철분 (황산제일철)

Mechanisms of 2-butoxyethanol carcinogenicity: studies on Syrian Hamster Embryo (SHE) cell transformation.

1. Toxicol Sci. 2002 Jul;68(1):43-50. doi: 10.1093/toxsci/68.1.43. Mechanisms of 2-butoxyethanol carcinogenicity: studies on Syrian Hamster Embryo (SHE) cell transformation. Park J(1), Kamendulis LM, Klaunig JE. Author information: (1)Division of Toxicology, Department of Pharmacology and Toxico

Effect of calcium supplementation in pregnancy on maternal anemia and iron status: Secondary analyses of two randomized trials in India and Tanzania.

1. Am J Clin Nutr. 2026 Apr 29:101338. doi: 10.1016/j.ajcnut.2026.101338. Online ahead of print. Effect of calcium supplementation in pregnancy on maternal anemia and iron status: Secondary analyses of two randomized trials in India and Tanzania. Ali NB(1), Sudfeld CR(2), Muhihi A(3), Thomas T(4), Perumal N(5), Sando MM(3), Masanja HM(6), Partap U(7), Duggan CP(8), Kurpad AV(9), Dwarkanath P(10), Pembe AB(11), Fawzi WW(12). Author information: (1)Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA; Division of Maternal and Child Health, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh. Electronic address: naziabinteali@g.harvard.edu. (2)Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA. (3)Africa Academy for Public Health, Dar es Salaam, Tanzania. (4)Department of Biostatistics, St. John's Research Medical College, Bangalore, India. (5)Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina, USA. (6)Ifakara Health Institute, Dar es Salaam, Tanzania. (7)Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA. (8)Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA; Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts. (9)Department of Physiology & Nutrition, St. John's Medical College & St. John's Research Institute, Bangalore, India. (10)Division of Nutrition, St. John's Research Institute, Bangalore, India. (11)Department of Obstetrics and Gynaecology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. (12)Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA. INTRODUCTION: While recent trials have shown daily prenatal low-dose 500 mg calcium supplementation to be noninferior to the recommended high-dose 1500 mg regimen for prevention of preeclampsia, its effects on maternal anemia and iron status remain unclear. METHODS: We conducted two individually randomized, non-inferiority trials in India and Tanzania (N=11,000 each) comparing daily 500 mg to 1500 mg calcium supplementation during pregnancy. All participants received standard IFA (60 mg iron) and were counseled to take calcium supplements several hours apart from the IFA. All participants had hemoglobin measured at baseline and at 32 weeks of gestation, while a random subset of participants had ferritin quantified at the same time points. Using an intention-to-treat approach, we assessed effects of 500 mg compared to 1500 mg calcium supplementation on mean hemoglobin and inflammation-adjusted serum ferritin (log-scale) using generalized linear models, and on anemia and iron deficiency anemia using log-binomial models. RESULTS: Third-trimester hemoglobin and serum ferritin were measured in 8,953 and 1,336 participants in India, respectively. In Tanzania, 8,496 participants had hemoglobin, and 882 had ferritin assessed. In both trials, there was no difference between 500 and 1500 mg calcium supplementation on third-trimester hemoglobin [India: mean difference (MD) 0.01 (95% confidence interval (CI): -0.03, 0.04); Tanzania: MD -0.02 (95% CI: -0.07, 0.03)], anemia [India: relative risk (RR) 1.01 (95% CI: 0.95, 1.07); Tanzania: RR 1.00 (95% CI: 0.96, 1.05)], or iron deficiency anemia [India: RR 1.20 (95% CI: 0.93, 1.57); Tanzania: RR 0.94 (95% CI: 0.77, 1.15)]. CONCLUSION: Low and high-dose calcium supplementation showed no differences in third-trimester hematologic outcomes. Future studies should assess the effects of co-administering or combining calcium and IFA into a single tablet on adherence and bioavailability of iron. CLINICAL TRIAL REGISTRY: ClinicalTrials.gov identifier, NCT03350516; Clinical Trials Registry India number, CTRI/018/2/12119; and Tanzania Medicines and Medical Devices Authority Trials Registry number, TFDA0018/TR/010/. Copyright © 2026 American Society for Nutrition. Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.ajcnut.2026.101338 PMID: 42067065 Conflict of interest statement: Competing interests The authors declare no competing interests.

Improved iron status, but not protein source, is related to appetite, satiety, and mood in women of reproductive age with iron deficiency: a randomized controlled trial.

2. J Nutr. 2026 Apr 28:101559. doi: 10.1016/j.tjnut.2026.101559. Online ahead of print. Improved iron status, but not protein source, is related to appetite, satiety, and mood in women of reproductive age with iron deficiency: a randomized controlled trial. Hennigar SR(1), Miller KM(2), Murphy RD(2), Braymer A(3), Mayet CL(3), Greenway FL(3), Cheung SN(4), Weschenfelder C(3), Berryman CE(4). Author information: (1)Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, FL; Pennington Biomedical Research Center, Baton Rouge, LA. Electronic address: stephen.hennigar@pbrc.edu. (2)Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, FL. (3)Pennington Biomedical Research Center, Baton Rouge, LA. (4)Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, FL; Pennington Biomedical Research Center, Baton Rouge, LA. BACKGROUND: Iron deficiency (ID) is associated with decreased appetite and altered mood, which can contribute to feelings of early satiety and reduced overall well-being. Few studies have examined differences in appetite, satiety, and mood between meals containing animal meat and plant-based meat, or whether improving iron status in those with ID improves these outcomes. OBJECTIVE: To determine appetite, satiety, and mood following consumption of a meal containing animal meat or plant-based meat at baseline and after consuming the meal with an iron supplement once a day for 8 weeks in women of reproductive age (WRA) with ID. METHODS: In this randomized, double-blind, parallel-arm study, 52 non-pregnant WRA (24 ± 7 y; BMI 22.9 ± 3.0 kg/m2) with ID (serum ferritin 13.7 ± 6.0 μg/L) consumed an iron supplement with a lunch meal containing either 4 oz. of beef (Animal) or Beyond Meat (Plant) once a day for 8 weeks. Meals were calorically matched but differed in macro- and micronutrient composition due to the inherent differences between protein sources. For this secondary analysis, at baseline and endpoint, fasted participants consumed a standardized lunch meal containing beef or plant-based meat and rated appetite (fullness, hunger, desire to eat, and prospective consumption) using 100 mm visual analog scales. A composite satiety score was calculated. The Profile of Mood States questionnaire was assessed at baseline and endpoint. RESULTS: Indicators of iron status and anemia improved after 8 weeks (P<0.05 for all) but did not differ between Animal and Plant. Hunger and desire to eat decreased and fullness and composite satiety score increased following the meal (P-time<0.0001 for all). Measures of appetite, satiety, and mood did not differ between Plant and Animal at baseline or endpoint. Changes in transferrin saturation (r=0.4, P<0.01) and hemoglobin (r=0.3, P=0.04) and hematocrit (r=0.3, P=0.03) were positively associated with changes in prospective food consumption and changes in transferrin saturation were negatively associated with satiety (r=-0.3, P=0.02). Changes in transferrin saturation (r=0.3, P=0.03) and hematocrit (r=0.3, P=0.05) were positively associated with change in anger/hostility. CONCLUSIONS: These findings indicate that improvements in iron status, but not differences in protein source, affect appetite, satiety, and mood in WRA with ID. CLINICAL TRIAL REGISTRY: This trial was registered at Clinicaltrials.gov as NCT04793906. Copyright © 2026 American Society for Nutrition. Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.tjnut.2026.101559 PMID: 42061720

Effectiveness of mHealth-Based Nutritional Interventions on Iron Status of Pregnant Women: Systematic Review of Randomized Controlled Trials.

