{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T06:17:08Z","timestamp":1789021028225,"version":"build-2803163510"},"reference-count":58,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T00:00:00Z","timestamp":1656547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Polish Ministry of Science and Higher Education"},{"name":"Institute of Human Nutrition Sciences"},{"name":"Warsaw University of Life Sciences (WULS)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3390\/nu14132724","type":"journal-article","created":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T00:21:50Z","timestamp":1656634910000},"page":"2724","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Effectiveness of Dietary Interventions to Treat Iron-Deficiency Anemia in Women: A Systematic Review of Randomized Controlled Trials"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5818-9884","authenticated-orcid":false,"given":"Dominika","family":"Skolmowska","sequence":"first","affiliation":[{"name":"Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-776 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8588-7357","authenticated-orcid":false,"given":"Dominika","family":"G\u0142\u0105bska","sequence":"additional","affiliation":[{"name":"Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-776 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7044-6049","authenticated-orcid":false,"given":"Aleksandra","family":"Ko\u0142ota","sequence":"additional","affiliation":[{"name":"Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-776 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0784-3604","authenticated-orcid":false,"given":"Dominika","family":"Guzek","sequence":"additional","affiliation":[{"name":"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"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,30]]},"reference":[{"key":"ref_1","unstructured":"Badireddy, M., and Baradhi, K.M. (2022, April 21). Chronic Anemia, StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK534803\/."},{"key":"ref_2","unstructured":"World Health Organization (2004). Focusing on Anaemia: Towards an Integrated Approach for Effective Anaemia Control."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1111\/nyas.14092","article-title":"Anemia epidemiology, pathophysiology, and etiology in low-and middle-income countries","volume":"1450","author":"Chaparro","year":"2019","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_4","first-page":"17","article-title":"Nutritional iron deficiency in women of child bearing age\u2014What to do?","volume":"21","author":"Ansari","year":"2009","journal-title":"J. Ayub. Med. Coll. Abbottabad"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1111\/anae.15405","article-title":"The effect of iron deficiency and anaemia on women\u2019s health","volume":"76","author":"Benson","year":"2021","journal-title":"Anaesthesia"},{"key":"ref_6","unstructured":"World Health Organization (2014). Global Nutrition Targets 2025, Policy Brief Series, WHO\/NMH\/NHD\/14.2."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"8977","DOI":"10.3390\/nu7115446","article-title":"The effect of plant proteins derived from cereals and legumes on heme iron absorption","volume":"7","author":"Weinborn","year":"2015","journal-title":"Nutrients"},{"key":"ref_8","first-page":"164","article-title":"Review on iron and its importance for human health","volume":"19","author":"Abbaspour","year":"2014","journal-title":"J. Res. Med. Sci."},{"key":"ref_9","unstructured":"Moustarah, F., and Mohiuddin, S.S. (2022, April 21). Dietary Iron, StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK540969\/."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"3747","DOI":"10.3390\/nu6093747","article-title":"Dietary determinants of and possible solutions to iron deficiency for young women living in industrialized countries: A review","volume":"6","author":"Beck","year":"2014","journal-title":"Nutrients"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Young, I., Parker, H.M., Rangan, A., Prvan, T., Cook, R.L., Donges, C.E., Steinbeck, K.S., O\u2019Dwyer, N.J., Cheng, H.L., and Franklin, J.L. (2018). Association between Haem and Non-Haem Iron Intake and Serum Ferritin in Healthy Young Women. Nutrients, 10.","DOI":"10.3390\/nu10010081"},{"key":"ref_12","unstructured":"World Health Organization (2017). Nutritional Anaemias: Tools for Effective Prevention and Control."},{"key":"ref_13","unstructured":"Nutritional Institutes of Health (2022, April 07). Iron, Available online: https:\/\/ods.od.nih.gov\/factsheets\/Iron-HealthProfessional\/."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.tifs.2020.02.021","article-title":"Iron deficiency anemia: A comprehensive review on iron absorption, bioavailability and emerging food fortification approaches","volume":"99","author":"Shubham","year":"2020","journal-title":"Trends Food Sci. Technol."},{"key":"ref_15","unstructured":"Stoltzfus, R.J., and Dreyfuss, M.L. (1998). Guidelines for the Use of Iron Supplements to Prevent and Treat Iron Deficiency Anemia."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Tolkien, Z., Stecher, L., Mander, A.P., Pereira, D.I., and Powell, J.J. (2015). Ferrous sulfate supplementation causes significant gastrointestinal side-effects in adults: A systematic review and meta-analysis. