Intermittent iron supplementation for reducing anaemia and its associated impairments in adolescent and adult menstruating women.

Background Anaemia is a condition in which the oxygen-carrying capacity of the blood is insufficient to meet the physiologic needs of body tissues. Approximately 29% of the nonpregnant women internationally experience this condition. Multiple direct causes of anaemia that frequently exist are: parasitic infections; inflammatory disorders; inherited disorders of haemoglobin (Hb) structure; and vitamin and mineral deficiencies such as that of vitamins A and B, and folate, and the most prevalent, iron. Worldwide figures suggest that 50% of anaemia is attributable to iron deficiency. Iron deficiency may derive from inadequate dietary iron intake, poor iron absorption or utilization, increased iron requirements, or blood loss – acute or chronic. The WHO recommends daily oral iron for pregnant women to prevent maternal anaemia, puerperal sepsis, low birth weight, and preterm birth, and folic acid to prevent neural tube defects, usually supplemented together. Iron deficiency anaemia may cause impaired muscle function and reduced resistance to infections, and is associated with reduced physical capacity and work performance in adolescents and adults. Conventionally, daily iron supplementation has been a standard practice for preventing and treating anaemia. Nevertheless, it has been associated with adverse side effects such as gastrointestinal disturbances, including nausea, constipation, diarrhoea, and teeth staining, which may lead to issues with compliance. The administration of intermittent iron supplementation – where supplements are administered once or twice a week on nonconsecutive days alone or with any other vitamins and minerals – is recommended as an effective and more tolerable alternative to prevent and reduce the incidence of anaemia and may in effect increase compliance. Improving iron