Prevention vs Treatment
Most of the studies examining nutrient intakes or nutritional interventions in relation to children’s BLLs involved children who already were exposed to lead, and some studies, especially those conducted in the 1980s and 1990s, enrolled children with moderately high lead levels. In that respect, they are more able to address the issue of effectiveness of dietary “treatment”for lowering BLLs once exposure has occurred, than of prevention. Complete prevention of lead exposure via dietary means is not possible.With sufficient exposure, well-nourished children will present with detectable and possibly elevated BLLs. In one RCT involving iron fortification, 18% of children in the fortification group had elevated BLLs at the end of the trial,19 suggesting that even if treatment is effective, not all children benefit. Part of the reason for this is that lead uses multiple types of transporters as well as tight junctions to cross epithelial cells in the intestine. Existing evidence cannot address the question of whether nutritional approaches would be more effective in acute-exposure scenarios.
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