n-3 Long-chain PUFAs reduce respiratory morbidity caused by iron supplementation in iron-deficient South African schoolchildren: a randomized, double-blind, placebo-controlled intervention.
| Autor: | Malan, Linda, Baumgartner, Jeannine, Calder, Philip C., Zimmermann, Michael B., Smuts, Cornelius M. |
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| Předmět: |
INFECTION prevention
ANALYSIS of covariance CHI-squared test COMBINED modality therapy CONFIDENCE intervals DIETARY supplements DISEASES FACTORIAL experiment designs GASTROINTESTINAL diseases IRON compounds IRON deficiency anemia PLACEBOS POISSON distribution PROBABILITY theory RESEARCH funding RESPIRATORY diseases T-test (Statistics) DOCOSAHEXAENOIC acid LOGISTIC regression analysis EICOSAPENTAENOIC acid SAMPLE size (Statistics) RANDOMIZED controlled trials BLIND experiment DATA analysis software KAPLAN-Meier estimator LOG-rank test ODDS ratio SYMPTOMS CHILDREN |
| Zdroj: | American Journal of Clinical Nutrition; Mar2015, Vol. 101 Issue 3, p668-679, 12p, 6 Charts, 1 Graph |
| Abstrakt: | Background: Although iron supplementation in malaria-free areas mostly reduces infectious morbidity, it can sometimes increase morbidity from infections as a result of the dependence of pathogenic microorganisms on iron. Supplementation with n-3 (ω-3) long-chain polyunsaturated fatty acids (LCPUFAs) improved morbidity in several human studies. However, information on the combined effect of iron and n-3 LCPUFA supplementation on infectious morbidity is limited. Objective: We determined whether n-3 LCPUFAs and iron supplementation, alone or in combination, affected absenteeism and illness in iron-deficient schoolchildren with low fish intake. Design: A total of 321 South African children (aged 6-11 y) with iron deficiency (ID) were randomly divided into 4 groups to receive 1) iron plus placebo, 2) a mixture of docosahexaenoic acid and eicosa-pentaenoic acid (DHA/EPA) plus placebo, 3) iron plus DHA/EPA, or 4) placebo plus placebo as oral supplements 4 times/wk for 8.5 mo. Morbidity was recorded, and iron-status indexes were measured. The total phospholipid fatty acid composition of peripheral blood mononuclear cell membranes was analyzed in a subsample (n = 130). Results: Iron supplementation increased the number of days with illness when all symptoms were considered (B: 0.87; 95% CI: 0.71, 1.03) as well as illness that was specifically caused by respiratory symptoms (B: 1.45; 95% CI: 1.21, 1.70), whereas DHA/EPA reduced the number of days with illness at school (B: 20.96; 95% CI: - 1.33, -0.59). The increases caused by iron were reduced to the levels seen in the placebo plus placebo group when iron was provided in combination with DHA/EPA as indicated by significant iron 3 DHA/EPA interactions (both P < 0.001). Conclusion: Iron supplementation increased morbidity (mostly respiratory) in iron-deficient South African schoolchildren with low DHA/EPA intake, but when iron was given in combination with DHA/EPA, this effect was prevented. This trial was registered at clinicaltrials.gov as NCT01092377. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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