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Engineering cyanogen synthesis and turnover in cassava (Manihot esculenta).

Cassava is the major root crop for a quarter billion subsistence farmers in sub-Saharan Africa. It is valued for its ability to grow in adverse environments and the food security it provides. Cassava contains potentially toxic levels of cyanogenic glycosides (linamarin) which protect the plant from herbivory and theft. The cyanogens, including linamarin and its deglycosylated product, acetone cyanohydrin, can be efficiently removed from the root by various processing procedures. Short-cuts in processing, which may occur during famines, can result in only partial removal of cyanogens. Residual cyanogens in cassava foods may cause neurological disorders or paralysis, particularly in nutritionally compromised individuals. To address this problem and to further understand the function of cyanogenic glycosides in cassava, we have generated transgenic cassava in which cyanogenic glycoside synthesis has been selectively inhibited in leaves and roots by antisense expression of CYP79D1/D2 gene fragments. The CYP79D1/D2 genes encode two highly similar cytochrome P450s that catalyze the first-dedicated step in cyanogenic glycoside synthesis. Transgenic plants in which the expression of these genes was selectively inhibited in leaves had substantially reduced (60- 94% reduction) linamarin leaf levels. Surprisingly, these plants also had a greater than a 99% reduction in root linamarin content. In contrast, transgenic plants in which the CYP79D1/D2 transcripts were reduced to non-detectable levels in roots had normal root linamarin levels. These results demonstrate that linamarin synthesized in leaves is transported to the roots and accounts for nearly all of the root linamarin content. Importantly, transgenic plants having reduced leaf and root linamarin content were unable to grow in the absence of reduced nitrogen (NH3) . Cassava roots have previously been demonstrated to have an active cyanide assimilation pathway leading to the synthesis of amino acids. We propose that cyanide derived from linamarin is a major source of reduced nitrogen for cassava root protein synthesis. Disruption of linamarin transport from leaves in CYP79D1/D2 anti-sense plants prevents the growth of cassava roots in the absence of an alternate source of reduced nitrogen. An alternative strategy for reducing cyanogen toxicity in cassava foods is to accelerate cyanogenesis and cyanide volatilization during food processing. To achieve this objective, we have expressed the leaf-specific enzyme hydroxynitrile lyase (HNL) in roots. HNL catalyzes the breakdown of acetone cyanohydrin to cyanide. Expression of HNL in roots accelerated cyanogenesis by more than three-fold substantially reducing the accumulation of acetone cyanohydrin during processing relative to wild-type roots.

Asparagine↗

Cassava biology and physiology.

Cassava or manioc (Manihot esculenta Crantz), a perennial shrub of the New World, currently is the sixth world food crop for more than 500 million people in tropical and sub-tropical Africa, Asia and Latin America. It is cultivated mainly by resource-limited small farmers for its starchy roots, which are used as human food either fresh when low in cyanogens or in many processed forms and products, mostly starch, flour, and for animal feed. Because of its inherent tolerance to stressful environments, where other food crops would fail, it is often considered a food-security source against famine, requiring minimal care. Under optimal environmental conditions, it compares favorably in production of energy with most other major staple food crops due to its high yield potential. Recent research at the Centro Internacional de Agricultura Tropical (CIAT) in Colombia has demonstrated the ability of cassava to assimilate carbon at very high rates under high levels of humidity, temperature and solar radiation,which correlates with productivity across all environments whether dry or humid. When grown on very poor soils under prolonged drought for more than 6 months, the crop reduce both its leaf canopy and transpiration water loss, but its attached leaves remain photosynthetically active, though at greatly reduced rates. The main physiological mechanism underlying such a remarkable tolerance to drought was rapid stomatal closure under both atmospheric and edaphic water stress, protecting the leaf against dehydration while the plant depletes available soil water slowly during long dry periods. This drought tolerance mechanism leads to high crop water use efficiency values. Although the cassava fine root system is sparse, compared to other crops, it can penetrate below 2 m soil,thus enabling the crop to exploit deep water if available. Leaves of cassava and wild Manihot possess elevated activities of the C4 enzyme PEP carboxylase but lack the leaf Kranz anatomy typical of C4 species, pointing to the need for further research on cultivated and wild Manihot to further improve its photosynthetic potential and yield,particularly under stressful environments. Moreover, a wide range in values of Km (CO2) for the C3 photosynthetic enzyme Rubisco was found among cassava cultivars indicating the possibility of selection for higher affinity to CO2, and consequently higher leaf photosynthesis. Several plant traits that may be of value in crop breeding and improvement have been identified, such as an extensive fine root system, long leaf life, strong root sink and high leaf photosynthesis. Selection of parental materials for tolerance to drought and infertile soils under representative field conditions have resulted in developing improved cultivars that have high yields in favorable environments while producing reasonable and stable yields under stress.

