CeSSIAM

The Center for Studies of Sensory Impairment, Aging and Metabolism (CeSSIAM) was founded in 1985 in Guatemala for the original purpose of investigating the association between vitamin A deficiency and blindness. 

CeSSIAM is currently investigating the effects of diet and specific micronutrients on outcomes such as health and function. It also mentors pre-doctoral and doctoral students as they lead several research projects.  CeSSIAM works in partnership with INF to conduct cutting-edge nutritional research in Latin America and is staffed by six core research professionals working in three thematic investigative areas, which are described below.

Executive and Scientific Director: Noel W. Solomons, MD

Click here to read Dr. Solomons and the CeSSIAM staff's bios.

Research Themes

Click headings for more details:

1. Diet and Health

Leads: Marieke Vossenaar, PhD, CeSSIAM Post Doctoral Fellow, and Gabriela Montenegro-Bethancourt, MS, CeSSIAM Research Fellow

Collaborators: Universidad Rafael Landivar, Vrije Universiteit, Tufts University, Dublin Technical Institute

The Diet and Health theme focuses on the following research areas:

Adherence with Diet and Lifestyle Recommendations to Reduce Cancer Risk: Concordance Project

• Examine concordance of diet and health (food preparation, eating, physical activity and lifestyle) behaviors in four nations (Netherlands, Scotland, Mexico and Guatemala) in comparison global dietary and lifestyle recommendations

Promotion of Adolescent and Child Health: Xela-Children Study:

• Examine differences in dietary intake among urban children (3rd and 4th grade) in different socio-economic school settings (private and public schools), Quetzaltenango, Guatemala
• Use of innovative and interactive pictorial self-registration method for dietary data collection
• Examine differences in water and beverage consumption.

2. Iron and Health

Leads: Monica Orozco, MS, PhD candidate, CeSSIAM Research Fellow, and Maria-Eugenia Romero-Abal, BS, MS, CeSSIAM Research Fellow

Collaborators: Hildegard Grunow Stiftung, Technical University of Munich, University of Innsbruck, University of Nijmengen, University of Utrecht, University of Manitoba

Response of Non-Transferrin-Bound Iron (NTBI) to Graded Doses of Oral Iron in Healthy Men

Examining circulation of non-transferrin-bound iron (NTBI) is important especially in the context of prophylactic iron intervention and potential contribution to mortality in malarial endemic areas.

Comparative NTBI responses to ferrous sulfate, NaFeEDTA and iron polymaltose 

Ferrous sulfate, the least expensive and most widely used iron compound for food fortification and oral supplementation, is a highly reactive form of iron. Other iron compounds (sodium iron EDTA (NaFeEDTA) and iron polymaltose) used for fortification/supplementation appear to have intestinal uptake mechanisms more similar to those of heme iron and could produce lower NTBI responses after oral ingestion.  A comparative trial of magnitude of NTBI in 10 healthy subjects is currently being planned.

Interactions and Associations among Hepcidin Species Measured Simultaneously in Healthy Subjects

Hepcidin, a hepatic peptide hormone, first identified in 2001, has the primary function of regulating iron transport at the level of its export from intestinal cells.   A post-hoc project derived from collections of urine and serum made in the metabolic study in 2005 will examine, using assays, 25-hepcidin (the 25-amino-acid-chain active hormone), and prohepcidin (the 84-amino-acid-chain precursor form) in four formats: serum 25-hepcidin; urinary 25-hepcidin (normalized for creatinine); serum prohepcidin; and urinary prohepcidin (normalized for creatinine). 

Abatement of Iron Pro-oxidant Effects in Stools by Antioxidants of Palm Fruit Origins

Conducted a pilot (n = 5 subjects) and definitive (n = 12 subjects) phase metabolic trial in healthy volunteers at the CeSSIAM headquarters in Guatemala City examining the changes in pro-oxidant properties of iron in stool as an effect of varying levels of anti-oxidants of palm-fruit origin.

Dissertation completed: "In Situ and In Vivo Modification by Palm Fruit-Derived Carotenes and Tocotrienols of the Oxidative Response to Commonly-prescribed Doses of Oral Iron"

Fecal ROS response: Comparison among three iron compounds used in supplementation: Ferrous sulfate, Iron polymaltose and NaFeEDTA: 

Using the technique and design of the study with palm-derived antioxidants, a comparison of ROS responses with consecutive-day supplementation with 120 mg of ferrous sulfate, iron polymaltose and NaFeEDTA is being planned. The latter compounds used in fortification/supplementation have more intricate complexation chemistry which might keep the iron in a less reactive situation as it passes through the lower intestine.

