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Overweight impairs efficacy of iron supplementation in iron-deficient South African children: a randomized controlled

J Baumgartner1, C M Smuts, I Aeberli

  • 1Centre of Exellence for Nutrition (CEN), North-West University, Potchefstroom, South Africa. jeannine.baumgartner@gmail.com

International Journal of Obesity (2005)
|September 5, 2012
PubMed

Insights

Overweight children with iron deficiency (ID) are at higher risk of remaining iron deficient after supplementation. Higher body mass index (BMI) in children with ID may reduce iron absorption, impacting anemia control efforts.

Area of Science:

  • Pediatric Nutrition
  • Nutritional Biochemistry
  • Public Health

Background:

  • Countries undergoing nutrition transition often face high rates of iron deficiency (ID) and overweight (OW).
  • Overweight status in children may exacerbate ID, potentially due to inflammation hindering iron absorption.

Purpose of the Study:

  • To determine if weight status influences the effectiveness of oral iron supplementation in South African children with ID.
  • Investigate the predictive role of body mass index-for-age z-scores (BAZ) on treatment response.

Main Methods:

  • A placebo-controlled trial involving 321 children aged 6-11 years with ID, with 28% classified as OW or obese.
  • Oral iron supplementation (50 mg, 4x weekly for 8.5 months) or placebo was administered.
  • Measurements included BMI-for-age z-scores (BAZ), hepcidin, hemoglobin, serum ferritin (SF), transferrin receptor (TfR), zinc protoporphyrin (ZnPP), and C-reactive protein (CRP). Body iron was calculated using the SF to TfR ratio.

Main Results:

  • Higher BAZ correlated with increased C-reactive protein (CRP) and hepcidin levels at baseline.
  • Children with normal weight who received iron showed significantly lower TfR levels compared to overweight children receiving iron or placebo.
  • Increased BAZ predicted higher TfR and lower body iron at endpoint, and a higher likelihood of remaining iron deficient.

Conclusions:

  • Children with higher BAZ have a doubled risk of persistent ID post-supplementation, likely due to elevated hepcidin reducing iron absorption.
  • The rising prevalence of overweight in developing nations may impede efforts to combat anemia in vulnerable populations.
  • Clinical trial registered with ClinicalTrials.gov (NCT01092377).
Abstract

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