Effects of iron supplements and iron-containing micronutrient powders on the gut microbiome in Bangladeshi infants: a randomized controlled trial

Anemia is highly prevalent globally, especially in young children in low-income countries, where it often overlaps with a high burden of diarrheal disease. Distribution of iron interventions (as supplements or iron-containing multiple micronutrient powders, MNPs) is a key anemia reduction strategy. Small studies in Africa indicate iron may reprofile the gut microbiome towards pathogenic species. We seek to evaluate the safety of iron and MNPs based on their effects on diversity, composition, and function of the gut microbiome in children in rural Bangladesh as part of a large placebo-controlled randomized controlled trial of iron or MNPs given for 3 months (ACTRN12617000660381). In 923 infants, we evaluate the microbiome before, immediately following, and nine months after interventions, using 16S rRNA gene sequencing and shotgun metagenomics in a subset. We identify no increase in diarrhea with either treatment. In our primary analysis, neither iron nor MNPs alter gut microbiome diversity or composition. However, when not adjusting for multiple comparisons, compared to placebo, children receiving iron and MNPs exhibit reductions in commensal species (e.g., Bifidobacterium, Lactobacillus) and increases in potential pathogens, including Clostridium. These increases are most evident in children with baseline iron repletion and are further supported by trend-based statistical analyses.

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Publication Details

Journal
Nature Communications
Published
2024-10-05
DOI
https://doi.org/10.1038/s41467-024-53013-x
Citations
12
Primary Topic
Iron Metabolism and Disorders
Type
article
Field-Weighted Citation Impact
5.45

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article

Effects of iron supplements and iron-containing micronutrient powders on the gut microbiome in Bangladeshi infants: a randomized controlled trial

I. A. Azeez, P.K. Roy, Beverley‐Ann Biggs, Michael B. Zimmermann et al.
12 citations
Nature Communications
Iron Metabolism and Disorders
5.45
article

Effects of iron supplements and iron-containing micronutrient powders on the gut microbiome in Bangladeshi infants: a randomized controlled trial

I. A. Azeez, P.K. Roy, Beverley‐Ann Biggs, Michael B. Zimmermann, Jena Derakhshani Hamadani, Cavan Bennett, Andrew Baldi, Danielle Clucas, Mohammad Saiful Alam Bhuiyan, Ricardo Ataíde, Leila M Larson, Sabine Braat, Marilou H. Barrios, Sant‐Rayn Pasricha, Aaron R. Jex, Rory J. Bowden, N. F. Jones, Mohammed Imrul Hasan, Stephen Wilcox
article en
12 citations

Abstract

Anemia is highly prevalent globally, especially in young children in low-income countries, where it often overlaps with a high burden of diarrheal disease. Distribution of iron interventions (as supplements or iron-containing multiple micronutrient powders, MNPs) is a key anemia reduction strategy. Small studies in Africa indicate iron may reprofile the gut microbiome towards pathogenic species. We seek to evaluate the safety of iron and MNPs based on their effects on diversity, composition, and function of the gut microbiome in children in rural Bangladesh as part of a large placebo-controlled randomized controlled trial of iron or MNPs given for 3 months (ACTRN12617000660381). In 923 infants, we evaluate the microbiome before, immediately following, and nine months after interventions, using 16S rRNA gene sequencing and shotgun metagenomics in a subset. We identify no increase in diarrhea with either treatment. In our primary analysis, neither iron nor MNPs alter gut microbiome diversity or composition. However, when not adjusting for multiple comparisons, compared to placebo, children receiving iron and MNPs exhibit reductions in commensal species (e.g., Bifidobacterium, Lactobacillus) and increases in potential pathogens, including Clostridium. These increases are most evident in children with baseline iron repletion and are further supported by trend-based statistical analyses.

Nature CommunicationsVol. 15(1)
The Royal Melbourne Hospital (AU), Royal Women's Hospital (AU), University of South Carolina (US), The University of Melbourne (AU), Walter and Eliza Hall Institute of Medical Research (AU), International Centre for Diarrhoeal Disease Research (BD), Peter MacCallum Cancer Centre (AU), John Radcliffe Hospital (GB), Melbourne Sexual Health Centre (AU), Peter Doherty Institute (AU), MRC Human Immunology Unit (GB)
Australian Government, Medical Research Council, National Health and Medical Research Council
Zero hunger
Openalex Percentile: Top 4%
Iron Metabolism and Disorders
5.45
DOIOpen Access PDFOpenAlex
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