Heme and Non-heme Iron Intakes, Gut Microbiota, and Influence on Host Iron Absorption

Recruiting

• Conditions: Anemia, Iron Deficiency; Iron Overload

• Registration Number: NCT06146608
• Lead Sponsor: Cornell University

Brief Summary

The FeMicrobiome study will evaluate gut microbiome features and their relationships with dietary iron absorption in healthy adults. The investigators hypothesize that (1) the gut microbiota can be shaped by the heme and non-heme Fe content of the diet and that (2) this will influence individual variation in dietary Fe absorption.

Detailed Description

Iron is an essential micronutrient ingested as either heme iron (from animal products) or non-heme iron (from both plant and animal sources). Humans have no regulatable means of eliminating absorbed iron, necessitating tight control of dietary iron absorption. Likewise, native microbes have evolved efficient iron sensing and utilization pathways to scavenge iron from the gastrointestinal environment, resulting in a competition for iron between the host and their microbiota. As growing numbers of Americans adopt plant-based diets, heme iron intakes are markedly reduced. This may shift the gut microbiome as some gut microbiota cannot independently synthesize heme and require host dietary heme sources to support their heme-dependent functions. Animal data have recently discovered that other gut microbiota respond to a low iron. To date, significant knowledge gaps exist on the interplay between dietary iron sources, native gut microbes, and iron utilization in humans. In the FeMicrobiome study, study investigators will recruit 120 adults who habitually ingest plant-based diets or habitually ingest diets containing animal protein (e.g., beef, pork, chicken, fish, and seafood). Iron absorption will be measured by using an in vivo, functional approach based on stable iron isotopes (i.e., 57Fe). Study participants will consume 57Fe (as ferrous sulfate) in the fasted state followed by two standardized meals. Two weeks after iron dosing, a blood sample will be collected from each participant and the amount of 57Fe incorporated into red blood cells will be measured using magnetic sector thermal ionization mass spectrometry. A stool sample will be collected near the time of 57Fe consumption. DNA will be extracted from this stool sample and sequenced using a high-depth shotgun metagenomic approach.

Study Timeline

• Study Start: 2023-01-15
• Study First Submitted: 2023-07-11
• Study First Submitted QC: 2023-11-21
• Study First Posted: 2023-11-24
• Status Verified: 2025-02
• Last Update Submitted: 2025-02-21
• Last Update Posted: 2025-02-24
• Primary Completion: 2026-01-14
• Study Completion: 2026-01-14

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 120

Inclusion Criteria

• Healthy adults
• Age between 18- 40y
• Non-smoking
• Not currently taking vitamin, mineral, prebiotic, and probiotic supplements.
• Females: premenopausal and not pregnant or lactating
• No preexisting medical complications (such as eating disorders, hemoglobinopathies, malabsorption diseases, steroid use, substance abuse history, or taking medications known to influence iron homeostasis)
• Body mass index (BMI) between 18 - 27 kg/m2.

Exclusion Criteria

• BMI <18 or > 27 kg/m2,
• Age <18 y or > 40y,
• Smoking
• Pregnancy, lactating
• Have gastrointestinal disorders/malabsorption diseases/hemoglobinopathies/dietary restrictions/steroid use/ medication use of medications known to impact iron status, iron utilization or inflammatory status
• Currently take vitamin, mineral, prebiotic, and probiotic supplements.
• Recently received antibiotic treatment

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
The concentrations of ferritin	baseline	The concentrations of ferritin (ug/L)
The concentrations of hemoglobin	baseline	The concentrations of hemoglobin (d/dL)
Dietary information on the day prior to iron dosing	baseline	Detailed dietary information about all foods and beverages consumed on the day prior to iron dosing will be obtained from the Automated Self-Administered 24-Hour Dietary Assessment Tool. Total iron intake will be presented as a proportion of the daily iron requirement. Total heme and non-heme iron intakes will be quantified.
The percent of non-heme iron absorption	2-week	Percent non-heme iron absorption will be determined by red blood cell iron incorporation of stable 57Fe
Serum transferrin receptor	baseline	Serum transferrin receptor in mg/L
Gut microbiome composition	baseline	Shotgun metagenomic sequencing will be performed to assess the gut microbiome compositions and gene functional features in a stool sample collected within one day before or after iron dosing.
The hematocrit	baseline	Blood hematocrit in %
Habitual dietary information	baseline	Habitual dietary information will be obtained from Diet History Questionnaire III.

Trial Locations

Locations (1)

Cornell University; 🇺🇸 Ithaca, New York, United States