Where is HGF found in this field?

Attempts to respond to the world nutrition problems have primarily ethical dimensions. Relief measures, however, require effective instruments based on findings in nutrition and food sciences. Work to develop such instruments and to adapt them to ever changing local conditions hardly finds any public interest. It is much less ostentatious than pictures of emaciated children and overstrained first aiders or reconstruction works in areas hit by disaster, who, however, would not be able to do effective and sustainable jobs without such instruments. The Hildegard Grunow Foundation is working towards this end and tries to test and adapt new concepts and instruments for effective use in Third World nutrition.

A current example

The range and ramification of corresponding activities can best be illustrated by an example. “Hidden hunger” is the term for deficiency of essential micronutrients, such as iodine, vitamin A and iron. Thus, iron deficiency is widely spread in developing countries, which is due to almost exclusive consumption of vegetarian food staples. Due to high demand during rapid growth iron-deficiency is particularly common in children and restricts their physical and intellectual development. In pregnancy it leads to frequent miscarriages and abortions. National supplementation programs in the affected target group try to cope with the situation.

Iron deficiency is particularly common in tropical regions and overlaps largely with areas endemic for malaria. Malaria plasmodia, in turn, require iron for their expansion in the host. This leads to the question, if such compulsory supplemental iron intake rather supports the development of the child or rather that of the plasmodia. A large study on Pemba, an island off the Tanzanian coast, published in 2006, revealed significantly more severe and often deadly courses of malaria in iron-supplemented as compared to non-supplemented children. Consequently, the study was stopped preterm. This result left the concept of untargeted iron supplementation programs in the dilemma of choice between not treating iron-deficiency and inducing more severe clinical causes of malaria.

Closer analysis showed, however, that such iron-related damage was restricted to children who received iron without corresponding demand. In contrast, iron supplementation to iron-deficient children influenced the course of malaria beneficially. Consequently, WHO recommended restricting iron supplementation to iron-deficient individuals. This requires the development and testing of affordable methods to assess iron status. Moreover, these methods should be non-invasive to avoid the risk of spreading blood-borne diseases like HIV and hepatitis by blood sampling. Hildegard Grunow Foundation bought and tested devices of 3 different manufacturers in the field which were constructed for this purpose. However, no breakthrough was achieved so far. Alternatively, iron-preparations could be used that supply the host organism, though they are less accessible to plasmodium. Another task is to distinguish malaria-induced inflammatory effects on anemia from the effect of iron-deficiency. This field, thus, encompasses a number of urgent questions and our foundation participates in the quest to find solutions.