Faculty Expert in Global Health

Laura E. Smith, PhD

Portrait of a female professor.

Assistant professor Laura E. Smith joined the Epidemiology and Environmental Health department in June 2017. Previously, she was a postdoctoral research associate at Cornell University where she earned a PhD in International Nutrition. There she developed a deep interest in understanding how multiple toxins impact food and health outcomes through research in Kenya and Zimbabwe.

A native of Newfield, NY, Dr. Smith shares with OGHI the foundation of her scholarly interests and reflects on her current projects with the SHINE trial (Sanitation, Hygiene, Infant Nutrition Efficacy Project). OGHI interviewed Dr. Smith in February 2018.  

Community Food Security in Kenya: Local/Global Connections

When I was an undergraduate I started working on program development and program evaluation at Tompkins County Cooperative Extension. I also studied abroad in Kenya as an undergraduate. I had always been interested in nutrition but before that it been domestic, local work. The study abroad program in Kenya had a research component so I did research on community food security in a rural area of Kenya. When I returned my faculty advisor and I started looking at these similar theories about community safety nets and different kinds of communities, we were working with low-income families in Syracuse, NY and the Philippines. I stayed very connected with my colleagues and host family in Kenya. For the next several years I was going back and forth between Kenya and Cornell, and started a cross school gardening project with the school that I grew up in and a school in western Kenya.

Farming Communities and Nutritional Epidemiology

Having grown up in a farming community I’ve always had a fascination with farming communities and how disconnected we are from our food system. When I began my PhD program at Cornell I was very interested in behavior change and agriculture and nutrition connections, then happened upon this issue of toxins in food.  I was working on a project for Catholic Relief Services in 2009 and taking a class in which we were applying principles of adult education in developing modules for a project with the Great Lakes Cassava Initiative, funded by the Bill and Melinda Gates Foundation. My focus area was on cassava nutrition and looking at how to increase cassava farming and consumption in communities in East and Central Africa that were not eating a lot of cassava. When you talked to people, one of the major reasons for not eating cassava had to do with the perceived cyanide in cassava- which is there, but as long as you process it correctly is not an issue. I became fascinated with the presence of toxins in food and how that interacts with people’s decision making around food. I transitioned into looking at mycotoxin exposure, going from behavior to biomedical sciences and back.

Interdisciplinary Connections

I was awarded a National Science Foundation IGERT fellowship (Integrative Graduate Education and Research Traineeship) for food systems and poverty reduction at Cornell. I received funding to go to Kenya for two summers as well as funding for my research. When I started to get really interested in the mycotoxin issue I realized that before we get to behavior and behavior change there is a big gap in the actual science there. What I really needed was to be part of another large project collecting biological samples with children, to look at the questions I wanted to examine. Right around that time I was working on a review paper because I thought why are we focusing on just one toxin when there are all of these different contaminants in food? That paper looked at different mechanisms and how they may interact, for example on child growth. That was right around the time the Gates Foundation became interested in mycotoxins and child growth. I had never been to Zimbabwe but the infrastructure was excellent, they were very interested in my research topic, and provided additional funding. I went to Zimbabwe for the first time in 2012.

SHINE Trial in Zimbabwe

There are stunting rates in Zimbabwe of 27% and we still don’t know very much about what is causing all that stunting. The formative work for the SHINE trial in Zimbabwe started in 2008, recruitment of pregnant women and kids started in November 2012. In Zimbabwe there is a big problem with mycotoxins in the moms and kids- we have found biomarkers for multiple toxins are almost half of the pregnant women. Thus far, we have measured mycotoxin exposure in more than 4,000 pregnant women and about a quarter of them had a detectable aflatoxin. In the infants we’ve measured about 1,000 and found that even in the 3 months old they have detectable aflatoxin, the numbers goes up as they age and as they eat more food to about a quarter being exposed by 18 months of age.                                                                                                                                                                                       
The organization that I’ve been working with, Zvitambo Institute for Maternal and Child Health Research, has been around for 20 years and is a Zimbabwean organization. Jean Humphrey of John Hopkins University (SHINE Trial principal investigator) is the director, and helped to found the organization. Zvitambo has an enormous capacity of human resources and infrastructure and ability to conduct high quality research. We have learned a lot from this trial and I think we learned that there is a ton more research that needs to be done about the causes of child stunting. We have an opportunity in this cohort to advance knowledge about mycotoxins because of the size of the study, we have so many kids and so many moms. Most other work on mycotoxins has been limited by fairly small studies.

Field Experience: Student and Researcher

On the ground field experience is important, I’m hoping to bring my dedication to that to the students here in the department. Right before I went to Zimbabwe I was out in farmers’ fields for 9 hours a day in Kenya. I was talking to people and really trying to understand why people do what they do, do they understand what mycotoxins are? My work in Zimbabwe has been a very different experience. Field experience really depends on what type of project you’re working on. The SHINE trial is very large and has a large staff, my work is much more in the lab than in the field. I’ve spent time learning from the lab staff, working out and setting up new procedures and working and looking at the literature and thinking about how to measure these things, how could we do better, how we develop new methods to do lab assays that could be done in country instead of sending them out, and working with a broad group of different researchers at the organization.

Why Global Health?

I’ve always been really passionate about helping people be healthier. In my research about  birth outcomes and stunting I see how many kids are dying unnecessarily and also how children are not growing to their full potential. If I can do anything to contribute to any body of knowledge, I will. From an emotional standpoint, I think why I chose nutrition. More practically, I thought about a question that I want to devote my scientific career to, questions that I am very passionate about—the integration between agriculture and farming families and health outcomes, and getting back to my roots, and thinking across disciplines. As a scientist those kinds of questions excited me. I find it fascinating why people do the things that they do, and how amazing and complicated the body is.

Dr. Smith will teach EEH 601: Advanced Epidemiological Study Designs and a new course, Public Health Nutrition, in fall 2018.

From nutrition education program development and evaluation at Cornell University to molds and stunting in Zimbabwe.