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October 30, 2006
Nutrition research focuses on global health problems, disease

by haley curtis stevens

World class, international nutritional research is being conducted at the Rollins School of Public Health in the Hubert Global Health Department, the first endowed department of Emory University.

“Last year, we received $15.4 million in research funding and were ranked fifth among all departments in the university,” said Reynaldo Martorell, Woodruff professor of International Nutrition and chair of the RSPH Hubert Department of Global Health since 1997.

The global health interest of these researchers—many of whom are also members of the Nutrition and Health Sciences Ph.D. training program of the Division of Biological and Biomedical Sciences—focuses on the problem of nutrition in developing countries.

“Nutrition is woven into a wide range of core areas of the University,” said Aryeh Stein, NHS program director. “There is a strength here in global health, in particular in residual problems of undernutrition and emerging areas of overnutrition.”

Martorell, for example, has been recognized internationally for his ongoing work in Guatemala on childhood malnutrition. His study has traced the long term effects of a community intervention conducted between 1969–77, which has become one of the longest running follow up trials in history. His findings suggest a strong link between poor nutrition in childhood and intellectual development into adulthood.

In this trial, mothers’ diets were supplemented with a protein- and nutrient-rich drink. Their infants showed significantly higher birth weights and reduced mortality rates when compared to children of women receiving a less nutritious drink. Children who consumed the protein rich drink went further in school and had greater incomes as adults.

Although Martorell started his study long before he came to Emory in 1993, his collaborators here have been crucial to the success of his trial.

“At Emory, we have tremendous resources. We have the medical school, the graduate school of biological sciences, and the RSPH all right here. We have the Centers for Disease Control and Prevention next door and we collaborate very closely,” said Martorell. “What it allows is an interdisciplinary approach to nutrition, which is a multidisciplinary problem.”

Current international nutrition projects at Emory are highlighted by ongoing worldwide micronutrient fortification of flour, led by RSPH Professors Godfrey Oakley and Glen Maberly. Numerous countries across the globe are experiencing significant detriments to their economies due to micronutrient deficiencies.

Maberly, founder of the Global Health Department, is using his past success with the worldwide salt iodization program to launch a new fortification project that strives to add iron and folic acid to all milled flour worldwide, in an effort to prevent micronutrient deficiencies, including spina bifida and anencephaly.

“There are more children with anencephaly and spina bifida worldwide than with pediatric AIDS. This unnecessary epidemic is the result of a tragic failure of global public policy. With folic acid flour fortification, we absolutely can make these defects go away,” said Oakley.

This goal is what launched the new micronutrient fortification program.

The initiative has a very clear objective: to fortify 70 percent of the world’s flour by 2008.

“We’re at the innovative, cutting edge of these programs,” Maberly said.

Oakley and Maberly are currently working with many countries, including India, New Zealand, Ireland, Pakistan, South Africa and China to fortify their grains. Through a surveillance system here at Emory, they can monitor each country’s progress.

Global Health Department newly appointed faculty member Venkat Narayan was recruited to Emory from the CDC to continue his highly accredited work in international obesity and diabetes, a rapidly growing problem that, according to Narayan, all nations will face eventually.

“Obesity is a very costly disease, both in terms of human suffering and in terms of financial costs,” said Narayan. “It is happening all over the world. Developing countries are experiencing the most rapid rate of increase.”

Narayan has been involved with several large, population-based diabetes prevention trials in the U.S.
“I see diabetes and obesity very much at the cross-roads of globalization and health. Our challenge in our research is to understand the epidemic further, understand the causes at the individual level and at the policy level, and think of interventions to control this,” Narayan said. “We need to network with several groups across the world and that’s the direction we are planning to go.”

Narayan sees enormous potential at Emory for global health progress, given the University’s intense dedication to this issue.

“What has impressed me about Emory is a very strong commitment to Global Health, to seeing issues like chronic diseases and also wanting to be at the forefront of research and change. That is permeating all the way from the president to the deans to the departments,” said Nayaran.

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