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Helping children get the protein they need

July 10, 2015
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CFRI investigator Dr. Rajavel Elango was one of 10 international nutrition experts invited to take part in a Food and Agricultural Organization of the United Nations (FAO) Working Group to identify the best methods for measuring protein quality in human foods. 

The group's recently published report will help scientists develop better recommendations for meeting the nutritional needs of sick children, pregnant and nursing mothers, and other groups with high protein requirements. Their work may also eventually lead to new international guidelines that will help ensure children all over the world eat the right proteins to promote health and wellness. 

What was the goal of this FAO Working Group?

Dr. Rajavel Elango: When we consider protein in the human diet, we have to think both in terms of quality and quantity. Some foods contain a lot of protein, but it's not in a form that humans can absorb. We need to determine the amount of usable protein in different foods so we can give people better information about how to incorporate high-quality proteins in their diets. This work has particular relevance for groups with unique nutritional needs like pregnant women and hospitalized children. 

A previous FAO working group recommended that scientists do more research on protein quality in humans, but they didn't make recommendations about how to do this. Our Working Group met to address this question and determine the best scientific methods for evaluating protein quality in humans. 

What were the major recommendations to come out of this meeting?

RE: The Working Group compared four major methods for studying protein quality in humans, including a method I helped develop, and currently use here in my lab at CFRI. They ultimately recommended my method as the only one for scientists to use going forward because there's a strong body of research showing it works.

My method is called Indicator Amino Acid Oxidation (IAAO), and it involves giving study participants specially prepared foods and then collecting breath and urine samples from them over the course of a day. Then we evaluate these samples to determine how much protein they've absorbed from the food they've eaten. 

One of the great benefits of the IAAO method is that it's safe and minimally invasive. For the first time, we're able to study the protein needs of vulnerable groups like pregnant and nursing women and sick children. Many of the current dietary recommendations for protein are based on studies done in adult men and they don't necessarily meet the unique nutritional requirements of women and children. 

How could this work contribute to better health outcomes for children?


RE: Protein is key to child health, because protein is what makes children grow. Our work will help ensure children at BC Children's Hospital and other treatment centres receive a well-balanced diet that is tailored to fuel growth and recovery. We're studying the specific protein needs of children and infants with different health conditions in order to create an evidence base for the development of improved hospital menus and formulas for children with feeding tubes. 

Identifying sources of high-quality protein is also important in the developing world, where many children have stunted growth because they're not getting enough protein. Children with stunted growth are more likely to die during childhood, perform poorly in school and have lower quality of life in adulthood.

A number of the foods we know are high in protein – like dairy products, for example – are prohibitively expensive for most people living in developing countries. If we could conclusively determine that less expensive, more readily available foods have high-quality protein, then we could actively promote their consumption to combat childhood malnutrition.

What are the next steps?

RE: We're putting the Working Group's recommendations into practice and using the IAAO method to study protein quality in humans. Right now, my lab at CFRI is using IAAO to study the protein quality requirements of high-need populations like pregnant women, hospitalized children. Our long-term plan is to develop a body of evidence that will support new international recommendations for protein quality. Improved, more accurate data on protein quality has the potential to influence public health programs all over the world and help ensure children get the nutrition they need to recover from illness and lead healthy and productive lives.

Dr. Rajavel Elango is a CFRI investigator at BC Children's Hospital and an Assistant Professor in the Department of Pediatrics and the School of Population and Public Health at the University of British Columbia. Dr. Elango's research is made possible by the support of BC Children's Hospital Foundation. 

Read More: Research approaches and methods for evaluating the protein quality of Human Foods: Report of a FAO Working Group, Food and Agriculture Organization of the United Nations, 2014.