Adaptation, Physiological↗

Type 2 diabetes in children.

The emerging epidemic of type 2 diabetes (T2DM) in young people reflects increasing rates of obesity and parallels the increasing frequency of T2DM in adults. As in adults, T2DM in children is part of the insulin resistance syndrome that includes hyperandrogenism seen as premature adrenarche and polycystic ovary syndrome, hypertension, dyslipidemia, and other atherosclerosis risk factors. Recent studies in children document risk factors for T2DM, and associated cardiovascular risk factors, including obesity, family history, diabetic gestation, and underweight or overweight for gestational age. Genetically determined insulin resistance or limited beta-cell reserve has been demonstrated in high-risk individuals, including first-degree relatives of girls with premature adrenarche. This genetic background, considered advantageous in a feast-and-famine existence (the thrifty genotype), is rendered detrimental with abundant food and physical inactivity, a lifestyle demonstrated to be typical of families of children with T2DM. The increasing incidence of T2DM in children and adolescents threatens to become a major public health problem. Risk factors for cardiovascular disease, hypertension, hyperlipidemia, and microalbuminuria are present at diagnosis of T2DM in Native American adolescents, indicating that insulin resistance has been present for some time before the diagnosis of diabetes was made. Case finding is likely to be beneficial in high-risk youths. Treatment is the same as that of adults. The only data on use of oral hypoglycemic agents in children have been with metformin. Community and governmental efforts to educate all children and their parents about the need for physical activity and dietary modification are essential to control this epidemic.

Child↗

Xerophthalmia and anterior segment blindness.

The prevalence of presumed vitamin A-related corneal scars among 5,589 preschool-age Haitian children ranged from 1.2 per 1,000 in the south, to almost 1% in the famine-afflicted north. These scars accounted for at least 45% of all corneal scars, and all bilateral corneal blindness encountered. Most lesions were acquired during the first three years of life. There was no variation by sex or ecology of the sample site. This country of 5.5 million inhabitants acquires 345 new surviving cases of vitamin A-related corneal destruction, over one fourth bilaterally blind, each year, although local ophthalmologists rarely encounter the disease and Bitot's spots were absent from our study population. Countrywide clinical prevalence surveys are the only unbiased means of determining the magnitude, severity, and geographic distribution of vitamin A-related corneal destruction, prerequisites for the design of public health prevention programs.

Blindness↗

Fuel metabolism in growth hormone-deficient adults.

Apart from being a stimulator of longitudinal growth, growth hormone (GH) regulates fuel metabolism in children and adults. A halfmark is mobilization of lipids, which involves an inhibition of lipoprotein lipase activity in adipose tissue and activation of the hormone sensitive lipase. Suppression of basal glucose oxidation and resistance to insulin are other important effects. This may cause concern during GH substitution in GH-deficient adults, some of whom may present with insulin resistance due to concomitant abdominal obesity. However, there are data to suggest that the GH-induced reduction in fat mass and increase in lean body mass may offset the insulin antagonistic actions of the hormone. The nitrogen-retaining effects of GH seem to involve a direct stimulation of protein synthesis in addition to secondary effects such as generation of insulin-like growth factor-I (IGF-I), hyperinsulinemia, and promotion of lipolysis. Thus, during periods of substrate affluence, GH acts in concert with insulin and IGF-I to promote protein anabolism. Postabsorptively, GH is primarily lipolytic and thereby indirectly protein-sparing. This effect becomes further accentuated with more prolonged fasting. In that sense, GH is unique by its preservation of protein during both feast and famine. These fuel metabolic effects add merit to the principle of GH substitution in hypopituitary adults.

Adult↗

Food and health at the time of Rubens A lecture given at the ESPEN Congress, Antwerp 1991.

The Renaissance period in Europe saw many dietary changes due to imports of new ingredients from the Far East as well as from newly discovered Central and South America. Maize and potatoes rapidly conquered European markets and because of their easier cultivation and higher calorie content, displaced grains such as wheat and rye. Drinking habits too changed, when tea, coffee and chocolate were introduced, first as strengthening medicines, later as 'délicatesses' in the aristocratic British and French cafés. These new foods and beverages may have helped diminish the periods of famine typical of Medieval and Early Renaissance times. In the 16th and 17th century, new diseases were described that were directly related to dietary intake. Ergotism and scurvy, particularly, sometimes decimated whole populations in rural areas or at sea. It was not until the 18th century that scientific research elucidated the cause of such diseases and helped us to understand the importance of a balanced diet.