3. JMIR Mhealth Uhealth. 2026 Apr 9;14:e81001. doi: 10.2196/81001. Effectiveness of mHealth-Based Nutritional Interventions on Iron Status of Pregnant Women: Systematic Review of Randomized Controlled Trials. Belay SA(1)(2), Bezabih AM(3), Petegem WV(4), Matthys C(1)(5)(6). Author information: (1)Department of Chronic Diseases and Metabolism, Clinical and Experimental Endocrinology Unit, KU Leuven, Herestraat 49 ON1 Bus 902, Leuven, 3000, Belgium, 32 476 72 61 77. (2)Continuing Professional Development Center, College of Health Sciences, Mekelle University, Mekelle, Ethiopia. (3)Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia. (4)Engineering Technology Education Research (ETHER) Unit, Group T Leuven Campus, Faculty of Engineering Technology, KU Leuven, Leuven, Belgium. (5)Department of Endocrinology, University Hospitals Leuven, KU Leuven, Leuven, Belgium. (6)Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa. BACKGROUND: Anemia is a global health concern. It is disproportionately prevalent among pregnant women in low-resource regions, where iron deficiency is the leading cause. Given the multifactorial nature of anemia, a range of nutritional interventions is recommended. However, effective implementation is often hindered by limited health care access, poor adherence to supplementation, and gaps in nutrition knowledge and counseling. To address these challenges and optimize hemoglobin (Hb) levels among pregnant women, mobile health (mHealth)-based nutritional interventions offer a promising alternative. OBJECTIVE: The aim of the study is to review available evidence on the effectiveness of mHealth-based nutritional interventions on iron status (Hb and/or serum ferritin concentration) among pregnant women. METHODS: Searches were conducted in Embase, CINAHL, Cochrane Library, PubMed, Web of Science, and Scopus, and supplemented by snowballing to identify additional relevant studies from citation lists. The key search strings comprised 4 concepts: "mobile health," "nutritional intervention," "Hb, anemia or iron deficiency anemia," and "pregnant women." Predefined inclusion and exclusion criteria were applied during screening. The methodological quality of included studies was assessed using the Risk of Bias 2 tool. The primary end point was the change in mean Hb concentration or serum ferritin level. Effect sizes (ESs) were calculated as standardized mean differences, including Cohen d and Hedges g. RESULTS: Of the 14,284 studies identified, only 11 randomized controlled trials were included. These studies used various modes of delivery, including mobile phone calls (n=1), SMS text messaging (n=3), and mobile apps (n=4), with some using more than 2 modes (n=3). The effect of mHealth-based nutritional interventions on iron status varied significantly. In total, 4 studies demonstrated a large ES (>0.8), with 3 relying on WhatsApp Messenger as an mHealth delivery mode. Approximately 82% (9/11) of the included studies reported a positive effect (P values ranging from <.001 to .047) of the intervention on Hb level, whereas 2 studies reported no statistically significant association (P=.33 and P=.35, respectively). Notably, interventions with the largest ES achieved clinically significant improvements in Hb concentration, with within- and between-group differences exceeding 1 g/dL. However, including behavioral change theories and nutrition-sensitive components was not consistently associated with larger ESs. Due to high heterogeneity (I2>95%), attributed to variations in mHealth delivery modes, functions, and interactive features across the included studies, meta-analysis could not be performed. CONCLUSIONS: This review demonstrates that mHealth-supported nutritional interventions effectively optimize Hb concentration in pregnant women. While SMS text messaging was less effective in improving Hb concentration, combining it with another mHealth delivery mode, such as phone calls, improved intervention effectiveness. However, the variability in mHealth delivery modes, functions, and interactive features underscores the need for tailored strategies that account for context-specific challenges, digital literacy, and access to technology to enhance effectiveness. © Saba Abraham Belay, Afework Mulugeta Bezabih, Wim Van Petegem, Christophe Matthys. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org). DOI: 10.2196/81001 PMCID: PMC13065237 PMID: 41955565 [Indexed for MEDLINE] Conflict of interest statement: Conflicts of Interest: None declared.

The effects of antenatal interventions on gestational weight gain in low and middle-income countries: a systematic review.

4. BMJ Glob Health. 2026 Apr 2;11(4):e019344. doi: 10.1136/bmjgh-2025-019344. The effects of antenatal interventions on gestational weight gain in low and middle-income countries: a systematic review. Aggrey PA(#)(1), Nguyen CH(#)(1), Asghari-Kamrani A(#)(1)(2), Fawzi WW(3)(4)(5), Wang D(6). Author information: (1)Department of Global and Community Health, George Mason University College of Public Health, Fairfax, Virginia, USA. (2)Department of Family Science, University of Maryland School of Public Health, College Park, Maryland, USA. (3)Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA. (4)Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA. (5)Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA. (6)Department of Global and Community Health, George Mason University College of Public Health, Fairfax, Virginia, USA dwang25@gmu.edu. (#)Contributed equally BACKGROUND: Gestational weight gain (GWG) during pregnancy is a critical factor that affects maternal and child health outcomes. The considerable burden of inadequate GWG and the rising tide of excessive GWG are overlooked challenges in low and middle-income countries (LMICs). METHODS: This systematic review assessed the impact of antenatal interventions on GWG in LMICs. Randomised controlled trials (RCTs) on antenatal interventions on GWG in LMICs were included. These interventions included educational, behavioural, nutritional supplementation and pharmacological therapies. A systematic literature search was conducted using PubMed, Embase, Web of Science, CINAHL and the Cochrane Library from the start of each database through September 2025. RESULTS: Out of the 33 642 unique articles identified, 70 articles were included in our systematic review, with 59 individual RCTs and 11 cluster RCTs. Nutritional interventions (31 studies) included food and micronutrient supplementations. Micronutrient supplementation such as multiple micronutrient supplementations was found to reduce the risk of severely inadequate or inadequate GWG among pregnant women compared to iron only or iron and folic acid supplementation (Grading of Recommendations Assessment, Development and Evaluation [GRADE]: moderate certainty). Food supplementation showed mixed results, although most trials demonstrated higher mean GWG among undernourished pregnant women and a greater likelihood of achieving Institute of Medicine-recommended ranges (GRADE: moderate certainty). Behavioural (counselling/education) interventions (20 studies) were associated with significant reductions in excessive GWG among pregnant women with overweight or obesity and improved adequacy of GWG (GRADE: moderate certainty). Physical activity (seven studies) was found to reduce the risk of excessive GWG (GRADE: moderate certainty). Combined dietary and physical activity interventions (six studies) were found to reduce the risk of excessive GWG among pregnant women (GRADE: low certainty). CONCLUSIONS: Well-structured antenatal interventions, initiated before 20 weeks of gestation and continuing beyond this period, tailored to local cultural contexts and available resources, can effectively help pregnant women in LMICs in achieving optimal GWG. PROSPERO REGISTRATION NUMBER: CRD42022366354. © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. DOI: 10.1136/bmjgh-2025-019344 PMCID: PMC13052686 PMID: 41927311 [Indexed for MEDLINE] Conflict of interest statement: Competing interests: None declared.

Effect on birthweight of an antenatal multiple micronutrient supplementation programme compared with iron-folic acid supplementation: a cluster-randomised, controlled trial in 85 698 Ethiopian women.

