Ano is a Justmeans staff writer for health, and an instructional designer for the newly created Master of Health Care Delivery program (mhcds.dartmouth.edu) at Dartmouth College. Ano brings over a decade of evidenced-based health research and writing, and a Masters of Public Health from Dartmouth Medical School to the Justmeans Editorial section. Special interests include health policy, conflict ...
DHA in infant formula: experimenting with children's health?
Martek Biosciences Recently sold for $1.1 billion to Dutch corporation Royal DSM NV. When assessing a company in the health sector, does the profitability of the products it produces override their significance or perceived contributions to public health?
Martek has an interesting array of products: Culturelle is a rare dietary supplement that actually has good evidence that it actually works. It contains lactobacillus GG, which reduces the incidence of antibiotic associated diarrhea. Then there are a slew of so-so products, such as vitamin C and echinacea blends that purport to strengthen immunity despite evidence that they don't work; and vitamin gum balls for kids.
But perhaps the most controversial offering from Martek, and the likely reason for its handsome price, is the infant formula additives DHA and ARA. These substances exist in human breast milk, so the logic of adding them to infant formula may seem sound. Anyone who has ever had to purchase infant formula can attest to the massive cost, and thus massive market potential, of being involved in this health sector. But critics are concerned that since it's not ethically possibly to study food additives in infants, we have no idea what the long-term impact of such potent supplementation will be. Two other question marks loom over the additives:
--Supplemented nutrients do not always have the same health effects as their naturally occurring counterparts found in food (beta carotene is a classic example of this). So supplemental amounts of a substance with health benefits in its naturally occurring form won't necessarily provide equal or superior benefits. In fact sometimes the opposite is true, supplements can cause harm. On the other hand, widespread B vitamin supplementation of the food supply is credited with reducing neural- tube defects in newborns down to a fraction of what they once were.
--Even if DHA has been shown to have health benefits in adults and animals, who we can study, that doesn't mean it's ok for infants, who are developing at such a rapid pace that we still don't fully understand their biology or how it interacts with their environment and diet.
Further conflating the potential for controversy, Martek invested significant resources to get the FDA's seal of approval for the infant formula additives. Infant health groups put up loud protest, butnin the end the FDA ruled in Martek's favor. Many opponents still contend that introducing DHA enhanced infant formula onto the open market is essentially a massive un controlled experiment on the youngest of the young. The results of such post- market surveillance is often written in gruesome headlines after unfixable harms have already occurred.
Martek's DHA, incidentally, is sustainably produced from algae.
So is Martek a company doing good work tom improve health, or merely innovating in profitable region of scientific ambiguity? And does it even matter to parse such niceties, so long as laws are not begin broken?
What's your take on Martek, additives in infant formula, or whether this type of public health based assessment of a company's product line has any value?
Photo credit: The author, via flickr