Celebrity / NYJSM Consult / Nigel Barker

Nigel Barker consults Dr. Vasey and NYJSM.com

March 13, 2010

Matthew Vasey, MD

"Dr. Vasey, could you provide your readers with information about Edeyo and the importance of nutrition in children? Please invite them to visit, www.edeyo.org."

Certainly, it was a pleasure meeting you after the America's Next Top Model show at Bryant Park's Mercedes-Benz Fashion Week. This excerpt is taken directly from the Edeyo webpage, "Edeyo is an independent not-for-profit organization dedicated to improving the future of children in Haiti by rebuilding dilapidated schools, supplying students with learning materials, and providing them with nutritional support. " (3) The webpage also references the support you were able to generate for the children through a gallery event in New York City with photos taken during a visit to Haiti in 2007. All proceeds from that event continue to support the cause. Sadly, the school was destroyed and many lives were lost in the earthquake. Efforts are already underway to rebuild thanks to your efforts and others on January 21st raising fifty thousand dollars for Haitian relief.

While significant efforts are being made towards complex scientific discovery in HIV/AIDS related research and eradication of Malaria among other efforts, there is exist great opportunities for large scale health improvement by applying what is already known, the importance of nutrition, particularly in children. According to the World Health Organization, malnutrition contributes to an estimated 54% of childhood death (6). Penny in the textbook, Nutrition in Pediatrics describes the gap between existing knowledge and the reality of management abysmal, with regard to malnutrition in children.

The self defining term protein-energy malnutrition (PEM) refers to the classic syndromes Marasmus, Kwashiorkor and a combination of both. (1) While many healthy gym goers might consider PEM to be the manifestation of a refrigerator without a carton of Muscle Milk, malnutrition as defined by the WHO represents a more physiologically fundamental "cellular imbalance between the supply of nutrients and energy and the body's demand for them to ensure growth, maintenance, and specific functions." (4)

Marasmus is thought to represent a withering or wasting syndrome (Greek translation of marasmos) more gradual in onset where the body has for lack of a better word adapted (5), at least temporarily to inadequate nutrient intake because essential body functions are maintained ie. organ and brain function. (4) Individuals with Marasmus tend to be more a product of environmental or psychological famine.

GOOGLE IMAGES of MARASMUS: (Click to view)

Kwashiorkor while maintaining some similarity to Marasmus as both are type of PEM represents a more complicated mechanism that is not fully understood. The term Kwashiorkor is a local name of the African Gold Coast dating back in the literature to the landmark publication in 1933 by Cicely Williams. Kwashiorkor translates to "one who is physically displaced". Williams declared a disease the deposed baby gets when the next one is born. (11). While a complex interaction of protein and energy deficiency and infections is believed to be the cause of Kwashiorkor, one defining observation is that of edema, or body swelling.


Deficiencies of any or all of the following can lead to symptoms related to malnutrition: (7)
ESSENTIAL FATTY ACIDS - Linoleic and Linolenic acid
WATER SOLUBLE and B VITAMINS - Thiamine (Vitamin B1) , Riboflavin (Vitamin B2), Niacin (Vitamin B3), Pyridoxine (Vitamin B6), Biotin (Vitamin B7), Folate (Vitamin B9), Vitamin B12, Abscorbic acid (Vitamin C)
MINERAL AND TRACE ELEMENTS - Calcium, Phosphate, Magnesium, Iron, Zinc, Copper, Selenium, Iodide, Potassium, Manganese, Molybdenum

Worldwide the most common cause of malnutrition is not enough food. Young children are most at risk as they depend on others. (8) Every day, almost 16,000 children die from hunger-related causes--one child every five seconds. (2) That's nearly 6 million children a year. Without making light of the AIDS pandemic or Malaria, according to USaid.gov, AIDS caused 2 million deaths in 2008 in people of all ages. (9) Malaria in 2006 caused nearly one million deaths in children. (10) An investment towards something as simple as a daily sandwich, glass of water and children's multivitamin appears to be a realistic proven high-yield means to save a life.

Be sure to check out the Edeyo Foundation:

As well as, Nigel Barker's webpage and blog:

1. Balint, JP. Physical findings in nutritional deficiencies. Pediatr Clin North Am 1998; 45:245.
2. Black, Robert, Morris, Saul, & Jennifer Bryce. "Where and Why Are 10 Million Children Dying Every Year?" The Lancet 361:2226-2234. 2003.
3. Edeyo.org
4. Onis M de, Monteiro C, Clugston G. The worldwide magnitude of protein-energy malnutrition: an overview from the WHO Global Database on Child Growth. Bulletin of the World Health Organization. 1993;71(6).
5. Gura, Chan. Chapter 18 - Nutrition in Pediatrics: Basic Science & Clinical Applications, BC Decker 2008, 4th ed. 191-208
6. Penny. Chapter 13 - Nutrition in Pediatrics: Basic Science & Clinical Applications, BC Decker 2008, 4th ed. 121-141.
7. Phillips, MS, RD, LD, Jensen, MD Clinical manifestations of malnutrition in children. www.uptodate.com
8. Scheinfeld N, Mokashi A. Protein-Energy Malnutrition. January 8, 2010.
9. Usaid.gov
10. World Health Organization. http://www.who.int/mediacentre/factsheets/fs094/en/index.html
11. Williams CD. Arch Dis Child, 1933. Vill 423

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