A Jump-Start into the World of Nutrition

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On June 7th, 2018, only three-days after starting my summer internship with Sight and Life, I found myself on a long-haul flight traveling to Boston, Massachusetts, from Switzerland. I was invited to join the Sight and Life team at the American Society for Nutrition’s (ASN) Nutrition 2018 conference – what an incredible opportunity! I could not have been more excited for this perfect introduction into the world of nutrition, particularly since I am interested in applying my current academic background in economics and law to the field of nutrition.

Initiation as an Intern

On the first day, I participated in a team workshop where I met the global team of Sight and Life – such an interesting mix of people! As a complete newbie, I quickly observed that the team is held together by their passion for nutrition, as their backgrounds are quite diverse. Besides nutritionists and scientists, I was stunned to discover there is an assortment of business, communications, marketing, and architecture degrees amongst the group. Additionally, I gained insight on how Sight and Life operates. The team of twelve is spread across four different continents – India, Egypt, Switzerland, South Africa, and USA – completing the majority of their work remotely and therefore making team retreats of great importance.  


The workshop focused on ‘design thinking’ and was a great opportunity for everyone to learn a new method of problem solving. Additionally, having a team with a wide variety of knowledge and experiences presented interesting and rich discussions the during group exercises. The most valuable take aways, for me, were learning the importance of a broad stakeholder analysis, defining a high potential but underdeveloped stakeholder, and how you can engage with an assortment of stakeholders within a complex interdependent system. This mirrors the importance of a multi-sector and multi-stakeholder approach to solving the complicated malnutrition puzzle. The day culminated at Fenway Park cheering on the Boston Red Sox’s as they played the Chicago White Sox for a Sight and Life team outing. 

A Peek into Nutrition

For the next three days, I participated in ASN’s Nutrition 2018 at the Hynes Convention Center. As I have never been to a conference, let alone one focused on nutrition, and I was eager to see how it all worked. With over 3,500 participants registered, it was shaping up to be the largest ASN conference so far. When I walked through the main entrance for the first time, I thought something probably quite typical of a European in America, “Oh my god, this is so big!” Sight and Life showcased a booth in the gigantic exhibitors hall, but there was also several floors of meeting rooms where I would spend the coming days in listening to interesting presentations. 

ASN, Sight Life, Nutrition2018, conference, malnutrition

Eager to learn, I attended as many sessions as I could possibly fit into my schedule covering a wide variety of nutritional topics. I didn’t know what to expect when I saw the list of speakers for each session, naively I thought they would all sit in front and have a panel discussion. However, they were mostly individual presentations sharing the results from their recent research. I learned about behavior change communication, nutrition education, heard about different nutrition strategies and their implementation, and community health interventions that were completed in India and one in a refugee camp in Beirut.
 
For me, the most interesting session was “Demographics, Diversity and Disparities in Nutrition Science”. A few speakers presented research that was focused on a specific region in Hawaii, USA, and an ethnic group of American indigenous people while others presented nutrition issues and development on the global level. The most shocking session I attended was, without doubt, about the nutrition situation of Native Americans by Dr. Donald Warne, a member of the Oglala Dakota tribe from South Dakota, USA. He provided extensive evidence that one does not have to travel far to find health issues as they exist in native communities in the United States of America. He argued that it is almost perverse that in America you are automatically eligible for dialysis in the case of kidney failure; yet, a child is not automatically eligible for healthy food. An anecdote that resonated with me was a story Warne shared of three sisters illustrating the importance of targeting health problems at their roots.

As three sisters walk along a river, they see there are children in the river who cannot swim and are about to drown. One of the sisters says, “Something needs to be done.” She jumps into the river and tries to save the children. The second sister disagrees with the first one saying, “We just need to teach them how to swim!” The third sister has not said or done anything, and the other two are furious with her. “Why aren’t you helping us?” they exclaim, “These children need to be saved!” The third one turns away and starts to walk up the river saying, “I will find and stop the person who is throwing these children into the water.”

