Third world children are America's lab rats

Parul Christian, DrPH
Center for Human Nutrition
Johns Hopkins Bloomberg School of Public Health
615 N. Wolfe St
Room W2041
Baltimore, MD 21205

Dear Dr. Christian,

Today I read the account of your research done on Nepalese children in the Dec 22/29, 2010 issue of JAMA.

My first pregnancy was in 1961 and I received prenatal vitamins containing iron, and I believe the need for folic acid has been known and added to prenatal vitamins since before 1990. For some years it has been known that the relationship between zinc and iron is iffy, with the benefits of each perhaps cancelling the other.

Why is it ethical to experiment on third world children when we already know the benefits of prenatal supplements, and have known for 50 years or more? The control group will remain behind the supplement group for the rest of their lives. Just looking through other studies on the interaction of zinc and iron, I see Bloomberg is supporting research on poor children in other countries. So was that the real point of this research, to show that zinc is not useful as a supplement?

Norma Bruce
Faculty Emeritus
The Ohio State University

Parul Christian, Dr. P.H., of Johns Hopkins University, Baltimore, and colleagues conducted a study to assess intellectual and motor functioning in a group of 676 children, aged 7 to 9 years in June 2007-April 2009, who had been born to women in 4 of 5 groups of a community-based, randomized controlled trial of prenatal micronutrient supplementation conducted between 1999 and 2001 in rural Nepal. Study children were also in the placebo group of a subsequent preschool iron and zinc supplementation trial. Women whose children were followed up had been randomly assigned to receive daily iron/folic acid, iron/folic acid/zinc, or multiple micronutrients containing these plus 11 other micronutrients, all with vitamin A, vs. a control group of vitamin A alone from early pregnancy through 3 months postpartum. These children did not receive additional micronutrient supplementation other than biannual vitamin A supplementation. Through various tests, intellectual (including memory and reasoning), executive (such as processing speed) and motor function (such as manual dexterity and balance) were assessed.

The researchers found that maternal prenatal supplementation with iron and folic acid was positively associated with general intellectual ability, some aspects of executive function, and motor function, including fine motor control, in offspring in a rural area where iron deficiency is prevalent. In general, the differences in test scores between the other intervention groups and controls were not statistically significant.
http://pubs.ama-assn.org/media/2010j/1221.dtl#3