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.
We congratulate CeSSIAM for celebrating its 25th anniversary!
Executive and Scientific Director: Noel W. Solomons, MD
Learn more about CeSSIAM:
Now available to download: The CeSSIAM Bulletin!
Gabriela Montenegro-Bethancourt is awarded the National Young Scientist Prize for Guatemala of the Third World Academy of Science (TWAS).
Gabriela Montenegro and Dr. Solomons
Dr. Solomons wins the Guatemalan "Medalla de la Ciencia y Tecnologia" (Medal of Science and Technology) for his contributions to Nutrition research in Guatemala. (See INF's Facebook page for more photos!)
From left to right: Congressman José Roberto Alejos Cámbara, President of the National Legislature, Dr. Noel W. Solomons, awardee of the Science and Technology Medal for 2010 of the National Counsel of Science and Technology of Guatemala, Dr. Rafael Espada, Vice-President of the Republic of Guatemala, Dr. Hector Centeno, Advisor to the National Secretariat for Science and Technology (SENACYT), and Dr. Rosa María Amaya de López, Secretary General of SENACYT.
CeSSIAM celebrates its 25th Anniversary!
CeSSIAM was started in 1985 by Dr. Noel Solomons. For 25 years it has produced top-tier nutrition research articles and supported the careers of many talented Guatemalan scientists, as well as scientists from all over the world. CeSSIAM hosted a 25th anniversary celebration with a brunch in Porto, Portugal during the 2nd World Congress on Public Health Nutrition.
Dr. Solomons and the CeSSIAMcitas at the CeSSIAM 25th anniversary brunch in Porto, Portugal.
Click headings for more details:
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.
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.
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.
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.
Minority Health International Research Training (MHIRT) in collaboration with the University of Alabama at Birmingham
- Includes annual summer training programs for at least two minority students
Universidad Rafael Landivar
- Two nutrition school BSc candidates will have completed projects with CeSSIAM
- Two MS (Public Health Nutrition) students will complete internship requirement at CeSSIAM
- One student completing an MSc in Nutrition at Wageningen
- Three students completing a MS degree in International Life Science (Specialty: Public Health)
Boston University School of Public Health
- One student completing a MPH
Tufts University, School of Nutrition Science and Policy and School of Medicine
- A recent graduate with MSc in Nutrition on exchange for professional development
New York University
- One doctoral candidate in cultural anthropology with a Fulbright Scholarship for graduate studies in Guatemala will be affiliated as an exchange student.
1. Assessment of Prevalence of Asymptomatic Giardiasis in Day-Care Center Settings, Quetzaltenango, Guatemala
Leads: Gabriela Montenegro-Bethancourt, MSc, CeSSIAM Research Fellow, Viki Alvarado, MS, RD and Caitlin Crowley, MPH
Ms. Montenegro-Bethancourt and Ms. Crowley at a participating day-care center in Quetzaltenango
In 1987, a series of reports were published documenting outbreaks of diarrheal infections with the protozoa, Giardia intestinalis, among children attending day-care centers in various parts of the world. This was the first documentation of person-to-person transmission of this pathogen.
A year earlier, Michael Farthing MBBS, in a collaboration with Leonardo Mata (facilitated by Jerry Keusch), analyzed the data from the longitudinal growth study in the village of Santa Maria Cauque, Guatemala and reported an association with more frequent isolation of Giardia in stool samples and poorer growth (Farthing MJ et al, Am J Clin Nutr 1986; 43: 395-405).
An endemic state for colonization with Giardia, without active disease, in clusters of children in close contact (day-care center model) has been extensively reconfirmed over two decades, including in studies at CeSSIAM in Guatemala City in 2002-3 (unpublished observations).
The dilemma is how to respond to endemic colonization with G. intestinalis, as appropriate treatment is prolonged 7 days and expensive (metronidazole), especially in the absence of overt symptoms, and the dynamics of transmission are such that prompt reinfection is virtually assured.