Experiencing the Conference

During the three days, my time spent at the Sight and Life booth was both busy and truly engaging. I found it most interesting to talk to students, researchers, journalists, and scientists from all over the world and explain what Sight and Life stands for. It was intriguing to visit the other exhibitors at the conference presenting a variety of nutrition topics from non-profit organizations fighting malnutrition to private corporations offering vitamin supplements. One booth representing a company called Allulite Rare offered samples of chocolate and gummys made with a new kind of sweetener that tastes just like sugar, but without all the disadvantages such as calories, glycemic effect or digestive upset. At the InBody exhibit, I had a body measurement analysis done free. This machine provides individual results for weight and body fat percentage as well as the distribution of lean muscle mass in less than a minute. 

Sight Life, Elevator Pitch Contest, EPC, Finalists 
A highlight for Sight and Life was the Elevator Pitch Contest, where selected students and young researchers presented their innovative ideas on nutrition assessment to a panel of experts. It was fascinating to hear about these cutting edge concepts and that many people my age share the passion for nutrition. Many of the presentations introduced fascinating new mobile applications for measuring food intake. One of my favorite pitches was from Andrea Spray of INATU, standing for ICT’s for Nutrition Agriculture and Time Use. By attaching a tiny camera to women’s clothing, the device provided in-depth research for nutrition assessment as the device automatically takes a picture every minute. Her project in Africa proved that the gadget was generally well received in communities and proved to be a good option for measuring nutrition behavior remotely without much paperwork – this was an interesting idea. It is impressive to see the tremendous progress that can be made in a relatively short time when one is focused on a goal and teams up with the right people.
 
After spending a sunny day sightseeing in Boston, I once again found myself onboard a flight back to Zurich. It was an incredible experience. I learned so much about nutrition, the broadness of the worldwide nutrition issues currently at hand and the importance of bringing all stakeholders to the table. I would like to thank the Sight and Life team and my boss, Klaus Kraemer, for making this possible and for welcoming me into the Sight and Life family.

Take a look through the picture gallery from ASN: 

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Where are they now?

Sight and Life Elevator Pitch Contest Finalists

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Ever wonder what happened to the first Sight and Life Elevator Pitch Contest finalists from 2016? Sight and Life had the privilege of catching up with four of the ten finalists from Elevator Pitch Contest to find out what they are up to now and reflect on their experience.

EPC, Elevator Pitch Contest

 
During this competition, graduate and post-doctoral students were invited to submit their ideas on the theme ‘The Future of Micronutrient Innovation’ across diverse categories in nutrition-related products, services and technologies. We received over 90 submissions from students in 18 different countries. With the support of a distinguished jury, we narrowed the selection to ten bold ideas for presentation. The finalists were sponsored by Sight and Life and Tata Trusts, who mentored them as they prepared to present their ideas to a panel of experts, in front of an audience of conference participants during the Micronutrient Forum in Cancun, Mexico. Read more about the 2016 Sight and Life Elevator Pitch Contest here

The first and second place winners, Muzi Na and Nicholas Myers, share their status and weigh in on the Elevator Pitch Contest along with finalists Nicholas Myers and Sambri Bromage. 
 
Uzi Na, Elevator Pitch Contest FinalistMuzi Na
Location: China
Concept: Empower Grandparents – A mobile application using SMART feeding messages that empower senior caregivers, such as grandparents, to better feed their grandkids in rural China.
 
Na was the first place winner of the 2016 Elevator Pitch Contest with her innovative mobile phone application and persuasive pitch. Today, the idea is on paper with plans to write grant allowing her to collect data about acceptability regarding the idea among the target population. Currently, Na is on faculty at Penn State University as an Assistant Professor in Nutritional Epidemiology.

EPC, Elevator Pitch Contest, Philip James

Philip James
Location Gambia
Concept: Next Generation Supplement Design – A novel nutritional supplement to optimize the mother’s micronutrient status in early pregnancy to better regulate infant epigenetics and decrease future disease risk.
 
