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A Dietary Solution to Arsenic
Poisoning in Bangladesh
2016 International Conference on Pulses
For Health, Nutrition and Su...
As
As
As
As
Coal with high As content mountainous regions
of China
Emerging in more water sources globally . . . .
In drin...
Known areas with natural arsenic contamination
Ravenscroft et al. 2008
Health problems associated with arsenicosis
 Hyperkeratosis & hyperpigmentation
(thickening & blackening of skin)
 Perip...
 Se builds the major anti-oxidant of the body (as glutathione – GSH)
 controls free radical damage produced by normal me...
Globally - soil is deficient in Se
- some ‘hot spots’ have high Se - toxicity problems
- a few regions are just right
Good...
 medicinal uses to treat diseases such as syphilis
 used as a growth promotant in poultry & swine feed
 popular means o...
Shahrasti, Chandpur
1) Identify households with As ≥ 100 ppb in tube well water
- 102 wells tested
- tube wells 60 – 120 f...
Seeking the solution through
Saskatchewan lentil
filter to
remove arsenic
- defunct 10 yrs ago As
Conjugate
urinary & feca...
icddr.,b colleagues –
Shahrasti field station
Lentils in storage in
Sharasti –
weekly distribution
to families
6 Month Dietary Trial in Shahrasti, Bangladesh
Screening
well water
Arsenic ≥
100ppb
Day 1:
Physical exam
sample collectio...
Macronutrients Sask. Lentils Idaho Lentils
Protein % by weight 26.22 27.73
Starch % by weight 38.00 37.00
TDF % by weight ...
Coauthors & Acknowledgements
 Regina Krohn, PhD University of Calgary, Calgary, AB, Canada
 Rubhana Raqib, PhD icddr,b, ...
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A Dietary Solution to Arsenic Poisoning in Bangladesh

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Oral Presentation 03 by Judit E.G. Smits at the International Conference on Pulses in Marrakesh, Morocco, 18-20 April 2016

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A Dietary Solution to Arsenic Poisoning in Bangladesh

  1. 1. A Dietary Solution to Arsenic Poisoning in Bangladesh 2016 International Conference on Pulses For Health, Nutrition and Sustainable Agriculture for Drylands Marrakesh, Morocco April 2016 Judit E.G. Smits, DVM, PhD Professor, Ecosystem & Public Health Faculty of Veterinary Medicine ?
  2. 2. As As As As Coal with high As content mountainous regions of China Emerging in more water sources globally . . . . In drinking water emerging in areas throughout Europe, North & South America Mine tailings & dust
  3. 3. Known areas with natural arsenic contamination Ravenscroft et al. 2008
  4. 4. Health problems associated with arsenicosis  Hyperkeratosis & hyperpigmentation (thickening & blackening of skin)  Peripheral vascular disease - arterial blockage leading to gangrene of extremities  Cardiovascular disease - arsenic blocks major blood vessels  Hepatic disease – similar in humans & experimental animals - hepatomegaly, fatty change - liver fibrosis - decreased GSH - increased oxidative damage (MDA in liver, 8-OHdG in plasma)  Pulmonary & bladder cancer 70 100 130 160 190 220 250 280 MDA (nmol/mg of protein) PCC (ng/mg of protein) 8-OHdG (ng/mg of protein) RelativeDifference(%) CTR 0.4ppm 4ppm 40ppmControl vs arsenic 0.4, 4, 40ppm MDA 8-OHdG Liver damage from arsenic
  5. 5.  Se builds the major anti-oxidant of the body (as glutathione – GSH)  controls free radical damage produced by normal metabolism  free radicals are much higher in malnourished people (+ - As toxicity)  Se enhances immune surveillance vs neoplastic (cancer) cells  Much of the earth’s soils are deficient in Se lentil production area in North America IV injection of As & Se separately, produces the conjugate seleno-bis-arsinium ion (GS)2AsSe] excreted in bile, then feces Zeng H, Uthus EO, & Combs GF,Jr. (2005) Mechanistic aspects of the interaction between selenium and arsenic. J of Inorganic Biochemistry, 99: 1269-1274. Gailer J, et al. (2002) Biliary excretion of [(GS)(2)AsSe](-) after intravenous injection of rabbits with arsenite and selenate. Chem Research in Toxicology, 15: 1466-1471. The story of selenium (Se) Normal SeSeverely deficient Se
  6. 6. Globally - soil is deficient in Se - some ‘hot spots’ have high Se - toxicity problems - a few regions are just right Good Se levels in Saskatchewan soils - old sea bed – high selenium - crops take up selenium in seeds 0 100 200 300 400 500 600 CanadaBangladesh India A ustralia U S A N epal Syria TotalSeconcentration (µg.kg-1 ) Se
  7. 7.  medicinal uses to treat diseases such as syphilis  used as a growth promotant in poultry & swine feed  popular means of murder during Victorian times in the 19th century  In 1970’s in BD arsenic started appearing in ‘clean’ tube-well water  As 3+ is the most common form in drinking water in south Asia  in vivo As 5+ is normally reduced to the more toxic form, As 3+ during metabolism  largest mass poisoning in history: WHO estimates that 140 million people are exposed to As levels > 50 ug/L (US EPA & WHO limits of <10 ug/L) History of arsenic
  8. 8. Shahrasti, Chandpur 1) Identify households with As ≥ 100 ppb in tube well water - 102 wells tested - tube wells 60 – 120 ft deep - 92 As higher than 100 ppb - 88% with As > 250 ppb - no influence of well depth on As content >250 ppb As drinking water standard As < 50ppb Arsenicosis in Bangladesh
  9. 9. Seeking the solution through Saskatchewan lentil filter to remove arsenic - defunct 10 yrs ago As Conjugate urinary & fecal As excretion Se WHO efforts for clean water: Large vessels to collect rain water from roof
  10. 10. icddr.,b colleagues – Shahrasti field station Lentils in storage in Sharasti – weekly distribution to families
  11. 11. 6 Month Dietary Trial in Shahrasti, Bangladesh Screening well water Arsenic ≥ 100ppb Day 1: Physical exam sample collection 3 months: Physical exam sample collection 6 months: Physical exam Sample collection Physical examinations: BMI, BP, NIOX MINO® lung inflammation exam • Bi-weekly morbidity questionnaire • Weekly lentil consumption log • Weekly lentil consumption questionnaire Block randomization Recruitment: Socio-demogr. questionnaire Adult & child consent Samples:
  12. 12. Macronutrients Sask. Lentils Idaho Lentils Protein % by weight 26.22 27.73 Starch % by weight 38.00 37.00 TDF % by weight 8.48 6.66 Phytochemicals Phytic acid g/kg 0.61 0.72 Minerals Calcium mg/kg 328 378 Potassium g/kg 10.45 10.94 Sodium mg/kg 72 75 Magnesium mg/kg 786 943 Copper mg/kg 9.3 11.4 Iron mg/kg 75.75 65.3 Zinc mg/kg 42.15 51.9 Manganese mg/kg 16.9 14.6 Selenium mg/kg 0.854 0.029 Arsenic mg/kg <0.001 <0.001
  13. 13. Coauthors & Acknowledgements  Regina Krohn, PhD University of Calgary, Calgary, AB, Canada  Rubhana Raqib, PhD icddr,b, Dhaka, Bangladesh  Albert Vandenberg, PhD University of Saskatchewan, Saskatoon, SK, Canada Funders  Global Institute for Food Security – (Government of Saskatchewan, University of Saskatchewan, Potash Corp)  Saskatchewan Pulse Crop Development Board  Grand Challenges Canada- Stars in Global Health

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