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0117383"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1016\/j.femsim.2004.11.010","article-title":"Iron and infection: The heart of the matter","volume":"43","author":"Bullen","year":"2005","journal-title":"FEMS Immunol. Med. Microbiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1093\/nutrit\/nuw055","article-title":"Dietary strategies for improving iron status: Balancing safety and efficacy","volume":"75","author":"Prentice","year":"2017","journal-title":"Nutr. Rev."},{"key":"ref_19","unstructured":"Howson, C.P., Kennedy, E.T., and Horwitz, A. (2022, April 21). Prevention of Micronutrient Deficiencies: Tools for Policymakers and Public Health Workers, Prevention of Iron Deficiency, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK230103\/."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Liberati, A., Altman, D.G., Tetzlaff, J., Mulrow, C., G\u00f8tzsche, P.C., Ioannidis, J.P., Clarke, M., Devereaux, P.J., Kleijnen, J., and Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. PLoS Med., 21.","DOI":"10.2427\/5768"},{"key":"ref_22","unstructured":"(2021, November 16). Assessing Risk of Bias in Non-Randomized Studies. Chapter 13.5.2.3. Available online: http:\/\/handbook-5-1.cochrane.org\/."},{"key":"ref_23","unstructured":"(2022, June 10). RoB 2: A Revised Cochrane Risk-of-Bias Tool for Randomized Trials. Available online: https:\/\/methods.cochrane.org\/bias\/resources\/rob-2-revised-cochrane-risk-bias-tool-randomized-trials."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.jclinepi.2020.06.015","article-title":"The revised Cochrane risk of bias tool for randomized trials (RoB 2) showed low interrater reliability and challenges in its application","volume":"126","author":"Minozzi","year":"2020","journal-title":"J. Clin. Epidemiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1080\/07315724.2001.10719056","article-title":"Can dietary treatment of non-anemic iron deficiency improve iron status?","volume":"20","author":"Heath","year":"2001","journal-title":"J. Am. Coll. Nutr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1093\/ajcn\/74.5.650","article-title":"Dietary treatment of iron deficiency in women of childbearing age","volume":"74","author":"Patterson","year":"2001","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1093\/ajcn\/78.2.267","article-title":"Ascorbic acid from lime juice does not improve the iron status of iron-deficient women in rural Mexico","volume":"78","author":"Garcia","year":"2003","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.jcs.2005.04.001","article-title":"Long-term intake of iron fortified wholemeal rye bread appears to benefit iron status of young women","volume":"42","author":"Hansen","year":"2005","journal-title":"J. Cereal Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1007\/s00394-007-0683-6","article-title":"The impact of a meat-versus a vegetable-based diet on iron status in women of childbearing age with small iron stores","volume":"46","author":"Tetens","year":"2007","journal-title":"Eur. J. Nutr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1007\/BF03179067","article-title":"Iron status biomarkers in iron deficient women consuming oily fish versus red meat diet","volume":"65","author":"Schoppen","year":"2009","journal-title":"J. Physiol. Biochem."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1017\/S0007114510003144","article-title":"Gold kiwifruit consumed with an iron-fortified breakfast cereal meal improves iron status in women with low iron stores: A 16-week randomised controlled trial","volume":"105","author":"Beck","year":"2011","journal-title":"Br. J. Nutr."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1652","DOI":"10.1017\/S0007114510005490","article-title":"Efficacy of a microencapsulated iron pyrophosphate-fortified fruit juice: A randomised, double-blind, placebo-controlled study in Spanish iron-deficient women","volume":"105","author":"Toxqui","year":"2011","journal-title":"Br. J. Nutr."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1007\/s00394-012-0375-8","article-title":"Relationship between vitamin D deficiency, bone remodelling and iron status in iron-deficient young women consuming an iron-fortified food","volume":"52","author":"Toxqui","year":"2013","journal-title":"Eur. J. Nutr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1080\/07315724.2013.826116","article-title":"Effects of an iron or iron and vitamin D-fortified flavored skim milk on iron metabolism: A randomized controlled double-blind trial in iron-deficient women","volume":"32","author":"Toxqui","year":"2013","journal-title":"J. Am. Coll. Nutr."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1080\/09735070.2014.11886475","article-title":"Intervention Trials with Pearl Millet Based Iron Rich Ladoo and Iron Folic Acid (IFA) Tablets on Hemoglobin Status of Adolescent Females in Bikaner City","volume":"8","author":"Singh","year":"2014","journal-title":"Stud. EthnoMe."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1735","DOI":"10.3945\/jn.114.209957","article-title":"Regular Consumption of a High-Phytate Diet Reduces the Inhibitory Effect of Phytate on Nonheme-Iron Absorption in Women with Suboptimal Iron Stores","volume":"145","author":"Armah","year":"2015","journal-title":"J. Nutr."