• Elango, Rajavel

    Titles
    Investigator, BC Children's Hospital

    Associate Professor, Department of Pediatrics, School of Population and Public Health, University of British Columbia

    Degrees / Designations
    PhD
    Primary Area of Research
    Healthy Starts
    Secondary Area(s) of Research
    Phone
    604-875-2000 ext. 4911
    Fax
    604-875-3597
    Lab Phone
    604-875-2000 ext. 4607
    Mailing Address

    BC Children's Hospital Research Institute
    Room 170
    950 West 28th Avenue
    Vancouver, BC  V5Z 4H4

    Affiliate Websites
    Research Areas
    • Nutrient requirements: Protein and amino acid requirements during key stages of growth and development including, pregnancy, lactation, childhood and during childhood malnutrition
    • Stable isotopes: Application of stable isotope based methods to determine protein metabolism and amino acid flux in vivo
    • Nutritional Assessment: Using non-invasive techniques including indirect calorimetry, hand-held indirect calorimeter, bioelectrical impedance analysis, handgrip dynamometer and diet analysis software
    Summary

    The goal of my research program is to identify protein and amino acid (building blocks of protein) requirements during key life stages of growth and development, and in disease.

    During pregnancy the nutritional state of the mother influences the rapidly growing fetus and affects long-term health. Due to ethical constraints protein requirements during pregnancy is not well studied. With the use of stable isotope tracers, which are completely safe for use in vulnerable populations like pregnant women, my research will measure requirements and trace complex amino acid metabolic pathways in the human body. The focus will be to make dietary protein and amino acid recommendations to improve long-term health for the mother and child.

    Undernutrition or malnutrition has been implicated to be the underlying cause of ~50% of all deaths in children in the developing world. My research will examine the impact of childhood malnutrition on protein and amino acid requirements with collaborations between research institutes located in India and BCCHR in Vancouver.
    Current Projects

    Determination of protein and amino acid requirements during pregnancy and lactation 

    It is important that pregnant women eat an adequate amount and quality of protein to ensure healthy growth and development of the fetus. It is well known that pregnant women need more high quality protein in their diet, but how much additional protein is required remains unclear. There is reason to believe that current Dietary Reference Intake (DRI) recommendations for protein intake in pregnancy are too low. Additionally, metabolic adaptations that occur in a woman’s body throughout pregnancy result in different nutritional requirements during the 1st, 2nd, and 3rd trimesters. To better define protein and amino acid requirements and identify good sources of protein throughout pregnancy, we are studying healthy pregnant women 19-35y, in their 2nd and 3rd trimester of pregnancy using a stable isotope (L-1-13C-Phenylalanine) based technique.

    Assessment of the protein quality of foods

    While the amount of protein we eat needs to be optimal, dietary recommendations for protein are based on food sources. But food sources vary in their indispensable and dispensable amino acid content, with some foods quite rich and balanced, while some have a few key indispensable amino acids as too low. In addition, during digestion there is some loss of these amino acids, and will result in less amino acids available for growth and development in children. Thus, we are conducting experiments to explore how amino acids from various food sources are ‘metabolically available’ for protein synthesis in young children using state-of-the-art stable isotope based methods.

    Determination of the optimal amounts of protein and amino acids to be added to medical foods in children with in-born errors of metabolism, including Phenylketonuria, Methylmalonic acidemia/Propionic acidemia

    Children who are born with deficiency of an enzyme, have a block in metabolic pathways and causes toxic increases of some metabolites. Phenylketonuria (PKU) is an autosomal recessive disorder caused by deficiency of the enzyme phenylalanine hydroxylase (PAH). PAH deficiency leads to increased levels of phenylalanine (an amino acid) in plasma. Similarly, Methylmalonic Acidemia (MMA) and Propionic Acidemia (PA) involves children born with a defect in conversion of Methylmalonyl-CoA to Succinyl-CoA, which are formed from the metabolism of amino acids - methionine, threonine, isoleucine and valine. Treatment involves dietary restriction of these amino acids, with provision of added protein from specially formulated medical foods. We are exploring what amounts of protein and other amino acids are adequate for these vulnerable children to support growth, using minimally-invasive stable isotope based methods.

    Courses Taught

    • FNH 472 Maternal and Fetal Nutrition, Faculty of Land and Food Systems, UBC
    • SPPH 581R Pediatric Nutrition and Public Health, School of Population and Public Health, UBC
    Selected Publications

    For the latest publications, please visit Dr. Elango's ORCID profile.