5. Lancet Glob Health. 2026 May;14(5):e772-e780. doi: 10.1016/S2214-109X(26)00050-1. Epub 2026 Mar 20. Effect on birthweight of an antenatal multiple micronutrient supplementation programme compared with iron-folic acid supplementation: a cluster-randomised, controlled trial in 85 698 Ethiopian women. Tessema M(1), Defar A(2), Tessema B(3), Daba AK(3), Tollera G(3), Tesfa A(3), Opondo C(4), Persson LÅ(5), Schellenberg J(5), Marchant T(5). Author information: (1)Ethiopian Public Health Institute, Addis Ababa, Ethiopia. Electronic address: dr.masresha.tessema@gmail.com. (2)Ethiopian Public Health Institute, Addis Ababa, Ethiopia; Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK. (3)Ethiopian Public Health Institute, Addis Ababa, Ethiopia. (4)Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK. (5)Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK. BACKGROUND: Prenatal multiple micronutrient supplementation (MMS) including iron, folic acid, and other essential micronutrients, has shown potential to improve birth outcomes in controlled studies. We did an effectiveness study in Ethiopia to determine the effect on mean birthweight of MMS provided as part of routine antenatal care, relative to iron-folic acid supplementation (IFA). METHODS: A pragmatic, two-arm, facility-based, cluster-randomised controlled trial was conducted across 42 districts in five regions of Ethiopia to determine the effect on birthweight of MMS relative to IFA. Districts were randomly assigned to either retain IFA as part of routine antenatal care or switch to MMS. Randomisation was stratified by region and done using a random number generator within statistical software. All live singleton births at participating health facilities were eligible for inclusion and birthweights were recorded. Additionally, data were collected on maternal receipt and utilisation of MMS or IFA. The primary outcome was birthweight, analysed in the intention-to-treat population. This completed trial is registered at ClinicalTrials.gov, NCT05708183. FINDINGS: Between Jan 1, 2023, and Dec 31, 2024, birthweights were recorded for 47 325 babies in the 21 IFA districts and 36 473 babies in the 21 MMS districts. Mean age of mothers was 26·2 years (SD 5·3) and median gestational age of babies at birth was 38 weeks (IQR 38-39). The effect of MMS on birthweight was a mean increase of 38 g (95% CI 20-55) in the MMS arm relative to the IFA arm after adjustment for time, geographical region stratification factor, gestational age, sex of baby, and parity. Among women who reported taking at least 90 tablets of their assigned supplement, the increase in mean birthweight in the MMS arm relative to the IFA arm was 58 g (38-79). Stillbirth risk was 7·5 per 1000 births in the IFA arm and 6·9 per 1000 births in the MMS arm. INTERPRETATION: The findings of this trial are consistent with those from efficacy trials in other settings, indicating that the transition from IFA to MMS as part of routine antenatal care in Ethiopia could lead to a small but clear improvement in birthweight, although adherence to supplements and programme sustainability require careful attention. FUNDING: Children's Investment Fund Foundation. Copyright © 2026 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved. DOI: 10.1016/S2214-109X(26)00050-1 PMID: 41871585 [Indexed for MEDLINE] Conflict of interest statement: Declaration of interests We declare no competing interests.

Comparative efficacy of biweekly preventive supplementation, with multiple micronutrients and iron folic acid or iron folic acid alone, on hemoglobin concentrations and anemia prevalence in children aged 6-59 months: a randomized controlled trial in rural India.

6. Am J Clin Nutr. 2026 May;123(5):101281. doi: 10.1016/j.ajcnut.2026.101281. Epub 2026 Mar 19. Comparative efficacy of biweekly preventive supplementation, with multiple micronutrients and iron folic acid or iron folic acid alone, on hemoglobin concentrations and anemia prevalence in children aged 6-59 months: a randomized controlled trial in rural India. Upadhyay RP(1), Chowdhury R(1), Mundra S(1), Taneja S(2), Jacob M(3), Kapil U(4), Bavdekar A(5), Bhandari N(1). Author information: (1)Society for Applied Studies, New Delhi, India. (2)Society for Applied Studies, New Delhi, India. Electronic address: sunita.taneja@sas.org.in. (3)Department of Biochemistry, Christian Medical College, Vellore, India. (4)Department of Clinical Epidemiology, Institute of Liver and Biliary Sciences, New Delhi, India. (5)Department of Pediatrics, KEM Hospital Research Centre, Pune, India. BACKGROUND: Anemia affects more than two-thirds of children aged <5 y in India, despite biweekly iron folic acid (IFA) supplementation under the Anemia Mukt Bharat national program. Multiple micronutrient (MMN) deficiencies may also contribute to the presence of anemia, but the incremental benefit of MMN supplementation in addition to IFA remains unclear. OBJECTIVES: We aimed to compare the efficacy of biweekly preventive supplementation with MMNs plus IFA compared with IFA alone on hemoglobin concentrations and prevalence of anemia in children aged 6-59 mo. METHODS: In this individually randomized, open-label trial, eligible children received biweekly supplementation with either MMN plus IFA (intervention) or IFA alone (control) for 100 doses over 50 wk. Primary outcomes were mean hemoglobin concentration and anemia prevalence. Secondary outcomes included serum ferritin, soluble transferrin receptor, vitamin B12, folate, and zinc. RESULTS: Among 1300 children enrolled (648 intervention and 652 control), supplementation compliance exceeded 75%. At the endline, the mean hemoglobin was slightly higher in the intervention group [adjusted mean difference, 0.12 g/dL; 95% confidence interval (CI): 0.00, 0.25]. The prevalence of anemia was 17.6% in the intervention group and 24.0% in the control group (adjusted relative risk, 0.72; 95% CI: 0.58, 0.90). No significant differences were observed in serum biomarkers of iron status or other micronutrients. CONCLUSIONS: Biweekly supplementation with MMN plus IFA resulted in a modest increase in hemoglobin concentrations and a relative reduction in anemia prevalence compared with IFA alone, particularly in older children. Lack of improvement in biochemical markers and a small rise in hemoglobin concentrations suggest that a reduction in the prevalence of anemia may be driven by shifts near diagnostic thresholds, rather than meaningful physiological benefits. MMN adds minimal value where IFA adherence is already high. The study was registered at Clinical Trial Registry of India as #CTRI/2020/10/028299 (https://ctri.nic.in/Clinicaltrials/login.php). Copyright © 2026 American Society for Nutrition. Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.ajcnut.2026.101281 PMID: 41862001 [Indexed for MEDLINE] Conflict of interest statement: Conflict of interest RPU reports financial support was provided by Indian Council of Medical Research. All other authors report no conflicts of interest.

Comparative Effectiveness of Pharmacological and Non-pharmacological Therapies for ADHD: A Systematic Review and Meta-analysis of Randomized Controlled Trials (2008-2023).

