According to the latest global estimates undernutrition is a contributory cause to 45% of all child deaths. Undernutrition affects all stages of the lifecourse and has strong intergenerational echoes. The size and nutritional status of parents has a lifelong influence on their children with a mother’s nutrition at conception, in pregnancy and as she breastfeeds her baby being particularly critical.
Stunting among children, low birthweight and anaemia rates are used to assess a country’s progress in combatting undernutrition. The Gambia succeeded in meeting the Millennium Development Goals for improving child nutrition, but stunting rates are still high (~30%) and anaemia rates among women and children are very high. Meeting the new Nutrition Targets 2025 set by WHO will be extremely challenging unless new pathways to intervention can be found.
The Nutrition Theme at MRC Unit The Gambia at LSHTM concentrates on identifying, and then developing, next-generation nutrition interventions through discovery science that will inform a clearer understanding of the basic mechanisms linking diet and disease. Non-specialists will frequently assume that the causes of malnutrition are already well understood and that rectifying the situation simply requires the efficient implementation of known interventions. However, meta‐analyses of major intervention trials in pregnancy, lactation and childhood (with crucial outcomes such as birthweight, preterm birth, pre‐eclampsia, stillbirths, neonatal deaths, child survival, stunting and anaemia, etc) have generally revealed very disappointing outcomes. The factors at play are clearly more complex than hitherto assumed and require fresh insights to steer novel therapeutic pathways.
Our research on iron, infection and anaemia – underpinned by the discovery of hepcidin as the master regulator of iron – radically transforms nutritionists’ understanding of the etiology of anaemia, and hence how to combat it. Our epigenetic research into the profound effect of a mother’s nutritional status at the time she conceives a baby moves the focus from pregnancy to pre-conception. These are examples of how we seek to trace a path towards better nutritional health in low-income populations.
Prof. Andrew Prentice
Andrew Prentice was born and raised in Uganda and educated in East Africa and the UK. He graduated in Biochemistry followed by a PhD in Nutrition from Darwin College, Cambridge. His first post-doc position was in MRCG Keneba almost 40 years ago. After 15 years leading the Energy Regulation and Obesity Group at the MRC Dunn Clinical Nutrition Centre in Cambridge he created the MRC International Nutrition Group at LSHTM where he is Professor of International Nutrition, and refocused all his attention on global health research. With the full integration of MRC Keneba into MRCG in 2015 he became the Nutrition Theme leader.