My major research interests include:
- the nutritional management of acute and persistent diarrhea,
- micronutrient trials in developing countries, and
- general aspects of energy and protein metabolism in catabolic diseases.
My colleagues and I have performed studies evaluating the formulation and effectiveness of oral rehydration solutions (ORS) for the treatment of acute diarrhea. In several resource poor settings, we have performed clinical trials of ORS, the results of one such study resulting in the first significant change in the composition of ORS since its inception in the late 1960's. In collaboration with colleagues at HSPH and Muhimbili University of Health and Allied Sciences in Dar es Salaam, Tanzania, our group is evaluating the efficacy of micronutrient supplementation in infants and young children born to women with or at risk of HIV infection. With colleagues at St John's Research Institute in Bangalore, India, we are evaluating the effects of maternal vitamin B12 supplementation on biochemical and clinical parameters during pregnancy.
In both developing and industrialized countries, we have completed studies on the micronutrient status of children, including those with cystic fibrosis, malaria, undernutrition, and short bowel syndrome. We are applying state of the art nutritional assessment techniques (e.g., stable isotopes, indirect calorimetry, body composition methodologies) to patients with a variety of catabolic illnesses, including HIV/AIDS, inflammatory bowel disease, short bowel syndrome and cancer. One study has shown that infants with short bowel syndrome had better nutrititional outcomes when fed breastmilk. Another study among children undergoing stem cell transplantation found that, contrary to popular assumptions, energy expenditure is lower in the weeks immediately after transplant, a finding that may significantly alter the manner in which nutritional support is provided to these ill patients.
I have been an active member in several large multi-center clinical trial groups, including the CHOICE (a multinational group evaluating an ORS of reduced osmolarity) and ZAP groups (a multinational group evaluating the effects of supplemental zinc therapy in children with acute malaria). I am an inauguaral Site Director for the Glaser Pediatric Research Network, a multicenter research network for cutting edge pediatric clinical studies based at Children's Hospital, Boston as well as sites at Stanford, UCSF, UCLA and Baylor.