Worldwide, about a quarter of billion children are anaemic. At least half of childhood anaemia is partly caused by a lack of iron. Currently, iron replenishment therapies in underdeveloped tropical countries show minimal effect with severe advents, such as infections, intestinal inflammation and diarrhoea. New research of our experts together with scientists of ETH Zurich, the Jomo Kenyatta University of Agriculture and Technology (Kenya) and the Swiss Tropical and Public Health Institute, shows that prebiotic GOS may counteract the adverse effect of iron on the infant gut microbiome while maintaining efficacy against anaemia. NIZO contributed to this study by isolating DNA from stool samples and in-depth analysis of changes in gut microbiota composition over time.
The need for safer and effective iron treatments
Iron deficiency anaemia has major health consequences, such as impairment of cognitive and motor development in infants. Iron deficiency can often be corrected by iron supplementation programs. However, given the adverse effects of iron supplements on inflammation and diarrhoea, there is a high need to make iron treatments both safer and more effective, especially in the developing world.
Prebiotic galacto-oligosaccharides (GOS) counteract the adverse effects on the infant gut microbiome
Previous work of our experts, together with scientists of ETH Zurich, the Radboud University Medical Center and African universities, has shown that iron-containing micronutrient powders (MNPs) can favour the outgrowth of harmful enteropathogens at the expense of beneficial microbes such as Bifidobacteriaceae and Lactobacillaceae. It also caused intestinal inflammation and diarrhoea in some children. In the current study a new formulation of iron-containing MNPs with GOS was engineered to counteract the adverse effect of iron on the infant gut microbiome while maintaining efficacy against anaemia at a relatively low dose of iron. GOS has the potential to selectively enhance growth of the beneficial Bifidobacteriaceae and Lactobacillaceae. It is also recognized as safe and is frequently added to infant formula. Our in-depth microbiome analyses show that GOS indeed was able to counteract the adverse effects of iron on the gut microbiome by stimulating beneficial Bifidobacteriaceae, while reducing the abundance of enteric pathogens. At the same time the MNP was effective in restoring iron deficiency anaemia of the infants. These promising results warrant further research on the efficacy and tolerability of GOS in the African infant population.