Journal Article↗

Microbial life at extremely low nutrient levels.

Many microorganisms ("oligotrophs") grow in distilled water: Pseudomonas spp., Caulobacter spp., Hyphomicrobium spp., Arthrobacter spp., Seliberia spp., Bactoderma alba, Corynebacterium spp., Amycolata (Nocardia) autotrophica, Mycobacterium spp., yeasts, and Chlorella spp. Also, certain lower fungi can be found here. In the laboratory, these organisms thrive on contaminations of the air (CO, hydrocarbons, H2, alcohols etc.). All are euryosmotic and often grow also in higher concentrations of salts and nutrients. Natural locations with extremely low nutrient levels (snow, rain water pools, springs, free ocean water, Antarctic rocks and soils) do not contain more than 1-5 mg/l of organic carbon. Oligotrophs found here are especially adapted to constant famine: they frequently live attached to surfaces, form polymers and storage products even while starving, and often aggregate. Many of these oligotrophs alter their morphology (surface to volume ratio) with changing nutrient concentrations. Extreme oligotrophs also occur in generally nutrient-rich environments such as sewage aeration tanks or compost soil. Here they are thought to survive in nutrient-depauperate microhabitats.

Bacteria↗

The development of health and social services for the elderly in Iceland: an overview.

In the present paper, we provide a general overview of the changing position of the aged population in Iceland. After a long history of subsistence, Icelandic society has evolved only recently from pre-industrial conditions compared with other Western developed nations. The 1000-year preindustrial record is in large part one of a struggle for survival in which formal and informal measures to support the frail and disabled were often overwhelmed by disease and famine; this history is outlined to provide a baseline for recent changes. Both the speed and propinquity of Iceland's transition from these conditions have left a unique stamp on the present-day society: development has driven a quick elaboration of occupational roles and other social status shifts, vast health status improvements, and great population and urban growth. Public and personal health services have grown in scope and adequacy in comparatively recent decades, contributing to the now unsurpassed health status of the general population. The effect of these trends on the condition of elderly is described. As the birth rate in Iceland has dropped in recent decades, the proportion and number of Icelanders in the older and especially the oldest age-strata has been steadily rising. The current and planned organization of health and social services is reviewed, as Iceland faces new tasks of caring for elderly.

Aged↗

Health as a target: South Africa's destabilization of Mozambique.

Since 1982 attacks on the health services have been an integral part of South African destabilization of Mozambique. After independence in 1975, Mozambique began successfully to implement a primary health care policy. By attacking primary health care units, kidnapping and killing health workers and destroying transport, a South African supported rebel movement has attempted to undermine this policy. The combined effects of the negative economic consequences of the war, the forced displacement of over a million people and the destruction and disruption of health services have worsened the health of the Mozambican people. Preventive programmes have been severely disrupted. Effects on health include an increase in mortality rates, famine and infectious disease epidemics. Similarities exist between this war and the low intensity conflict in Nicaragua. Given the intensity of the onslaught, the primary health care system has proved remarkably resistant to destruction.

Black People↗

Ecological upheavals with special reference to desertification and predicting health impact.

This paper begins with an introduction that touches on the ecological upheavals of earthquakes, floods, as well as other upheavals that result from sudden huge crowding of people in one place such as in refugee situations and situations of a famine disaster. The point is made that for sudden emergencies the health impact will very much depend on the nature of traumatic physical damage on the people's bodies and property as well as the capacity with which response is organised for assessment of damage and medical management. A number of texts are mentioned with respect to management in emergencies, including health, feeding and water and the point made that familiarity with these texts provides a starting point in responding to emergencies. These have put together information on how one goes about organising the response to save lives. Also mentioned are the consequences of the approach taken to providing food in these situations; whether it is through distribution of dry ration to be taken home, or whether one is dealing with shelter situations. In this introduction, land degradation/desertification is mentioned as being the largest and possibly the most devastating ecological upheaval. The rest of the paper goes on to address this ecological upheaval of land degradation/desertification. The magnitude of this upheaval is presented. The contribution of overcultivation, overgrazing, deforestation and irrigation to desertification are discussed. The health consequence of this process is then presented and finally, there is a discussion on the challenges that social scientists and health professionals could help to address in order to bring about some appropriate interventions that would contribute to arresting and possibly reversing the desertification process.

Africa↗

Intellectual, social and nutritional status of children in an Ethiopian orphanage.

