Grant: Doctoral: Vanier Canada Graduate Scholarships

Stunting is a form of chronic undernutrition leading to poor growth in children. It is a major risk factor for child mortality and is responsible for up to 17% of child deaths worldwide. Stunting is also associated with reduced physical and cognitive capacity, and leads to poor school achievement in children and reduced income potential in adult life. Furthermore, stunting is intergenerational; stunted children become stunted adults and the risk cycle of undernutrition continues. In Cambodia, stunting prevalence is severe, affecting 40% of children. In rural and/or poor households, the rates are even higher. We have little information on the causes of stunting in this population. Diet and inflammation are speculated contributors, but it is not known to what extent. In Cambodia, there is also a high prevalence of genetic hemoglobin disorders, affecting about 55% of the population. These genetic disorders change the structure of hemoglobin, the protein found in red blood cells that carries oxygen. A defective hemoglobin structure can lead to negative health outcomes, such as severe anemia. It is important to distinguish between nutritional anemia (that is treatable) and anemia of other causes (i.e. genetic disorders), in order to prescribe appropriate public health responses. This research will investigate correlates between stunting and micronutrient deficiencies, inflammation, and genetic hemoglobin disorders in Cambodian children, and determine the proportion of anemia that is related to iron-deficiency (nutritional anemia) compared to anemia of other causes. In Canada, this research is relevant to understanding the diagnosis of anemia and for guiding policy on the treatment of anemia and prenatal genetic counseling in this population. This research is highly relevant to policy makers in the South East Asia region given the comparable context, and in all countries with a high prevalence of stunting given the sheer magnitude of this global health problem.