Difference between revisions of "Team:Paris Bettencourt/Background"

 
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<h2>Background</h2>
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<h1>Background</h1>
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According to the Food and Agriculture Organization (FAO), more than 17% of the world’s population is underfed, with around 25,000 people dying of malnutrition every day and a large concentration of malnourishment present in Southeast Asia. These figures seem hard to change and hide many causes and consequences. A sufficiently nutritious diet should provide, among other things, ions, vitamins or essential amino acids. A deficiency in one of these elements can trigger pathologies: an iron deficiency disturbs oxygen transport, or a vitamin A deficiency can lead to blindness. <font color="red">[to re-write]
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Malnutrition is a lack of vital nutrients. Many vitamins, minerals, and essential amino acids can not be produced by human metabolism and must be obtained from dietary sources for good health. One billion people worldwide do not have an adequate diet and are malnourished, and an additional 850 million people are undernourished. The consequences are weakness, fatigue, blindness, infant mortality, compromised immunity, and many dangerous and debilitating medical and mental health conditions.
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Efforts to fight malnutrition have been shown to be one of the most efficient developmental aids for developing countries. In 2015, the Paris Bettencourt iGEM team will produce genetically engineered microbes to produce and distribute zero-cost vitamin supplements to specific communities that need them.
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<br><br>[give some numbers about malnutrition in India]</font>
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<br>
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<h2>A Tour of the Deficiencies and Deficiencies Related Disorders around the world</h2>
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<br>
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<h3>Vitamin A Deficiency</h3>
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<p slyte="align:justify">
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<br>Vitamin A deficiency (VAD) is, along with iron, iodine and zinc deficiencies, one of the most prevalent and severe micronutrient deficiencies in the world.
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People whose diets are mostly based on starchy foods like rice are especially at risk, as these foods do not contain retinol (vitamin A) or provitamin A (carotenoids).
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Symptoms of vitamin A deficiency include xerophthalmia (extreme dryness of the eyes), night blindness, retinal degeneration, cancer, impaired immune response, birth defects and death.
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13.8 million children have some degree of vision loss related to vitamin A deficiency.
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It is estimated that 250,000,000 preschool children have a vitamin A deficiency. Of those 250 million, 500,000 become blind every year.
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Half of the children who become blind die within 12 months.
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<br><br>The FAO reports that more than half the adults have a BMI under 18.5 kg/m2 in the states of Karnataka, Gujarat, Madhya Pradesh and Orissa, due to malnutrition. The states of Arunachal Pradesh, Maharashtra Andhra Pradesh are also shown to have extremely poor nutritional status.
 
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<br>However, several studies reveal an improvement in the nutritional status of the Indian population in the last two decades. They are attributed by the FAO to socio-economic factors, increased availability of drinking water and improvement of health facility. The Global nutrition report 2014 also mentions nutrition-specific interventions, improved access to food and education, and diminution of poverty and fertility as key factors that have allowed child stunting to be reduced by 1/3 since 2006. But the situation is still dire.
 
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<br>In order to evaluate whether and how synthetic biology could help fighting malnutrition in this country, we researched the other solutions that have been proposed so far to reduce vitamin and iron deficiency, and examined their respective benefits and what obstacles and drawbacks they faced.
 
