Nutrition

Prakarsh Singh of Amherst College in the U.S. will test different financial incentives to motivate staff at day care centers in India to improve their performance. These day care centers provide meals for preschoolers and nutritional education to their mothers, however the service is often below optimal. They will perform a randomized trial in slum areas of Chandigarh to evaluate three different methods to financially reward caregivers for improving the weight-for-height of malnourished children visiting their day care centers.

Lindsay Allen of ARS Western Human Nutrition Research Center in the U.S. will develop methods to rapidly and accurately measure concentrations of multiple micronutrients (vitamins and minerals) in small volumes of human breast milk. This will enable them to test whether micronutritional supplements during lactation can boost infant health and development. In Phase I, they established new methods to detect low concentrations of specific micronutrients including vitamin B12, iron, copper and zinc.

Clare Elwell of University College London in the United Kingdom is using non-invasive optical brain imaging (near-infrared spectroscopy) to assess cognitive function in malnourished infants and children in low-resource settings over time. The technology is relatively low-cost and portable, and their approach could be used to determine the impact of malnutrition on the developing brain and guide nutrition-related interventions.

Yun Yun Gong of Queen’s University Belfast in the United Kingdom and colleagues will identify mechanistic biomarkers of child stunting caused by the dietary contaminant aflatoxin, which is common in many parts of sub-Saharan Africa. They will determine the mechanism by which aflatoxin inhibits growth in early life using blood samples and growth charts from 300 children in Gambia and analyzing the relationship between aflatoxin exposure and changes in insulin-like growth factor signaling, epigenetic marks, and gene expression.

Charles King of Case Western Reserve University in the U.S. and his team will study how chronic parasitic infections in pregnant mothers affect infant immunity and childhood development. Using existing and prospective maternal-child cohorts in Kenya they will analyze the effect of parasitic infections, such as schistosomiasis and intestinal helminths, encountered in utero on subsequent infant vaccine responses, and on general growth and development later in childhood.

Peter Gluckman of the University of Auckland in New Zealand and colleagues will test whether intrauterine growth retardation and childhood stunting, which are commonly seen in developing countries, are caused by epigenetic changes that can be corrected in pregnancy and infancy by modifying nutrition. Stunting is associated with many negative outcomes including decreased cognitive ability and immune function.

Daniel Roth of the Hospital for Sick Kids in Canada and colleagues will test whether endocrine factors cause stunting in early infancy. They will analyze parathyroid hyperactivity in a cohort of infants from Bangladesh, where stunting is estimated to affect almost half of all children under the age of 5. To uncover the mechanisms responsible for this hyperactivity, they will conduct a vitamin D supplementation trial and analyze maternal, cord, and infant plasma specimens for evidence of dysregulation of the parathyroid-vitamin D axis.

Andrew Prentice of the Medical Research Council in the United Kingdom will conduct a phase II clinical trial to test the ability of a unique nano iron compound to safely and more effectively treat iron-deficiency anemia in children. Iron-deficiency anemia is a common condition particularly in women and children in resource-poor settings and can be deadly. Current iron supplements have limited effects in these settings and undesirable side effects including increasing the risk of infectious diarrhea in children which causes severe morbidity and mortality.

Sean Moore and colleagues at Cincinnati Children's Hospital in the U.S. will generate a mouse model of human environmental enteropathy, which is characterized by stunted growth and physiological defects in the gut, and is caused by malnutrition and repeated infections. The model will be used to test whether environmental enteropathy is affected by diet and contaminated water, and whether it reduces the effect of oral vaccines. In Phase I, they proved that feeding mice a nutritionally deficient diet mimicked at least some of the features of the human disease.

Laura Woollett of the University of Cincinnati in the U.S., in collaboration with the MRC International Nutrition Group in The Gambia, will test whether increasing plasma cholesterol in pregnant mothers from developing countries can improve fetal growth rates and reduce the associated risk of mortality and developmental defects. They hypothesized that the high incidence of low birth weight in developing countries is caused by lower levels of cholesterol in pregnant women.