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Healthier Lives in Latin America:

Nutrition Programmes Gain Edge Through IAEA Support

children in Chile

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Poor men, women, and children in Latin America are getting the chance to lead healthier lives with the help of nuclear science and technology. National nutrition programmes in Brazil, Chile, Cuba, and Mexico have gained a leading edge by applying sensitive techniques that allow experts to monitor and evaluate their true impact under local conditions.

Through an IAEA regional technical cooperation project, the countries' nutrition scientists are using isotopes -- forms of chemical elements such as iron and zinc -- and nuclear analytical techniques to evaluate how well foods fortified with essential nutrients and minerals sustain the body's health and growth. The information is critical to the success of school and community nutrition programmes in which several billion dollars are invested annually in Latin America.

Dr. Uauy

Dr. Ricardo Uauy

"We're taking the science and applying the tools to solve some real problems of nutrition and health, especially in children," says Dr. Ricardo Uauy, Director of the Institute of Nutrition and Food Technology (INTA) in Chile and Principal Coordinating Counterpart of the IAEA nutrition project in Latin America. "About 80 million rural and urban poor people in Latin America are covered to some degree by national nutrition programmes costing billions of dollars," he notes, citing a study of 19 Latin American countries by the UN Food and Agriculture Organization (FAO). "But without careful measurement and monitoring of the body's intake and use of vitamins and minerals, the programmes cannot be as effective," he says.

Dr. Vio

Dr. Fernando Vio

Classical methods of evaluation -- such as tracking a person's height and weight -- are too broad and generalized to provide the specific type of information needed to assess the benefits of supplying food supplements, or they take more time to analyze the many complex factors involved, says Dr. Fernando Vio, who works with Dr. Uauy at INTA. Nuclear and isotopic techniques are sensitive tools that yield specific data for closely tracking programmes, and to refine and optimize them so that they do the most good. Scientists apply them in studies to closely monitor body composition, such as fat and muscle tissue; energy expenditure; and biological effects of minerals and nutrients supplied to the human body. The data have made a difference -- they are being used for reviews of national policies and -- for the first time -- to set baseline nutritional guidelines tailored to local conditions and needs.

Dramatic Gains, Complex Challenges. In Chile, dramatic gains have been made since the IAEA project began in 1999, notably in combating anemia in malnourished children. Evaluations based on isotope studies contributed to the government's decision to modify its policies for pre-school programmes supplying food and milk fortified with iron and zinc. Within a year, anemia was reduced from 30% to less than 5% among a sample of 300 children in Chile's nutrition intervention programme.

"Down the line, we foresee a considerable positive impact on the healthy growth of children, and how well they perform at school, and later in jobs," says Dr. Uauy. Chile spends about $300 million a year for large programmes that supplement the nutritional needs of 1.3 million people. Programmes especially target pregnant women, infants, and pre-school children.

Yet alongside Chile's dramatic gains stands a complex and far-reaching challenge -- the problem of stunted growth and obesity among chronically undernourished children. "This is a different and often hidden side of malnutrition," says Dr. Vio. "Stunting has been more resistant to change," he says. "Stunted children tend to have a diminished need for calories and providing too many or the wrong food supplements can hurt, rather than help, them." he says. Obesity can arise because their bodies expend little energy through growth and their physical activity often is low. In its review of pre-school nutrition programmes, Chile found that too many calories were being provided to both boys and girls, and adjustments were made accordingly.

Strengthening Capabilities. By sharing results among the project's partners, nutrition programmes in Brazil, Cuba, and Mexico are being finetuned and strengthened. Brazilian authorities have launched a pioneering epidemiological study covering groups of undernourished children receiving fortified milk in 20 municipalities. In Mexico, researchers are establishing baseline nutritional guidelines for four million people, focusing on expectant and nursing mothers, as part of its $2 billion national nutrition campaign. The country's Social Security System has equipped a laboratory with two mass spectrometers dedicated for nutritional measurement and analysis.

Dr. Salazar

Ms. Gabriela Salazar

The investment decision was rooted in the dramatic gains seen in Chile, to which Mexico previously turned for analytical support. "When researchers in Mexico saw the impact to programmes in Chile, they recognized the potential immediately," says Ms. Gabriela Salazar of INTA. "Helping to build up local capabilities means we not only have more expertise in the region, but the work can be done more cost effectively."

Mexico's laboratory is the third in Latin America -- alongside labs in Chile and Brazil -- that today are dedicated to nutritional analysis using isotope techniques.

Dr. Hernanzez-Triana

Dr. Manuel Hernandez-Triana

Dr. Manuel Hernandez-Triana of Cuba's Institute of Nutrition in Havana thinks the steps to improve national capabilities and programmes will pay big dividends in the region. Through its cooperation with Chile, Cuba is gaining key analytical support for a programme that provides daily food baskets of fortified milk and other foods to one million pre-school children.

"For the first time, nuclear techniques are being used more widely to evaluate nutrition programmes in the Third World," he says. "The big contribution of the IAEA's project is that we're obtaining the concrete data we need to track programmes and to recommend changes that will benefit more people."

The results of project studies on energy expenditure of young children in Cuba and Chile are being used by the Expert Committee of the FAO, World Health Organization, and United Nations University to set new recommended standards for the region. Before the IAEA project started, no data existed from Latin American countries to provide a scientific basis for formulating nutrition programmes suited to local conditions. Rather, recommendations and guidelines were based on data from surveys in industrialized countries.

"Just following the book has proved to be the wrong approach for developing countries fighting malnutrition," says Dr. Uauy, the IAEA Project's Principal Coordinating Counterpart . "Now we're beginning to see the benefits of applying the best scientific tools to reach regional solutions."