Children at the Jimma community orphanage between the ages of 5 and 14 years were given a battery of tests to assess their intellectual, social, and nutritional well-being relative to a group of family-reared controls. On two tests of intellectual ability, the Ravens Progressive Matrices and the Conservation test, the orphanage children performed as well as the family children. Children who entered the orphanage at an early age scored higher than those who entered later. On social-emotional measures of self-esteem, the orphanage children scored higher than or similar to the controls. However, in terms of their relationships with adults, the orphanage children reported fewer interactions and weaker attachments to adults. This was largely determined by the higher child: adult ratio in the orphanage than in family homes. Also, the orphanage children were more likely to be stunted but not more likely to be wasted than the family children. The former was attributed to the malnutrition experienced by children before they entered the orphanage, which in many cases was during the 1984 famine. Stunting was associated with lower Ravens scores. The generally favourable status of the orphanage children can largely be attributed to the noninstitutional orphanage rather than to their preorphanage family life. This raises disturbing questions about family life under conditions of economic stress.

Child↗

Eosinophilic meningitis beyond the Pacific Basin: the global dispersal of a peridomestic zoonosis caused by Angiostrongylus cantonensis, the nematode lungworm of rats.

The principal etiologic agent of human eosinophilic meningitis, Angiostrongylus cantonensis, was first detected in rats in Canton, China in 1933. The first human case was detected on Taiwan in 1944. Epidemic outbreaks were noted on Ponape (E. Caroline Is.) from 1944 to 1948. The disease may present as transient meningitis or a more severe disease involving the brain, spinal cord and nerve roots, with a characteristic eosinophilia of the peripheral blood and CSF. Since 1961 it has been known that human infections are usually acquired by purposeful or accidental ingestion of infective larvae in terrestrial mollusks, planaria and fresh-water crustacea. There is no effective specific treatment. The African land snail, Achatina fulica played an important role in the panpacific dispersal of the organism: it will be important in Africa in the future as well. Rats were, and will continue to be the principal agents of expansion of the parasite beyond the Indopacific area. During and just after WWII the parasite was introduced, and/or spread passively from South and Southeast Asia into the Western Pacific islands and eastward and southward through Micronesia, Melanesia, Australia and into Polynesia, sequestered in shipments of war material and facilitated by post-war commerce. In the 1950s numerous cases were identified for the first time on Sumatra, the Philippines, Taiwan, Saipan, New Caledonia, and as far east as Rarotonga and Tahiti. Then cases were detected in Vietnam, Thailand, Cambodia, Java, Sarawak, the New Hebrides, Guam and Hawaii during the 1960s. Subsequently in the Pacific Basin the disease has appeared on Okinawa, other Ryukyu islands, Honshu, Kyushu, New Britain, American Samoa and Western Samoa, Australia, Hong Kong, Bombay, India, Fiji and most recently in mainland China. The parasite in rats now occurs throughout the Indopacific Basin and littoral. Beyond the Indopacific region, the worm has been found in rodents in Madagascar (ca 1963), Cuba (1973), Egypt (1977), Puerto Rico (1984), New Orleans, Louisiana (1985) and Port Harcourt, Nigeria (1989). Human infections have now been detected in Cuba (1973), Réunion Island (1974) and Côte d'Ivoire (1979) and should be anticipated wherever infected rats of mollusks have been introduced. Caged primates became infected in zoos in Hong Kong (1978) and New Orleans and Nassau, Bahamas (1987). The use of mollusks and crustacea as famine foods, favored delicacies and medicines has resulted in numerous outbreaks and isolated infections. Economic and political instability, illicit trade, unsanitary peridomestic conditions and lack of health education promote the local occurrence and insidious global expansion of parasitic eosinophilic meningitis.(ABSTRACT TRUNCATED AT 400 WORDS)

Africa↗

Oral rehydration therapy--qualitative studies of balance between pragmatism and scientific rigour in managing diarrhoea.

In the experience of the author, oral rehydration therapy has proven effective at home, in the ambulatory and in the institutional care setting. A series of anecdotal reports on the successful use of oral rehydration on refugees, in famine and poverty, on medical students, prisoners, and the well-off people of western countries, is presented. The essential principles of oral rehydration are identified and we show how these can be adapted to a particular health care setting. A clear understanding of local attitudes and beliefs about diarrhoea is essential to professional health workers if they are to act as agents of change.

Child↗

Sedentism and child health among Rendille pastoralists of northern Kenya.

