A Systematic Review and Meta-Analysis on the Effects of Probiotic Species on Iron Absorption and Iron Status
What this study found
Lp299v consistently improved non-heme dietary iron absorption and was the only probiotic species with pooled evidence supporting this outcome. All 8 absorption studies reported a statistically significant increase, and the meta-analysis showed a pooled standardized mean difference of 0.55 (95% CI 0.22-0.88, p = 0.001). In contrast, iron-status markers did not improve consistently: only 1 study found better serum iron with Lp299v, while ferritin, hemoglobin, hematocrit, sTfR, and TIBC were generally unchanged or inconsistent. Overall, evidence for probiotic species other than Lp299v remains…
- Study & population
- Systematic review with meta-analysis of human studies assessing probiotic species and iron absorption or iron status.
- Intervention
- The review evaluated probiotic supplementation across 15 human studies, with a focused meta-analysis of Lactobacillus plantarum 299v (Lp299v) in 8 studies.
- Key limitation
- The evidence base was small and heterogeneous, with half of the studies enrolling fewer than 30 participants and interventions varying substantially by species, dose, delivery vehicle, and duration.
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Open PDFOriginal abstract
Background: Strategies to prevent iron deficiency anemia (IDA) have varying effectiveness. The purpose of this systematic review of the literature and meta-analysis was to examine the effects of probiotics on iron absorption and iron status-related markers in humans. Methods: We followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) reporting guidelines. Relevant articles were identified from Embase, Pubmed, Scopus, and CINAHL from inception to February, 2019. We conducted a meta-analysis for eight studies examining the effect of the probiotic Lactobacillus plantarum 299v (Lp299v) on iron absorption. Results: Fifteen studies reported in 12 articles were identified (N = 950). Our meta-analysis of eight studies using a random-effects model demonstrated a significant increase in iron absorption following administration of the probiotic Lp299v with a pooled standardized mean difference (an average intervention effect size) of 0.55 (95% CI 0.22–0.88, p = 0.001). Of the seven randomized clinical trials (RCTs) and nonrandomized clinical trials examining a range of probiotic species on iron status, only one study supplementing with Lp299v showed improvement in serum iron; no other studies reported improvement in iron status-related indices with probiotic treatment. Conclusions: Lp299v significantly improved iron absorption in humans. Future research should include the assessment of Lp299v effect on iron absorption and iron status in populations at high risk of IDA, including pregnant women.