Deploying stable isotopes to assess a condition contributing to growth failure in children has a potential to improve our understanding of what Environmental Enteric Dysfunction (EED) is and how it can be combatted, two recent scientific reviews co-authored by IAEA experts have highlighted.
The reviews were published in the world-renowned journals Pediatrics (November 2016) and the Journal of Pediatric Gastroenterology and Nutrition (September 2016).
“EED is an important public health problem that limits child growth and future adult potential,” said Cornelia Loechl, Head of the Nutrition Section at the IAEA and a co-author of the two papers. “Development of accurate, field-based non-invasive methods to diagnose the condition is urgently needed and stable isotope techniques offer the advantage that they can be used to assess multiple aspects of EED.”
EED is an inflammatory disorder of the gut primarily resulting from recurring infection in the small intestine, causing incomplete absorption and ineffective use of nutrients. It also weakens the immune system, and can undermine the effectiveness of oral vaccines (see What is EED?). Children are particularly susceptible, and EED often contributes to poor child growth, which results in reduced cognitive development and reduced economic productivity later on in life.
The two scientific reviews are the result of an experts’ meeting hosted by the IAEA in 2015 to discuss the link between EED and growth failure in children. The papers propose mechanisms for the interaction between the condition and child growth and how the problem can be treated. They also explain how stable isotopes offer a gateway to a better understanding of the condition and how to tackle it.
Current techniques to measure EED in children, such as the sampling of intestinal tissue by biopsy, are cumbersome, invasive, expensive and as a result often not carried out, Loechl explained. “The use of non-radioactive stable isotopes to non-invasively track EED was favourably proposed as an efficient alternative to those techniques because of their versatility.”
Stable isotopes can be used to study how the stomach and intestinal system work and track individual nutrients – including proteins, fat, carbohydrates, minerals and vitamins – and bacterial cells to help understand how these are affected by EED. These techniques can also be used to measure health implications of EED on body composition and energy partitioning. Carbon 13, for example, can be used to label nutrients and track their digestion and absorption by the body. Deuterium oxide, a stable isotope of hydrogen, can be used to measure lean or fat mass accumulation, to track synthesis of protein and fatty acids and study the function of individual bacterial cells.
Treatment of EED should include provision of essential nutrients, improving hygiene and sanitation and promotion of the growth of beneficial bacteria in the intestine.
