WE ARE WHAT WE EAT: THE REAL IMPACT OF NUTRITION ON HEALTH
Cyril Enwonwu, ScD, PhD, MDS, University of Maryland
"Global health research is Baltimore, and global health research is Africa."
In 2007, a 12 year old boy from Baltimore, Maryland tragically and unnecessarily died from a "toothache," after an infection from his mouth spread to his brain. What could have been solved by an $80 visit to a dentist exploded into a $250,000 hospital and surgical care bill and his ultimate death. The young boy lived in poverty, with no regular dental or medical check-ups because his family did not have insurance. "Diseases resulting from a lack of proper oral hygiene and nutrition are not exclusively African or tropical diseases," Enwonwu states. "They can occur here, or anywhere else where there is poverty-driven degradation. And that means no matter the location, the same devastating, fatal outcome can occur. Global health research is Baltimore, and global health research is Africa."
Born in Nigeria, Cyril Enwonwu, ScD, PhD, MDS's father sent him to school in England to get a good education and become a dentist. While in dental school, Enwonwu learned about noma, a devastating disease that leads to severe facial disfiguration and is associated with high rates of death and disease. Noma is thought to be caused from an interaction of malnutrition, poor oral health, and a weakened immune system. It was common in parts of Europe and North America until the early 1900s when it essentially disappeared, and is now almost exclusively seen in young children living in remote areas of the developing world, particularly in Africa. In his first visit back to Nigeria, Enwonwu saw the massive amounts of people afflicted with this terrible disease, which is still killing nearly 140,000 people in Africa each year, mostly children. "It changed my life. If you see these children, and you have a soul, you can't forget them."
Enwonwu conducts his research in Africa, and focuses on nutrition (either lack of or overabundance of) and its impact on oral and bodily health, and more specifically, the role poverty has in determining these factors and the incidence of disease. His research advanced this science in the late 1960s when he published research showing a relationship between malnourishment and its impact on severe oral diseases which could not be attributed to simply a lack of poor oral hygiene, a view very unpopular in the dental community at the time. Previous to Enwonwu's work, oral health problems were viewed as separate from diseases which affect our body's systems or organs. "Oral health was believed to have no relation to obesity, heart problems, or diseases like diabetes," he explains. "Now we know that is exactly the opposite - these factors are closely related and integrated."
Enwonwu's research in Africa has continued to enhance our understanding of this relationship, and is providing useful clues on how best to prevent and treat diseases in communities worldwide. For example, most of the mothers of children with noma were found to be themselves chronically malnourished during pregnancy, and consequently subject to many infections and hostile conditions which impaired the pre-natal nutrition and development of their babies.
"We are learning more about the impact on our bodies of what we eat and don't eat. Through our research, we are gaining crucial information about the complex relationship between nutrition, oral health, disease, and our response to disease." And although Enwonwu's and others' research on nutrition has been ongoing for more than 40 years, Enwonwu acknowledges the little attention it receives in the health and medical fields. "In order to turn this research into better health worldwide, including our ability to save lives, we must underscore the importance of nutrition and its health ‘consequences' in the training of our health professionals."