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Purpose  Adverse effects of iron fortification/supplements such as Micronutrient Powder (MNP) on gut microbiota have previously been found in infection-prone African settings. This study examined the adversaries of a low-iron MNP compared with the standard MNP on the composition of gut microbiota in Bangladeshi children exposed to a high concentration of iron from potable groundwater.    Methods  A randomized controlled trial was conducted in 2- to 5-year-old children, drinking groundwater with a high concentration of iron (≥ 2 mg/L). Children were randomized to receive one sachet per day of either standard MNP (12.5 mg iron) or low-iron MNP (5 mg iron), for 2 months. A sub-sample of 53 children was considered for paired assessment of the gut microbiome by 16S rRNA amplicon sequencing.    Results  At baseline, the gut microbiota consisted of  Bifidobacteriaceae  (15.6%),  Prevotellaceae  (12.2%),  Lactobacillaceae  (3.6%),  Clostridiaceae  (4.1%) and  Enterobacteriaceae  (2.8%). Overall, there was no significant treatment effect of the low-iron MNP compared to the standard MNP. However, an apparent treatment effect was observed in children with a relative adult-like microbiota, with a higher relative abundance of potentially pathogenic  Enterobacteriaceae  after receiving the standard MNP compared to the low-iron MNP. This effect, however, was statistically non-significant ( p  = 0.07).    Conclusion  In Bangladeshi children drinking iron-rich groundwater, a low-iron MNP supplementation did not have a significant impact on their gut microbiota profile/composition compared to the standard MNP.  The trial registration number is ISRCTN60058115; Date of registration 03/07/2019; retrospectively registered.    Supplementary Information  The online version of this article (10.1007/s00394-021-02523-1) contains supplementary material, which is available to authorized users.

european journal of nutrition

Effect of low-iron micronutrient powder (MNP) on the composition of gut microbiota of Bangladeshi children in a high-iron groundwater setting: a randomized controlled trial