A future full of potential, James caught the attention of the jury panels with his inventiveness in 2016. The nutritional supplement has now been designed and is currently in the process of setting up a clinical trial in Gambia to test its effectiveness in correcting micronutrient deficiencies. James and histeam is also looking at how nutrition in pregnancy, particularly at the time of conception, has the potential to influence the way an infant’s genes are expressed, and the implication this may have for the health of that child over his or her life.
 
EPC, Sight and Life, Elevator Pitch Contest Nicholas Myers
Concept: Paper Analytical Devices – A lab-on-paper that measuresiodine levels in salt and urine samples to monitor iodized salt programs at a low cost in real time. 
 
Myers has found support through The Black Lion Hospital, in conjunction with the Ethiopian Food, Medicine, and Health Care Administration and Control Authority, and is performing an implementation study in Ethiopia. If the study is successful, health agencies and governments may use the test card to monitor the quality of iodized salt in marketplaces.
 
With a shift from the nutrition field to public health, Myers has adapted the chemistry of his iodine test card to instead quantify the amount of penicillin-class antibiotics present in finished pharmaceutical pills with greater than 95% accuracy. His hopes are that the test card becomes a field-friendly technology that governments use to detect breaches in medicine compliance.

EPC, Elevator Pitch, Sabri BromageSabri Bromage
Location: Mongolia
Concept: Leveraging Academic Networks for Dietary Survey (LANDS) – A global student-centered network for collecting, analyzing, sharing, and applying dietary data from populations in low-and middle-income countries.
 
Today LANDS is used in Mongolia with interest to expend it internationally. Bromage is currently finishing his dissertation on “Epidemiology of dietary and micronutrient deficiencies in Mongolia” and beginning the search for a post-doc position or job. In tandem, he is working on new and interesting projects that he will be able to share in the future.

1. What did participating in the Sight and Life Elevator Pitch Contest mean to you personally and your innovation?

Na – The Sight and Life Elevator Pitch Contest meant a lot to me! Personally, the contest provided an opportunity for me to meet and know manyyoung innovators working in diverse fields all over the world. From the innovation’s perspective, the elevator pitch style is very different from writing a proposal or a manuscript, as there is a short window of time to articulate an idea, including the rationale behind the idea and the potential impact. I really want to thank Sight and Life for organizing this fantastic event, in which I discovered new possibilities to share and sell novel ideas that aim to tackle nutrition problems. 
 
James – It was a privilege to be short-listed for the contest. Being able to attend the contest at the Micronutrient Forum enabled me to meet so many people from different fields in nutrition, to network with people who were interested in my team’s project and to be able to benefit from everything else happening at the Forum.
 
Myers – As an inventor, I welcome any chance to disseminate information about my invention. At the competition, I pitched an idea about an inexpensive paper test card that quantifies iodine levels in fortified salt with greater than 90% accuracy and how it can be used in low- and middle-income countries. At the time of the contest, my invention was making its way through the “Valley of Death,” which is a relatively low funding period between R&D and commercialization. The contest provided a platform on which I, a chemist, reached hundreds of experts in the micronutrient sector, and these multi-disciplinary connections are critical to push an invention through the “Valley of Death” and to commercialization.
 
Bromage – Participating in the Sight and Life Elevator Pitch Contest helped me realize the international potential of my innovation. Personally, it exposed me to nutrition innovation, a part of nutrition I have not had much experience with as I mostly work in research.

2. What was the biggest challenge you experienced through the creation process of your innovation?

Na – I guess there were many challenges but the biggest one for me probably was to identify the ‘big’ problem that maybe solved by a ‘small’technology, which I understood. Once a niche target population was identified, the process to identify and design an intervention, applying feasible technology to serve the population was straightforward.
 
James – The field of nutritional epigenetics is still rapidly developing, so consolidating the evidence base to design a supplement was an interesting but challenging piece of work. 
 
Myers – The biggest challenge for me was overcoming small but daily setbacks. I had to rapidly prototype dozens of devices with relatively minor changes, most of which did not work. I came to term this ‘Edisoning’ as Thomas Edison had to follow a similar process as he trialed 2000+ materials to develop the light bulb. My technology and I survived the research and development phase because I saw the benefits of the final product outweighing the emotional, physical, and monetary costs to create it.
 