2. Non-invasive Screening of Hematological Status Project, San Francisco el Alto, Guatemala
Leads: Gabriela Montenegro-Bethancourt, MSc, CeSSIAM Research Fellow, Viki Alvarado, MS, RD and Caitlin Crowley, MPH, CeSSIAM Intern
Collaborators: Hildegard Grunow Foundation
Church in San Francisco el Alto
The findings in the Pemba Study (Sazawal et al, Lancet 2006; 367: 133-143) raised international concerns and cautions about the oral supplementation of iron to individuals who already have an adequate iron status, especially in a malarial area. These individuals had more deaths and hospitalizations when routinely given iron-folic acid supplements in Tanzania. On the other hand, those individuals who were anemic in the malarial area seemed to benefit from iron, by overcoming their anemia, without apparent adverse effects.
Since the realization of the “Pemba dilemma”, CeSSIAM and the Hildegard Grunow Foundation have looked for a field-friendly approach that would allow for reliable non-invasive screening of hematological status. If one could distinguish anemia status using such a non-invasive device, iron supplementation could be safely distributed to only those who are deficient.
Well before the Pemba ferment, the late Rainer Gross, his son, and his associates explored the Erlanger Photomicroprobe (EMPHO) prototype to measure hemoglobin by skin-contact probes and published the findings in the Food and Nutrition Bulletin. (Gross et al, FNB 1996; 7: 27-36). The HGF has purchased two instruments: The Haemospect (MBR Optical Systems) and the Rad-87/Rainbow SET (Masimo), which provide digital read-outs of hemoglobin with a skin-contact probe system.
Caitlin Crowley traveled to Germany to receive the instruments, collaborate with investigators at the Children's Hospital of Munich, and receive instructions from the technical representatives of the two manufacturers. Now in Guatemala, the plan is to assess their hemoglobin measures against a laboratory-based determination on whole blood in two settings. The first is among men living the high highlands town of San Francisco El Alto, at 2600 meters above sea-level, and the second is among pregnant women in the hookworm-infested lowlands in Retalhuleu at sea-level. This should provide the full range of hemoglobins from anemic to plethoric, for a calibration/validation exercise across the spectrum of potential readings and determine other features of the "field-friendly" nature of each device.
CeSSIAM is located in Guatemala City, Guatemala. The small, modest building belies the copious amounts of cutting-edge nutrition research going on within!
Dr. Solomons and the CeSSIAM staff at one of the weekly meetings that are an integral part of the Center
The CeSSIAMcitas, joined by Dr. Odilia Bermudez (far right) from Tufts University; the coordination was a complete coincidence!
The presence of CeSSIAM in the scientific nutrition community can be felt at almost any nutrition conferences. With many publications every year coming out of the Center, Dr. Solomons encourages the CeSSIAMcitas to submit abstracts to conferences. Just in 2009 and 2010, there has been CeSSIAM representation at Experimental Biology and the International Congress of Nutrition in Bangkok.
Marieke Vossenar presenting at the ICN 2009
Monica Orozco, Klaus Shueman, Liza Hernandez, Noel Solomons and Gabriela Montenegro-Bethancourt at EB 2009
Liza Hernandez presenting her poster at EB 2008
Noel W. Solomons, M.D.
Director of CeSSIAM
Dr. Solomons, along with a Salvadorean biochemist (Dr. Oscan Pineda) and two Guatemalan physicians (Dr. Fernando Beltranena, Dr. Gustavo Hernandex-Polanco) founded the Center for Studies of Sensory Impairment, Aging and Metabolism (CeSSIAM) on July 1, 1985. As Director, Dr. Solomons has guided the Center to a scientific agenda that includes diet and chronic disease, patterns of complementary feeding, iron status and anemia, and the safety of oral iron therapy. He is also Chair of the IUNS Task-Force on Diet, Nutrition and Long-term Health.
Dr. Orozco is a post-doctoral fellow with CeSSIAM, having worked with CeSSIAM since 2001. She is currently sharing time in collaboration with an appointment at the Universidad del Valle in Guatemala City and focusing on issues of the effects of iron on colonic health. This is based on a novel technique developed during her PhD studies at the University of Manitoba, where she was a an INF/EMF Fellow.