  
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<img src="https://static.igem.org/mediawiki/2015/b/bc/Igemparisbettencourtmapofindiadeficie%2CcyvitAjb.jpg" >
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<h2>1. The Integrated Child Development Services (ICDS) programme</h2>
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<p>The ICDS is a indian governmental programme established in 1975 which monitors growth and provides supplementary foods, as well as education and primary healthcare for children under six and  pregnant and lactating mothers. The programme is implemented through a network of community-level <i>anganwadi</i> centres (AWC), which gives supplementary food daily in the center, as well as take-home rations. Those supplements include doses of vitamin A and tablets of iron and folic acid, in order to prevent xerophtalmia - which can lead to blindness - and anaemia. </p>
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<br><i>(The highest prevalence of vitamin A deficiencies are reported in regions of Africa and South-East Asia.)</i>
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<p>However, the National Family Health Survey (NFHS-3) held in 2005-2006 in India reports that only 28% of children received those supplements and healthcare even though 4/5 of children under six lived in a region covered by an <i>anganwadi</i> center. In the 6 months preceding the survey, only 1/4 of the children between 12-35 months were given vitamin A supplements - and in 9 states of India, this number falls to less than 20%. The access to ICDS was improved in the recent years though (2). A national survey held in 2013-14 says that 46% of children aged 6-59 months had received vitamin A doses.</p>
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<p>Doses of other vitamins do not seem to be included in the programme.</p>
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<p>It is also to be noted that India is one of the country with the less coverage rate of nutrition-specific interventions for iron and folic acid supplementation according to the 2014 Global nutrition report - which could suggest that there is a lack of such interventions. The 2013-14 survey reports only 14% of children aged 6-59 months having received iron and folic acid supplements.</p>
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<p>In conclusion, the ICDS programme holds great promises, especially for vitamin A supplements, and seems to be helping more and more children and women in the recent years. But it is limited by the important cost of the numerous centers in every state, the access people have to such centers, and its lack of intervention for other vitamins and iron and folic acid.</p>
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<br><br>
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<h2>2. Vitamin pills</h2>
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In India, an estimated 2 million people die every year because of vitamin A deficiency-related diseases. 1.9 million are disabled for the rest of their lives. The states with the lowest incomes are the most affected. <br>
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(to be updated)
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<br>summary: they are more and more popular, but people take them on a daily basis without consulting their doctors, and that's dangerous for their health. They could have an overdose of vitamins, and the pills could have dangerous cocktail effects with other chemicals.
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<br><br>
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<br><br><br>
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<h2>3. Golden Rice</h2>
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(to be updated)
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<br>summary: Cool but not legal in india. Worries = public health, environment, dependence to western companies.
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<h3>Iron Deficiency</h3>
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Iron deficiency is the most common deficiency in the world.
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<img src="https://static.igem.org/mediawiki/2015/0/05/Igemparisbettencourtmapofirondeficiency2015.png" width='1200px'>
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<br><i>WHO estimates of iron deficiency anemia rates in 2002 (yellow is lowest, red is highest.)</i><br>
 
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<h2>3. Amma Unavagam</h2>
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The main cause of iron deficiency is inadequate intake.
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(to be updated)
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Symptoms of iron deficiency include fatigue, dizziness, hair loss, weakness, pica, anemia and thrombocytosis.
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<br>summary: Cheep canteens with fermented foods. For now only in Chennai. They're very popular and they're cool because of fermented food.
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<br>
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The consumption of foods with high iron content, such as red meat, poultry, and insects can prevent iron deficiency-related disorders. Non-heme iron can be found in vegetables such as lentils, beans, and tofo, but has a reduced bioavailability.
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<br>
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<img src="https://static.igem.org/mediawiki/2015/a/a0/Igemparisbettencourthemeiron2015.png" width="200px">
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<br><i>Heme Iron</i><br>
  
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<b>Phytic acid is a saturated cyclic acid</b> which has a strong affinity for important minerals such as calcium, iron and zinc. Bound minerals form an insoluble precipitate that is far less absorbed in the intestines.
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It is a major issue for people whose diet is mainly based on foods that contains phytic acid. Rice contains phytic acid and is consumed as a staple food in India and in east Asia, worsening the deficiencies status in those countries.
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<br>
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<img src="https://static.igem.org/mediawiki/2015/1/1a/Igemparisbettencourtphyticacidfordeficiencypagejb2015.png" width="200px">
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<br><i>Phytic Acid</i><br>
  
