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Meta-Analysis
. 2019 Dec 3;11(12):2938.
doi: 10.3390/nu11122938.

A Systematic Review and Meta-Analysis on the Effects of Probiotic Species on Iron Absorption and Iron Status

Susan C Vonderheid  1 , Lisa Tussing-Humphreys  2 , Chang Park  1 , Heather Pauls  1 , Nefertiti OjiNjideka Hemphill  3 , Bazil LaBomascus  3 , Andrew McLeod  3 , Mary Dawn Koenig  1
Affiliations
Meta-Analysis

A Systematic Review and Meta-Analysis on the Effects of Probiotic Species on Iron Absorption and Iron Status

Susan C Vonderheid et al. Nutrients. .

Abstract

Background: Strategies to prevent iron deficiency anemia (IDA) have varying effectiveness. The purpose of this systematic review of the literature and meta-analysis was to examine the effects of probiotics on iron absorption and iron status-related markers in humans.

Methods: We followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) reporting guidelines. Relevant articles were identified from Embase, Pubmed, Scopus, and CINAHL from inception to February, 2019. We conducted a meta-analysis for eight studies examining the effect of the probiotic Lactobacillus plantarum 299v (Lp299v) on iron absorption.

Results: Fifteen studies reported in 12 articles were identified (N = 950). Our meta-analysis of eight studies using a random-effects model demonstrated a significant increase in iron absorption following administration of the probiotic Lp299v with a pooled standardized mean difference (an average intervention effect size) of 0.55 (95% CI 0.22-0.88, p = 0.001). Of the seven randomized clinical trials (RCTs) and nonrandomized clinical trials examining a range of probiotic species on iron status, only one study supplementing with Lp299v showed improvement in serum iron; no other studies reported improvement in iron status-related indices with probiotic treatment.

Conclusions: Lp299v significantly improved iron absorption in humans. Future research should include the assessment of Lp299v effect on iron absorption and iron status in populations at high risk of IDA, including pregnant women.

Keywords: human; iron absorption; iron status; probiotic.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart for selection of studies. a 15 studies in 12 articles, b eight studies in five articles.
Figure 2
Figure 2
Bias assessment of intervention studies with comparison groups. Green circle with plus sign = low risk of bias; yellow circle with question mark = unclear risk of bias; red circle with minus sign = high risk of bias.
Figure 3
Figure 3
Quality assessment for crossover studies. Green circle with plus sign = low risk of bias; yellow circle with question mark = unclear risk of bias; red circle with minus sign = high risk of bias a Carry-over controlled for in the analysis. Results do not report carry-over effect. b Reports two studies in one article; same methodology except tested different colony forming units (CFU) per gram of L. plantarum 299v. c Placebo administered before probiotic. d Reports two studies in one article; same methodology. e Reports two studies in one article; same methodology except tested subjects with low or high phytate bread rolls.
Figure 4
Figure 4
Effect of probiotic (Lp299v) on iron absorption for all eight studies. SMD: standardized mean difference; CI: confidence interval; I-squared: variation in SMD attributable to heterogeneity; S: study; p value associated with Q statistic.
Figure 5
Figure 5
Effect of probiotic (Lp299v) on iron absorption for subgroup analysis of six studies. SMD: standardized mean difference; CI: confidence interval; I-squared: variation in SMD attributable to heterogeneity; S: study; p value associated with Q statistic.
See this image and copyright information in PMC

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