Collaborative efforts lead to global impact
A collaborative study in Bangladesh has upended long-held beliefs about the benefits of iron supplements for young children, with implications for global nutrition policy.
“The most important thing to highlight about global research is that it’s the local people who are most instrumental in these projects.”
This is the key message that University of Melbourne Professor Beverley-Ann Biggs, Head of the International and Immigrant Health Group at the Doherty Institute, drives home when talking about the research projects that she is involved with around the globe.
“It is the people in the country, on-site, who are doing the work, day in-day-out. After the planning phase, we visit when we can and provide training and ongoing support,” says Professor Biggs.
A collaborative study she was involved in last year looking into the effects of preventive iron treatment in young children could now lead to major changes, as key stakeholders in global childhood nutrition policy consider the findings.
The study in rural Bangladesh examined the effects of daily iron supplements in young children, long-thought to improve childhood development, and concluded that the treatment had no impact on measures of brain development or growth.
Iron supplements are given to young children worldwide to prevent anaemia, in line with global guidelines. For decades it was also believed these supplements had the added benefit of improving cognitive development.
Led by the Walter and Eliza Hall Institute Associate Professor Sant-Rayn Pasricha, in collaboration with Dr Jena Hamadani from the International Center for Diarrheal Diseases Research Bangladesh and Professor Biggs from the Doherty Institute, the study, published in the New England Journal of Medicine, measured the impact of iron given as an oral supplement or in multiple micronutrient powders to young children the clinical outcomes of cognitive function, development and behaviour.
“We recruited over 3,300 children in rural Bangladesh from eight months of age and provided supplements in the form of both iron drops and home fortification packets,” explains Professor Biggs.
“While both types of supplements improved anaemia, neither intervention improved child development.”
The study measured children’s cognitive, language and motor development, as well as behaviour and growth, including height and weight, and found the supplements had no impact on any of these areas.
“We now think that the most important time for iron absorption is in the first six months of a child’s life, and when in utero. So, this means making sure women are taking iron supplements when pregnant,” says Professor Biggs.
The study also evaluated adverse side effects in children who took the iron supplements finding that some supplements are potentially doing more harm than good.
For children who did not have anaemia, taking the iron supplements may have increased their presentations to clinics due to episodes of diarrhoea.
Professor Biggs said she anticipated the findings would inform future global health policy guidelines about the use of iron interventions in young children.
“We have been actively presenting this data to key stakeholders such as the World Health Organization, UNICEF and the Gates Foundation,” says Professor Biggs.
“The World Health Organization recommends iron supplements are given to all young children in low and middle-income countries where anaemia is common. However, given the potential negative effects of the supplement, this intervention should be reconsidered.
“This study may also help inform guidelines for the treatment and prevention of anaemia in ‘at risk’ populations in Australia.”
This work was made possible with funding from the Australian National Health and Medical Research Council (NHMRC), the Government of Bangladesh, Global Affairs Canada, the Swedish International Development Cooperation Agency and the Victorian Government, with support from the Foreign, Commonwealth and Development Office in the United Kingdom.
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