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21 MAY 2015

The 3rd Research Coordination Meeting reviews the influence of infection with Helicobacter pylori on food fortification and supplementation strategies

3rd Research Coordination Meeting Participants

Participants of the 3rd Research Coordination Meeting on ‘Stable isotope techniques to design effective food fortification strategies in settings with high Helicobacter pylori infection’

The 3rd Research Coordination Meeting on ‘Stable isotope techniques to design effective food fortification strategies in settings with high Helicobacter pylori infection’ is being held this week at IAEA Headquarters, Vienna, from 18 to 21 May 2015. This is the last meeting of a series that brought together seven research contract holders from India, Bangladesh, Tanzania, Morocco, Cuba, Argentina and Chile and one agreement holder from the United Kingdom. The main aim of the meeting is to review the progress and results of the different studies that are all applying stable isotope techniques (UBT) to diagnose H. pylori infection.

H. pylori infection is the most common bacterial infection in humans in developing countries (80-90% among adults), being associated with factors such as low socio economic status, low education level, poor sanitation and rural residence. If most individuals don’t show any symptoms, however, there is evidence that gastric acid output is reduced which limits the absorption of micronutrients. Limited absorption of non-water-soluble compounds of iron and zinc might compromise the effectiveness of food fortification and supplementation programs. Then, in a context of high rates of infectious diseases and malnutrition, H. pylori infection represents an additional burden to vulnerable population groups.

The IAEA started a coordinated research project in 2010 to evaluate the effect of H. pylori infection on gastric acid secretion and on iron absorption from different fortification compounds as well as on the effect of food fortification and supplementation on iron status in developing countries. The new evidence obtained will assist public health policy makers in designing effective food fortification strategies using bioavailable compounds to address micronutrient deficiencies.

One of the specific objectives of this research project was to explore possibilities to develop a non-invasive test using stable isotopes to measure gastric acid secretion since at the moment it can only be measured directly by the invasive intubation method. This has limited the collection of data on gastric acid output in community studies in developing countries and the development of a non-invasive method has therefore high priority in public health. The calcium carbonate breath test was discussed during the first coordination meeting as a promising non-invasive test to provide precise and quantitative measures of gastric acid secretion. It is a stable isotope technique and needed to be validated versus the gold standard, the intubation method. Results of the validation were presented at this week’s meeting and further explored by Dr Tom Preston from Glasgow University and Dr Shafiqul Sarker from the International Centre for Diarrhoeal Diseases research (icddr,b) in Bangladesh, where the clinical part of the study was conducted.

Studies on the evaluation of the role of H. pylori on iron fortification and supplementation have been carried out on women of reproductive age in Bangladesh, Cuba and Morocco; and in young children in Tanzania, India and Chile. The influence of H. pylori infection on the hormonal modulation of food intake and its consequences on nutritional status was also studied in Argentina. Data collection and analysis is still ongoing and links between H. pylori infection, gastric acid secretion and iron absorption from different fortification compounds will continue to be explored.

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