According to the World Health Organization, 30 million children in Bangladesh and southern India suffer from malnourishment, and in Bangladesh, 40 percent of children under the age of 5 suffer from stunted growth.

A recent study published in Nature, an international weekly journal of science, explores the reason some malnourished children still remain ill even after receiving food. Human stomachs contain bacteria that aid in the absorption and digestion of food. In severely malnourished children, even after they are supplied with food, the necessary forms of bacteria did not return to their systems. Research of doctors from Washington University in Saint Louis suggests that malnutrition greatly damages this process to the extent that it is not able to be adequately repaired.

Dr. Jeffery Gordon from Washington University in Saint Louis Medical School explained to an NBC reporter how he began to analyze this problem. Deciding to focus on the region of Dhaka, Bangladesh, Gordon first ran a series of tests on fecal samples of healthy children from infancy to age 2 in order to get an idea of how the microbial communities should appear. He then ran the same test on 64 malnourished children of the same age as the first group before, both during and after they received food supplements. He split the group in two and provided one with a peanut based food (Plumpy’Nut) and the other with a rice and lentil based food (Khichuri-Halwa) and took fecal samples from the children every month for four months.

Even after the children from both groups began to gain weight, neither group matured normally. Additionally, the children’s microbial communities did not mature normally, either. Dr. Sathish Subramanian, also from Washington University, commented in an interview with the BBC, “the severity of a child’s malnourishment was tied closely with the degree of immaturity of his or her gut microbial community.”

While the exact process that is occurring is still being researched, it is clear, as Dr. Gordon stated in his interview, “We can’t just think about food as a repair item.” His next move is to determine what exactly makes the digestive system livable for the bacteria that aid in food absorption and digestion.

— Jordyn Horowitz

Sources: NBC, BBCNatureWorld Health Organization
Photo: National Geographic

Malnourished Children
Researchers studying malnourished children in Bangladesh have concluded that current therapeutic food interventions, while effective in saving lives, is not enough to reverse damage done in formative years.

Doctors have been trying to address problems that formerly malnourished children now in treatment still face such as stunted growth, immune deficiencies and slow intellectual growth. It is now becoming apparent that these development challenges are due to an immature system of microbial organisms that inhabit the digestive tracts of healthy children.

In the study, researchers compared fecal samples of 64 malnourished children to samples from 50 healthy Bangladeshi children that had been collected monthly over the first two years of their lives. In the healthy samples, 24 species of bacteria were found and used to predict the maturity of a child’s microbial system.

The study showed that when these children were afflicted with diarrhea, their microbial systems quickly recovered. The malnourished children hospitalized for diarrhea showed little recovery in the maturity of these systems after treatment with antibiotics and therapeutic foods, as they were lacking in healthy microbes to begin with.

This deficiency likely stems from undernourishment in the first two years of life, a formative period that is essential to developing a healthy brain, immune system and microbial system.

“Perhaps healthy growth and attainment of our full potential requires healthy development of our microbial organ, and also microbes living in other parts of our bodies,” said researcher Jeffrey I. Gordon of Washington University in St. Louis.

Current treatment for undernourishment includes rehydration, a liquid diet of milk suji (whole milk powder, rice powder, sugar and soya oil) and a series of multivitamins and antibiotics to help fight infection. This method has decreased the mortality rate in malnourished children by 47 percent and reduced risk of hypoglycemia.

Researchers in the recent study questioned the long-term results of such treatment protocols and the extent to which they restore normal growth and development. Gordon stated that the current methods should be adjusted to include probiotic supplements, as well as prolonged consumption of therapeutic foods.

“We need to think of food as interacting with this microbial organ,” he said.

Ed Yong, a science writer for Discover Magazine, writes that roughly 1,000 species of bacteria reside in the human bowel, though the makeup of these species varies from person to person. Each individual carries about 160 different bacterial species; it is estimated that 57 exist in the majority of the population. These microbes serve functions such as breaking down complex sugars, producing vitamins and fatty acids and converting chemicals into useful substances.

Factors that impact the development of healthy bacteria include diet, genetics and locale. Research has shown that even the method of delivery can impact the bacterial makeup of an infant; those that are delivered via C-section show less diversity in microbial systems than those delivered naturally. These differences can affect other facets of daily life including susceptibility to disease, predisposition to obesity and the ease with which certain foods are digested.

