Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-776 Warsaw, Poland.
Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-776 Warsaw, Poland.
Nutrients. 2022 Jun 30;14(13):2724. doi: 10.3390/nu14132724.
Iron-deficiency anemia is the most frequent nutritional deficiency, with women of reproductive age being particularly at risk of its development. The aim of the systematic review was to assess the effectiveness of dietary interventions to treat iron-deficiency anemia in women based on the randomized controlled trials. The systematic review was conducted according to the PRISMA guidelines and registered in the PROSPERO database (CRD42021261235). The searching procedure was based on PubMed and Web of Science databases, while it covered records published until June 2021. It included all randomized controlled trials assessing effectiveness of various dietary interventions on treatment of iron-deficiency anemia in women of childbearing age. The total number of 7825 records were screened, while 14 of them were finally included in the systematic review. The studies were screened, included, and reported, and the risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomized trials by two independent researchers. The included studies compared the effectiveness of various dietary interventions with supplementation, placebo, control, or any other dietary intervention, while the assessed dietary interventions were based either on increasing iron supply and/or on increasing its absorption (by increasing vitamin C or vitamin D or decreasing phytate intake). The duration of applied intervention was diversified from 3 months or less, through 4 or 5 months, to half of a year or more. Among the assessed biochemical measures, the following were analyzed in majority of studies: hemoglobin, ferritin, transferrin receptor, hematocrit, and transferrin. The majority of included studies supported the influence of dietary interventions on the treatment of iron-deficiency anemia, as the applied dietary intervention was not effective in only three studies. The majority of included studies were assessed as characterized by medium risk of bias, while the overall risk was high for only four studies, which resulted from the randomization process, deviations from the intended interventions, and selection of the reported result. The majority of included studies were conducted for increasing iron supply and/or increasing vitamin C supply; however, only for the interventions including increasing iron supply and simultaneously increasing its absorption by vitamin C supply were all results confirmed effective. Vitamin D also seems to be an effective dietary treatment, but further studies are necessary to confirm the observations. Considering this fact, dietary interventions recommended for anemic female patients should include increased intake of iron and vitamin C.
缺铁性贫血是最常见的营养缺乏症，育龄妇女尤其容易发生缺铁性贫血。本系统评价的目的是评估基于随机对照试验的饮食干预治疗育龄妇女缺铁性贫血的有效性。系统评价按照 PRISMA 指南进行，并在 PROSPERO 数据库（CRD42021261235）中进行了登记。检索过程基于 PubMed 和 Web of Science 数据库，涵盖截至 2021 年 6 月发表的记录。它包括所有评估各种饮食干预措施对育龄妇女缺铁性贫血治疗效果的随机对照试验。共筛选了 7825 条记录，最终有 14 条被纳入系统评价。研究的筛选、纳入和报告，以及偏倚风险的评估均由两名独立研究人员使用修订后的 Cochrane 随机试验偏倚风险工具进行。纳入的研究比较了各种饮食干预与补充剂、安慰剂、对照组或任何其他饮食干预的效果，而评估的饮食干预要么基于增加铁的供应和/或增加其吸收（通过增加维生素 C 或维生素 D 或减少植酸摄入）。应用干预的持续时间从 3 个月或更短，到 4 个月或 5 个月，再到半年或更长时间不等。在评估的生化指标中，大多数研究都分析了以下指标：血红蛋白、铁蛋白、转铁蛋白受体、红细胞压积和转铁蛋白。纳入的大多数研究都支持饮食干预对缺铁性贫血治疗的影响，因为只有三项研究表明应用的饮食干预无效。纳入的大多数研究被评估为具有中等偏倚风险，而只有四项研究的总体风险较高，这是由于随机化过程、偏离预期干预措施以及选择报告结果造成的。纳入的大多数研究都旨在增加铁的供应和/或增加维生素 C 的供应；然而，只有包括增加铁的供应并同时通过维生素 C 供应增加其吸收的干预措施，所有结果都被证实是有效的。维生素 D 似乎也是一种有效的饮食治疗方法，但需要进一步的研究来证实这一观察结果。考虑到这一事实，建议缺铁性贫血女性患者的饮食干预应包括增加铁和维生素 C 的摄入。
