What this means
The growing geriatric population has increased the burden of age-related conditions such as anaemia, highlighting the need for effective strategies to promote healthy ageing. This study evaluated the effect of supplementation of iron and folic acid (IFA) with probiotics on haematological, inflammatory, and gut microbiome parameters among elderly individuals with mild-to-moderate anaemia.
A plain-English summary is on its way. Until then, this is the start of the authors' own summary.
- Who it was tested in
- Not stated
- Kind of research
- A study
The science
- Original title
- Impact of supplementation of a package of iron folic acid (IFA) with probiotics on haemoglobin levels in the elderly with mild to moderate anaemia: A double-blind, randomised controlled trial (PRobiotics in Anaemia Trial for Healthy Ageing Management - PRATHAM).
- Authors
- Ahamed F, Palepu S, Pal D et al.
- Journal
- Clinical nutrition ESPEN
- Published
- Oct 26, 2026
- Study type
- Study
- PMID
- 42933603 ↗
Abstract
Background
The growing geriatric population has increased the burden of age-related conditions such as anaemia, highlighting the need for effective strategies to promote healthy ageing. This study evaluated the effect of supplementation of iron and folic acid (IFA) with probiotics on haematological, inflammatory, and gut microbiome parameters among elderly individuals with mild-to-moderate anaemia.
What they did
This community-based, placebo-controlled, double-blind, randomised controlled trial was conducted among individuals aged ≥60 years from the "AIIMS SBIMB Study on Healthy Ageing (ASTHA)" cohort. A total of 200 participants were randomised in a 1:1 ratio. The intervention group received daily IFA tablets containing 60 mg of elemental iron and 500 μg of folic acid, along with probiotic capsules containing Streptococcus faecalis, Bifidobacterium, and Lactobacillus (30 billion CFUs/capsule) for 12 weeks. The control group received IFA tablets with placebo capsules containing one milligram of oral rehydration solution (ORS). Haemoglobin, ferritin, hepcidin, CRP, acute infections, and gut microbiome diversity were assessed at baseline and 12 weeks. An intention-to-treat (ITT) analysis was performed as the primary analysis, with a per-protocol analysis conducted as a sensitivity analysis.
What they found
A total of 184 study participants completed follow-up; missing endline biochemical data for the remaining participants were imputed using the last observation carried forward approach. The mean change in haemoglobin in the intervention and control groups was 1.0 ± 1.1 g/dL and 1.2 ± 1.1 g/dL, respectively (p=0.439). Hepcidin increased in both groups, with no significant between-group difference (p=0.550). Ferritin increased significantly more in the control group than in the intervention group (20.6 ± 34.2 ng/mL vs 10.0 ± 20.4 ng/mL; p=0.033). Baseline alpha-diversity was higher in the intervention group, while most endline diversity measures were comparable between groups. IFA with probiotics did not provide additional benefit in haemoglobin or ferritin responses compared with IFA alone over 12 weeks, and there were no significant between-group differences in hepcidin or most gut microbiota alpha-diversity measures at endline.
Other details
CTRI/2023/09/057830.
The authors' abstract, grouped under plain headings from its own section labels.
Ahamed F, Palepu S, Pal D et al. Impact of supplementation of a package of iron folic acid (IFA) with probiotics on haemoglobin levels in the elderly with mild to moderate anaemia: A double-blind, randomised controlled trial (PRobiotics in Anaemia Trial for Healthy Ageing Management - PRATHAM). Clinical nutrition ESPEN. 2026. doi:10.1016/j.clnesp.2026.105208. PMID: 42933603. https://pubmed.ncbi.nlm.nih.gov/42933603/