Nutritional and Health-Related Environmental Studies
Operational Co-ordinated Research Projects
CRP Number: E4.30.23.
CRP Title: Stable isotope techniques in the development and monitoring of nutritional interventions for infants and children with malaria, TB and other infectious diseases
Objective: Malnutrition is a contributing factor in approximately half of the deaths of young children in developing countries that are attributed to infectious diseases such as acute respiratory infections, diarrhoeal diseases, and malaria. A better understanding is needed for developing and evaluating appropriate nutritional care for infants and children in endemically infectious areas. Mortality from tuberculosis (TB) is on the increase, especially in association with HIV infection, and poverty, partly reflecting poor nutrition, is the strongest risk factor for childhood TB infection. Recent unexpected findings suggest that micronutrient supplementation in accordance with previously established guidelines may have adverse effects in regions where malaria is endemic, and more information is needed on the best way to manage nutritional deficiencies in such regions. The overall objective of this CRP is to contribute to development or monitoring of practices for improving the nutrition of infants and young children at high risk of infectious diseases such as malaria and tuberculosis.
Number of RCMs: 0
Next RCM: 2009
Year of Commencement: 2009
Details
CRP Number: E4.10.15.
CRP Title: Stable isotope technique to assess human milk intake in infants living in contaminated areas
Objective: The World Health Organization (WHO) recommends that infants should be exclusively breastfed for the first six months of life, followed by the introduction of appropriate complementary foods and continued breastfeeding for up to two years to achieve optimal growth, development and health. Paediatricians and policy makers agree that protection, promotion and support of breastfeeding are a public health priority. WHO classifies exclusively breastfed infants as receiving human milk and nothing else. Predominantly breastfed infants receive human milk and small amounts of other fluids (teas, water or juice) on at least three days a week. Many infants are predominantly breastfed until 9 months of age, especially in developing countries. Human milk is used in human biomonitoring as an indicator for accumulation of environmental chemicals. Evidence about toxic and potentially toxic chemicals in human milk can be used to promote environmental protection issues, but this can have an adverse effect on the public health messages issued by WHO. Breastfeeding is safer and cheaper than formula feeding and has significant advantages for the mother and her baby. Breastfed infants score significantly higher than formula-fed infants in studies of mental development. In addition, breastfeeding improves the bonding between mother and baby and has positive effects on the baby’s immune function including fewer incidents of gastrointestinal infections. There is currently no information available on the effect of environmental contamination from mining activities and natural sources on lactation performance of women living in contaminated areas. Young infants are particularly vulnerable since human milk is their primary or sole source of nutrition. Human milk intake and thus lactation performance can be accurately assessed using stable isotope technique. The CRP will use a longitudinal study design to focus on assessing human milk intake and lactation performance of nursing mothers using the deuterium oxide dose-to-mother technique. Repeated measures will be performed in infants aged 3, 6 and 9 months. Depending on the study location, the infants’ intake of lead (Pb), mercury (Hg), arsenic (As), cadmium (Cd), selenium (Se) and manganese (Mn) though human milk will be assessed by combining accurate data on human milk intake with measures of concentration. The infants’ growth will be monitored with reference to the new WHO growth standards and they will be monitored for incidence of infectious diseases.
The overall objective of the proposed CRP is to assess lactation performance of women living in contaminated areas and to provide better estimates of transfer of toxic and potentially toxic elements from mother to child via human milk.
Number of RCMs: 0
Next RCM: 2009
Year of Commencement: 2009
Details
CRP Number: E4.30.21.
CRP Title: Food fortification and biofortification to improve micronutrient status during early life
Objective: The high prevalence of micronutrient deficiencies, in particular deficiencies of iron, zinc and vitamin A, is contributing significantly to the unacceptably high childhood morbidity and mortality observed in developing countries. Food fortification and biofortification are potentially useful strategies to prevent and control these deficiencies, however, limited data are available on the efficacy of these public health interventions in infants and children. Stable isotope techniques can be used in the development and evaluation of nutritional strategies by the assessment of bioavailability of iron, zinc and pro-vitamin A carotenoids as well as by monitoring changes in body pools of vitamin A to evaluate efficacy. This CRP will generate new information on the usefulness of food fortification and biofortification to improve micronutrient status in infants and children.
Number of RCMs: 1
Next RCM: 2010
Year of Commencement: 2008
Number of Contract Holders: 7
Number of Agreement Holders: 2
Details
CRP Number: E4.30.22.
CRP Title: Management of severe acute malnutrition during early life; addressing nutritional requirements by stable isotope techniques
Objective: The World Health Organization (WHO) estimates that nearly 20 million children under 5 years of age suffer from severe acute malnutrition (SAM). Children with SAM are at considerably higher risk of dying compared to well nourished children, either as a direct cause of SAM or as an indirect cause as SAM dramatically increases the risk of dying from common illnesses such as diarrhoea and pneumonia. Estimates suggest that SAM contributes to about 1 million child deaths every year - one child death every thirty seconds. The large majority of children with SAM live in south Asia and sub-Saharan Africa and although children with SAM appear in news coverage of humanitarian emergencies, the silent suffering of most of these children remains largely unnoticed.
