A Review of the Effect of Iron Supplementation on the Gut Microbiota of Children in Developing Countries and the Impact of Prebiotics.

Iron is essential for many physiological functions of the body, and it is required for normal growth and development. Iron deficiency (ID) is the most common form of micronutrient malnutrition and is particularly prevalent in infants and young children in developing countries. Iron supplementation is considered the most effective strategy to combat the risk of ID and ID anaemia (IDA) in infants, although iron supplements cause a range of deleterious gut-related problems in malnourished children. The purpose of this review is to assess the available evidence on the effect of iron supplementation on the gut microbiota during childhood ID and to further assess whether prebiotics offer any benefits for iron supplementation. Prebiotics are well known to improve gut-microbial health in children and recent reports indicate that prebiotics can mitigate the adverse gut-related effects of iron supplementation in ID and IDA children. Thus, provision of prebiotics alongside iron supplements has the potential for an enhanced strategy for combating ID and IDA among children in the developing world. However, further understanding is required before the benefit of such combined treatments of ID in nutritionally-deprived children across populations can be fully confirmed. Such enhanced understanding is of high relevance in resource-poor countries where ID, poor sanitation and hygiene, alongside inadequate access to good drinking water and poor health systems are serious public health concerns.