– Kristen Bezner

Sources: Discover, Science Direct, National Geographic 1, National Geographic 2, Nature
Photo: Chai Counselors

The Republic of Rwanda is a small sovereign state in the Eastern part of Central Africa. Rwanda ranked at 166 of 187 countries on the UNDP Human Development Index in 2011. Rwanda also has the highest population density in the region with 416 people per square kilometer.

Low income, limited natural resources, and food and water insecurity pose a problem for citizens in Rwanda every day. In the years following the Rwandan Genocide in 1994, international rebuilding efforts have been on the ground trying to make sustainable changes to alleviate some of the hunger and water issues.

Here are five facts that explain the state of hunger in Rwanda and how it may change in the coming years:

  1. The 1994 Rwandan Genocide marked the end of the ceasefire signed the year before that stopped the fighting of the Rwandan Civil War. The war began between two ethnic groups the Hutu and Tutsi. The Genocide began when the plane carrying the Hutu supported president Juvenal Habyarimana was shot down and he, along with several other members of the government, were killed. The genocide lasted 100 days and an estimated 800,000 to 1,000,000 people were killed. The fallout from the Rwandan Genocide is the cause for much of the instability in the region that lasts today.
  2. Secondary school attendance in Rwanda is one of the lowest in the world and the literacy rate is 55%.
  3. Approximately 65% of the population has access to safe, clean drinking water
  4. 45% of children under 5 years of age are malnourished.
  5. Over 67,000 refugees from neighboring countries currently reside in Rwanda.

Even though there is a lot of strain on the country today, organizations have been working with the government to address one of Rwanda’s major problems: food insecurity. Agriculture was the country’s main sector before the genocide, and since then, major efforts have been made to make it profitable one more.

Updating the agricultural practices is what the World Food Programme credits with directly reducing the number of food insecure people.

The country hopes that with the reliance on agricultural programs it will improve its GDP to US$900 by the year 2020, up US$380 from its current GDP. Rwanda was also the first country to sign the Comprehensive Africa Agriculture Development Programme (CAADP), meaning that addressing malnutrition and food insecurity is one of the government’s main priorities.

Even though Rwanda still has a long way to go, the government has been taking steps in the right direction that could provide a template for other countries in the region to follow.

– Colleen Eckvahl

Sources: World Food Programme, World Vision
Photo: Rising Continent

According to the Hunger Project, a non-profit organization that works to end global hunger, “malnutrition occurs when the variety or quality of food is insufficient to support proper development and health.”

Roughly 15 percent of babies born in developing countries are of low birth weight due to maternal malnutrition, and even those born at a healthy weight are at risk for malnutrition due to insufficient breastfeeding. Malnutrition causes one-third of global child deaths, perpetuated as undernourished women give birth in low-resource settings.

When a malnourished woman gives birth to a low-birth weight baby that has already been affected by her mother’s malnourishment, the child will suffer from a compromised immune system and will most likely stay malnourished, even when she reaches reproductive age. Her child, too, will be born malnourished, and the cycle of malnourishment will continue.

Seeking to break the cycle of malnourishment, the Hospital for Sick Children in Toronto, Canada is developing a daily microencapsulated micronutrient powder through its affiliate SickKids.

Called “Prenatal Sprinkles,” this powder contains iron, folic acid and calcium. Pregnant and lactating women in poor areas can simply sprinkle their food with this supplement in order to combat malnutrition.

Prenatal Sprinkles will help to combat anemia during pregnancy, which often leads to premature birth, and preeclampsia associated with hypertension, which often causes maternal and fetal death.

Prenatal Sprinkles can potentially lower maternal hypertensive disease related mortality by 20 percent and preterm birth by 24 percent. Previously, supplements could not contain both iron and calcium due to poor absorption, but Prenatal Sprinkles contain differential time-release nutrients that increase iron and calcium absorption and prevent calcium-iron interaction. They also have a smooth texture and a pleasant flavor, making them palatable for malnourished women.

The Hospital for Sick Children is partnering with companies in the private sector in order to finance the production of Prenatal Sprinkles, but the projected cost of mass production is very low for the supplement.

Though Prenatal Sprinkles are not yet in wide circulation, they offer a simple and cost effective solution to malnutrition, a problem that cannot be solved by food aid alone.

Katie Bandera

Sources: Sprinkles (R) 60mg Fe for Pregnant and Lactating Women, Issues: Malnutrition
Photo: Girls’ Globe