Many nomadic pastoralists of Africa are settling near towns and famine-relief centers in response to drought-induced livestock loss, loss of pasture land, increased involvement in market economies and political turmoil including civil war. The present study uses measurements of child health, particularly morbidity, dietary and growth patterns, to evaluate the consequences of sedentism for three Rendille communities of northern Kenya. A nutritional and health survey utilizing interviews, anthropometric measurements, physical examinations and hemoglobin measurements was conducted for 105 mothers and their 174 children under six years of age in three Rendille communities, one fully nomadic and two sedentary, in July 1990, a year of above average rainfall, and again in June 1992, a drought year. Results indicate that while the nomadic Rendille community of Lewogoso shares similar morbidity patterns with its sedentary counterparts and had similar numbers of malnourished children during the wet year, the sedentary communities had significantly more malnutrition among children under six during the dry year. Moreover, the children in the settled town of Korr had significantly higher levels of anemia. Differences in malnutrition are attributed to distinctive dietary regimes: during the drought, nomadic children consumed three times as much milk as the sedentary children, while settled children's diets concentrated on starches, fat and sugar. This study suggests that the pastoral nomadic diet, particularly one dependent on camels' milk, offers children better resistance to the pressures of drought and supports findings that the subsistence base of mixed-species pastoralism is superior to sedentary alternatives with respect to child health.

Adolescent↗

Immune modulation and disease patterns in population groups.

A hypothesis which explains disease prevalence among different socio-economic groups following early infantile modulation of cell-mediated immunity by infection and nutrition related stress is presented. Wealthy populations living under highly hygienic circumstances can develop their cell-mediated immunity to genetic expectation while their humoral systems remains unstimulated. Primitive populations protect the infant's immune development by breast feeding and suffer from temporary cell-mediated immune deficiencies due to intercurrent infectious disease and famine later on. Intermediary populations harbour a small percentage of people, whose cell-mediated immune system has been permanently damaged by infection in early childhood, leading to a high incidence of diseases linked to cell-mediated immune deficiency. The possible cocarcinogenesis of the cell-mediated immune deficiency following repeated gastroenteritis and persistent stimulation of B cells, leading to alpha heavy chain disease and primary intestinal lymphoma, or due to falciparum malaria in newborns and its impact on the EB virus genome in development of Burkitt's lymphoma, are discussed.

Africa↗

Serum fatty acid/albumin molar ratio and the risk of diseases.

Free fatty acids (FFA) in blood are carried by serum albumin. A hypothesis is offered that conditions giving a high molar ratio of FFA to albumin may lead to dysfunction of the cells which are directly exposed to the high FFA/albumin ratio, i.e. the red and white blood cells, and endothelial cells. The hypothesis is supported by observations of (1) hemolytic effect of FFA, and protection by albumin in vitro, (2) inhibition of white blood cells by FFA, (3) increased FFA/albumin ratio and erythrocyte susceptibility to hemolysis in pre-eclampsia, (4) increased incidence of eclampsia in undernutrition, (5) the paradox at famine suppresses and refeeding activates malaria, and (6) an inverse relationship between serum albumin level and mortality.

Disease↗

Neural control of appetite: cross-talk between homeostatic and non-homeostatic systems.

The new lifestyle in the modern world is causing a rapid increase in the prevalence of obesity and associated health problems. Increased availability of palatable and energy dense foods, combined with a lack of physical activity overpower a homeostatic regulatory system that evolved to survive periods of famine rather than preventing obesity. Environmental and lifestyle factors influence energy balance mainly through their impact on cortico-limbic brain structures dealing with reward, cognitive, and social aspects of food intake and voluntary physical activity. To find new behavioral and pharmacological treatments of obesity, it will be important to identify the specific pathways that link these externally driven processes with the homeostatic regulatory system.

Appetite↗

Global warming and infectious disease.

Global warming has serious implications for all aspects of human life, including infectious diseases. The effect of global warming depends on the complex interaction between the human host population and the causative infectious agent. From the human standpoint, changes in the environment may trigger human migration, causing disease patterns to shift. Crop failures and famine may reduce host resistance to infections. Disease transmission may be enhanced through the scarcity and contamination of potable water sources. Importantly, significant economic and political stresses may damage the existing public health infrastructure, leaving mankind poorly prepared for unexpected epidemics. Global warming will certainly affect the abundance and distribution of disease vectors. Altitudes that are currently too cool to sustain vectors will become more conducive to them. Some vector populations may expand into new geographic areas, whereas others may disappear. Malaria, dengue, plague, and viruses causing encephalitic syndromes are among the many vector-borne diseases likely to be affected. Some models suggest that vector-borne diseases will become more common as the earth warms, although caution is needed in interpreting these predictions. Clearly, global warming will cause changes in the epidemiology of infectious diseases. The ability of mankind to react or adapt is dependent upon the magnitude and speed of the change. The outcome will also depend on our ability to recognize epidemics early, to contain them effectively, to provide appropriate treatment, and to commit resources to prevention and research.

Animals↗