Effect of supplementation with ferrous sulfate or iron bis-glycinate chelate on ferritin concentration in Mexican schoolchildren: a randomized controlled trial

Abstract

BackgroundIron deficiency is one of the most common nutritional deficiencies worldwide. It is more prevalent when iron requirements are increased during pregnancy and during growth spurts of infancy and adolescence. The last stage in the process of iron depletion is characterized by a decrease in hemoglobin concentration, resulting in iron deficiency anemia. Iron deficiency, even before it is clinically identified as anemia, compromises the immune response, physical capacity for work, and intellectual functions such as attention level. Therefore, interventions addressing iron deficiency should be based on prevention rather than on treatment of anemia. The aim of this study was to compare short- and medium-term effects on ferritin concentration of daily supplementation with ferrous sulfate or iron bis-glycinate chelate in schoolchildren with iron deficiency but without anemia.MethodsTwo hundred schoolchildren from public boarding schools in Mexico City who had low iron stores as assessed by serum ferritin concentration but without anemia were randomly assigned to a daily supplement of 30 mg/day of elemental iron as ferrous sulfate or iron bis-glycinate chelate for 12 weeks. Iron status was evaluated at baseline, one week post-supplementation (short term), and 6 months (medium term) after supplementation.ResultsFerritin concentration increased significantly between baseline and post-supplementation as well as between baseline and 6 months after supplementation. One week post-supplementation no difference was found in ferritin concentration between iron compounds, but 6 months after supplementation ferritin concentration was higher in the group that received bis-glycinate chelate iron. However, there is no difference in the odds for low iron storage between 6 months after supplementation versus the odds after supplementation; nor were these odds different by type of supplement. Hemoglobin concentration did not change significantly in either group after supplementation.ConclusionsSupplementing with 30 mg/d of elementary iron, either as ferrous sulfate or iron bis-glycinate chelate for 90 days, showed positive effects on increasing ferritin concentration in schoolchildren with low iron stores, and this effect persisted 6 months after supplementation.

Effect of iron supplementation in children with breath holding spells

“…It was interesting to note that in the present study despite 3 months of iron therapy, significant proportion (29.7%) of children continued to have low ferritin levels. A study from Mexico showed that after 3 months of daily iron supplementation, 10% of children still remain iron‐deficient (ferritin < 12 µg/L) . A systematic review of studies concluded that daily iron supplementation in pre‐school children reduces the risk ratio of iron deficiency to 0.21 (95% confidence interval 0.07–0.63).…”

Effects of a Tripeptide Iron on Iron-Deficiency Anemia in Rats

“…It has reported that IDA affects the mental and physical health of children, the developmental stage for teenagers, or the chronic fatigue and compromised immune system for adults [6]. The bioavailability and iron absorption from the daily diet are influenced by the type and quantity of iron present in food as well as by the presence of inhibitors and promoters of iron absorption in the diet and the individual's iron status [7]. So iron supplements have been widely used to overcome IDA.…”

Time Trends in Prevalence of Anaemia in Adolescent Girls

“…Supplementation programmes are expensive because personnel are required for counselling, distributing supplements and monitoring to improve compliance. It has been well documented that not all anaemic persons become non-anaemic after three-months of daily supplementation; once supplementation is stopped some of those who became non-anaemic may become anaemic (27)(28)(29)(30). Taking these into consideration, the WHO advocates food fortification with iron for sustained improvement in iron intake in countries with low iron intake (31).…”