7. Rev Recent Clin Trials. 2026 Mar 13. doi: 10.2174/0115748871398269251202105316. Online ahead of print. Comparative Effectiveness of Pharmacological and Non-pharmacological Therapies for ADHD: A Systematic Review and Meta-analysis of Randomized Controlled Trials (2008-2023). Khan DI(1), Jameel S(2), Sabeeh(3), Meraj H(4). Author information: (1)Department of Pediatrics, Ajmal Khan Tibbiya College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India. (2)Ajmal Khan Tibbiya College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India. (3)Department of Ilmul Atfal, State Unani Medical College, Prayagraj, 211016, India. (4)Department of Niswan wa Qabalat (Obstetrics & Gynecology), Ajmal Khan Tibbiya College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India. BACKGROUND: Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental condition that affects attention, impulse control, and the ability to remain still. These challenges can make it harder for individuals with ADHD to succeed at school, work, and in social situations. Stimulant medications, such as methylphenidate and amphetamines, are commonly used as first-line treatments and are effective at reducing symptoms. However, their use can be limited by side effects, such as insomnia, appetite loss, cardiovascular risks, potential for misuse, and variability in individual response. Since current treatments have drawbacks, many people are exploring nonstimulant options, such as behavioral therapy, dietary changes, and neurofeedback. These approaches may be safer and easier to maintain, but research on their effectiveness remains uncertain. This systematic review and meta-analysis aim to compare the effectiveness of pharmacological and nonpharmacological therapies for ADHD. METHOD: We systematically searched PubMed, PsycINFO, Cochrane Library, ClinicalTrials.gov, and IEEE Xplore for randomized controlled trials (2008-2023) evaluating pharmacological (e.g., stimulant medications), non-pharmacological (e.g., behavioral therapy, cognitive training), or combined interventions in children and adolescents with ADHD. The search yielded 318 records. After screening titles and abstracts, 249 were excluded. Sixty-nine full-text articles were assessed, and 18 RCTs met the inclusion criteria for analysis. Primary outcomes were reductions in ADHD symptoms measured by standardized rating scales; secondary outcomes included academic performance, social functioning, and clinical global impression. RESULTS: Eighteen RCTs were pooled. ADHD symptoms were consistently reduced with stimulant medications (methylphenidate and amphetamines), although effects on academic performance were modest. Non-stimulants, such as viloxazine and guanfacine, showed significant improvements on ADHD-RS scores, but these improvements were only clinically modest. In contrast, some nutritional supplements, particularly iron and omega-3 fatty acids, showed more pronounced benefits in symptom reduction and social functioning. Behavioral and cognitive interventions were not very effective in achieving consistent outcomes. Combined approaches were somewhat more effective in achieving all identified outcomes, particularly social and functional outcomes. DISCUSSION: Stimulants, such as amphetamines and methylphenidate, consistently showed efficacy in reducing core ADHD symptoms, whereas non-pharmacological interventions showed mixed results. CONCLUSION: A comprehensive, individualized treatment plan that may combine pharmacological and non-pharmacological approaches often yields the best outcomes in managing ADHD. CLINICAL TRIAL REGISTRATION NUMBER: This review was conducted in accordance with the PRISMA recommendation. The review was entered into the Prospective International Registry of Systematic Reviews (PROSPERO 2024 CRD42024590678). Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net. DOI: 10.2174/0115748871398269251202105316 PMID: 41832627

Preconception micronutrient supplementation positively affects offspring perceptual reasoning at 10-11 years of age: follow-up of a randomized controlled trial in Vietnam.

8. Am J Clin Nutr. 2026 May;123(5):101270. doi: 10.1016/j.ajcnut.2026.101270. Epub 2026 Mar 12. Preconception micronutrient supplementation positively affects offspring perceptual reasoning at 10-11 years of age: follow-up of a randomized controlled trial in Vietnam. Nguyen PH(1), Tran LM(2), Khuong LQ(3), Nguyen PT(4), Van Nguyen B(4), Be TH(4), Young MF(2), DiGirolamo AM(5), Martorell R(2), Ramakrishnan U(2). Author information: (1)Nutrition and Health Unit, International Food Policy Research Institute, Washington, DC, United States; Pediatrics Department, Thai Nguyen University of Pharmacy and Medicine, Thai Nguyen, Viet Nam. Electronic address: P.H.Nguyen@cgiar.org. (2)Nutrition and Health Sciences, Emory University, Atlanta, GA, United States. (3)Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, United States. (4)Pediatrics Department, Thai Nguyen University of Pharmacy and Medicine, Thai Nguyen, Viet Nam. (5)Georgia Health Policy Center, Georgia State University, Atlanta, GA, United States. BACKGROUND: Maternal periconceptional nutrition is important for birth outcomes, but few studies examine long-term effects on offspring growth and development. OBJECTIVES: We assessed the impact of weekly preconception multiple micronutrients (MM) or iron and folic acid (IFA) supplements compared to folic acid (FA) alone, on cognitive function and nutritional status at 10-11 y. We also examined associations with early-life biological and socioenvironmental factors. METHODS: We conducted a follow-up study of 1599 children from a preconception randomized trial in Vietnam, in which females received weekly FA, IFA, or MM before conception and daily IFA during pregnancy. We assessed cognitive function, academic achievement, and nutritional status at ages 10-11 y. Early biological factors included maternal nutritional status, birth characteristics, and postnatal linear growth; socioenvironmental variables were maternal schooling, ethnicity, depression, infant feeding, socioeconomic status (SES), and home environment. Analyses used intention-to-treat and per protocol comparisons with inverse-probability-of-censoring weights to account for loss to follow-up. RESULTS: Offspring in the MM and IFA groups had higher perceptual reasoning scores than the FA group {mean difference [95% confidence interval (CI): MM: 1.68 (0.01, 3.35); IFA: 2.04 (0.33, 3.74)]}. The IFA groups also had higher reading scores [0.78 (0.11, 1.44)] and lower anemia prevalence [-4.26 (-7.60, -0.91)]. No differences were observed in full-scale intelligence quotient (FSIQ) or anthropometric measures. Maternal underweight was negatively associated with FSIQ [β (95% CI): -1.62 (-3.06, -0.18)] and reading scores [-0.59 (-1.12, -0.06)] whereas postnatal linear growth was positively associated with FSIQ [1.67 (0.91, 2.43)], mathematics [0.36 (0.12, 0.61)], and reading scores [0.47 (0.21, 0.74)]. Maternal schooling, home environment, SES, were also linked to improved cognitive and academic outcomes [β range: 0.64 (0.01, 1.27) to 8.89 (5.20, 12.58)], and exclusive breastfeeding was linked with higher mathematics scores [0.73 (0.27, 1.19)]. CONCLUSIONS: Preconception MM and IFA supplementation improved certain aspects of cognitive functioning at 10-11 y compared with FA alone, whereas early-life biological and socioenvironmental factors were positively associated with cognitive and academic outcomes. This study was registered at clinicaltrials.gov as NCT01665378 (https://clinicaltrials.gov/ct2/show/NCT01665378). Copyright © 2026 American Society for Nutrition. Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.ajcnut.2026.101270 PMID: 41831611 [Indexed for MEDLINE] Conflict of interest statement: Conflict of interest The authors report no conflicts of interest.

Effect of 2-Year Caloric Restriction in the Absence of Malnutrition on Indicators of Anemia, Iron Status, and Hepcidin in Healthy Adults: A Randomized Clinical Trial.

