The story began in Bangladesh during the 1980s at the International Centre for Diarrheal Disease Research (ICDDR, B) in Dhaka. Packets of glucose ORS were
often not available due to seasonal availability of sugar, especially in rural areas. Intravenous therapy is expensive and often not a possibility in many
areas around the world, including Bangladesh. The ICDDRB began to do research and investigate what source of carbohydrate might be available and effective.
Research was done on corn, wheat, sorghum, potatoes, rice and other substrates that researchers Dr. Majid Molla and Dr. WB Greenough, thought might work. All
possible solutions worked as well or better than simple sugars, but since rice was the most likely not to cause allergies, continued research was done on the rice. Child Health Foundation (CHF) of Columbia, MD, held two major symposia on this topic involving corporations, government agencies, international agencies and
governments. One in 1987 was held in collaboration with the National Council for International Health (NCIH) which is now the Global Health Council, in
Washington, DC, at the National Academy of Sciences. The other conference, in 1989, was in Pakistan, in collaboration with the Aga Khan Foundation, which
funded early work on rice-ORS. These conferences reviewed the science behind the theories, investigating why a large molecule would be more effective ORS than
simple glucose.Research:
July 2001 MARYLAND RICE-BASED ORS PRODUCT CLINICALLY SUPERIOR TO GLUCOSE-BASED ORAL REHYDRATION SALTS STUDY IN SWEDISH PEDIATRIC JOURNAL ACTA PAEDIATRICA What:
A study of 167 boys with cholera compared the safety and efficacy of CeraLyte, a rice-based oral rehydration solution (ORS) to the standard "World Health
Organization formula" glucose ORS, concluding that the CeraLyte ORS, as in other studies with long-chain rice carbohydrate, is more effective than glucose ORS.
The boys, ages 5 to 15 years, suffered severe dehydrating diarrhea, with losses equivalent to about 30% of their body weight while hospitalized. On average,
these boys were admitted 14 hours after their illness began, by which time they had already lost 14% of their body weight to dehydration. Thus, total average
volume lost during illness was about 44%. In a controlled study, the boys who received CeraLyte-90 had a significantly lower rate of diarrhea during the critical first eight to 12 hours: "The mean
stool output was 20% less in the rice ORS group," according to the article titled, 'ORS among children with cholera and cholera-like illness,' Acta
Paediatrica, May 2001, Stockholm, by K. Zaman, MBB, PhD, Md. Yunus, MBBS, MSc, A Rahman, MBBS, H.R. Chowdhury, MBBS, MSc, and D.A. Sack, MD. The article
continues, ".the outputs during the other time periods were similar in the two groups." Antibiotics and food given to the boys leveled the two groups after the
8 to 12 hour period. Severe purging is "a major problem to simple treatment of cholera patients. None of the patients in this study died but it is likely that more than 50% admitted
into the study would have died without the treatment provided," according to the article. All children in this study had cholera or cholera-like illnesses, were
malnourished and, thus, at high risk. Cera Products donated its packet form of rice-based CeraLyte 90 for the study. CeraLyte comes in three sodium strengths. CeraLyte-90 is for the most severe
cases, such as cholera, where a healthy adult can die in as short a time as eight hours. Although glucose ORS packets are subsidized in UNICEF and WHO
programs in developing countries, the increased cost of CeraLyte may be considered marginal as less of the CeraLyte may be needed for rehydration. In
addition, recovery with a rice-based formula provides more energy, as well as, quick and sustained hydration.
Where:
The study took place at the rural treatment center in Matlab, of the International Centre for Diarrheal Disease Research Bangladesh (ICDDR, B) in
conjunction with the Johns Hopkins University School of Hygiene and Public Health. Cera Products (9017 Mendenhall Court, Columbia, MD 21045) is a young, applied bio-technology firm that produces a patented line of advanced rice-based
products, including oral hydration and drug delivery products for health and wellness markets in the U.S. and abroad. Charlene Riikonen, Cera's President,
worked at the ICDDR, B in the 1980s. The ICDDR, B received the first Gates Foundation Global Health award in Washington, D.C., at the annual Global Health
Council meeting on May 31, 2001.
The Benefits of Rice-Based Oral Rehydration Therapy
- Cost Effective (IV vs. Oral)
- Lack of Complications
- Lack of Pain
- Provides calories from complex carbohydrates
- Less worry when mixing because rice-based ORS has a lower osmolarity then glucose-based ORS
- Lower osmolarity also means better absorption
- Always works as well as glucose-based ORS and is even more effective in severe cases of dehydration
- Sustained hydration (larger molecule, more substrate)
- Tastes better
Research Continued:
Rice-Based ORS Bibliography
General ORS Bibliography
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