Dr. Vossenaar has been working as a post-doctoral fellow with CeSSIAM since 2005. She first came to CeSSIAM in 1998 when she was a master student at Wageningen University, the Netherlands. Her doctoral work at the University of Dundee, Scotland was a collaboration study with CeSSIAM in which concordance with the 1997 WCRF/AICR recommendations were examined in several countries. Her research focuses on dietary and lifestyle habits in diverse populations in relation to cancer prevention, and dietary patterns in schoolchildren of Quetzaltenango and children attending day care centers in Guatemala City.
Ms Montenegro-Bethancourt is a research nutritionist fellow with CeSSIAM, having worked with CeSSIAM since 2000. She completed a Maaters of Science in Life Sciences with emphasis in International Health at the Vrije Universiteit of Amsterdam in 2006. He research focuses on dietary patterns in schoolchildren of her home city of Quetzaltenango as well as assorted inquiries into hematological status, vitamin D status, health delivery and nutritional genomics in the Quetzaltenango setting.
Ms. Hernandez has been working with CeSSIAM since 1999 on various research projects, including one on chronic diseases in urban settings of Guatemala, the Kraft Project, and the complementary feeding projects. She is currently working on a paper comparing complementary feeding patterns in children in a rural village.. In 2005, Ms. Hernandez completed a 4-month internship at the Human Nutrition Research Center on Aging at Tufts University in Boston, USA, with Dr. Odilia Bermudez. There, her activities included analysis of food databases from the Puerto Rican Project.
Possibly the longest running "CeSSIAMcita", Ms. Romero-Abal has been working with CeSSIAM since 1989. A licensed laboratory technician, Ms. Romero-Abal began her tenure at the Center mostly helping out with lab work, and has been involved in projects such as the involving micronutrients (vitamin A, iron, and zinc). She is also involved in data analysis for several CeSSIAM studies. Ms. Romero-Abal sometimes supervises students that come to work with CeSSIAM, and is, in fact, currently a student herself, working on her Master's in Public Nutrition at the Universidad de San Carlos.
Ms Alvarado has been associated with CeSSIAM since 2004, having completed her graduation thesis at the Universidad Francisco Marroquin on the topic of abdominal circumference in schoolchildren. She completed a Masters degree in International Public Health Nutrition at the Wageningen University in the Netherlands with a project on the reproducibility of self-reported weight, height and body image in Guatemala. She is currently working on programs of maize consumption.
Ms Mayorga, a research nutritionist Fellow, has been with CeSSIAM since 1998, when she performed her graduation thesis on the topic of body composition among lactating women in Alta Verapaz. She also worked on carotenoid content of breast milk before leading the field interviewers for the Guatemalan Concordance project. She is currently working on the programs on maize consumption with Viki Alvarado and Maria José Soto.
Ms. Campos has been working at CeSSIAM since 2000 when she became a research nutritionist fellow.. From 2001 to 2006, she was involved in the Zinc Project, and also completed her student thesis during this time. Ms. Campos is responsible for organizing contacts for projects, as well as collecting, entering and analyzing data for many CeSSIAM projects. She is currently involved with writing a paper for the rural segment of the Complementary Feeding project.
Ms. Soto began working with CeSSIAM in 2007 as a nutrition student working on her thesis at the Universidad Rafael Landivar. Since March 2008 she has been working at CeSSIAM, helping coordinate Masters students’ field research, making arrangements, and assisting with data entry. She has also been working with Ms. Mayorga and Ms. Alvarado on the day-care center research projects, and is currently involved with the Complementary Feeding Project.
Ms. Crowley is a January 2009 graduate of the Boston University School of Public Health, with a concentration in International Health. She first came to CeSSIAM for five weeks in March and April of this year, and has returned to stay from June through August. Ms. Crowley will be assisting Ms. Montenegro and Ms. Alvarado in the two Summer Projects: a study on the Non-invasive Screening of Hematological Status Project and Assessment of Prevalence of Asymptomatic Giardiasis in Day-Care Center Settings.