GAINESVILLE, Fla. --- Mainstream America has been bombarded in recent years with advertisements touting the health benefits of antioxidants such as vitamin E and beta carotene. But a new study from the University of Florida and Washington University in St. Louis suggests that they may be far more important to children in other parts of the world who have a severe form of malnutrition called kwashiorkor.
Based on the study, which uncovered the mechanisms by which kwashiorkor works, the researchers may be able to begin designing treatments to drastically reduce the fatality rate from kwashiorkor, a leading cause of juvenile death in Third World countries, said Christiaan Leeuwenburgh, an assistant professor in UF's department of exercise and sport sciences. Leeuwenburgh did the study with lead author Mark Manary, an associate professor of pediatrics at Washington University in St. Louis and Jay Heinecke, associate professor of medicine at Washington University School of Medicine in St. Louis Because of the lack of antioxidants in the diet of many children who suffer from kwashiorkor, their bodies undergo oxidative stress, in which particles called free radicals destroy healthy cells, the researchers found.
"Now that we've established that oxidative stress may be involved, simple oxidative therapies, like giving the children doses of various antioxidants, can help," Leeuwenburgh said. "Giving these children antioxidant supplements as well as supplemental proteins could increase their life spans."
Common sense might suggest that giving children more food would stop malnutrition, but with kwashiorkor, it's more complicated than that. From this study, researchers have determined that it's not the amount of food but the amount of antioxidants in the food that makes a difference.
Kwashiorkor is particularly devastating to children, 40 million of whom have the disease, Manary said. "It's an extremely serious form of malnutrition," he said. "Normally when you're starving, you just get thinner, which is normal because your body is conserving its energy for essential functions. When children get kwashiorkor, their mind is affected and they get large sores on their bodies. It's all over the world, especially in poor countries."
Results of the study, funded by the International Atomic Energy Agency and the National Institutes of Health, were published in September's Journal of Pediatrics.
Manary collected urine samples from 41 children in Malawi, a small country in southern Africa. The children were divided into three groups: those with kwashiorkor, those with malaria and those classified as healthy children. Manary stored the samples on dry ice at -70 degrees Celsius, and returned them to the United States, where Leeuwenburgh analyzed them using gas chromatography-mass spectrometry, a sensitive and specific procedure that tests for oxidative damage.
Leeuwenburgh found that children with malaria, and especially children with kwashiorkor, had very high levels of oxidative stress markers.
"Because of malnutrition, the defenses of these children is low," Leeuwenburgh said. "It really sets them up to be damaged from free radicals."
Based on this study, Manary is designing interventions that he hopes to test in Malawi within the next few years.
"It's very exciting," he said. "This means that this severe form of malnutrition could be prevented if you could increase the amount of antioxidants in people's diets. For people in Africa and Asia, we're going to try indigenous methods. Having them dry mangoes, which are all over Asia and Africa, is one idea. They're full of antioxidants, but they aren't in season very long, so if we could teach people to dry them for year-round use, it could help."
The study also points to new avenues that health organizations worldwide can pursue in the fight against hunger and disease.
The impact of the study on the health of children in the Third World could be staggering, Leeuwenburgh said. However, finding the right combination of proteins and antioxidants to supplement the often poor diets of malnourished children will require additional research.
"This is just the beginning of a big puzzle that needs to be figured out," Leeuwenburgh said. "But this is an important first step, because it is the first evidence of this type of free radical involvement in these diseases."
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