Iron from supplements consumed during infancy and toddlerhood and growth, size, and body composition a systematic review
Evidence available from 3 studies was insufficient to determine whether a relationship exists between iron from supplements, compared with a different dosage or duration of iron from supplements, and growth or size, because the studies used heterogeneous interventions that could not be compared.7. E...
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| Corporate Authors: | , |
| Format: | eBook |
| Language: | English |
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Alexandria (VA)
United States Department of Agriculture
[2020], 2020
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| Online Access: | |
| Collection: | National Center for Biotechnology Information - Collection details see MPG.ReNa |
| Summary: | Evidence available from 3 studies was insufficient to determine whether a relationship exists between iron from supplements, compared with a different dosage or duration of iron from supplements, and growth or size, because the studies used heterogeneous interventions that could not be compared.7. Evidence available from 2 studies was insufficient to determine whether a relationship exists between iron from supplements, compared with iron from fortified foods, and growth or size, because the studies used heterogeneous interventions that could not be compared BACKGROUND: 1. This important public health question was identified by the U.S. Departments of Agriculture (USDA) and Health and Human Services (HHS) to be examined by the 2020 Dietary Guidelines Advisory Committee.2. The 2020 Dietary Guidelines Advisory Committee, Birth to 24 Months Subcommittee, conducted a systematic review to answer this question with support from the Nutrition Evidence Systematic Review (NESR) team.3. The goal of this systematic review was to examine the following question: What is the relationship between iron from supplements consumed during infancy and toddlerhood and growth, size, and body composition? CONCLUSION STATEMENTS AND GRADES: 1. Moderate evidence indicates that human milk-fed infants who are supplemented with iron do not have greater growth, and may have slower growth, than human milk-fed infants not supplemented with iron. (Grade: Moderate)2. Dietary supplements are products that contain one or more dietary ingredients (in this case, iron) intended to be taken by mouth to supplement the diet. Nine studies examined iron supplementation during infancy, and only 1 study examined iron supplementation during toddlerhood.3. The comparators of interest were different dosages of iron from supplements and iron from fortified foods.4. The outcomes of interest were measures of growth, size, and body composition at any age. However, no articles were identified that examined outcomes beyond 24 months. The articles presented evidence about growth (i.e., change in size between birth or baseline and follow-up) and size (i.e., attained size at follow-up). However, no articles presented evidence about body composition (e.g., percent fat mass, skinfold thickness).5. Articles were screened by two NESR analysts independently for inclusion based on pre-determined criteria.2. Data extraction and risk of bias assessment were conducted for each included study, and both were checked for accuracy. The Committee qualitatively synthesized the body of evidence to inform development of conclusion statements, and graded the strength of evidence using pre-established criteria for risk of bias, consistency, directness, precision, and generalizability. SUMMARY OF THE EVIDENCE: 1. Ten articles met the inclusion criteria for this systematic review, which presented evidence from 8 randomized controlled trials, 1 non-randomized controlled trial, and 1 study that did not clearly describe its prospective study design.2. The intervention or exposure of interest was iron from supplements consumed during infancy and toddlerhood. Insufficient evidence is available to determine the relationship between iron from supplements consumed during infancy and body composition during infancy. (Grade: Grade not assignable)3. Insufficient evidence is available to determine the relationship between iron from supplements consumed during infancy and growth, size, and body composition beyond age 12 months. (Grade: Grade not assignable)4. Insufficient evidence is available to determine the relationship between iron from supplements consumed after age 12 months and growth, size, and body composition. (Grade: Grade not assignable) METHODS: 1. A literature search was conducted using 4 databases (PubMed, Embase, CINAHL, and Cochrane) to identify articles that evaluated the intervention or exposure of iron from supplements consumed during infancy and toddlerhood and growth, size, and body composition outcomes. A manual search was conducted to identify articles that may not have been included in the electronic databases searched. Moderate evidence, from 5 studies that compared iron from supplements with no iron from supplements, indicated that human milk-fed infants who are supplemented with iron do not have greater growth, and may have slower growth, than human milk-fed infants not supplemented with iron. Inconsistencies in the evidence may be explained by differences in the risk of iron deficiency between the populations studied, differences in participants' consumption of iron-fortified formula or iron-rich foods, and differences in the timing of iron supplementation. This heterogeneity, the small number of studies, and the small sample sizes, were the primary factors limiting the ability to draw stronger conclusions.6. |
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| Physical Description: | 1 PDF file (56 pages) illustrations |