A way forward: Meeting vitamin and mineral needs globally

Lindsay Allen

Efforts to curb or eliminate vitamin and mineral deficiencies globally have existed for almost a century, although there are now still as many questions if not more than ever before about what the next steps should be. There are seldom solutions that are simple to guide public policy internationally and there remain large challenges when it comes to making informed recommendations. 

Lindsay Allen, Ph.D., R.D, who is the 2012-2013 recipient of the E. V. McCollum International Lectureship in Nutrition, discussed a new way forward to improve the health of infants, children, and pregnant women internationally on April 22 at the McCollum Lecture organized by the American Society for Nutrition at Experimental Biology 2012 in San Diego. She currently serves as the Center Director of the USDA, ARS Western Human Nutrition Research Center. 

She discussed the challenges faced in global research and policy on micronutrient deficiencies as well as new methodologies on the horizon to improve research. She also called for the bringing together of more nutritional biology expertise—such that was present at the meeting—to assist in overcoming the difficulties in nutritional research such as ethical considerations when performing intervention studies in pregnant women and children.

In her presentation, Allen pointed out that modern technologies could assist in surmounting the unreasoned differences in recommendations of micronutrient intake such as that of iron or folic acid from one age to another either upwards or downwards. For example, there are measurements now available that can make use of samples of saliva, hair, or urine.

"I think that the methods we have been using like growth of babies, biochemical markers in blood are just not picking up changes in metabolism and immune function," she said. "You have these special tools to do genomics, metabolomics, and looking at gut microbiota. If we can draw in the expertise and ideas as well of people in the society and put all those different things in context of the studies we have ongoing, then we can really understand what’s happening when we give micronutrients to people."

She added, "The way forward is to bring that kind of expertise into the kind of rigorous field work that people are doing in developing countries.”

Another next step proposed by Allen is to encourage more basic nutritional science to be done in the United States of which could have an impact on health across the globe. For example, she said, there is more research needed in how micronutrients are absorbed in the diet and how micronutrients interact with each other. 

Moreover, Allen noted, there exists a greater need for research in methods development. For example, the development isotope analysis could bring new tools for use in international micronutrient deficiency research.

Former E.V. McCollum lecturer Andrew Prentice, Ph.D., who introduced and closed the lecture, called Allen’s presentation a "comprehensive tour de force" of micronutrient research and policy. He said Allen proposals presented a more agnostic approach to micronutrient research versus having various camps, such as the zinc promotional camp or iron or vitamin A. The key is to ask questions more intelligently.

"It would be so lovely if we could come up with very simple solutions and say we know that this is the policy process that we should undertake. It’s just a matter of implementing it," Prentice said. "In one or two cases that is true. Vitamin A supplementation of children has very clear-cut benefits. But with most of the other micronutrients we really don't know what to do, in whom to do it, at what levels to do it, and what would be the benefits."

Read more about Allen's talk in Nutrition Notes Daily, a publication circulated by the American Society for Nutrition.