sci 2013; 9(3): 194-200.
[http://dx.doi.org/10.2174/15734013113099990001] [PMID: 23966890]
[16]
Helmyati S, Sudargo T, Kandarina I, et al. Tempeh extract fortified with iron and synbiotic as a strategy against anemia. Int Food Res J 2016; 23: 2296-9.
[17]
Food Safety and Standards Authority of India. Manual of methods of analysis of foods. India: Ministry of Health and Family Welfare 2012.
[18]
Helmyati S. Effectivity test of the addition of synbiotic fermented milk on iron supplementation and fortification among iron-deficient childrean towards gut microbiota balance 2015.
[19]
Utami T, Harmayani E, Rahayu ES. Survival of Lactobacillus plantarum Dad 13 during spray drying and its application for yoghurt fermentation. Int Res J Biol Sci 2016; 5: 16-22.
[20]
Bering S, Suchdev S, Sjøltov L, Berggren A, Tetens I, Bukhave K. A lactic acid-fermented oat gruel increases non-haem iron absorption from a phytate-rich meal in healthy women of childbearing age. Br J Nutr 2006; 96(1): 80-5.
[http://dx.doi.org/10.1079/BJN20061683] [PMID: 16869994]
[21]
Rao RK, Samak G. Protection and restitution of gut barrier by probiotics: nutritional and clinical implications. Curr Nutr Food Sci 2013; 9(2): 99-107.
[http://dx.doi.org/10.2174/1573401311309020004] [PMID: 24353483]
[22]
Sundberg M. Iron bioavailability and pro- and prebiotics. Swedish University of Agricultural Science Uppsala 2011.
[23]
Camaschella C. Iron-deficiency anemia. N Engl J Med 2015; 372(19): 1832-43.
[http://dx.doi.org/10.1056/NEJMra1401038] [PMID: 25946282]
[24]
Zhang F, Yung KKL, Chung SSM, Yeung CK. Supplementation of fructooligosaccharide mildly improves the iron status of anemic rats fed a low-iron diet. Food Nutr Sci 2017; 8: 294-304.
[http://dx.doi.org/10.4236/fns.2017.82019]
[25]
Wolvers D, Antoine JM, Myllyluoma E, Schrezenmeir J, Szajewska H, Rijkers GT. Guidance for substantiating the evidence for beneficial effects of probiotics: prevention and management of infections by probiotics. J Nutr 2010; 140(3): 698S-712S.
[http://dx.doi.org/10.3945/jn.109.113753] [PMID: 20107143]
[26]
Soliman AT, Dabbagh MM, Habboub AH, Adel A, Humaidy NA, Abushahin A. Linear growth in children with iron deficiency anemia before and after treatment. J Trop Pediatr 2009; 55(5): 324-7.
[http://dx.doi.org/10.1093/tropej/fmp011] [PMID: 19261662]
[27]
Lind T, Lönnerdal B, Stenlund H, et al. A community-based randomized controlled trial of iron and zinc supplementation in Indonesian infants: effects on growth and development. Am J Clin Nutr 2004; 80(3): 729-36.
[http://dx.doi.org/10.1093/ajcn/80.3.729] [PMID: 15321815]
[28]
Sachdev H, Gera T, Nestel P. Effect of iron supplementation on physical growth in children: systematic review of randomized controlled trials. Public Health Nutr 2006; 9(7): 904-20.
[http://dx.doi.org/10.1017/PHN2005918] [PMID: 17010257]
[29]
Pasricha SR, Hayes E, Kalumba K, Biggs BA. Effect of daily iron supplementation on health in children aged 4-23 months: a systematic review and meta-analysis of randomized controlled trials. Lancet Glob Health 2013; 1(2): e77-86.
[http://dx.doi.org/10.1016/S2214-109X(13)70046-9] [PMID: 25104162]
[30]
Barth-Jaeggi T, Moretti D, Kvalsvig J, et al. In-home fortification with 2.5 mg iron as NaFeEDTA does not reduce anaemia but increases weight gain: a randomized controlled trial in Kenyan infants. Matern Child Nutr 2015; 11(Suppl. 4): 151-62.
[http://dx.doi.org/10.1111/mcn.12163] [PMID: 25420455]
[31]
Sazawal S, Dhingra U, Hiremath G, et al. Effects of Bifidobacterium lactis HN019 and prebiotic oligosaccharide added to milk on iron status, anemia, and growth among children 1 to 4 years old. J Pediatr Gastroenterol Nutr 2010; 51(3): 341-6.
[http://dx.doi.org/10.1097/MPG.0b013e3181d98e45] [PMID: 20601905]
[32]
Onubi OJ, Poobalan AS, Dineen B, Marais D, McNeill G. Effects of probiotics on child growth: a systematic review. J Health Popul Nutr 2015; 34: 8.
[http://dx.doi.org/10.1186/s41043-015-0010-4] [PMID: 26825706]
[33]
Park S, Bae JH. Probiotics for weight loss: a systematic review and meta-analysis. Nutr Res 2015; 35(7): 566-75.
[http://dx.doi.org/10.1016/j.nutres.2015.05.008] [PMID: 26032481]
[34]
Bhutta ZA, Ahmed T, Black RE, et al. Maternal and Child Undernutrition Study Group. What works? Interventions for maternal and child undernutrition and survival. Lancet 2008; 371(9610): 417-40.
[http://dx.doi.org/10.1016/S0140-6736(07)61693-6] [PMID: 18206226]
[35]
Archibald F. Lactobacillus plantarum, an organism not requiring iron. FEMS Microbiol Lett 1983; 19: 29-32.
[http://dx.doi.org/10.1111/j.1574-6968.1983.tb00504.x]
[36]
Bezkorovainy A, Kot E, Miller-Catchpole R, et al. Iron metabolism in bifidobacteria. Int Dairy J 1996; 6: 905-19.
[http://dx.doi.org/10.1016/S0958-6946(96)00003-9]
[37]
Dostal A, Baumgartner J, Riesen N, et al. Effects of iron supplementation on dominant bacterial groups in the gut, faecal SCFA and gut inflammation: a randomised, placebo-controlled intervention trial in South African children. Br J Nutr 2014; 112(4): 547-56.
[http://dx.doi.org/10.1017/S0007114514001160] [PMID: 24916165]
[38]
Kochan I. Role of iron in the regulation of nutritional immunity. Bioinorg Chem 1976; 2: 55-7.


Rights & PermissionsPrintExport Cite as

Article Details

VOLUME: 16
ISSUE: 2
Year: 2020
Page: [220 - 227]
Pages: 8
DOI: 10.2174/1573401314666181017110706

Article Metrics

PDF: 16
HTML: 3