Effects of dietary polyphenol supplementation on iron status and erythropoiesis: a systematic review and meta-analysis of randomized controlled trials
Teng Xu, The American Journal of Clinical Nutrition, 19 April 2021
Background
The iron-chelating activities of polyphenols raise concern whether there is a risk of iron deficiency or anemia induced by polyphenol supplementation. Results from clinical trials regarding the effects of polyphenol supplementation on iron status and erythropoiesis are inconclusive.
Objective
We performed a systematic review and meta-analysis of randomized controlled trials to determine the effects of polyphenol supplementation on iron status and erythropoiesis.
Methods
Published articles were searched between May 1988 and 7 December, 2020. Finally, we identified 34 randomized controlled trials. Random-effects meta-analyses were performed to obtain the weighted mean difference of serum iron (SI), transferrin saturation (TS), ferritin, and hemoglobin concentration. Funnel plots and Egger's test were used to determine the risk of bias. The robustness of the effect sizes was examined by sensitivity analysis.
Results
Polyphenol supplementation had an inhibitory effect on the SI concentration (–13.72 μg/dL; 95% CI: –20.74, –6.71) and TS (–3.10%; 95% CI: –4.93, –1.27), with no effect on ferritin (–9.34 ng/mL; 95% CI: –28.55, 9.87). Polyphenols increased the hemoglobin concentration (8.53 g/L; 95% CI: 3.33, 13.73). In healthy participants, polyphenol reduced the TS (–3.83%; 95% CI: –7.47, –0.19) and increased the hemoglobin concentration (12.87 g/L; 95% CI: 1.61, 24.14). Similarly, polyphenol reduced the SI concentration (–8.60 μg/dL; 95% CI: –16.10, –1.10) and increased the hemoglobin concentration (8.50 g/L; 95% CI: 0.86, 16.15) in patients with metabolic diseases. In patients with β-thalassemia, polyphenol decreased the SI concentration (–23.19 μg/dL; 95% CI: –35.84, –10.55), TS (–3.23%; 95% CI: –5.54, –0.91), and ferritin concentration (–223.62 ng/mL; 95% CI: –359.32, –87.91), but had no effect on the hemoglobin concentration.
Conclusion
Healthy individuals and patients with metabolic diseases may benefit from the positive impact of polyphenols on erythropoiesis. Patients with β-thalassemia may benefit from the effect of polyphenols on reducing SI.