Systematic reviewindependent cross-checkabstract checked I-SUP-123 standard review
Diet to treat anaemia in pregnancy
Effectiveness of Dietary Interventions in Prevention and Treatment of Iron-Deficiency Anemia in Pregnant Women: A Systematic Review of Randomized Controlled Trials.
Overview
Skolmowska D et al.. Nutrients 2022 · PMID 35893877 · DOI 10.3390/nu14153023
Seven small trials suggest that diet changes, fortified foods or counselling can raise haemoglobin in pregnancy, but the evidence is weak.
Does the study support the specific claim? Partly · Methodological quality: low
Plain-language summary
Study explained simply
- What did the researchers want to find out?
To test food-based approaches against anaemia in pregnancy.
- How was the study done?
Systematic review of 7 trials.
- How many people, animals or samples were studied?
Not stated.
- What was actually found?
Dietary interventions improved haemoglobin.
- How large was the observed effect?
Not pooled.
- What do the results mean in everyday life?
Diet matters, but it is not shown to replace iron tablets when anaemia is present.
- What are the study's limitations?
Few, biased trials; fortified foods contain added iron.
- What does it say about Elawady's specific claim?
Partly supports the idea that diet matters; does not support the ban.
- Do the results apply to Germany and Europe?
Applicable.
- What can explicitly not be concluded from this study?
Cannot show diet alone is enough in anaemia.
Scientific in-depth review
1. Full reference
- Authors
- Skolmowska D et al.
- Journal
- Nutrients
- Year
- 2022
- Identifier
- PMID 35893877 DOI 10.3390/nu14153023 · PMC9332092
- Verification
- verified – PubMed efetch 2026-10-26; Crossref works API 2026-10-26
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
COI statement in record: The authors declare no conflict of interest.
2. Research question
Are dietary interventions effective in preventing and treating iron-deficiency anaemia in pregnancy?
3. Study design and population
- Study design
- Systematic review – Systematic review of randomised controlled trials (no meta-analysis)
- Population
Anaemic or mixed pregnant women
- Country
Multinational
- Period
Search to June 2021
- Sample size
7 RCTs (participant total not stated in abstract)
- Inclusion and exclusion criteria
RCTs of dietary interventions (fortified foods, regular foods, counselling)
4. Methods and endpoints
- Exposure / intervention
Dietary interventions incl. iron-fortified products and counselling
- Comparator
Placebo, supplementation or control
- Endpoints
Haemoglobin and other iron indices
- Statistical methods
Narrative synthesis; RoB 2
5. Actual results
- Results
All included dietary interventions (increased iron, multiple nutrients, or counselling) were reported effective on haemoglobin; most studies medium risk of bias, some high risk.
- Absolute risks
not reported in abstract
- Authors' conclusion
Dietary interventions were effective, but more rigorous RCTs are needed to confirm this.
6. Strengths
- PROSPERO-registered; RoB 2
7. Weaknesses
- Only 7 heterogeneous trials
- Several interventions used iron-fortified products, i.e. added iron
- No pooled estimates; medium-high risk of bias
8. Risk of bias
- Orienting tool
- AMSTAR 2
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Narrative synthesis.
9. Assessment of the statistical interpretation
No pooled effect; cannot compare with supplementation.
10. Relevance to the specific claim
Best available supporting-side evidence: diet and counselling can raise haemoglobin; it does not show that diet can replace iron treatment in anaemic pregnant women.
11. Independent contrary findings
Fortified foods are themselves a form of added iron.
12. Transferability to Germany and Europe
Applicable.
13. Overall methodological judgement
Weak support for diet as one tool; no support for banning supplements.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | low |
| Risk of bias | some concerns |
| Precision of results | low |
| Directness | direct |
| Reproducibility | not replicated |
| Consistency with the overall evidence | unknown |
| Regional transferability | moderate |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
Head-to-head comparisons of diet vs supplements in anaemia.
15. Linked fact checks
- There is no such thing as iron supplements: they are forbidden even for a pregnant woman with anaemia, because a diet that needs supplements is deficient. – Studies with mixed or unclear results