Once Weekly Low-dose Iron Supplementation Effectively Improved Iron Status in Adolescent Girls

Abstract

Iron supplementation has been suggested as a strategy for prevention and treatment of iron deficiency (ID) and iron deficiency anemia (IDA) in many countries, but non-compliance of daily regimens and common dosage remain as major challenges. The aim of this study was to investigate the effects of low dose once weekly iron supplementation in adolescent girls. The study was designed as a community-based, randomized, supplementation trial. The initial sample consisted of 200 female high school students, aged 14-16 years old, of whom 193 students concluded the study. They were randomly selected and assigned into either iron-supplemented group (ISG) or iron-unsupplemented group (IUG). The ISG received 150 mg ferrous sulfate once weekly for 16 weeks, whereas the IUG received nothing. Weight, height, and hematological parameters were measured and compared between the two groups before and after the intervention. There was no significant difference between the initial measures of the two groups before the intervention. After 16 weeks of intervention, mean of hemoglobin and serum ferritin improved significantly in ISG compared to IUG. At the beginning of the study, percent of anemia, IDA, and ID in ISG were 12.5%, 8.3%, and 30.2%, whereas these figures for IUG in this period of study were 14.4, 10.3, and 38.2, respectively, which were not significantly different between the two groups. However, percentages of the above items at the end of study in ISG were 2.1%, 0%, and 21.9%, respectively. In contrast to IUG, all cases of IDA were abolished in the ISG. Our study showed that once weekly supplementation of 150 mg ferrous sulfate for 16 weeks significantly improved iron status in female adolescents and effectively treated IDA. There is no need for higher dosage of iron for supplementation that may cause adverse effects and bear higher costs.

Systematic review on evidence‐based adolescent nutrition interventions

“…(B) Weekly/intermittent IFA supplementation versus placebo: hemoglobin (g/L) in adolescents. References: Beasley, Bruner, Eftekhari, Hettiarachchi, Mozaffari‐Khosravi, Rezaeian, Shobha, Agarwal, Gilgen, Hall, Jayatissa, Roschnik, Soekarjo …”

“…14,26,27 Our search for primary trials on iron supplementation in adolescents identified 11 studies, of which seven reported serum hemoglobin as an outcome. [46][47][48][49][50][51][52][53][54][55][56] Studies were conducted in India, Iran, Pakistan, Sri Lanka, Tanzania, the United States, and Vietnam and provided iron as ferrous sulfate preparations in dosages ranging from 50 to 260 mg. The pooled analysis showed a significant impact of iron supplementation on improving serum hemoglobin levels (SMD 1.83; 95% CI 0.59-3.08; seven studies; n = 1257) ( Fig.…”

“…Eftekhari, 47 Hettiarachchi, 48 Mozaffari-Khosravi, 54 Rezaeian, 56 Shobha, 55 Agarwal, 58 Gilgen, 60 Hall, 61 Jayatissa, 62 Roschnik, 67…”

Доцільність Корекції Латентного Дефіциту Заліза В Лікуванні Школярів Із Дисфункцією Жовчного Міхура Та Сфінктера Одді

“…Children and adolescents are at high risk of iron deficiency due increased iron requirements secondary to intensive growth and puberty period [1]. Latent iron deficiency affects 47.12 % children in Ukraine [2] and is associated with poorer general health and wellbeing and higher levels of diseases [1,[3][4][5]. It is imperative that iron deficiency is effectively managed to prevent burdened course of coexisting gastrointestinal pathology as well as progression to anaemia.…”

Comparison of Two Doses of Elemental Iron in the Treatment of Latent Iron Deficiency: Efficacy, Side Effects and Blinding Capabilities

“…Such side effects can compromise blinding within trials. Lower dose iron supplements have fewer side effects [10,14] yet the effect of varying the dosage of iron on iron status [15,16,17] has rarely been studied, with no studies conducted in non-pregnant young women. Whether lower doses are absorbed as efficiently as higher doses in non-pregnant young women remains unknown [18].…”