The overall goal of this CRP is to contribute new information to re-examine and improve dietary recommendations for treatment of children with SAM. Stable isotope techniques provide powerful tools to provide much needed information on energy and nutrient kinetics in vulnerable population groups but the application of these techniques has been limited in children with SAM. However, the usefulness of these techniques is clearly highlighted by recent studies, for example in Malawi and Jamaica.
The results generated within this CRP will contribute to improved management of severe acute malnutrition in infants and young children.
Number of RCMs: 0
Next RCM: 2009
Year of Commencement: 2008
Number of Contract Holders: 6
Number of Agreement Holders: 1
Details
CRP Number: E4.10.14
CRP Title: Exposure to toxic and potentially toxic elements in women of childbearing age in developing countries
Objective: Rapid urbanization and industrialisation increase the risk of exposure to toxic/potentially toxic elements such as lead, mercury and manganese in developing countries. In addition, drinking water and foods contain high levels of arsenic and mercury in many resource poor settings where undernutrition is common. For example, drinking water with high arsenic content is consumed widely in Bangladesh and India. Undernutrition and exposure to toxic/potentially toxic elements have often been treated as separate issues. However, there is now increased concern about whether undernourished people are potentially more vulnerable to exposure to toxic/potentially toxic elements. The overall aim of new CRP “Exposure to toxic and potentially toxic elements in women of childbearing age in developing countries” is to contribute to a better understanding of these issues by evaluating exposure in adult women with different nutritional status.
Number of RCMs: 3
Year of Commencement: 2005
Number of Contract Holders: 8
Number of Agreement Holders: 2
CRP Number: E4.30.20.
CRP Title: Nutrition and HIV/AIDS: The efficacy of food based nutrition interventions evaluated by stable isotope techniques
Objective: The overall aim of this CRP is to evaluate the efficacy of nutrition interventions in people living with HIV/AIDS based on changes in body composition (muscle mass), measured by stable isotope techniques. In particular, the associations between nutrition - HIV/AIDS - antiretroviral treatment will be given special emphasis. The outcome of the project will contribute to a better understanding of the importance of nutrition in the management of HIV/AIDS. The results will be of particular relevance to countries where the prevalence of HIV/AIDS is high and where there is an urgent need to develop effective nutrition interventions based on locally appropriate, sustainable food based strategies to integrate nutrition into a comprehensive response to HIV/AIDS.
Number of RCMs: 2
Next RCM: 2009
Year of Commencement: 2005
Number of Contract Holders: 7
Number of Agreement Holders: 2
Details
CRP Number: E4.30.19.
CRP Title: Body fat and its relationship with metabolic syndrome indicators in overweight pre-adolescents and adolescents
Objective: Overweight and obesity are defined as an excess of body fat. Children and adolescents can be defined as overweight or obese based on reference percentiles of BMI (body weight/hight2) for age. However, although BMI for age standards is a widely accepted approach for classifying overweight and obesity, careful interpretation of weight-height relationships is required in children and adolescents with low stature resulting from chronic undernutrition. Moreover, the assumption that BMI can classify overweight and obesity in all ethnic groups of children and adolescents has not been demonstrated. The overall objectives of this CRP are to establish the relationship between body mass index (body weight/stature2) and body fat and explore the association with indicators of the metabolic syndrome in pre-adolescents of 9 years at first Tanner stage of puberty (T-1) and adolescents of 16 years at 4th and 5th Tanner stages of puberty (T4-5) who are at risk of overweight (above the 85th percentile of BMI for age according to the CDC charts) in different ethnic groups.
Number of RCMs: 2
Next RCM: 2009
Year of Commencement: 2005
Number of Contract Holders: 11
Number of Agreement Holders: 2
Details
CRP Number: E4.30.18.
CRP Title: Zinc nutrition during early life
Objective: The overall objective of this CRP is to contribute to a better understanding of zinc nutrition during the first year of life. More specifically, the aim is to evaluate human milk intake and the introduction of other fluids during the first year of life in different countries. In countries with high prevalence of small for gestational age (SGA) infants, SGA infants and infants appropriate for gestational age (AGA) will be studied in parallel. In addition, changes in human milk zinc concentration (and zinc intake from human milk) will be evaluated during the first year of life. In some settings, zinc status will be measured by stable isotope techniques in sub-groups of SGA and AGA infants.
Number of RCMs: 2
Next RCM: 2009
Year of Commencement: 2005
Number of Contract Holders: 8
Number of Agreement Holders: 3
Details