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Effect of supplementation with ferrous sulfate or iron bis-glycinate chelate on ferritin concentration in Mexican schoolchildren: a randomized controlled trial

Ximena Duque1, Homero Martinez23*, Jenny Vilchis-Gil3, Eugenia Mendoza1, Sergio Flores-Hernández4, Segundo Morán1, Fabiola Navarro1, Victoria Roque-Evangelista1, Anayeli Serrano1 and Robertino M Mera5

Author Affiliations

1 Instituto Mexicano del Seguro Social, Av. Cuauhtemoc No. 330, CP 06725 México, DF, México

2 RAND Corporation, Santa Monica, California 90407, USA

3 Hospital Infantil de México Federico Gómez, Dr. Marquez No. 162, CP 06720 México, DF, México

4 Instituto Nacional de Salud Pública, Universidad No. 658, CP 62100 Cuernavaca, Morelos, Mexico

5 Vanderbilt University Medical Center, Nashville, TN, USA

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Nutrition Journal 2014, 13:71  doi:10.1186/1475-2891-13-71

Published: 15 July 2014

Abstract

Background

Iron deficiency is one of the most common nutritional deficiencies worldwide. It is more prevalent when iron requirements are increased during pregnancy and during growth spurts of infancy and adolescence. The last stage in the process of iron depletion is characterized by a decrease in hemoglobin concentration, resulting in iron deficiency anemia. Iron deficiency, even before it is clinically identified as anemia, compromises the immune response, physical capacity for work, and intellectual functions such as attention level. Therefore, interventions addressing iron deficiency should be based on prevention rather than on treatment of anemia. The aim of this study was to compare short- and medium-term effects on ferritin concentration of daily supplementation with ferrous sulfate or iron bis-glycinate chelate in schoolchildren with iron deficiency but without anemia.

Methods

Two hundred schoolchildren from public boarding schools in Mexico City who had low iron stores as assessed by serum ferritin concentration but without anemia were randomly assigned to a daily supplement of 30 mg/day of elemental iron as ferrous sulfate or iron bis-glycinate chelate for 12 weeks. Iron status was evaluated at baseline, one week post-supplementation (short term), and 6 months (medium term) after supplementation.

Results

Ferritin concentration increased significantly between baseline and post-supplementation as well as between baseline and 6 months after supplementation. One week post-supplementation no difference was found in ferritin concentration between iron compounds, but 6 months after supplementation ferritin concentration was higher in the group that received bis-glycinate chelate iron. However, there is no difference in the odds for low iron storage between 6 months after supplementation versus the odds after supplementation; nor were these odds different by type of supplement. Hemoglobin concentration did not change significantly in either group after supplementation.

Conclusions

Supplementing with 30 mg/d of elementary iron, either as ferrous sulfate or iron bis-glycinate chelate for 90 days, showed positive effects on increasing ferritin concentration in schoolchildren with low iron stores, and this effect persisted 6 months after supplementation.

Keywords:
Iron deficiency; Serum ferritin; Ferrous sulfate; Bis-glycinate chelate iron; Schoolchildren