9. J Nutr. 2026 Mar 11;156(5):101474. doi: 10.1016/j.tjnut.2026.101474. Online ahead of print. Effect of 2-Year Caloric Restriction in the Absence of Malnutrition on Indicators of Anemia, Iron Status, and Hepcidin in Healthy Adults: A Randomized Clinical Trial. Dugan C(1), Das SK(2), Racette SB(3), Martin CK(1), Ravussin E(1), Redman LM(1), Hennigar SR(4). Author information: (1)Pennington Biomedical Research Center, Baton Rouge, LA United States. (2)Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, United States. (3)College of Health Solutions, Arizona State University, Phoenix, AZ, United States. (4)Pennington Biomedical Research Center, Baton Rouge, LA United States. Electronic address: stephen.hennigar@pbrc.edu. BACKGROUND: Caloric restriction (CR) is a promising nutritional intervention for improving metabolic and age-related health outcomes, but its long-term effects on hematologic health remain unclear. Clarifying how prolonged CR affects anemia risk and iron status is essential for evaluating its long-term safety and clinical relevance. OBJECTIVES: To determine the effects of a 2-y CR intervention on markers of anemia, iron status, and hepcidin in females and males enrolled in the Comprehensive Assessment of Long-Term Effects of Reducing Intake of Energy (CALERIE) Phase 2 trial. METHODS: Participants in CALERIE Phase 2 (n = 220) were randomly assigned to 25% CR or ad libitum (AL) control. AL continued their habitual diet, whereas CR received an intensive intervention to promote CR over 2 y. All participants received a multivitamin/mineral supplement containing 18 mg iron. Fasted blood was collected at baseline (BL) and 12 (M12) and 24 (M24) mo and indicators of iron status (ferritin, soluble transferrin receptor, and serum iron), anemia (hemoglobin and hematocrit), and regulators of iron status (hepcidin, C-reactive protein, and IL-6) were measured. Six-day diet diaries were collected twice at BL and once each at M12 and M24. An anemia surveillance protocol monitored hemoglobin, hematocrit, red blood cell (RBC) count, and serum iron throughout the intervention, with medical evaluation and temporary/permanent CR discontinuation as needed. Linear mixed-effects models were used to evaluate the effect of treatment (CR compared with AL), time (BL, M12, and M24), and their interaction (treatment × time). RESULTS: Participants (n = 218) were mostly female (70%) with an mean age (±SD) of 38.1 ± 7.2 y and a mean BMI of 25.2 ± 1.7 kg/m2. At baseline, ferritin (105.5 ± 126.9 μg/L), hepcidin (8.6 ± 5.8 ng/mL), and dietary iron intake (16.1 ± 5.5 mg/d) were similar between groups (P > 0.05). There were no group × time interactions for markers of anemia, indicators of iron status, or hepcidin (P > 0.05). Despite the anemia surveillance protocol, anemia prevalence remained >5% in both groups across all timepoints. Low RBC count was the most common trigger, and participants who triggered the protocol had lower hematocrit at M12 (P < 0.001) and M24 (P < 0.001); however, dietary iron intake remained similar and there were no differences in any indicators of iron status or hepcidin between those who triggered the protocol and those who did not. CONCLUSIONS: These findings suggest that prolonged CR in the absence of malnutrition does not adversely affect iron status or hepcidin in healthy adults. Copyright © 2026 The Author(s). Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.tjnut.2026.101474 PMID: 41825741 Conflict of interest statement: Conflict of interest SRH is an Editorial Board Member for The Journal of Nutrition and played no role in the Journal’s evaluation of the manuscript. All other authors report no conflicts of interest.

Association Between Trace Mineral Concentrations and Oxidative Stress in Children with ADHD Supplemented with Multinutrients.

10. Biol Trace Elem Res. 2026 Mar 3. doi: 10.1007/s12011-026-05017-5. Online ahead of print. Association Between Trace Mineral Concentrations and Oxidative Stress in Children with ADHD Supplemented with Multinutrients. Robinette LM(1), Hatsu IE(2)(3), Wu CM(4), Adetona O(4), Bruton AM(5), Ast HK(5), Odei JB(6), Leung BMY(7), Johnstone JM(5), Ziouzenkova O(1). Author information: (1)Department of Human Sciences, The Ohio State University, 29 W. Woodruff Ave, 160 Ramseyer Hall, OH, 43210, Columbus, USA. (2)Department of Human Sciences, The Ohio State University, 29 W. Woodruff Ave, 160 Ramseyer Hall, OH, 43210, Columbus, USA. hatsu.1@osu.edu. (3)OSU Extension, The Ohio State University, OH, Columbus, USA. hatsu.1@osu.edu. (4)Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, OH, USA. (5)Center for Mental Health Innovation, Psychiatry Department, Oregon Health & Science University, Portland, OR, USA. (6)Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, USA. (7)Faculty of Health Sciences, University of Lethbridge, Lethbridge, Canada, Alberta. Oxidative stress (OS) arises from an imbalance between antioxidant defenses and the generation of reactive oxygen species (ROS), both of which are influenced by the levels and composition of trace elements. The Micronutrients for ADHD in Youth randomized controlled trial demonstrated behavioral improvements following 8 weeks of multinutrient supplementation in 54% of children compared to 18% on placebo. This secondary analysis examined the relationship between plasma minerals and OS-related parameters [biological antioxidant potential (BAP), glutathione peroxidase (GPx), glutathione reductase (GR), and reactive oxygen metabolites (ROM)] in 71 children (44 multinutrient, 27 placebo; median age 10.4 years). Correlation analysis revealed that selenium and zinc improved antioxidant response measured as GPx change in both treatment groups (r = 0.26, p = 0.03) and BAP in multinutrient group (r = 0.37, p = 0.01), respectively, while chromium change was inversely related to BAP (r=-0.41, p = 0.005) in the multinutrient group. BAP change was moderated by baseline selenium (β=-9.45, p = 0.006), zinc (β=-2.13, p < 0.001), and chromium (β = 68.9, p = 0.02), where children in the multinutrient group with low selenium, low zinc, and high chromium at baseline experienced BAP increases. Selenium also exhibited pro-oxidant effects: ROM change correlated positively with change in selenium in multinutrient group only (r = 0.34, p = 0.03). Baseline copper predicted ROM change (β = 0.213, p < 0.001), and ROM change correlated positively with changes in copper in both groups (r = 0.51, p < 0.001) and negatively with Mn (r=-0.24, p = 0.05), while iron did not moderate OS. Multinutrient supplementation may enhance antioxidant defenses in children who had low plasma zinc and selenium, while potential pro-oxidant effects in those with higher selenium and chromium warrant further investigation. Clinical Trial Registry number for MADDY RCT: NCT03252522. © 2026. The Author(s). DOI: 10.1007/s12011-026-05017-5 PMID: 41776068 Conflict of interest statement: Declarations. Competing Interests: Hardy Nutritionals provided the multinutrient and placebo capsules at no charge. Hardy Nutritionals had no role in study design, data analysis, or interpretation of results. The authors declare that the research was conducted without any conflict of interest.

Ironing Out the Deficiency: Tracking Iron in Celiac Disease Before and After the Gluten-Free Diet.

11. Nutrients. 2026 Feb 11;18(4):590. doi: 10.3390/nu18040590. Ironing Out the Deficiency: Tracking Iron in Celiac Disease Before and After the Gluten-Free Diet. Dillawn P(1), Nagle S(2)(3), Liu E(1)(3), Stahl MG(1)(3). Author information: (1)Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO 80045, USA. (2)Department of Clinical Nutrition, University of Colorado School of Medicine, Aurora, CO 80045, USA. (3)Colorado Center for Celiac Disease, Digestive Health Institute, Children's Hospital Colorado, Aurora, CO 80045, USA. Celiac disease (CeD) is a gluten-induced immune-mediated enteropathy that preferentially involves the proximal duodenum. Consequently, iron deficiency is common in CeD, impacting at least 10% of newly diagnosed individuals. In this narrative review, we aim to investigate the mechanisms, prevalence, treatment, and monitoring of iron deficiency and the impacts of a gluten-free diet (GFD) on iron deficiency in individuals with CeD. We will also review the role of and approach to iron supplementation in this population. Specifically, we will explore whether mucosal healing on a GFD is sufficient for the management of iron deficiency amongst individuals with CeD. DOI: 10.3390/nu18040590 PMCID: PMC12943008 PMID: 41754107 [Indexed for MEDLINE] Conflict of interest statement: M.G.S.—Takeda (celiac disease advisory board); Pfizer (DSMB—celiac disease clinical trial); UptoDate (celiac disease contributing author). E.L.—Takeda (celiac disease advisory board); UptoDate (celiac disease contributing author). The other authors declare no conflicts of interest.