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1586","DOI":"10.3945\/jn.115.224741","article-title":"Consuming Iron Biofortified Beans Increases Iron Status in Rwandan Women after 128 Days in a Randomized Controlled Feeding Trial","volume":"146","author":"Haas","year":"2016","journal-title":"J. Nutr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"746","DOI":"10.3945\/ajcn.115.127555","article-title":"Efficacy of iron-supplement bars to reduce anemia in urban Indian women: A cluster-randomized controlled trial","volume":"105","author":"Mehta","year":"2017","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_39","first-page":"741","article-title":"Optimal management of iron deficiency anemia due to poor dietary intake","volume":"4","author":"Aspuru","year":"2011","journal-title":"Int. J. Gen. Med."},{"key":"ref_40","unstructured":"Institute for Quality and Efficiency in Health Care (2022, April 23). How can I get enough iron?, StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK279618\/."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1038\/ejcn.2014.291","article-title":"Comparison of food habits, iron intake and iron status in adolescents before and after the withdrawal of the general iron fortification in Sweden","volume":"69","year":"2015","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1207\/s15324796abm2702_5","article-title":"Gender differences in food choice: The contribution of health beliefs and dieting","volume":"27","author":"Wardle","year":"2004","journal-title":"Ann. Behav. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/S0950-3293(02)00041-1","article-title":"Gender specific preferences and attitudes towards meat","volume":"13","author":"Ueland","year":"2002","journal-title":"Food Qual. Prefer."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"59","DOI":"10.7175\/cmi.v11i2.1313","article-title":"Gender-related differences in dietary habits","volume":"11","author":"Masella","year":"2017","journal-title":"Clin. Manag. Issues"},{"key":"ref_45","first-page":"324","article-title":"Effect of iron status on iron absorption in different habitual meals in young south Indian women","volume":"137","author":"Kalasuramath","year":"2013","journal-title":"Indian J. Med. Res."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Fern\u00e1ndez-L\u00e1zaro, D., Mielgo-Ayuso, J., C\u00f3rdova Mart\u00ednez, A., and Seco-Calvo, J. (2020). Iron and physical activity: Bioavailability enhancers, properties of black pepper (bioperine\u00ae) and potential applications. Nutrients, 12.","DOI":"10.3390\/nu12061886"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1024\/0300-9831.74.6.403","article-title":"Enhancers of iron absorption: Ascorbic acid and other organic acids","volume":"74","author":"Teucherl","year":"2004","journal-title":"Int. J. Vitam. Nutr. Res."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Sabatier, M., Rytz, A., Husny, J., Dubascoux, S., Nicolas, M., Dave, A., Singh, H., Bodis, M., and Glahn, R.P. (2020). Impact of Ascorbic Acid on the In Vitro Iron Bioavailability of a Casein-Based Iron Fortificant. Nutrients, 12.","DOI":"10.3390\/nu12092776"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1111\/j.1749-6632.1980.tb21325.x","article-title":"Interaction of vitamin C and iron","volume":"355","author":"Lynch","year":"1980","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"S7","DOI":"10.1301\/002966402320285137","article-title":"How to ensure adequate iron absorption from iron-fortified food","volume":"60","author":"Hurrell","year":"2002","journal-title":"Nutr. Rev."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1097\/MED.0000000000000199","article-title":"Vitamin D and anemia: Insights into an emerging association","volume":"22","author":"Smith","year":"2015","journal-title":"Curr. Opin. Endocrinol. Diabetes Obes."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1186\/s12937-016-0192-7","article-title":"Effect of vitamin D 3 supplementation on iron status: A randomized, double-blind, placebo-controlled trial among ethnic minorities living in Norway","volume":"15","author":"Madar","year":"2015","journal-title":"Nutr. J."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"65","DOI":"10.3945\/ajcn.112.050609","article-title":"The absorption of iron from whole diets: A systematic review","volume":"98","author":"Collings","year":"2013","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1089\/whr.2019.0011","article-title":"Iron deficiency in menstruating adult women: Much more than anemia","volume":"1","author":"Moreno","year":"2020","journal-title":"Women\u2019s Health Rep."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1309\/LMM7A0F0QBXEYSSI","article-title":"Hemoglobin and serum iron concentrations in menstruating nulliparous women in Jos, Nigeria","volume":"44","author":"Ofojekwu","year":"2013","journal-title":"Lab. Med."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1007\/s00277-013-1901-3","article-title":"Iron-dependent erythropoiesis in women with excessive menstrual blood losses and women with normal menses","volume":"93","author":"Napolitano","year":"2014","journal-title":"Ann. Hematol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1079\/BJN20051493","article-title":"Impact of menstrual blood loss and diet on iron deficiency among women in the UK","volume":"94","author":"Harvey","year":"2005","journal-title":"Br. J. Nutr."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1111\/j.1749-6632.1993.tb26345.x","article-title":"The Cochrane Collaboration: Preparing, maintaining, and disseminating systematic reviews of the effects of health care","volume":"703","author":"Chalmers","year":"1993","journal-title":"Ann. N. Y. Acad. 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