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<h3>Riboflavin deficiency or ariboflavinosis</h3>
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<br>
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Riboflavin is a cofactor involved in a lot of enzymatic reactions. It can be found in many foods, including meat, legumes, and mushrooms.<br>
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Yeast extract is known to be especially rich in B2. <br>
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<br>
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Ariboflavinosis symptoms are including ulcerations of the mouth, tongue and lips, rashes, inflammation of the eyes, photosensibility. Because of it’s involvment in iron absorbtion, B2 deficiency often results in anemia.<br>
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Deficiency during pregnancy can result in heart defects and deformities.<br><br>
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Because riboflavin is not stored in the body, it needs to be eaten on a regular basis.<br>
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In rice eating population of Asia, studies are showing that even if the average energy intake is adequate, the average riboflavin consumption was only covering 70% the RDA. This partially explain the spreading of anemia in south-east Asia and in India<br><br>
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<img src="https://static.igem.org/mediawiki/2015/7/7c/Riboflavineillustrationfromwikipediathankwikipedia.png" width="200px">
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<i>Riboflavin</i>
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<br>
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<br><h3>Cobalamin (vitamin B12) Deficiency or Hypocobalaminemia</h3><br>
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Vitamin B12 or cobalamin is a complex molecule that can only be produced by bacteria. All animals have to get their B12 from microorganisms in various ways. Humans usually get their B12 from consuming meat, fish, eggs and dairy products. Vegetarian and especially vegan populations are at risk of having a B12 deficiency.
 
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<h2>Our solution: engineering the microbiome of traditional fermented foods</h2>
 
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(to be updated)
 
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<br>summary: decided to work with fermented foods because they're traditional and healthy. Everyone could use our yeast in their batter and cook it at home (and maybe backslop a few times), so it's more accessible than anganwadi. More healthy and less expensive (?) than vitamin pills. No dependance to western companies since you can either backslop, or even if backslop doesn't work you can stop buying it at any time, which is not so easy with Golden Rice.
 
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<br>Hopefully it would be supported and distributed by the government for free, like they already distribute vitamin A supplements (in Amma Unavagam and anganwadi) + villages could start they own culture in a community lab.
 
  
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B12 is crucial for brain and nervous system development and maintenance. Lack of it can cause severe and irreversible damages to the brain and nervous system. Symptoms are including depression, psychosis, lethargy and extreme weakness.<br><br>
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In India, a majority of the population follows a vegetarian diet due to various cultural and socio-economic factors. Studies have shown that 75% of people have metabolic signs of b12 deficiency (hyperhomocysteinemia and methylmalonic acidemia). Additionally, 50% of pregnant Indian women have low levels of plasmatic B12, which can lead to birth defects. 80% of preschool children are also deficient.<br><img src="https://static.igem.org/mediawiki/2015/2/2b/Igemparisbettencourt2015jbvcokloakmine.png" width="200px">
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<i>Cobalamin</i><br>
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<br><br><br><br>
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<b>Bibliography</b>
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Potential impact and cost-effectiveness of Golden Rice Alexander J. Stein1 , H.P.S. Sachdev2 & Matin Qaim  October 2006<br>
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Samuel T.M.a, f · Duggan C.b, d · Thomas T.a · Bosch R.c · Rajendran R.a · Virtanen S.M.e, f · Srinivasan K.a · Kurpad A.V.a
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<br>Malnutrition Quantifying the health impact at national and local levels Monika Blössner Mercedes de Onis (WHO)<br>
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Levels & Trends in Child Malnutrition UNICEF-WHO-The World Bank Joint Child Malnutrition Estimates<br>
 
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Latest revision as of 17:18, 13 November 2015

Background

Malnutrition is a lack of vital nutrients. Many vitamins, minerals, and essential amino acids can not be produced by human metabolism and must be obtained from dietary sources for good health. One billion people worldwide do not have an adequate diet and are malnourished, and an additional 850 million people are undernourished. The consequences are weakness, fatigue, blindness, infant mortality, compromised immunity, and many dangerous and debilitating medical and mental health conditions.
Efforts to fight malnutrition have been shown to be one of the most efficient developmental aids for developing countries. In 2015, the Paris Bettencourt iGEM team will produce genetically engineered microbes to produce and distribute zero-cost vitamin supplements to specific communities that need them.

