Wednesday, August 19, 2009

Misleading advertsing makes my blood boil


Some people hate baby formula companies and believe that they are the scourge of the earth. I am normally a bit more ambivalent to them, as sometime when we are so passionate about something we can become militant about it, and this ostracizes people. I personally don't think that formula companies are deliberately evil, just naive and misunderstand the issues.

However when I saw this add above in a magazine it mad me mad and I tore it out (lucky I wasn't browsing the mag in a store!). I have left of the bottom half of the ad which has words and a can of formula. It makes me mad because it is a half truth.

There two massive assumptions; that adding vitamins into milk powder will enable these vitamins to be used by baby/toddler/child. Secondly that all vegetables have in them in vitamins. Both of these are wrong.

Life is never as simple as it is made out. Vitamins are often found in plants and animals bound to carrier proteins which makes them much more bioavailable. Some examples are:

Vitamin B12
Vitamin B12 is carried by special protein haptocorrin. This has two functions, firstly it stops B12 from being digested in the stomach. Secondly it enables B12 to be uptaken by the stomach lining, and into the body. Adults make haptocorrin, so if you eat any B12 without it being naturally bound to haptocorrin, it can be attached to the B12 so the body can use it. However it is unknown if babies and infants can make haptocorrin! Cows milk is low in B12 so it is added into the powder as unbound vitamin B12. Therefore there is no evidence that babies get any B12 from the formula. Critic of course could argue that they must get enough otherwise clinical disease would show up.

Well lets have a look at clinical disease definitions. Vitamin B12 deficiency can cause ataxia. This shows up as lack of coordination, trouble walking and trouble with looking at objects. This sounds to me to be normal baby behavior and by time they are on solids at 2 years old they will be getting haptocorrin bound vitamin B12 from animal products.

Pallor can also be caused by vitamin B12 deficiency. This is when the skin is pale, again all my babies have always had pale skin!

So without a blood test it would be impossible to know vitamin B12 status in babies.

Folates
Folate is a very interesting vitamin. Folic acid is vitamin B9, however folic acid is not as common as folates in nature. Folates are the folic acid with additional chemicals bound to it. These different chemicals result is more, or less, uptake by the body.

In the body folates are transported around by a proteins called Folate Binding Proteins (FBP). This group of transport proteins are used for various functions in the body. Some are designed to resist digestion and tolerate a low pH as what would be found in stomach. Work with rat intestinal cells shows folate uptake higher than free folate, so these FBP play an important part with absorption of vitamin B9. In adults these functions are still being uncovered, so we really don't know if folic acid in formula can be absorbed by babies without the FBP's.

Again clinical signs are nebulous, a sore back, pallor as discussed above, and again a blood test is needed to determine any clinical defiancies.

The second assumption most people would now disagree with. Vegetables and colorful fruit are packed with micronutrients/flavonoids/phytochemicals. Even though these nutrients would be reduced due to modern day farming and storage. The more I read, the more I realise that the vitamins are the small tip of the iceberg when it comes to health benefits. Therefore it is better to eat your broccoli and carrots than take a vitamin A pill. The exception to this is if your supplements come from concentrated fruits/vegetables. But as these are expensive I can almost guarantee that the formula vitamins will be synthetic and contain no additional plant factors. I did once try and find this out from the formula manufactures and got a simple marketing fob off. And my contacts in the milk industry tell me that they are synthetic vitamins that are added.

In summary formula probably has enough vitamins in it that baby or child is unlikely to have a clinical vitamin deficiency. However they are extremely unlikely to absorb all the vitamins in the milk powder. We have no idea about how bioavailable these vitamins are.

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