When Dr. Tahmeed Ahmed began seeing patients fresh from graduating medical school in his native Bangladesh, he saw one problem over and over again that all of his medical training could do little to change. “I took care of patients suffering from diarrhea and malnutrition, and it was very frustrating for me especially to take care of children, some of whom would die,” he says. “There were not many things we could do despite all of our best intentions and efforts.”
So as Ahmed began his career at ICDDR,B (formerly the International Center for Diarrheal Disease Research, Bangladesh), where he is now executive director, he decided to address the problem. A chance encounter with Dr. Jeffrey Gordon, a professor at Washington University in St. Louis, over breakfast in 2009 sparked a potential solution. Gordon was studying how the bacteria in the gut differed in people with obesity and those with malnutrition. Could these microbes be the key to a novel treatment for malnutrition? When Ahmed and his colleagues went into the slums of Dhaka, Bangladesh, they found an interesting dichotomy. Some children were healthy, while others suffered from malnutrition, wasting, and stunted growth. What distinguished the healthy children, he found, was their gut microbiome, and what heavily influenced these bacteria was their diet. Working with Gordon, Ahmed identified the beneficial gut bugs that were helping the healthy children, and traced them to the kinds of things they were eating, including tilapia, chickpeas, green bananas, and peanuts.
But the finding didn’t materialize into a solution until Ahmed worked with a local food producer to turn these ingredients into an easily dispensed food product. They combined powdered forms of these foods with other essential micronutrients and mixed them into a paste with vegetable oil. Ahmed has been testing the food, which children and their moms can eat throughout the day in small sachets, in six countries: Bangladesh, India, Tanzania, Mali, Pakistan and soon, Niger. Early studies have already shown children in Bangladesh eating the food gain weight and grow compared to those who get standard therapies. Results from broader studies will help organizations like UNICEF, the World Health Organization, and national governments to begin endorsing and distributing the food more widely. “We have a huge proportion of children suffering from malnutrition,” Ahmed says. “In Bangladesh about 300,000 children under five are suffering from severe wasting. These children run a nine times higher risk of death compared to children who are not malnourished. We have to do something for them.”