Folic acid supplementation and malaria susceptibility and severity among people taking antifolate antimalarial drugs in endemic areas.

12. Cochrane Database Syst Rev. 2026 Feb 18;2(2):CD014217. doi: 10.1002/14651858.CD014217.pub2. Folic acid supplementation and malaria susceptibility and severity among people taking antifolate antimalarial drugs in endemic areas. Qi YP(1), Crider KS(1), Gutman J(2), Centeno-Tablante E(3)(4), Fothergill A(3), Daniels K(5), Yeung LF(1), Mai CT(1), Mehta S(3)(4), Williams JL(1), Finkelstein JL(3)(4)(6)(7). Author information: (1)National Center on Birth Defects and Developmental Disabilities, US Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA. (2)Division of Parasitic Diseases & Malaria, Malaria Branch, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Roybal Campus, Atlanta, GA, USA. (3)Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA. (4)Cornell Joan Klein Jacobs Center for Precision Nutrition and Health, Cornell University, Ithaca, NY, USA. (5)Eagle Global Scientific LLC, Atlanta, USA. (6)Cochrane Center, Cornell University, Ithaca, NY, USA. (7)Division of Epidemiology, Department of Population Health Sciences, Weill Cornell Medical College, NY, NY, USA. Update of Cochrane Database Syst Rev. 2022 Feb 01;2(2022). doi: 10.1002/14651858.CD014217. BACKGROUND: Malaria is an infectious disease transmitted by female Anopheles mosquitoes, with ongoing transmission in over 80 countries. The malaria parasite requires folate for survival and growth; antifolate antimalarial medications used for prevention and treatment target enzymes in folate metabolism as their mechanism of action. Periconceptional folic acid (synthetic form of folate) supplementation (400 μg/day) is the standard of care for neural tube defect prevention. Concerns have been raised about the potential effects of folic acid (including above the tolerable upper intake level (UL) >1.0 mg/day) in the context of malaria prevention and treatment, including the efficacy of antimalarial medications. Examining the potential impact of folic acid on malaria risk and severity amongst people taking antifolate antimalarial medications may inform public health programmes in malaria-endemic areas. OBJECTIVES: To examine the effects of folic acid supplementation on the risk and severity of malaria infection amongst people taking antifolate antimalarials and living in areas with malaria endemicity. PREVENTION: Amongst uninfected people taking antifolate antimalarial medications for malaria prevention, does folic acid supplementation increase susceptibility or severity of malaria infection? TREATMENT: Amongst people with malaria infection who are being treated with antifolate antimalarial drugs, does folic acid supplementation reduce parasite clearance or increase the risk of treatment failure? SEARCH METHODS: We searched databases including CENTRAL, MEDLINE, Embase, CINAHL, Scopus, and trial registries (September 13, 2024), grey literature, and reference searches to identify additional studies. SELECTION CRITERIA: Randomised trials evaluating the effects of folic acid supplementation (alone or in combination with iron or other vitamins and minerals) amongst individuals taking antifolate antimalarial medications in malaria-endemic areas. DATA COLLECTION AND ANALYSIS: Primary outcomes included uncomplicated malaria or severe malaria, parasite clearance, and treatment failure. Cochrane RoB 2 was used to evaluate the risk of bias. Certainty of evidence was assessed using GRADE for primary outcomes. We performed meta-analyses using random-effects models for all outcomes. MAIN RESULTS: Eight trials with 3486 participants were included: three malaria prevention trials and five malaria treatment trials. Most treatment trials included folic acid doses above the UL (> 1.0 mg/d); one trial included 400 μg per day. Antifolate antimalarials included sulfadoxine-pyrimethamine (SP; five trials), sulfisoxazole plus pyrimethamine (one trial), atovaquone-proguanil (one trial), and proguanil (one trial). Some studies had unclear or high risk of bias due to missing outcome data. Malaria prevention Comparison 1: Folic acid (alone or in combination with other vitamins and minerals) + antifolate antimalarials versus placebo/no folic acid + antifolate antimalarial medications. Data for primary outcomes, uncomplicated and severe malaria, were not reported. One trial reported laboratory parasitaemia; there was little to no difference in malaria parasitaemia amongst pregnant women receiving folic acid (with iron) and antifolate antimalarials compared to iron and antifolate antimalarials (Risk Ratio (RR) 1.21; 95% CI 0.56 to 2.62; P = 0.63; 1 trial, 643 individuals). Comparisons 2-4: No studies reported data for Comparisons 2-4. Malaria treatment Comparison 1: Folic acid (alone or in combination with other vitamins and minerals) + antifolate antimalarial medications versus placebo/no folic acid with antifolate antimalarials. People receiving folic acid (alone or with iron) and antifolate antimalarials were less likely to clear malaria parasites (day 3) compared to individuals who did not receive folic acid (RR 0.89; 95% CI 0.84 to 0.95, 4 trials, 929 individuals, moderate-certainty evidence); and had increased risk of treatment failure on day 7 (RR 2.12; 95% CI 1.41 to 3.19, 4 trials, 1062 individuals, moderate-certainty evidence), day 14 (RR 1.97; 95% CI 1.44 to 2.70, 3 trials; 891 individuals; moderate-certainty evidence), and day 28 (RR 1.35; 95% CI 1.21 to 1.51; 4 trials; 1012 individuals, moderate-certainty evidence). Comparison 2: Folic acid alone + antifolate antimalarials versus placebo/no folic acid + antifolate antimalarial medication. Folic acid supplementation with antifolate antimalarials likely had lower parasite clearance (day 3) (RR 0.87; 95% CI 0.79 to 0.96, 2 trials, 229 individuals, moderate certainty of the evidence), and increased treatment failure (day 7: RR 2.58; 95% CI 0.89 to 7.45; P = 0.08; 2 trials; 344 individuals, moderate-certainty evidence; day 14: RR 4.15; 95% CI 0.92 to 18.65; P = 0.06; 1 trial; 173 individuals, moderate-certainty evidence; and day 28: RR 1.47; 95% CI 0.86 to 2.49; P = 0.16; 2 trials; 294 individuals, moderate-certainty evidence), compared to no folic acid and antifolate antimalarials. Comparison 3: Folic acid with iron + antifolate antimalarial medication versus placebo/no folic acid with iron + antifolate antimalarial medication. People receiving folic acid with iron and antifolate antimalarials were less likely to clear malaria parasites (day 3: RR 0.90; 95% CI 0.83 to 0.98; P = 0.02; 2 trials; 700 individuals, moderate-certainty evidence), and had increased treatment failure (day 7: RR 1.96; 95% CI 1.05 to 3.65; P = 0.03; 2 trials; 718 individuals; day 14: RR 1.90; 95% CI 1.35 to 2.67; 2 trials; 718 individuals; day 28: RR 1.17; 95% CI 0.79 to 1.74; 2 trials; 578 individuals; all moderate-certainty evidence), compared to iron and antifolate antimalarials. Comparison 4: No studies reported data. AUTHORS' CONCLUSIONS: Malaria prevention: None of the included trials reported primary outcomes. Malaria treatment: People who received folic acid supplementation (alone or with iron) and antifolate antimalarial treatment were less likely to clear malaria parasitaemia (day 3), and had increased treatment failure (days 7, 14, 28). Most of the included trials provided folic acid with doses above the tolerable UL (> 1.0 mg). One trial included folic acid at a dose of 400 μg/d (recommended dose for preventing neural tube defects) and showed little to no difference in parasite clearance or treatment failure. Copyright © 2026 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. DOI: 10.1002/14651858.CD014217.pub2 PMCID: PMC12915520 PMID: 41705996 [Indexed for MEDLINE] Conflict of interest statement: Yan Ping Qi: No conflicts of interest to declare. Yan Ping Qi is a full‐time staff member of the CDC. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC. Krista S Crider: No conflicts of interest to declare. Krista S Crider is a full‐time staff member of the Centers for Disease Control and Prevention (CDC). The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC. Julie Gutman: No conflicts of interest to declare. Julie Gutman is astaff member of the CDC and works part‐time as a hospitalist at a children's hospital. Her role as a hospitalist has no relationship to the topic of the reivew. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC. Elizabeth Centeno Tablante: No conflicts of interest to declare. Amy Fothergill: No conflicts of interest to declare. Amy Fothergill is a full‐time staff member of the Centers for Disease Control and Prevention (CDC). The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC. Kelicia Daniels: No conflicts of interest to declare. Kelicia Daniels is a full‐time contractor of Eagle Global Scientific (EGS) supporting a contract at the CDC. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of EGS. Lorraine F Yeung: Possesses stocks in Pfizer and Proctor & Gamble. Lorraine Yeung is a full‐time staff member of the CDC. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC. Cara T Mai: No conflicts of interest to declare. Cara Mai is a full‐time staff member of the CDC. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC. Saurabh Mehta: No conflicts of interest to declare. Jennifer L Williams: No conflicts of interest to declare. Jennifer L Williams is a full‐time staff member of the CDC and a clinician with the U.S. Public Health Service. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC. Julia L Finkelstein: Dr Finkelstein is a principal investigator on research grants to examine the burden and aetiology of anaemia in women of reproductive age, biomarkers of nutritional status in women of reproductive age, and to conduct randomised trials with micronutrient interventions to improve the health of women of reproductive age (National Institutes of Health, U.S. Centers for Disease Control and Prevention, U.S. Department of Agriculture) ‐ not related to this review. Dr. Finkelstein has no known conflicts of interest to declare.

