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The newspaper of The Johns Hopkins University December 4, 2006 | Vol. 36 No. 13
Fortified Milk Reduces Morbidity in Preschool Children

By Kenna Lowe
Blloomberg School of Public Health

Consumption of milk fortified with specific micronutrients — zinc, iron, selenium, copper and vitamins A, C and E — significantly reduces diarrhea and acute lower respiratory illness among children in developing countries, according to researchers from the Johns Hopkins Bloomberg School of Public Health and the Center for Micronutrient Research at Annamalai University in India. The study was published Nov. 28 on the Web site of the British Medical Journal.

"Some micronutrients have a crucial role in generation, maintenance and amplification of immune responses in the body. Deficiencies in multiple micronutrients among preschool children are an important determinant of child health in developing countries," said Sunil Sazawal, lead author of the study and an associate professor in the Bloomberg School's Department of International Health.

The authors conducted a randomized, controlled trial among 633 children aged 1 to 4 years in a peri-urban population in New Delhi, India, from April 2002 to April 2004. An intervention group of 316 children received milk fortified with additional micronutrients — 7.8 mg zinc, 9.6 mg iron, 4.2 g selenium, 0.27 mg copper, 156 mg vitamin A, 40.2 mg vitamin C and 7.5 mg vitamin E — while a control group of 317 children received the same milk without fortification. The study was undertaken in children over 12 months of age, in whom breast-feeding is not the primary source of nutrition.

The children who received fortified milk had fewer episodes of diarrhea and acute lower respiratory illness (pneumonia); the number of days with severe illness was reduced by 15 percent, the number of days with high fever by 7 percent, the incidence of diarrhea by 18 percent and the incidence of pneumonia by 26 percent.

Robert E. Black, co-author and professor and chair of the Bloomberg School's Department of International Health, said, "Together, these results suggest an improved immunity against common infections in children. There is an urgent need to develop and implement strategies to reduce the burden of micronutrient deficiencies in the developing world," he said. "Our results suggest that micronutrients can be delivered successfully through fortified milk, which is also a well-accepted delivery method in these communities."

Co-authors of the study from the Bloomberg School, in addition to Sazawal and Black, are Usha Dhingra and Girish Hiremath. Jitendra Kumar, Pratibha Dhingra, Archana Sarkar and Venugopal P. Menon, with Annamalai University, also co-authored the study.

The study was supported by Fonterra Brands.


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