Effect of Prebiotics on Iron Absorption in Women With Low Iron Stores

NCT ID: NCT03325270

Last Updated: 2019-01-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

46 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-01-10

Study Completion Date

2018-04-28

Brief Summary

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Rationale:

According to the WHO, iron deficiency is still the most common and widespread nutritional disorder in the world. Current iron supplements have limitations in terms of bioavailability and tolerability. Prebiotic fibers, such as galacto-oligosaccharides (GOS), selectively enhance growth of beneficial colonic bacteria. Prebiotics in general enhance the production of short-chain fatty acids (SCFAs) and thereby decrease luminal pH. Through the reduction in colonic pH, prebiotics can enhance absorption of minerals such as calcium and magnesium and they have been proposed to potentially improve iron absorption as well.

The primary objective of this study is to investigate the effect of an addition of GOS to an iron supplement on iron absorption in iron deplete, healthy, normal weight women.

Detailed Description

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Iron deficiency is still the most common and widespread nutritional disorder in the world according to WHO. It does not only affect large numbers of women and children in the developing world, but also in industrialized countries. The current estimation is that 2 billion people, or around 30% of the world's population, are anemic, of which around 50% is caused by iron deficiency. In industrialized countries, ID remains a public health concern in young women, affecting 16% of females between the ages of 12-49y in the United states.

Iron supplementation has been recommended by the WHO as an approach to improve iron status in varying age and risk groups. Iron supplementation can be practical for high-risk groups such as pregnant women and has been proven effective for increasing hemoglobin levels in women. However, iron absorption from supplements is generally low and epigastric side effects reduce compliance. With the high global burden of iron deficiency and anemia, improved products which allow better absorption and reduce side effects are urgently needed.

Targeted iron supplementation in high risk groups is the preferred way to treat iron deficiency. However, the recommendation is to consume iron supplements away from food in order to increase bioavailability which often causes nausea and epigastric pain and thus reduces compliance. Taken together with food, bioavailability of most supplements is reduced by about two thirds. Thus, a lot of unabsorbed iron passes into the colon where it can increase the abundance of enteropathogens.

Prebiotic fibers, such as galacto-oligosaccharides (GOS), selectively enhance growth of beneficial colonic bacteria. GOS are enzymatically produced from lactose and are a mixture of glucose- and galactose- based di- and oligosaccharides of varying structure and seem to have an increased selectivity towards Bifidobacterium spp compared to other prebiotics. Prebiotics in general enhance the production of short-chain fatty acids (SCFAs) and thereby decrease luminal pH, which may reduce growth of enteropathogens. Through the reduction in colonic pH, prebiotics can enhance absorption of minerals such as calcium and magnesium and they have been proposed to potentially improve iron absorption, by reducing ferric to ferrous iron in the colon. Even though colonic absorption is minimal compared to absorption in the duodenum in healthy humans, it may become more important in iron deficiency or anemia as demonstrated in animal studies.

The primary objective of this study is to investigate the effect of an addition of GOS to an iron supplement on iron absorption in iron deplete, healthy, normal weight women.

Conditions

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Iron-deficiency

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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ferrous fumarate

labeled iron as Ferrous Fumarate

Group Type EXPERIMENTAL

labeled ferrous fumarate

Intervention Type DIETARY_SUPPLEMENT

labeled iron as Ferrous Fumarate

ferrous fumarate and GOS

labeled ferrous fumarate + prebiotics

Group Type EXPERIMENTAL

labeled ferrous fumarate + prebiotics

Intervention Type DIETARY_SUPPLEMENT

labeled iron as Ferrous Fumarate + galacto-oligosaccharides

ferrous sulfate and GOS

labeled ferrous sulfate + prebiotics

Group Type EXPERIMENTAL

labeled ferrous sulfate + prebiotics

Intervention Type DIETARY_SUPPLEMENT

labeled iron as Ferrous Sulfate + galacto-oligosaccharides

Interventions

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labeled ferrous fumarate

labeled iron as Ferrous Fumarate

Intervention Type DIETARY_SUPPLEMENT

labeled ferrous fumarate + prebiotics

labeled iron as Ferrous Fumarate + galacto-oligosaccharides

Intervention Type DIETARY_SUPPLEMENT

labeled ferrous sulfate + prebiotics

labeled iron as Ferrous Sulfate + galacto-oligosaccharides

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Female, 18 to 45 years old
* SF levels \<20 µg/L
* Normal body Mass Index (18.5-24.9 kg/m2)
* Body weight \<70 kg
* Signed informed consent

Exclusion Criteria

* Severe anaemia (Hb \< 80 g/L)
* Elevated CRP \>10.0 mg/L
* Any metabolic, gastrointestinal kidney or chronic disease such as diabetes, renal failure, hepatic dysfunction, hepatitis, hypertension, cancer or cardiovascular diseases (according to the participants own statement)
* Continuous/long-term use of medication during the whole studies (except for contraceptives)
* Consumption of mineral and vitamin supplements within 2 weeks prior to 1st supplement administration, including pre- and-or probiotics supplements (excluding foods and beverages with life cultures such as yoghurt, raw milk cheese and kombucha)
* Blood transfusion, blood donation or significant blood loss (accident, surgery) over the past 4 months
* Difficulties with blood sampling
* Use of antibiotics over the past month
* Known hypersensitivity to iron supplements in the given amount, GOS, or lactose
* Women who are pregnant or breast feeding
* Women who intend become pregnant during the course of the study
* Lack of safe contraception, defined as: Female participants of childbearing potential, not using and not willing to continue using a medically reliable method of contraception for the entire study duration, such as oral, injectable, or implantable contraceptives, or intrauterine contraceptive devices, or who are not using any other method considered sufficiently reliable by the investigator in individual cases
* Known or suspected non-compliance, drug or alcohol (more than 2 drinks/day) abuse -
* Smokers (\> 1 cigarette per week)
* Inability to follow the procedures of the study, e.g. due to language problems, self-reported psychological disorders, etc. of the participant
* Enrolment of the investigator, his/her family members, employees and other dependent persons
Minimum Eligible Age

18 Years

Maximum Eligible Age

45 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Burgerstein Vitamine

INDUSTRY

Sponsor Role collaborator

Swiss Federal Institute of Technology

OTHER

Sponsor Role lead

Responsible Party

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Prof. Michael B. Zimmermann

Head of Laboratory of Human Nutrition

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Michael Zimmermann, Prof. Dr.

Role: PRINCIPAL_INVESTIGATOR

University of Zurich

Locations

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ETH Zurich

Zurich, , Switzerland

Site Status

Countries

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Switzerland

References

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Jeroense FMD, Michel L, Zeder C, Herter-Aeberli I, Zimmermann MB. Consumption of Galacto-Oligosaccharides Increases Iron Absorption from Ferrous Fumarate: A Stable Iron Isotope Study in Iron-Depleted Young Women. J Nutr. 2019 May 1;149(5):738-746. doi: 10.1093/jn/nxy327.

Reference Type DERIVED
PMID: 31004135 (View on PubMed)

Other Identifiers

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Fe_GOS_1

Identifier Type: -

Identifier Source: org_study_id

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