A Tour of the Deficiencies and Deficiencies Related Disorders around the world


Vitamin A Deficiency


Vitamin A deficiency (VAD) is, along with iron, iodine and zinc deficiencies, one of the most prevalent and severe micronutrient deficiencies in the world. People whose diets are mostly based on starchy foods like rice are especially at risk, as these foods do not contain retinol (vitamin A) or provitamin A (carotenoids). Symptoms of vitamin A deficiency include xerophthalmia (extreme dryness of the eyes), night blindness, retinal degeneration, cancer, impaired immune response, birth defects and death. 13.8 million children have some degree of vision loss related to vitamin A deficiency. It is estimated that 250,000,000 preschool children have a vitamin A deficiency. Of those 250 million, 500,000 become blind every year. Half of the children who become blind die within 12 months.






(The highest prevalence of vitamin A deficiencies are reported in regions of Africa and South-East Asia.)



In India, an estimated 2 million people die every year because of vitamin A deficiency-related diseases. 1.9 million are disabled for the rest of their lives. The states with the lowest incomes are the most affected.



Iron Deficiency

Iron deficiency is the most common deficiency in the world.
WHO estimates of iron deficiency anemia rates in 2002 (yellow is lowest, red is highest.)


The main cause of iron deficiency is inadequate intake. Symptoms of iron deficiency include fatigue, dizziness, hair loss, weakness, pica, anemia and thrombocytosis.
The consumption of foods with high iron content, such as red meat, poultry, and insects can prevent iron deficiency-related disorders. Non-heme iron can be found in vegetables such as lentils, beans, and tofo, but has a reduced bioavailability.

Heme Iron
Phytic acid is a saturated cyclic acid which has a strong affinity for important minerals such as calcium, iron and zinc. Bound minerals form an insoluble precipitate that is far less absorbed in the intestines. It is a major issue for people whose diet is mainly based on foods that contains phytic acid. Rice contains phytic acid and is consumed as a staple food in India and in east Asia, worsening the deficiencies status in those countries.

Phytic Acid

Riboflavin deficiency or ariboflavinosis


Riboflavin is a cofactor involved in a lot of enzymatic reactions. It can be found in many foods, including meat, legumes, and mushrooms.
Yeast extract is known to be especially rich in B2.

Ariboflavinosis symptoms are including ulcerations of the mouth, tongue and lips, rashes, inflammation of the eyes, photosensibility. Because of it’s involvment in iron absorbtion, B2 deficiency often results in anemia.
Deficiency during pregnancy can result in heart defects and deformities.

Because riboflavin is not stored in the body, it needs to be eaten on a regular basis.
In rice eating population of Asia, studies are showing that even if the average energy intake is adequate, the average riboflavin consumption was only covering 70% the RDA. This partially explain the spreading of anemia in south-east Asia and in India

Riboflavin

Cobalamin (vitamin B12) Deficiency or Hypocobalaminemia


Vitamin B12 or cobalamin is a complex molecule that can only be produced by bacteria. All animals have to get their B12 from microorganisms in various ways. Humans usually get their B12 from consuming meat, fish, eggs and dairy products. Vegetarian and especially vegan populations are at risk of having a B12 deficiency.

B12 is crucial for brain and nervous system development and maintenance. Lack of it can cause severe and irreversible damages to the brain and nervous system. Symptoms are including depression, psychosis, lethargy and extreme weakness.

In India, a majority of the population follows a vegetarian diet due to various cultural and socio-economic factors. Studies have shown that 75% of people have metabolic signs of b12 deficiency (hyperhomocysteinemia and methylmalonic acidemia). Additionally, 50% of pregnant Indian women have low levels of plasmatic B12, which can lead to birth defects. 80% of preschool children are also deficient.
Cobalamin




Bibliography Potential impact and cost-effectiveness of Golden Rice Alexander J. Stein1 , H.P.S. Sachdev2 & Matin Qaim October 2006
Samuel T.M.a, f · Duggan C.b, d · Thomas T.a · Bosch R.c · Rajendran R.a · Virtanen S.M.e, f · Srinivasan K.a · Kurpad A.V.a
Malnutrition Quantifying the health impact at national and local levels Monika Blössner Mercedes de Onis (WHO)
Levels & Trends in Child Malnutrition UNICEF-WHO-The World Bank Joint Child Malnutrition Estimates