Effect of iron supplementation with or without vitamin E (VE) on gut microbiome (MB) in iron deficient (ID) infants and toddlers

Abstract

ObjectiveTo assess the impact of VE on the efficacy of therapeutic iron and on gut MB in infants and toddlers with ID.DesignThis is a randomized, double blind efficacy trial of 8 weeks of iron therapy (6 mg/kg/d) alone or with VE, in 9‐24 mo old infants and toddlers with ID. Profiles of fecal gut MB were measured by 16S sequencing before and after treatment.Results32 infants (14 ± 4 mo) completed the study with pre‐ and post‐trial stool samples collected (IG: Iron Group n=18; IVEG: iron +VE Group n=14). Over time, allparticipants improved iron status. Compared with IG without group difference. Compared with IG, the IVEG had increase in serum vitamin E concentration (Δ1.3 ± 6.1 mcg/ml, P < 0.05). Microbial diversity increased overtime (P < 0.01) among all participants. Firmicutes increased (P < 0.05) and Bacteroidetes decreased (P < 0.05) in relative abundance (RA) in the IVEG, compared with IG. A group‐by‐time interaction was observed in which Bacteroidaceae (P = 0.07) and Bacteroides (P = 0.07) decreased, while the potential butyrate producers Lachnospiraceae (P = 0.01 and Roseburia (P = 0.04) increased in RA in the IVEG. Among all participants, correction of ID was associated with decreased Escherichia from 1.4% to 0.4% (P =0.01). Age and breastfeeding exposure had no impact on the results.ConclusionImproving iron status in U.S. infants and toddlers with ID reduced the abundance of putative pathogens. Adding VE to iron supplement beneficially affected the gut microbiome.Sponsored by: The Gerber foundation, NIH/NIDDK (K24 DK083772), Colorado CTSI, UCD Microbiome Research Consortium