Saturday, September 18, 2010

Fluoride and anemia?

An article that's been making the rounds at work alleges that fluoride is linked with anemia in pregnant women. The article, Effective interventional approach to control anaemia in pregnant women, looks at a number of women in India, and evaluates whether lowering fluoride intake had a positive effect.

Anaemia in pregnancy and low birth weight babies, a serious public health problem, troubles India and several other nations. This article reports the results of a approach to address the issue.
Results reveal that (1) the urine fluoride levels decreased in 67% and 53% of the pregnant women respectively, who attended ANCs during 1st and 2nd trimester of pregnancy. (2) An increase in Hb upon withdrawal of fluoride followed by nutritional intervention in 73% and 83% respectively has also been recorded. (3) Body mass index (BMI) also enhanced. (4) The percentage of pre-term deliveries was decreased in sample group compared to control. (5) Birth weight of babies enhanced in 80% and 77% in sample group women who attended ANC in 1st and 2nd trimester respectively as opposed to 49% and 47% respectively in the control group. (6) The number of low birth weight babies was reduced to 20% and 23% respectively in sample as opposed to 51% and 53% in control groups.

So we have fluoride levels in urine dropping, and at the same time, hemoglobin levels and body mass index increase. In addition, we see a decrease in birth complications.

Looks pretty telling, until you read this from the abstract:

The sample group was introduced to two interventions, viz.: (1) removal of fluoride from ingestion through drinking water, food and other sources, (2) counselling based intake of essential nutrients, viz. calcium, iron, folic acid, vitamins C, E and other antioxidants through dairy products, vegetables and fruits. No intervention was introduced for the control group.

The researchers changed two things at once – reduce fluoride intake, and increase the intake of essential nutrients. After both changes are made, the change in fluoride intake is given all the credit.

It would have been very interesting to see what the effect would have been had the women only gotten nutritional counseling. I suspect there'd have been positive results just from the improvement in nutrition.

1 comment:

nyscof said...

It is instructive to compare these results with those of earlier reports from

China,7,8 Bangladesh,9 Nepal,10 Indonesia,11 Guinea Bissau,12 and Mexico.13

Unlike our work,6 which is grounded on an adequate nutritional program and

lowering toxic levels of F intake to reduce anemia in pregnancy and to increase

birth weight, those studies, which were relatively unsuccessful, were based

primarily on micronutrient supplementation. Our findings support the view that

iron and folic acid at the levels currently in use are effective in reducing the risk of

low birth weight, provided they are accompanied by good nutrition and decreased

F intake. On the other hand, studies supplementing iron and folic acid with 14

micronutrients in rural Nepal show no improvement in low birth weight,14 and in

South Asia and Sub-Saharan Africa they indicate little or no amelioration of low

BMI (< 18.5), which is a key risk factor for poor pregnancy outcome.15 This low

BMI was present in 24% of women in our study in the initial stages of pregnancy,

but it was reduced to a mere 2% at the time of delivery after introduction of our