Effect of inulin, galacto oligosaccharides and iron fortification on iron deficiency anemia among women of reproductive age; a randomized controlled trial

Sehar Iqbal; Waqas Ahmed; Saira Zafar; Umar Farooq; Juweria Abid; Hassan Bin Usman Shah; Sajeela Akram; Madiha Ghazanfar; Abdul Momin Rizwan Ahmad

doi:10.3389/fnut.2022.1028956

Effect of inulin, galacto oligosaccharides and iron fortification on iron deficiency anemia among women of reproductive age; a randomized controlled trial

Front Nutr. 2022 Nov 14:9:1028956. doi: 10.3389/fnut.2022.1028956. eCollection 2022.

Authors

Sehar Iqbal¹, Waqas Ahmed², Saira Zafar³, Umar Farooq⁴, Juweria Abid⁵, Hassan Bin Usman Shah⁶, Sajeela Akram⁷, Madiha Ghazanfar⁴, Abdul Momin Rizwan Ahmad⁵

Affiliations

¹ College of Pharmacy, Al-Ain University, Abu Dhabi, United Arab Emirates.
² Department of Food Science and Human Nutrition, University of Veterinary and Animal Sciences, Lahore, Pakistan.
³ Department of Public Health, Health Services Academy, Islamabad, Pakistan.
⁴ Department of Diet and Nutritional Sciences, IBADAT International University, Islamabad, Pakistan.
⁵ Department of Nutrition and Dietetics, National University of Medical Sciences, Rawalpindi, Pakistan.
⁶ The Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
⁷ Department of Human Nutrition and Dietetics, University of Chakwal, Chakwal, Pakistan.

Abstract

Iron supplementation and fortification are the well-known approaches to treat iron deficiency anemia (IDA) in women of reproductive age. The objective of the current randomized controlled trial (RCT) was to evaluate the cumulative effects of prebiotics and iron fortification among women of reproductive age. For this purpose, a total of 75 iron deficient women of childbearing age were recruited and randomly divided into 5 groups (4 treatment groups and 1 control group). Four different types of fortified wheat flour were prepared using two iron fortificants (NaFeEDTA and FeSO₄) and two prebiotics [inulin and galacto oligosaccharides (GOS)], while control group was treated with iron fortified flour without any prebiotics. Blood samples were collected from overnight fasted women on monthly basis up to 90 days. Hematological indices such as Hemoglobin (Hb), Hematocrit, Red Blood Cell (RBC) Count and Mean Corpuscular Volume (MCV), as well as iron biomarkers including serum iron, ferritin, transferrin, and Total Iron Binding Capacity (TIBC) were evaluated for analyses. The results showed a considerable positive improvement in all iron biomarkers as well as hematological indices among the treatment groups (P-value < 0.05), as compared to the control group. A maximum Hb (11.86 ± 0.24 mg/dL) and hematocrit value (35.06 ± 1.32%), was reported in group G₃ which was treated with fortified wheat flour at a dose of 963 mg/kg GOS + 15 ppm FeSO₄. On the other hand, highest mean values for RBC Count (4.73 ± 0.41 mil/mm³), MCV (81.41 ± 3.21 fL), serum iron (75.62 ± 2.79 μg/dL), serum transferrin (16.82 ± 0.30 mg/dL), and TIBC (403.68 ± 7.27 μg/dL) were observed in G₄ group receiving the fortified wheat flour at a dose of 963 mg/kg GOS + 30 ppm FeSO₄ level. The study concluded that prebiotic fortification along with iron salts helps to enhance iron absorption among iron deficiency anemic women of reproductive age.

Keywords: galacto oligosaccharides; inulin; iron deficiency anemia; iron fortification; prebiotics.