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Effect of provision of daily zinc and iron with several micronutrients on growth and morbidity among young children in Pakistan: a cluster-randomised trial. 

This Gates-funded trial in Pakistan shows that Infants and young children given micronutrient powders (containing iron; folic acid; and vitamins A, C, and D, with or without additional zinc) had more bloody diarrhoea and more respiratory symptoms than controls. The authors have called for a closer look at safety before distribution is scaled up. "Use of micronutrient powders reduces iron-deficiency anaemia in young children. However, the excess burden of diarrhoea and respiratory morbidities associated with micronutrient powder use and the very small effect on growth recorded suggest that a careful assessment of risks and benefits must be done in populations with malnourished children and high diarrhoea burdens."

Soofi, Bhutta et al The Lancet - 18 April 2013: 10.1016/S0140-6736(13)60437-7

WHO Guideline:Use of multiple micronutrient powders for home fortification of foods consumed by infants and children 6–23 months of age does recommend the use of these powders - but with provisos: "Programmes involving the use of multiple micronutrient powders for home fortification of foods should be preceded by an evaluation of the nutritional status among children under 5 years of age ...to ensure that the daily micronutrient needs are met and not exceeded."

 http://whqlibdoc.who.int/publications/2011/9789241502047_eng.pdf

Profits and pandemics: prevention of harmful effects of tobacco, alcohol, and ultra-processed food and drink industries. 

This study assesses the effectiveness of self-regulation, Public Private Partnerships (PPPs), and public regulation and concludes that unhealthy commodity industries should have no role in the formation of Non-Communicable Disease (NCD) policy. On our request this was discussed at the European Platform Plenary meeting in February. Discussing the merits of product reformulation "in low-income countries, benefits are less obvious, and the dangers are very apparent. In such countries, consumption of ultra-processed products is low. These countries are therefore the prime targets of transnational corporations." An increase in the overall consumption of ultra-processed products would "undermine long-established dietary patterns based on fresh or minimally processed foods."

The Lancet, Volume 381, Issue 9867, Pages 670 - 679, 23 February 2013 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2962089-3/abstract

Call to end early cord cutting 

UK Medical bodies, senior doctors and the National Childbirth Trust (NCT) are calling for an end to clamping of a baby’s umbilical cord as soon as it is born. Newborn babies deprived of vital blood from the placenta are more at risk of iron deficiency - all the better for the companies selling fortified formulas and supplements! 

http://www.guardian.co.uk/society/2013/apr/25/cutting-cord-babies-risk-nhs?INTCMP=SRCH   http://www.who.int/elena/titles/cord_clamping/en/

Inconvenient truth?

Everyone agrees that malnutrition is a shameful world problem that must be tackled. However, the idea that the answer is giving micronutrient supplements to all children, regardless of whether they are needed, is risky. Marketing them freely to all even more so. The study from Pakistan below shows some of the problems and urges caution. Like all studies this needs to be evaluated and corroborated - but such evidence should not be overlooked just because it’s "inconvenient." The film from Cambodia* shows the importance of nutritious foods from local ingredients.

A bit of history on ‘Sprinkles’

Dr. Stanley Zlotkin did the research to develop a micronutrient powder called ‘Sprinkles’ in 1996 and owns its patent. He went on to commercialise them globally in conjunction with the H.J. Heinz Company and Foundation in 2001. He has been an infant feeding consultant for Nestlé and Mead Johnson and in Canada has pushed iron supplementation for all breastfed babies. 

* "Improve the food security of farming families affected by volatile food prices" by the Food and Agriculture Organisation (FAO) and the EU. See page 26.

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