Freeze-dried Lactobacillus plantarum 299v increases iron absorption in young females—Double isotope sequential single-blind studies in menstruating women

Abstract

BackgroundThe probiotic strain Lactobacillus plantarum 299v has earlier been shown to increase iron absorption when added to foods. However, it is not known if the same probiotic strain in a freeze-dried format included in a capsule increases the iron absorption.ObjectiveThe aim of this study was to test the hypotheses that non-heme iron absorption from a light meal is promoted by a simultaneous intake of freeze-dried Lactobacillus plantarum 299v (Lp299v, DSM 9843).Study designWith a single blinded placebo controlled sequential design, iron absorption from a light breakfast meal administered with or without capsules containing 1010 cfu freeze-dried Lp299v was studied in healthy female volunteers of fertile age. The methodology used was a double isotope technique (59Fe and 55Fe). Two studies were performed using the same protocol.ResultsIn study 1, the absorption of iron from a meal without Lp299v was found to be 17.4 ± 13.4%, and from an identical meal with Lp299v was found to be 22.4 ± 17.3% (mean ± SD). This difference was statistically significant (p = 0.040, n = 14).In study 2, the absorption of iron from a meal without Lp299v was found to be 20.9 ± 13.1%, and from an identical meal with Lp299v found to be 24.5 ± 12.0% (mean ± SD, n = 28), which again was statistically significant (p = 0.003).ConclusionFreeze-dried Lp299v enhances the absorption of iron when administered together with a meal with a high iron bioavailability.Trial registrationClinicalTrials.gov Identifier: NCT02131870

A Systematic Review and Meta-Analysis on the Effects of Probiotic Species on Iron Absorption and Iron Status

“…The nonrandomized clinical trials did not report blinding [23,24]. Of the eight cross-over studies, two were double-blinded [12,19], four studies were single-blinded [13,18], and two studies did not report blinding [20].…”

“…Across all of the studies, the two largest studies included children, 494 and 109, respectively [21,24], and another examined children with sleep problems and mild iron deficiency from the U.S. [29]. Seven study samples were healthy women of childbearing age [12,13,18,19,23]. One study included only pregnant women [11].…”

“…Two studies included participants with older mean ages having a diagnosis: diabetes [11] and chronic low-dose aspirin users with unexplained iron deficiency anemia [22]. Most studies [12,13,[18][19][20]22,29] included samples that are classified as high income based on the definition from The World Bank [31], followed by two studies which included samples classified as upper-middle income [23,24], and three studies with samples classified as lower-middle income [11,21,25].…”

“…Fermented foods (e.g., yogurt, vegetables) have also been shown to enhance dietary iron absorption [11,12]. Lactic acid-forming bacteria, including lactobacilli, are thought to increase dietary iron bioavailability through several mechanisms such as reducing intestinal pH [13], shifts in gut microbiota metabolism and metabolite formation [13][14][15], and promotion of anti-inflammatory immunomodulation [16]. This suggests that probiotic bacteria may be a clinical tool to optimize dietary iron bioavailability to improve iron status without the gastrointestinal burden of additional supplemental iron.…”

“…Probiotics have gained public popularity because of their possible preventative and therapeutic effects, relative low cost, and accessibility. Probiotics improve iron absorption [12,13,[18][19][20], but less certain is the effect of probiotics on body iron status [11,[21][22][23][24][25]. The primary purpose of this systematic review of the literature was to comprehensively examine the existing evidence regarding the effects of probiotics on iron absorption and iron status in humans.…”