Iron for Cognitive Pediatric
Verdict: Published with Warning
Across 5 PubMed studies, the evidence for Iron in Cognitive Pediatric grades Tier C — weak evidence. Effective, but with safety or population caveats.
C 🟠 C Weak Evidence Published with Warning
Why this grade7-layer evidence engine
Iron supplementation may help cognition in iron-deficient children, but the benefit does not generalize to replete kids. Meta-analyses (PMID 37368919, 36558491, 26629120) show positive signals mainly in deficiency-selected populations; subgroup analyses in replete children are null.
Evidence_level was inflated as '5 meta-analyses' when only three are true MAs; PMID 41710280 is an umbrella systematic review and PMID 22142898 is a narrative SR. L11 independently grades B while published tier is C after adjudication from engine D.
Tier C appropriately limits the claim to deficiency contexts. Do not market iron for cognitive enhancement in otherwise healthy, iron-replete children.
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Scoring transparency
All scores computed by a 7-layer evidence engine — fully auditableRaw score 0.71
D
C
B
A
S
← counter-evidence / ineffectiveeffective / strong evidence →
Final grade
C · Published with Warning
Confidence
76%
Broadly consistent
Evidence level
E3
PMID 41710280 is umbrella SR; PMID 22142898 is SR not MA
▸View the full decision path (audit trail)
- compute_raw_score — 加權公式: L2×0.30 + L3×0.25 + L5×0.25 + L11×0.10 + L1×0.10 = 0.715
- tier_from_score — 依分數區間映射至 tier letter
- apply_hec_rules — 高品質 SR/MA 顯示 negative 主導 (2 negative > 1 positive)，下層 RCT 不能推翻
- apply_hec_override — HEC-1 高階證據 negative — 強制由 A 改為 D
- tier_strict_requirement_check — Tier 條件達標，未降階
- detect_disputes — 偵測到 0 個 hard + 0 個 soft dispute
- decide_status — 依 tier + dispute 結果決定 status
PubMed studies (5)L2 · primary research & systematic reviews
Effect of iron supplements on cognitive development in children: an umbrella review
Finding: Across 17 systematic reviews (2,725 records screened; 3 rated high-confidence/low risk of bias), iron supplementation showed modest cognitive benefits (intelligence, memory, attention) in anemic children but negligible or uncertain effects in non-deficient children, with no consistent improvement in broader mental development or school achievement.
View on PubMed Effects of iron supplementation on cognitive development in school-age children: Systematic review and meta-analysis
Finding: Pooled across 13 RCTs, iron supplementation significantly improved intelligence (SMD 0.46, 95% CI 0.19-0.73, P<0.001), attention/concentration (SMD 0.44, 95% CI 0.07-0.81, P=0.02) and memory (SMD 0.44, 95% CI 0.21-0.67, P<0.001), but had no effect on school achievement (SMD 0.06, 95% CI -0.15-0.26, P=0.56); benefit was larger in baseline-anemic children (intelligence SMD 0.79, memory SMD 0.47).
View on PubMed Effect of Oral Iron Supplementation on Cognitive Function among Children and Adolescents in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis
Finding: Across 9 studies (1,196 participants, 5 countries), iron supplementation improved intelligence test scores (SMD 0.47, 95% CI 0.10-0.83) with a dose-response (OR 1.02 per dose unit, 95% CI 1.00-1.04), but showed no significant effect on attention, short-term memory, long-term memory, or school performance.
View on PubMed Daily iron supplementation on cognitive performance in primary-school-aged children with and without anemia: a meta-analysis
Finding: Pooling 5 trials (1,825 children), daily iron supplementation did NOT significantly improve global cognitive scores (mean difference 1.05, 95% CI -2.69 to 4.79); the authors concluded the effect on global cognitive outcomes in primary-school-aged children remains unclear.
View on PubMed The effect of iron on cognitive development and function in infants, children and adolescents: a systematic review
Finding: Of 14 included RCTs, 12 had high or moderate risk of bias and heterogeneity precluded quantitative meta-analysis; overall the studies suggested only a modest positive effect of iron on cognition and psychomotor outcomes in anemic infants and children after supplementation of at least 2 months.
View on PubMed Regulatory & authoritative positionsL4/L5 · FDA / EMA / NIH ODS / Cochrane / Mayo …
L4a US FDA
Supportive
NUTRIENT SUPPLEMENT source↗
L4b EU EFSA
Supportive
contributes to normal oxygen transport in the body source↗
L4c UK NHS
Cautious
You should be able to get all the iron you need from your daily diet. source↗
L4d TW TFDA / 衛福部
Supportive
育齡婦女及懷孕婦女每日建議攝取鐵量為15毫克，至懷孕第3期婦女則應增加每日攝取量至45毫克。 source↗
L4e WHO
Supportive
Daily oral iron and folic acid supplementation is recommended as part of antenatal care source↗
L5a NIH Office of Dietary Supplements
Supportive
Iron is an essential component of hemoglobin source↗
L5b Mayo Clinic
Supportive
Iron is a nutrient that's essential to your child's growth and development. Iron helps move oxygen from the lungs to the rest of the body and helps muscles store and use oxygen. If your child's diet lacks iron, he or she might develop a condition called iron deficiency. Iron deficiency in children can affect development and lead to anemia. To keep your child's growth and development on track, o… source↗
L5c Cleveland Clinic
Supportive
Iron is essential for your child's development, and an iron deficiency can affect your child's health and growth — and can even lead to anemia. In children, a lack of iron can also inhibit growth and development. source↗
L5d Harvard Health
Supportive
Iron. Meats, beans and lentils, fortified cereals and breads, dark leafy vegetables, and baked potatoes are among the best sources of iron. source↗
L5e Specialty Society (condition-mapped)
Supportive
Daily iron supplementation is recommended as a public health intervention in infants and young children aged 6–23 months, living in settings where the prevalence of anaemia is 40% or higher in this age group, for preventing iron deficiency and anaemia. Iron deficiency anaemia in children has been linked to increased childhood morbidity and impaired cognitive development and school performance. source↗