Grant: Project Grant

It is commonly thought that ~50% of anemia in low-income countries is due to iron deficiency. This has guided the 2016 global World Health Organization policy for untargeted (blanket) iron supplementation programs among non-pregnant women, which promote consumption of 12 weeks of 60mg iron daily in areas of high anemia prevalence. There is strong evidence of the benefit of iron supplementation in women that need it. However, there is a lack of evidence for the safety of daily iron supplementation in women who do not need it. Iron is a toxic element that may cause stress or harm in the body when consumed in high doses. The harms may be even higher in women who already have problems with using iron in the body. Our aim is to assess potential negative markers of iron supplementation in Cambodian women who received daily oral iron supplements in accordance with the global policy. We will recruit women and provide them with 60mg of the standard form of iron (ferrous sulfate), 18mg of a more bioavailable form of iron (NaFeEDTA), or a placebo for 12 weeks. We will collect blood and fecal swab samples before and after the supplementation. We will measure markers of potential harm that can indicate stress or damage in the body, and compare these markers among women in the three groups. The findings will provide important information to inform global policy for untargeted iron supplementation in non-pregnant women worldwide.