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Dietary Iron Is Crucial for Infant Development, Michigan Researcher Shows

Posted - Oct. 9, 2003 at 2:03 p.m.



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Oct. 8--ANN ARBOR, Mich.--Dr. Betsy Lozoff is a world traveler who cycles to work.

A pair of sturdy walking boots and a bike helmet are tucked behind her office door.

For 30 years, she has made one goal her life's work.

She wants to eliminate iron deficiency in the children of the world.

Lozoff's particular contribution is helping people understand how iron-rich diets play a critical role in child development.

Babies in Chile who didn't get sufficient iron in their diets showed fewer social skills, even when they interacted with their mothers, according to new research her team published this month in the journal Pediatrics.

"They process information more slowly . . . interact less socially or check their mother's reaction, all important ways that babies interact with the world," explains Lozoff, director of U-M's Center for Human Growth and Development, an interdisciplinary group of researchers involved in early learning studies.

Deficits in social and academic skills continue in adolescence even when iron deficiency is corrected in infancy, her team has found. Those children often repeated a grade in school by the time they were 12, were more depressed or anxious, had attention problems and lagged in math and writing.

The findings have implications even for countries like the United States, where baby formula has been fortified with iron since the '70s, because the problem has not been eliminated, Lozoff says.

As many as 5 percent of African-American and 18 percent of Mexican-American children have iron deficiencies, Lozoff says.

She currently is collaborating with Mary Lu Angelilli and Sandra Jacobsen, two Wayne State University School of Medicine researchers, to determine the incidence of iron deficiency in Detroit-area children, and their performance on developmental tasks.

For now, the important message is to alert pregnant women and parents of babies to be sure their children are getting the right amount of iron.

"The thing we've been telling moms, whether they breast-feed or not, is that babies are born with enough iron to get them through the first four to six months of life," Lozoff says.

"Then you need additional sources of iron."

Iron is important to the brain's early development, she says.

It regulates the brain chemical dopamine, involved with mood and memory, and is a critical player in the development of myelin, a fatty layer that insulates nerve cells.

Lozoff advises talking to a physician about a simple, cheap blood test if a child displays any symptoms of iron deficiency including pale skin, fatigue, weakness, irritability, headaches or, later on, a shiny, reddened tongue or blue tinge to the whites of the eyes.

"It's perfectly reasonable to say to the pediatrician, 'Would you take a closer look at my child's diet with me?' "

Teens also may have deficient iron in their diets.

"There's reason to worry about teens. Teenagers are the next big risk group for iron deficiency. If there's any concern, the child could be tested," she says.

Lozoff was far from settling on her life's work when she graduated from Radcliffe College in 1965.

A few years abroad helped.

She first worked as an au pair in Japan, then signed up to work on a study in India of childhood diarrhea. "That's where I got hooked (on public health)," she says.

After that, medical school made sense. She got her medical degree, then taught and worked for nearly 20 years at Cleveland's Case Western Reserve University. She's been at U-M since 1993.

In summer, she packs and heads for field work in places that have included India, Ecuador, Martinique, Costa Rica and Chile.

Since 1981, she has headed a team following nearly 200 lower middle-class Costa Rican children. All were otherwise healthy when they entered the study but some were iron-deficient. These children developed learning and behavior problems in their teens.

Largely as a result of her team's research, the Chilean government distributes iron-fortified powdered infant formula, produced at a fraction of the cost of American liquid formulas. Costa Rica is considering a similar effort.

She's not ready to make the next leap, to link iron deficiency to attention deficit disorder.

"A lot of people are asking that question" about ADD. "There hasn't been a large good study."

Worldwide, as many as 4-5 billion people -- 66 percent to 80 percent of the population in developing countries -- may be iron deficient, according to the World Health Organization.

Inadequate nutrition, malaria and hookworm infestations are its three biggest causes. Other contributing factors include exposure to lead paint and loss of blood, including from menstruation.

Solutions include finding cheap ways to get iron supplements into foods like pastes and spreads, or adding iron to rice through genetic engineering, Lozoff says. Some countries already have taken action.

"Nobody wants the only solution to be telling people to buy expensive formulas," she says.

Lozoff has ready answers for those who ask: Why should we care?

"In terms of the U.S., why should we care about developing countries?" she asks. "In crass economic terms, the more developing countries develop, the more their standard of living improves, the more places there will be for the kind of goods we produce here.

"But the other thing is the tremendous loss of human potential.

"We can make a difference."

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To see more of the Detroit Free Press, or to subscribe to the newspaper, go to http://www.freep.com

(c) 2003, Detroit Free Press. Distributed by Knight Ridder/Tribune Business News.

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