Supplementation with antioxidants and folinic acid for children with Down’s
syndrome
The results of our study on the effects on antioxidants and folinic acid have finally been released. You can view the results on the BMJ website here.
A comment on the findings by Peter Elliott, Chairman, DSRF
Dear Friends,
At last we can talk about the study.
There are important points mentioned
in the study and its results:
1) The dose rates were at the RDA except for Vitamin
E.
** RDA is the recommended Daily Allowance and is based on the
level needed to ensure good health in the general population. In babies,
the RDA is fixed up to age 12 months and then fixed for the next
12 months. It is not based on body weight, so the actual dose rate per
KG body weight becomes lower and lower up to age 12 months, then jumps to
a new level and then drops on a dose per KG basis month by month as the body
weight increases. Vitamins in food however will be more related to body
weight of the baby and to the food intake.
2) Babies are feeding on
mothers milk and this is the most perfect food for babies. So it is quite likely these babies have no nutritional
deficiencies and would therefore have
no benefit from nutritional supplements. Those babies getting formula would
have a broad spectrum of vitamins and minerals in that formula and again
are unlikely to have a need for additional supplements.
3) Babies were
chosen for this study because growth and development including brain
development is very fast in babies and any improvement would be easier to
detect. Earlier studies have shown a benefit from supplementation and most
baby formula is supplemented these days. This would infer no need for more
supplements in babies getting baby formula.
4) Folate metabolism is
impaired in children with trisomy 21 and the conversion of folic to folate is
impaired because there is a need to provide a methyl donor, typically B12 and
B6 needs to be available along with folic supplements. There was no B12 or B6
in this therapy. So the folic was most likely never converted to
the bioavailable form which is folate. And the folic dose rate is very
low anyway. So no basis to assume growth gains.
5) Antioxidants: It is
not clear when the blood samples were taken but safe to assume they were
fasting samples. So any metabolic activity would have been accomplished a few
hours after consumption and the antioxidants would be depleted or excreted.
This is a process where electrons are exchanged so assume microseconds for
free electrons to do anything and they have to negotiate the
digestive tract, acid then alkaline, so a lot of electron exchanges before
any free electrons make it into the blood stream. Vitamin E was seen to
be elevated in the blood stream compared to those babies not getting
the antioxidants. Perhaps this is having a benefit but there is insufficient
data to prove this.
6) It is usual to establish benchmarks before assuming
any intervention is needed or effective. I don't see these benchmarks
from the start of the study. The only information is one year after
the baby was in the study. So if you don't know where you have been,
you can't assess changes. All you can do is average all the data for
each group and compare that average to the average data for the babies
on the placebo. If you had the spread of that data for each group
this might indicate more consistency from one group to another.
7) In
this study what has been said is there are no differences in many areas that
should have been influenced. Perhaps they were influenced but only for a few
hours after feeding.
8) Not surprised at some vomiting - these vitamins can
taste disgusting.
This has been a very big study and parents who took
part should be thanked for helping with this research.
I know many
parents will be disappointed -- but there is no such thing as a failed
project, they are only steps along the road that leads to
success.
Babies are the most normal and the most healthy and are going to
be the most difficult to study for improvements.
Any other
comments? Let's hear what they are -- we all want to
know.
Nutrition is related to health and development. That's
beyond dispute. Understanding these complex issues is of great interest
to everyone
including the doctors who have to admit a project did not produce
a hoped-for result.
We don't give up; we just move on.
Peter
Got an opinion? Have any questions? Join the
discussion on the DSRF Yahoo Group here: http://groups.yahoo.com/group/DSRF/ |
