Copyright Notice
The contents of this document may be used and reprinted without permission. Endorsements by NESR, NGAD, CNPP, FNS, or USDA of derivative products developed from this work may not be stated or implied.
< PrevNext >
NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.
< PrevNext >
Iron from Supplements Consumed During Infancy and Toddlerhood and Growth, Size, and Body Composition: A Systematic Review
Kathryn Dewey, PhD, Lydia Bazzano, MD, PhD, Teresa Davis, PhD, Sharon Donovan, PhD, RD, Elsie Taveras, MD, MPH, Ronald Kleinman, MD, Darcy Güngör, MS, Sudha Venkatramanan, PhD, Emily Madan, PhD, Laural Kelly English, PhD, Nancy Terry, MS, MLS, Gisela Butera, MLIS, MEd, and Julie Obbagy, PhD, RD.
Author Information and AffiliationsAlexandria (VA): USDA Nutrition Evidence Systematic Review; 2020 Jul.
TECHNICAL ABSTRACT
Background
- 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.
- 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.
- 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
- 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)
- Insufficient evidence is available to determine the relationship between iron from supplements consumed during infancy and body composition during infancy. (Grade: Grade not assignable)
- 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)
- 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
- 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. Articles were screened by two NESR analysts independently for inclusion based on pre-determined criteria.
- 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
- 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.
- The intervention or exposure of interest was iron from supplements consumed during infancy and toddlerhood. 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.
- The comparators of interest were different dosages of iron from supplements and iron from fortified foods.
- 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).
- 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.
- 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.
- 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.
Contents
FUNDING SOURCE: United States Department of Agriculture, Food and Nutrition Service, Center for Nutrition Policy and Promotion, Alexandria, VA
Suggested citation:
Dewey K, Bazzano L, Davis T, Donovan S, Taveras E, Kleinman R, Güngör D, Venkatramanan S, Madan E, English LK, Terry N, Butera G, Obbagy J. Iron from Supplements Consumed During Infancy and Toddlerhood and Growth, Size, and Body Composition: A Systematic Review. July 2020. U.S. Department of Agriculture, Food and Nutrition Service, Center for Nutrition Policy and Promotion, Nutrition Evidence Systematic Review. Available at: https://doi.org/10.52570/NESR.DGAC2020.SR0303
In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex, gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs). Remedies and complaint filing deadlines vary by program or incident.
Persons using assistive technology should be able to access information in this report. For further assistance please email vog.ADSU@RSEN.NF.MS.
Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact the responsible Agency or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.
To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at How to File a Program Discrimination Complaint and at any USDA office or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by:
- (1)
mail: U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410;
- (2)
fax: (202) 690-7442; or
- (3)
email: vog.adsu@ekatni.margorp.
USDA is an equal opportunity provider, employer, and lender.
Related citation: Dietary Guidelines Advisory Committee. Scientific Report of the 2020 Dietary Guidelines Advisory Committee: Advisory Report to the Secretary of Agriculture and the Secretary of Health and Human Services. July 2020. U.S. Department of Agriculture, Agricultural Research Service. Available at: https://doi.org/10.52570/DGAC2020
- NLM CatalogRelated NLM Catalog Entries
- Review Vitamin D from Supplements Consumed during Infancy and Toddlerhood and Bone Health: A Systematic Review[ 2020]Review Vitamin D from Supplements Consumed during Infancy and Toddlerhood and Bone Health: A Systematic ReviewDewey K, Bazzano L, Davis T, Donovan S, Taveras E, Kleinman R, Güngör D, Venkatramanan S, Madan E, English LK, et al. 2020 Jul
- Review The Duration, Frequency, and Volume of Exclusive Human Milk and/or Infant Formula Consumption and Nutrient Status: A Systematic Review[ 2020]Review The Duration, Frequency, and Volume of Exclusive Human Milk and/or Infant Formula Consumption and Nutrient Status: A Systematic ReviewDewey K, Bazzano L, Davis T, Donovan S, Taveras E, Kleinman R, Güngör D, Madan E, Venkatramanan S, Terry N, et al. 2020 Jul
- Review The Duration, Frequency, and Volume of Exclusive Human Milk and/or Infant Formula Consumption and Overweight and Obesity: A Systematic Review[ 2020]Review The Duration, Frequency, and Volume of Exclusive Human Milk and/or Infant Formula Consumption and Overweight and Obesity: A Systematic ReviewDewey K, Bazzano L, Davis T, Donovan S, Taveras E, Kleinman R, Güngör D, Madan E, Venkatramanan S, Terry N, et al. 2020 Jul
- Review Maternal Diet during Pregnancy and Lactation and Risk of Child Food Allergies and Atopic Allergic Diseases: A Systematic Review[ 2020]Review Maternal Diet during Pregnancy and Lactation and Risk of Child Food Allergies and Atopic Allergic Diseases: A Systematic ReviewDonovan S, Dewey K, Novotny R, Stang J, Taveras E, Kleinman R, Raghavan R, Nevins J, Scinto-Madonich S, Butera G, et al. 2020 Jul
- Review Omega-3 fatty acids from Supplements Consumed before and during Pregnancy and Lactation and Developmental Milestones, Including Neurocognitive Development, in the Child: A Systematic Review[ 2020]Review Omega-3 fatty acids from Supplements Consumed before and during Pregnancy and Lactation and Developmental Milestones, Including Neurocognitive Development, in the Child: A Systematic ReviewDonovan S, Dewey K, Novotny R, Stang J, Taveras E, Kleinman R, Nevins J, Raghavan R, Scinto-Madonich S, Venkatramanan S, et al. 2020 Jul
- Iron from Supplements Consumed During Infancy and Toddlerhood and Growth, Size, ...Iron from Supplements Consumed During Infancy and Toddlerhood and Growth, Size, and Body Composition: A Systematic Review
Your browsing activity is empty.
Activity recording is turned off.
See more...