The effect of prenatal balanced energy and protein supplementation on small vulnerable newborn types in low- and middle-income countries: A systematic review and meta-analysis of individual participant data.

13. PLoS Med. 2026 Feb 17;23(2):e1004716. doi: 10.1371/journal.pmed.1004716. eCollection 2026 Feb. The effect of prenatal balanced energy and protein supplementation on small vulnerable newborn types in low- and middle-income countries: A systematic review and meta-analysis of individual participant data. Wang D(1), Partap U(2), Liu E(3)(4), Costa JC(2), Cliffer IR(2), Wang M(5)(6)(7), Nookala SK(8), Subramoney V(9), Briggs B(10), Ahmed I(11), Argaw A(12), Ariff S(11), Bhandari N(13), Chowdhury R(13), Dailey-Chwalibóg T(12)(14), Hanley-Cook GT(15), Huybregts L(12)(16), Jehan F(17), Krebs NF(18), Lachat C(12), Manandhar DS(19), McClure EM(20), Moore SE(21)(22), Muhammad A(23), Nisar MI(17), Prentice AM(22), Roberfroid D(24)(25), Saville NM(26), Shafiq Y(27)(28)(29), Shrestha BP(19), Sonko B(22), Soofi S(11), Taneja S(13), Toe LC(12)(30), Fawzi WW(2)(5)(31). Author information: (1)Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, Virginia, United States of America. (2)Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America. (3)Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Massachusetts, United States of America. (4)Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America. (5)Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America. (6)Department of Biostatistics, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America. (7)Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America. (8)Cytel Inc., India, on behalf of the Gates Foundation, Seattle, Washington, United States of America. (9)DVPL Tech, Dubai, United Arab Emirates. (10)Certara USA, Inc., on behalf of the Gates Foundation, Seattle, Washington, United States of America. (11)Aga Khan University, Karachi, Pakistan. (12)Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium. (13)Society for Applied Studies, New Delhi, India. (14)Agence de Formation de Recherche et d'Expertise en Santé pour l'Afrique (AFRICSanté), Bobo-Dioulasso, Burkina Faso. (15)Food and Nutrition Division, Food and Agriculture Organization of the United Nations (FAO), Rome, Italy. (16)Nutrition, Diets, and Health Unit, International Food Policy Research Institute, Washington, District of Columbia, United States of America. (17)Department of Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan. (18)University of Colorado School of Medicine, Aurora, Colorado, United States of America. (19)Mother and Infant Research Activities (MIRA), Kathmandu, Nepal. (20)RTI International, Durham, North Carolina, United States of America. (21)Department of Women & Children's Health, King's College London, London, United Kingdom. (22)MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia. (23)VITAL Pakistan Trust, Karachi, Pakistan. (24)Faculty of Medicine, University of Namur, Namur, Belgium. (25)Belgian Health Care Knowledge Centre, Brussels, Belgium. (26)Institute for Global Health, University College London, London, United Kingdom. (27)Center of Excellence for Trauma and Emergencies and Community Health Sciences, The Aga Khan University, Karachi, Pakistan. (28)Global Advancement of Infants and Mothers (AIM), Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America. (29)Harvard Humanitarian Initiative, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America. (30)Nutrition and Metabolic Diseases Unit, Health Sciences Research Institute (IRSS), Bobo-Dioulasso, Burkina Faso. (31)Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America. BACKGROUND: Small vulnerable newborn (SVN) types, defined by combinations of being born too soon or too small, have distinct determinants, health consequences, and prevention strategies. The effects of prenatal balanced energy and protein (BEP) supplementation on SVN types remain unknown. METHODS AND FINDINGS: We conducted a systematic review and meta-analysis of individual participant data from eight randomized controlled trials of prenatal BEP supplements (N = 10,252, with 5,164 in the BEP arm and 5,088 in the control arm) in low- and middle-income countries were used. The control arms varied across studies and included context-specific standards of care, iron and folic acid supplements, or multiple micronutrient supplements. Newborns were classified into 10 groups through the combinations of preterm birth, small for gestational age (SGA) birth, and low birthweight (LBW), such as term-appropriate-for-gestational-age (AGA)-nonLBW, preterm-SGA-LBW, preterm-large-for-gestational-age-LBW, term-SGA-LBW, preterm-AGA-nonLBW, and other permutations. Newborns were also analyzed using a four-group categorization that included term-nonSGA, preterm-nonSGA, term-SGA, and preterm-SGA. Log-binomial models were used to estimate study-specific risk ratios (RRs), which were pooled using meta-analyses. Subgroup analyses were conducted by maternal age, parity, gestational age at enrollment, early pregnancy body mass index, and maternal anemia status. In the 10-group categorization of SVNs, on average, prenatal BEP supplementation led to a 30% lower risk of preterm-SGA-LBW (RR: 0.70; 95% CI [0.53, 0.91]; P = 0.009), a 25% lower risk of preterm-AGA-LBW (RR: 0.75; 95% CI [0.60, 0.93]; P = 0.009), and a 20% lower risk of term-SGA-LBW (RR: 0.80; 95% CI [0.72, 0.90]; P < 0.001). In the four-group categorization, prenatal BEP supplementation led to a 31% lower risk of preterm-SGA (RR: 0.69; 95% CI [0.52, 0.91]; P = 0.008) and a 12% lower risk of term-SGA (RR: 0.88; 95% CI [0.81, 0.96]; P = 0.005). The protective effect of prenatal BEP supplementation on preterm-SGA was stronger among multiparous women and women without anemia. The protective effects on all three SVN types under the four-group categorization were stronger among women enrolled before 20 weeks of gestation. The main limitations of the study included the absence of some BEP trials and the small event numbers for some SVN types. CONCLUSIONS: Prenatal BEP supplementation reduces the risk of SVNs to varying extents. Further research is needed to determine the optimal targeting approach for providing BEP supplements to vulnerable pregnant women who are most likely to benefit from the supplementation. Copyright: © 2026 Wang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. DOI: 10.1371/journal.pmed.1004716 PMCID: PMC12912696 PMID: 41701774 [Indexed for MEDLINE] Conflict of interest statement: I have read the journal’s policy and the authors of this manuscript have the following competing interests: Authors employed by for-profit organizations: SKN is employed by Cytel Inc., India; VS is employed at DVPL Tech; BB is employed at Certara USA, Inc. All other authors declare no competing interests.

