Ferrous sulfate 160mg / Folic acid 400microgram modified-release tablets

BackgroundThis 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.MethodsRandomized 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.ResultsA 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].ConclusionThere 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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Nutritional deficiencies are prevalent in populations across the world. Fortification of staple foods has been used as an alternative to supplementation to address many deficiencies. One such staple is salt, which has long been fortified with iodine, but more recently with iron, folate, and other micronutrients. Our objective was to determine the effects of fortified salt on nutritional and health outcomes among children, adolescents, and adults. We conducted a systematic review of published and unpublished literature using a pre-defined search strategy. Abstracts and full texts were screened for randomized trials, quasi-randomized trials, and pre-post-designs of double or multiple fortified salt. We calculated the weighted pooled effect sizes for the effects of fortified salt on nutritional and health outcomes. Of the 395 studies identified, 33 (including 37 intervention-control comparisons) fit our inclusion criteria. Of these comparisons, 26 studied the effects of salt fortified with iron and iodine [double fortified salt (DFS)], 2 studied the effects of salt fortified with folic acid and iodine, 1 studied the effect of triple fortified salt, 1 studied the effect of quadruple fortified salt, and 7 studied the effects of multiple micronutrient fortified salt (MMFS; fortified with ≥5 nutrients). Pooled effect sizes indicated positive effects from all iron-containing fortified salt on hemoglobin concentration [standardized mean difference (95% confidence interval): DFS 0.36 (0.22, 0.50), n comparisons = 26; triple fortified salt 1.56 (1.42, 1.70), n comparisons = 1; quadruple fortified salt 0.33 (0.02, 0.63), n comparisons = 1; MMFS 0.23 (0.03, 0.43), n comparisons = 6]. DFS and MMFS reduced the odds of anemia and iron deficiency (ID) anemia. MMFS improved serum folate and reduced the odds of ID. Pooled effects on biomarkers of vitamin B12, vitamin A, and zinc status varied by type of salt, but were largely not significant. Fortification of salt with iodine and iron, with and without other nutrients, is effective in increasing hemoglobin and reducing the odds of anemia and ID in population-based studies.

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This systematic review, conducted under the COST Action CA20218 "Promoting Innovation of fermented foods" (PIMENTO), aimed to evaluate whether sourdough- and regular-bread fermentation improve iron bioavailability, absorption, and status in humans. Screening of PubMed, Scopus, and Cochrane Library (January 1970-December 2024) identified 8 human intervention studies, in healthy or iron-deficient participants, that met inclusion criteria. EFSA's scientific guidance for health claim applications, which integrates product characteristics and mechanisms of action to the human studies, was followed, and the extracted data were narratively presented. Results were inconclusive as acute postprandial studies increased non-haem iron bioavailability (especially in low-phytate breads); for example, low-phytate white bread produced a greater 2 h increase in serum iron than high-phytate wholemeal bread (59 vs. 30 μg Fe/100 mL), while exogenous phytase increased iron absorption by 50% for ferrous sulfate and 61% for iron bis-glycine chelate. However, long-term trials did not improve, and in one case even decreased, ferritin and total body iron; specifically, in the low-phytate sourdough rye bread group, ferritin declined from 32 ± 7 to 27 ± 6 μg/L and total body iron from 6.9 ± 1.4 to 5.4 ± 1.1 mg/kg over 12 weeks. On the other hand, phytate reduction combined with iron fortification showed positive effects on haemoglobin or prevented iron depletion; in anaemic children, fermented amaranth bread increased haemoglobin [adjusted β = 8.9 g/L (95% CI: 3.5-14.3)] and reduced anaemia prevalence (32% vs. 56%) compared to control bread. Despite convincing mechanistic evidence that the sourdough-fermentation process in bread fabrication improves iron bioavailability, through reduction of phytate, no human studies address this research question with the appropriate control and study quality.Systematic review registrationosf.io/gzt8m.

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ObjectiveTo estimate the prevalence and associated factors of anemia after Roux-en-Y gastric bypass (RYGB).MethodsA comprehensive literature search was conducted across PubMed, EMBASE, and CENTRAL from inception through 18 January 2025, utilizing search terms including anemia, anaemia, hemoglobin, haemoglobin, Hb, gastric bypass, and RYGB. Eligible studies reported anemia prevalence post-RYGB with data on either follow-up duration or Roux limb length.ResultsFrom 2787 screened records, 74 studies involving 12,262 patients met inclusion criteria. Pooled analysis revealed a 26% overall postoperative anemia prevalence. Temporal stratification revealed a progressive increase in prevalence: 15% at ≤1 year, 27% at >1-5 years, and 35% at >5 years post-surgery. Meta-regression confirmed a significant positive correlation between anemia prevalence and follow-up duration. Studies with inadequate supplementation of iron, vitamin B12, and folic acid reported higher anemia rates compared to those with adequate supplementation. Etiological analyses identified strong associations of anemia with vitamin B12 and iron deficiencies, but not with folic acid deficiency. Demographic risk factors included preoperative anemia, female sex, and baseline BMI >45 kg/m 2 . RYGB with longer Roux limbs showed a trend toward higher anemia risk.ConclusionThis study quantifies a substantial burden of anemia following RYGB, demonstrating its temporal progression. The findings underscore the necessity for protocolized long-term hematologic surveillance, optimized nutrient repletion strategies targeting iron and vitamin B12, and personalized risk mitigation approaches for high-risk cohorts, particularly women and those with long Roux limbs, preoperative anemia, or severe obesity.

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An estimated 40% of pregnant women worldwide are anaemic, of which 80% live in low- and middle-income countries (LMICs). The reality of finite health budgets, particularly in low-resource settings, means that interventions used for screening, diagnosing, and treating anaemia in pregnancy need to be informed by cost-effectiveness evidence. We conducted a systematic review to identify all studies evaluating the cost-effectiveness of managing anaemia in pregnancy. We searched two health economics (NHS EED and EconLit) and four medical (MEDLINE, Embase, CINAHL Plus and CENTRAL) databases for relevant studies published up to the 9th of August 2024. Studies were eligible if they conducted an economic evaluation of any intervention used in the management of anaemia in pregnancy regardless of aetiology, provided that anaemia was a specified outcome. Data were extracted and study quality assessed by two independent reviewers using the extended CHEC-E tool. Due to significant heterogeneity, data were analysed narratively. 19 eligible cost-effectiveness studies were identified. Nine studies related to iron deficiency anaemia, finding that intravenous rather than oral iron supplements were cost-effective in most instances. Multiple micronutrient supplements were also found to be cost-effective compared to iron and folic acid supplements. Ten studies related to malaria-related anaemia, identifying several cost-effective antimalarial regimens; both preventative and therapeutic. Cost-effective delivery channels of antimalarials as well as non-pharmacological interventions were also identified. This review identifies several avenues through which the management of anaemia in pregnancy can be optimised from an economic perspective. Despite this, there is a significant deficit of cost-effectiveness evidence relating to this condition, which limited the deduction of cost-effectiveness for many of the interventions assessed.

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