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Management of Severe Acute Malnutrition during Early Life; Addressing Nutritional Requirements by Stable Isotope Techniques
Closed for proposals
Project Type
Project Code
E43022CRP
1500Approved Date
Status
Start Date
Expected End Date
Completed Date
24 November 2014Description
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 the proposed 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
Objectives
To contribute new information to re-examine and improve the management of children with Severe Acute Malnutrition (SAM)
Specific objectives
Assess energy expenditure and macrokinetics by stable techniques in children with SAM
Evaluate the potential usefulness of body composition assessment as an outcome indicator of nutritional status of children with SAM, based on stable isotope technique and/or multi-frequency bioelectrical impedance analysis (BIA)..
Impact
Results of this CRP have contributed new information on the impact of ready-to-use therapeutic foods and micronutrient fortified complementary foods for the treatment of malnutrition in terms of growth and body composition in children recovering from malnutrition.
Relevance
This CRP has raised important operational research questions on appropriate indicators of nutritional status of children during recovery from malnutrition. As a follow up two technical meetings on SAM were organized by the IAEA together with the International Malnutrition Task Force (IMTF); one in Ghana in 2012 back to back to the third RCM of the CRP and one in Asia in 2013. The outputs of these meeting is were published as a special issue of the Food and Nutrition Bulletin, Volume 35, Supplement 1, June 2014, pp. 1S-89S(89).
Our understanding of the effects of interventions aimed at improving the treatment of acute malnutrition can be improved by assessing body composition using stable isotope techniques. Changes in body composition have short- and long-term outcomes related to health. Fat represents a store of energy, and adipose tissue supports immune function and may regulate linear growth of bone. Lean tissue represents functional tissue, which may also contribute to immune function but contributes significantly to quality growth. Today in the world there are 162 million (24.7%) children suffering from different forms of under-nutrition with a target for 2025 to decrease this number to 100 million. A very successful IAEA Symposium “Understanding moderate malnutrition in children for effective interventions” in May 2014 attracted more than 350 participants from 65 countries and had support from WHO, UNICEF, WFP, Bill and Melinda Gates Foundation among others and the role of stable isotope methods in evaluating programmes on acute malnutrition was emphasized in the symposium’s recommendations.