Effect of probiotic and prebiotics supplementation on hemoglobin levels and iron absorption among women of reproductive age and children: a systematic review and meta-analysis

Abstract Background This review aims to assess the effect of oral administration of probiotics and/or prebiotics in children and women of reproductive age (WRA) to improve intestinal iron absorption, hemoglobin, and ferritin levels. Methods Randomized controlled trials from published literature on p...

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Main Authors: Aditi Apte, Ashwini Parge, Radhika Nimkar, Anju Sinha
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Nutrition
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Online Access:https://doi.org/10.1186/s40795-025-01015-3
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author Aditi Apte
Ashwini Parge
Radhika Nimkar
Anju Sinha
author_facet Aditi Apte
Ashwini Parge
Radhika Nimkar
Anju Sinha
author_sort Aditi Apte
collection DOAJ
description Abstract Background This review aims to assess the effect of oral administration of probiotics and/or prebiotics in children and women of reproductive age (WRA) to improve intestinal iron absorption, hemoglobin, and ferritin levels. Methods Randomized controlled trials from published literature on probiotics and or prebiotics for prevention or treatment of anemia as a supplement or fortification in children or WRA till Jan 31, 2023, were included. Studies on probiotics and prebiotics in patients with anemia due to other causes were excluded. Screening and data extraction was done using Distiller SR and meta-analysis was performed using Revman 5.4.1. Results A total of 1925 records were identified from Pubmed, Embase, and Cochrane, of which 29 were included in the systematic review (14 supplementation and 15 fortification studies; 15 studies in children and 14 studies in WRA). The major interventions included galacto-oligosaccharide, inulin, heat-killed H61, Lactobacillus plantarum 299v, Lactobacillus reuteri, Lactobacillus acidophilus. Meta-analysis of 5 studies in WRA showed that the use of prebiotics and/or probiotics with or without iron was associated with little or no effect on hemoglobin. However, there is low certainty of evidence that the intervention led to improvement in fractional absorption of iron as compared to placebo or iron [8 studies, n = 335, mean increase 0.74%, 95%CI-0.11–1.38, p = 0.02]. Meta-analysis of 6 studies in WRA using prebiotics and/or probiotics with or without iron led to a significant increase in ferritin levels in WRA (mean increase 2.45 ng/ml, 95% CI 0.61–4.3, p = 0.009, n = 320) [Moderate certainty of evidence]. In children, meta-analysis of up to 8 studies did not result in any significant change in hemoglobin, ferritin and fractional iron absorption [low or very low certainty of evidence]. Conclusion There is some evidence to show that the use of prebiotics or probiotics (especially Lp299v and GOS) with or without oral iron can improve iron absorption in women and lead to improvement in ferritin levels in women. However, the current evidence does not conclusively show the benefit of these interventions in improving hemoglobin levels in women and children.
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spelling doaj-art-f19781bbf93a48e183a4ee0faaceaee42025-02-09T12:16:35ZengBMCBMC Nutrition2055-09282025-02-0111111910.1186/s40795-025-01015-3Effect of probiotic and prebiotics supplementation on hemoglobin levels and iron absorption among women of reproductive age and children: a systematic review and meta-analysisAditi Apte0Ashwini Parge1Radhika Nimkar2Anju Sinha3KEM Hospital Research CentreKEM Hospital Research CentreKEM Hospital Research CentreIndian Council of Medical ResearchAbstract Background This review aims to assess the effect of oral administration of probiotics and/or prebiotics in children and women of reproductive age (WRA) to improve intestinal iron absorption, hemoglobin, and ferritin levels. Methods Randomized controlled trials from published literature on probiotics and or prebiotics for prevention or treatment of anemia as a supplement or fortification in children or WRA till Jan 31, 2023, were included. Studies on probiotics and prebiotics in patients with anemia due to other causes were excluded. Screening and data extraction was done using Distiller SR and meta-analysis was performed using Revman 5.4.1. Results A total of 1925 records were identified from Pubmed, Embase, and Cochrane, of which 29 were included in the systematic review (14 supplementation and 15 fortification studies; 15 studies in children and 14 studies in WRA). The major interventions included galacto-oligosaccharide, inulin, heat-killed H61, Lactobacillus plantarum 299v, Lactobacillus reuteri, Lactobacillus acidophilus. Meta-analysis of 5 studies in WRA showed that the use of prebiotics and/or probiotics with or without iron was associated with little or no effect on hemoglobin. However, there is low certainty of evidence that the intervention led to improvement in fractional absorption of iron as compared to placebo or iron [8 studies, n = 335, mean increase 0.74%, 95%CI-0.11–1.38, p = 0.02]. Meta-analysis of 6 studies in WRA using prebiotics and/or probiotics with or without iron led to a significant increase in ferritin levels in WRA (mean increase 2.45 ng/ml, 95% CI 0.61–4.3, p = 0.009, n = 320) [Moderate certainty of evidence]. In children, meta-analysis of up to 8 studies did not result in any significant change in hemoglobin, ferritin and fractional iron absorption [low or very low certainty of evidence]. Conclusion There is some evidence to show that the use of prebiotics or probiotics (especially Lp299v and GOS) with or without oral iron can improve iron absorption in women and lead to improvement in ferritin levels in women. However, the current evidence does not conclusively show the benefit of these interventions in improving hemoglobin levels in women and children.https://doi.org/10.1186/s40795-025-01015-3AnemiaIron bioavailabilityIron deficiencyFerritin
spellingShingle Aditi Apte
Ashwini Parge
Radhika Nimkar
Anju Sinha
Effect of probiotic and prebiotics supplementation on hemoglobin levels and iron absorption among women of reproductive age and children: a systematic review and meta-analysis
BMC Nutrition
Anemia
Iron bioavailability
Iron deficiency
Ferritin
title Effect of probiotic and prebiotics supplementation on hemoglobin levels and iron absorption among women of reproductive age and children: a systematic review and meta-analysis
title_full Effect of probiotic and prebiotics supplementation on hemoglobin levels and iron absorption among women of reproductive age and children: a systematic review and meta-analysis
title_fullStr Effect of probiotic and prebiotics supplementation on hemoglobin levels and iron absorption among women of reproductive age and children: a systematic review and meta-analysis
title_full_unstemmed Effect of probiotic and prebiotics supplementation on hemoglobin levels and iron absorption among women of reproductive age and children: a systematic review and meta-analysis
title_short Effect of probiotic and prebiotics supplementation on hemoglobin levels and iron absorption among women of reproductive age and children: a systematic review and meta-analysis
title_sort effect of probiotic and prebiotics supplementation on hemoglobin levels and iron absorption among women of reproductive age and children a systematic review and meta analysis
topic Anemia
Iron bioavailability
Iron deficiency
Ferritin
url https://doi.org/10.1186/s40795-025-01015-3
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