Oral ferrous sulphate supplementation has greater efficacy, but lower tolerance than iron (III)-hydroxide polymaltose complexes in exercising women with low iron stores.

14. Clin Nutr. 2026 Mar;58:106594. doi: 10.1016/j.clnu.2026.106594. Epub 2026 Feb 9. Oral ferrous sulphate supplementation has greater efficacy, but lower tolerance than iron (III)-hydroxide polymaltose complexes in exercising women with low iron stores. McKay AK(1), Broome S(2), Tee N(2), Yim KL(3), Sim M(4), Peeling P(5), Burke LM(2). Author information: (1)Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia. Electronic address: alannah.mckay@acu.edu.au. (2)Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia. (3)Faulty of Health Sciences, Australian Catholic University, Melbourne, VIC 3000, Australia. (4)Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6067, Australia; Medical School, The University of Western Australia, Crawley, WA 6009, Australia. (5)School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, WA 6009, Australia; Western Australian Institute of Sport, Mt Claremont, WA 6010, Australia. BACKGROUND & AIMS: Iron deficiency (ID) is a global health condition that predominately affects women. Although oral iron supplementation is an effective treatment strategy for this issue, gastrointestinal complaints are common, and if persistent, may lead to poor compliance. The efficacy of different iron formulations which claim to improve tolerance is unclear. This study assessed the efficacy and tolerability of ferrous sulphate (FS) and iron (III)-hydroxide polymaltose complex (IPC) supplementation in three different cohorts of women.. METHODS: This study implemented a 12-week, single-blind, randomized controlled trial. Eligible participants had a serum ferritin concentration of <50 μg/L and met specific inclusion criteria to be enrolled to either the athlete, pre-menopausal or post-menopausal groups. Participants were randomized to receive FS (equivalent to 105 mg elemental iron) plus sodium ascorbate or IPC (equivalent to 100 mg elemental iron) daily. Venous blood samples were collected at baseline, 4-, 8- and 12-weeks of supplementation. A daily questionnaire was completed throughout the study period, documenting supplement tolerance (number and severity of symptoms), exercise load, menstrual characteristics, and supplement compliance. RESULTS: Fifty-seven participants completed the intervention with a compliance rate of 94.9 % [range: 74.8-100 %]. A significant interaction between supplement and time was evident for ferritin (p < 0.001), where FS increased after 12 weeks (+109 %; p < 0.001) but no change was evident in IPC (+7 %; p = 0.727). No differences were detected between cohorts (p > 0.05). The IPC group had a lower symptom rate compared to FS (28 % vs. 33 %; p < 0.001).. CONCLUSIONS: FS was superior in repleting ferritin concentrations after 12 weeks compared with IPC; however, FS also resulted in a greater number and severity of GI symptoms than IPC. Our data shows FS is the superior iron formulation for ID treatment, however future research should continue to address how to improve FS tolerance.. This trial was registered at https://www.anzctr.org.au/Trial/Registration/TrialReview as ACTRN12623000529640. Copyright © 2026 The Author(s). Published by Elsevier Ltd.. All rights reserved. DOI: 10.1016/j.clnu.2026.106594 PMID: 41698304 [Indexed for MEDLINE] Conflict of interest statement: Conflict of interest The authors report no conflicts of interest related to this work. De-identified data that underlie the results reported in this article can be made available upon reasonable request to the corresponding author. No AI tools were used during the writing processes of this manuscript.

Estimating the impact of Viamo call-in information services on sexual and reproductive health knowledge, behavior, and outcomes among women of reproductive age: A 2-arm open label randomized controlled trial in Uganda.

15. PLoS One. 2026 Feb 13;21(2):e0342327. doi: 10.1371/journal.pone.0342327. eCollection 2026. Estimating the impact of Viamo call-in information services on sexual and reproductive health knowledge, behavior, and outcomes among women of reproductive age: A 2-arm open label randomized controlled trial in Uganda. Fink G(1)(2), Owen BN(1)(2), Will J(3), Kozain I(4). Author information: (1)University of Basel, Basel, Switzerland. (2)Swiss Tropical and Public Health Institute, Allschwil, Switzerland. (3)Innovations for Poverty Action, Kampala, Uganda. (4)Viamo, Kampala, Uganda. BACKGROUND: Despite substantial increases in access to schooling and to the internet, health information and knowledge remains limited among women of reproductive health in many low- and middle-income countries. Given the near universal cell-phone coverage in low- and middle-income countries, call-in services offer an interesting new platform to provide high quality information to targeted populations. In this paper, we assessed the impact of the Viamo 3-2-1 call-in platform on health knowledge and behavior among women of reproductive age in Uganda. METHODS: We conducted a 2-arm open label randomized controlled trial targeting 6000 women, ages 18-49 years, with access to a simple feature Airtel cell phone in Uganda. Fifty enumeration areas were randomly selected in Kampala, Madi-Okollo, Rwampara and Katakwi districts for a total of 200 enumeration areas. Consenting women were asked to complete a baseline and endline survey implemented by trained interviewers using tablets through home visits. After completion of baseline, women were randomized with equal probability to treatment and control using a tablet-generated random number draw. Study staff introduced treated women to the call-in service and encouraged its use through various incentives and promotional messages. Primary outcomes were sexual and reproductive health knowledge scores as well as iron supplementation in pregnancy. Secondary outcomes included self-reported use of contraception, healthy diets, birth spacing and birth outcomes as well as hemoglobin levels and BMI. Linear regression models were used to estimate mean differences in outcomes between treatment and control. Standard errors were corrected for the cluster-based sampling of women. RESULTS: A total of 6,011 women were enrolled into the study between December 6, 2022 and February 11, 2023; 3,052 were assigned to treatment, 2,959 used as controls. Endline data was collected between May 8, 2024 and August 4, 2024. Overall follow-up rates were 92% in both the treatment and the control group. Treatment increased average sexual and reproductive health knowledge by 0.07 standard deviations (95% CI [0.01, 0.11], p-value = 0.02) and increased the likelihood of taking iron supplements by 4% pts among recently pregnant women ([0.003, 0.08], p-value 0.04). Results for secondary outcomes were mixed, with positive changes for nutritional intake and family planning behaviors and intentions and no impact on hemoglobin levels and BMI. No adverse events or outcomes were reported. CONCLUSIONS: The results of this trial suggest that access to call-in services can increase health knowledge and to some extent also health behaviors. Longer and more intensive program exposure may be needed to yield measurable changes in reproductive outcomes and nutritional status. Copyright: © 2026 Fink et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. DOI: 10.1371/journal.pone.0342327 PMCID: PMC12904432 PMID: 41686779 [Indexed for MEDLINE] Conflict of interest statement: The first, second and third author declare no competing interest. The last author (IK) is currently employed by Viamo, the company operating the service analyzed. She was not involved in the data analysis and did not modify the way the results are presented or described in any way.