Litchi is one of the tastiest seasonal fruit which is quite popular in India. It has notoriously poor shelf life, which makes it costly at times. I have enjoyed this fruit from my childhood but its evil side was revealed in the year 2014. I still vividly remember that more than 100 children, aged 15 years or below suddenly died of idiopathic neurological disorder. Many hypothesis flew around, from the widespread usage of pesticide to infectious disease but nothing was established. Now, a case control study published in journal LANCET clears the air further although molecular reasons behind this mystery began to emerge much earlier. We must not forget that similar findings were earlier reported in the journal CURRENT SCIENCE by Dr. Mukul Das in 2014, followed by later correspondence in 2015. Keeping the controversy aside the underlying mechanism is really interesting.
Mortality was observed to be significantly high in malnourished children who skipped their evening meals. The normal stores of glycogen in liver is sufficient for short term energy needs in normal healthy children, which is followed by oxidation of fatty acids in an event when glycogen stores are depleted. Now, in malnourished children this step is short-circuited with direct activation of fatty acid oxidation, in the absence of glycogen. Two naturally occurring molecules in litchi, hypoglycin A and methylenecyclopropylglycine (MPCG) , are known to disrupt fatty acid metabolism, which in turn greatly reduce the glucose levels in the bloodstream. The poor supply of glucose further caused irreversible damage to brain, followed by seizures and unconsciousness.
Hypoglycin A has been earlier linked to hypoglycaemic encephalopathy in Jamaica. It is abundantly present in ackee fruit, which is from the same soapberry family as litchi. Both these molecules have been known to induce similar symptoms in animal studies.
Most of the deaths in India were reported in families of litchi harvesting labourers. As the Current science correspondence revealed, the singular fruits dropping on the ground were left for consumption by children as litchi is mostly sold in bunches. The heavy intake of fruit along with skipping of evening meal worsened the situation. Public education and simple intervention steps as healthy cooked evening meal and infusion of dextrose in case children are rushed to the hospital is already saving many lives.
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