    Turki A, Ueda K, Cheng B, Giezen A, Salvarinova R, Stockler-Ipsiroglu S, Elango R. The Indicator Amino Acid Oxidation Method with the Use of l-[1-13C]Leucine Suggests a Higher than Currently Recommended Protein Requirement in Children with Phenylketonuria. J Nutr. 2017. PMID: 28053173  

    Woo P, Murthy G, Wong C, Hursh B, Chanoine JP, Elango R. Assessing Energy Expenditure in Obese Adolescents in a Clinical Setting: Is the Handheld Indirect Calorimeter Valid and Accurate? Pediatr Res. 2017;81(1-1):51-56.

    Elango R, Laviano A.  Protein and amino acids: key players in modulating health and diseaseCurr Opin Clin Nutr Metab Care. 2017;20(1):69-70. PubMed PMID: 27801686.

    Elango R and Ball RO. Protein and amino acid requirements during pregnancy. Adv Nutr. 2016;7(4):839S-44S.

    Pillai RR, Elango R, Ball RO, Kurpad AV, Pencharz PB. 2015. Lysine requirements of moderately undernourished school-aged indian children are reduced by treatment for intestinal parasites as measured by the indicator amino acid oxidation technique. J Nutr. DOI: 10.3945/jn.114.208439. PMID: 25761501

    *Arentson-Lantz E, Clairmont S, Paddon-Jones D, Tremblay A, Elango R. Protein: A nutrient in focus. Appl Physiol Nutr Metab. 2015;40(8):755-61.

    Stephens TV, Payne M, Ball RO, Pencharz PB, Elango R. 2015. Protein requirements of healthy pregnant women during early and late gestation are higher than current recommendations. J Nutr 145(1):73-8. DOI: 10.3945/jn.114.198622. PMID: 25527661

    Stephens TV, Woo H, Innis SM, Elango R. 2014. Healthy pregnant women in Canada are consuming more dietary protein at 16- and 36-week gestation than currently recommended by the dietary reference intakes, primarily from dairy food sources. Nutr Res 34(7):569-76. DOI: 10.1016/j.nutres.2014.07.001. PMID: 25150115

    Tang M, McCabe GP, Elango R, Pencharz PB, Ball RO, Campbell WW. 2014. Assessment of protein requirement in octogenarian women with use of the indicator amino acid oxidation technique. Am J Clin Nutr 99(4):891-8. PMCID: PMC3953883. DOI: 10.3945/ajcn.112.042325. PMID: 24429540

    FAO Expert Working Group Member, "Research approaches and methods for evaluating the protein quality of human foods - Report of a FAO Expert Working Group.” published March 5th, 2014 (http://www.fao.org/3/a-i4325e.pdf).

    Elango R, Ball RO and Pencharz PB. Recent advances in protein and amino acid requirements. Br J Nutr 2012;108:S22-30. PMID: 23107531

    Elango R, Levesque C, Ball RO and Pencharz PB. Available versus digestible amino acids - new stable isotape methods. Br J Nutr 2012;108:S306-14. PMID: 23107543

    Elango R, Humayun MA, Ball RO, Pencharz PB. Protein requirement of healthy school-age children determined by the indicator amino acid oxidation method. Am J Clin Nutr 2011 94: 6 1545-1552. PMID: 22049165

    Elango R, Humayun MA, Ball RO and Pencharz PB. Evidence that protein requirements have been significantly underestimated. Current Opinion in Clinical Nutrition and Metabolic Care 2010; 13: 52-57. PMID: 19841581

    Elango R, Ball RO and Pencharz PB. Amino acid requirements in humans: with a special emphasis on metabolic availability of amino acids. Amino Acids 2009; 37: 19-27. PMID: 19156481 
    Grants
    Honours & Awards

    Food and Agricultural Organization (FAO) of the United Nations, Expert Working Group Member, 2017

    Food and Agricultural Organization (FAO) of the United Nations, Expert Working Group Member, 2014

    Award from International Council on Amino Acid Science, 2014

    Vernon R. Young International Award for Amino Acid Research from the American Society for Nutrition, 2013

    CFRI Establishment Award, BC Children's & Women's Hospital, 2010

    Canadian Institutes of Health Research (CIHR) Clinician-Scientist Training Fellowship, The Hospital for Sick Children and University of Toronto, 2004 – March 2008.

    Nestle Nutrition Graduate Student Award, Student Oral Competition, Canadian Federation of Biological Societies, Ottawa, June 2001.

    Research Group Members
    • Betina Rasmussen, Research Coordinator
    • Madeleine Ennis, Graduate Student
    • Abrar Turki, Graduate Student
    • Peter Radonic, Graduate Student
    • Katia Cabellero, Graduate Student
    • Haneen Saleemani, Graduate Student