Abstract
In adolescents, iron-deficiency anemia is the leading cause of disability-adjusted life years lost. The World Health Organization recommends delivering iron supplementation through school-based platforms, requiring partnerships with the education sector. This anemia-reduction intervention is valued for the perceived benefits of improved learning and school performance. This article aims to systematically review the available evidence on the relationship between iron status and anemia and impacts of iron interventions on cognitive and academic performance in adolescents. Fifty studies were included: n = 26 cross-sectional and n = 24 iron-containing interventions. Our review suggests that iron status and anemia may be associated with academic performance in some contexts and that iron supplementation during adolescence may improve school performance, attention, and concentration. However, nearly all supplementation trials were judged to have moderate or high risk of bias. We did not find evidence suggesting that iron status and anemia influenced or were associated with attention, intelligence, nor memory in adolescents. Further, iron supplementation did not improve memory and recall or intelligence. Overall, more high-quality research is needed to guide programmers and policy makers to understand the relationships between anemia and educational performance and the potential impacts of iron interventions, which effectively reduce anemia, on adolescents’ learning and school performance.
Highlights
Iron is an essential trace mineral required for a variety of functions; it plays a role in brain development and brain function [1]
Fifty articles were selected for inclusion in this systematic review derwent full-text screening, and 132 papers were excluded based on the aforementioned eli(Figurecriteria
The potential effects of iron interventions need to be elucidated with rigorous research if ministries of health and education are to adopt such programming
Summary
Iron is an essential trace mineral required for a variety of functions; it plays a role in brain development and brain function [1]. Iron deficiency (ID) is commonly due to inadequate dietary intake of bioavailable iron; low iron status can happen during periods of increased growth requirements, such as early in childhood and adolescence when red blood cell mass is expanding [1,2]. The most marked consequence of ID, is characterized by a reduction in the blood’s oxygen-carrying capacity. This can lead to symptoms such as fatigue, weakness, and reduced work capacity [3]. This, in turn, may lead to poor academic performance. Irondeficiency anemia (IDA) is estimated to be the leading cause of disability-adjusted life years (DALYs) lost in boys and girls aged 10–14 years and girls aged 15–19 years [4]
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