Non-invasive assessment of iron status for screening: 

The implications of the Pemba trial have been interpreted in many quarters as contraindicating universal prophylactic iron supplementation for children in holoendemic malaria areas, and possibly with other intracellular infection endemicity (HIV, TB).  This would evoke the need for population screening to select appropriate recipients in a targeted strategy that would be non-invasive (not involving blood extraction), acceptable for use in young children and of low cost.  Approaches that use contact probes applied to the skin or mucosal surfaces have been explored since the 1990s.  CeSSIAM is working in consortium with the Hildegard Grunow Stiftung (Klaus Schuemann), Sight and Life (Klaus Kraemer) and Akzo Nobel (Geoff Smith).  Two innovation groups have been identified with the potential technological capacity to address the specifications of a non-invasive screening approach: The Otto Beckman Laser Laboratory at the University of California at Irvine and the MicroVision Medical Co of Wallingford, PA.

3. Community Child Health

Leads: Liza Hernandez, MS, RD, CeSSIAM Research Fellow, and Raquel Campos, MS, RD, CeSSIAM Research Fellow

Collaborators: Wageningen University, Netherlands; AgroSalud, Colombia; Vrije Universiteit

Reconnaissance of Food Intake among Rural and Urban Infants Aged 6 to 12 Months

The objectives of this project are to estimate breast milk intake plus complementary food for group and for individual infants (3 24-h recalls), as well as to ascertain the phasing of introduction of complementary foods by maternal retrospective and by age-intake mapping in two sites (the village of Santo Domingo Xenacoj and a local neighborhood of Guatemala City). 

Outcome variables other than food intake include growth changes, dietary diversity and differences in types of complementary food offered (family food/baby food, processed food/non-processed food, and traditional food/modern food).

Effect of Quality Protein Maize (QPM) on Health and Function of Day-Care Center Populations:

Potential randomized intervention trial in which day-care center children, aged 3 to 6 y, are fed either conventional maize or quality protein maize (QPM) with higher contents of the amino acids tryptophan and lysine.  Activities are currently underway to prepare for the designing and protocol development of such a study, filling in selected gaps of knowledge including a study of the type of food preparations (maize based foods and drinks).

Outcome variables include features of child health that might be affected by improved protein quality, while receiving the putative bioactive effects of lysine (immune modulation, stress reduction) and of tryptophan (sleep modulation). 

Preliminary Orientation on Water Sources, Microbiological Quality of Water, and Household Use of Water in Rural and Urban Households

To examine the degree of contamination of water samples with fecal bacteria both at the household source of drinking water and from the vessel of proximate consumption among 22 households in the rural, highland village of Santo Domingo Xenacoj.  The primary reservoir sources for the community were cultured and found to meet water quality standards.

4. Other Projects

Lead: Gabriela Montenegro-Bethancourt, MS, CeSSIAM Research Fellow

Collaborators: Creighton University, Newcastle University

Vitamin D Status of Elderly Mayans in Urban and Rural Settings of the Western Highlands of Guatemala

Interest in vitamin D has been in ascendancy as reports emerge that pigmented ethnic groups have insufficient circulating levels of 25-OH-vitamin D and chronic non-transmissible diseases may be prevented by abundant vitamin D status, while opinion grows that the current adequate intakes for the vitamin are too low and the upper tolerable limit is also overly conservative.  Studies in children in Quetzaltenango have shown very low intakes of dietary vitamin D.  Persons in this region, situated at 2300 m above sea-level at a tropical latitude, can be expected to have sustained, intense exposure to ultraviolet radiation.  However, dark skin pigmentation blunts the bioconversion of 7-OH-cholesterol to vitamin D.  Aging of the skin progressively losses 75% of its original efficiency for bioconversion of vitamin D.  Aging also can limit the amount of time spent out of doors.  These pros and cons for adequate vitamin D status converge in elderly Mayan adults in the Western Highlands.  A survey of circulating 25-OH-vit D in 100 Mayans, >60 y in urban and rural residence in the Quetzaltenango province, is currently underway. 

Polymorphism Frequencies for Carotene Monooxygenase I among Mayans

Collaborators: Newcastle University

It is a classical observation that the efficiency of bioconversion of provitamin A carotenes to active vitamin A varies from individual to individual, even when controlling for background vitamin A status.  It has been discovered that the intestinal cleavage enzyme, Carotene Monoxidase I, has a series of polymorphisms that can be characterized by a polymerase chain reaction (PCR).  Dr. Georg Lietz at the Newcastle University has developed a diagnostic PCR, and characterized the polymorphism frequency in an Anglo British population.  We shall collaborate in assessing the frequency in group of Mayan adolescents in the public school population of Quetzaltenango. 

Within-individual Reproducibility of Self-reported Weight and Height (and Derived Body Mass Index) and Stunkard Silhouette Figure Body Image: 

Collaborators: Wageningen University

CeSSIAM had a university student project in 2007 on the reproducibility of self-reported height and weight at a 14-day interval and their relation to measured values.  As an exchange-student internship project, we have extended the exploration of this theme to reproducibility of self-reported height and weight, combined with self-assessment of BMI-calibrated body images (Stunkard figure series), in 100 adult women of diverse social classes.

5. CeSSIAM Training Activities