Bromage – My biggest challenge is getting other people interested in my innovation because I am not really a natural born salesperson.

3. What was the most memorable moment from the Sight and Life Elevator Pitch Contest?

Na – It was the moment I decided to stay among the audience and not to give the pitch behind the podium. It was a completely random thought, mostly because I was very nervous. Once I started my pitch right next to the first row of listeners, I immediately felt a connection with the audience. It was an amazing feeling and my nerves immediately disappeared.
 
James – The session when we delivered our presentations was a great experience. It was so good to hear everyone’s pitches, get inspired by the creativity in the room, and to have the support of a room full of interested people. It was also encouraging afterwards to network with people who had further questions and advice.  
 
Myers – The moments I enjoyed the most happened behind the scenes when all the innovators had the opportunity to get to know each other personally. We are not just a bunch of mad scientists- we are a group of seemingly ordinary people with a shared desire to improve health, and with the motivation to do so.
 
Bromage – Getting to meet the other contestants and the Sight and Life team including Kalpana Beesabathuni, Kesso Gabrielle van Zutphen, and of course Klaus Kraemer.

4. What lesson(s) did you learn from your experience?

Na – Be bold, be confident. No idea is too small to share. Lastly, but not least, it is important for any speech-based contest to practice, practice, and practice. 
 
James – It was a great opportunity to learn how to explain an idea succinctly and avoiding technical jargon. An elevator pitch is a very different style of communication than I was previously used to and this was the ideal setting to learn more about how to develop those skills.
 
Myers – Even though I was one of the winners, investors and buyers are not knocking down my door to advance the technology. The lesson I learned is that perseverance is needed at all steps of product development and that I will have to keep pushing just as hard as I did through the research and development stage to survive the commercialization phase of my invention. It took a lot of hard work and gumption to achieve what I have so far, and it will take at least as much to reach the next level.
 
Bromage – Some of the greatest innovations are not devices but rather new ways of thinking about the world.

5. Where do you see the future of nutrition?

Na – I see a lot of potential for the future of nutrition is from the interdisciplinary perspective, where technology, engineering, biology, and other disciplines interact with nutrition making groundbreaking discoveries as well as solving critical nutrition and health problems.
 
James – I see a future where nutrition continues to be integrated with other sectors and disciplines. In my field that means analyzing nutritional biomarkers together with metabolomics, genomic, and epigenomic data to broaden our understanding of the complexities of human metabolism. 
 
Myers – The future of nutrition relies on all of us being citizen scientists making information-based health decisions. Ordinary people need to be provided easy-to-use and robust technologies to help them with these choices. We saw this at the competition, especially with the technologies presented by the three winners.
 
Bromage – Dealing with the effects of climate change.

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International Society for the Study of Fatty Acids and Lipids (ISSFAL) 

Congress Report 

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ISSFAL

The International Society for the Study of Fatty Acids and Lipids (ISSFAL) was established in 1991, with the main objective of providing a better understanding of the role of dietary fatty acids and lipids in health and disease through research and education. The 13th congress of ISSFAL was held at the MGM grand hotel and casino in Las Vegas, Nevada, USA. This congress provided a very unique opportunity for me to learn from the seasoned researchers and experts in my area of interest. Approximately 500 scientists, health professionals, administrators and educators with an interest in the health effects of dietary fats attended the congress. 

The ISSFAL program was well organised and comprised different satellite symposia, plenary and parallel break-out sessions. ISSFAL hosted two satellite symposia on Sunday, May 27. On this day, the registration desk was open and accessible through out the whole day. I attended the satellite symposium on arachidonic acid (AA) and docosahexaenoic acid (DHA) in infant and development. An international panel of thought leaders in this area were assembled specifically for these presentations and the symposium highlighted the biological functions of AA and DHA in early human and animal development.

In the evening, there was an opening reception at the Tropicana Hotel where the congress chair Hee-yong Kim from National Institutes of Health welcomed the attendees to Las Vegas and the congress. Kim encouraged all young investigators and junior scientists to take advantage of the many events within the program to interact with the seasoned researchers and experts in the field of fatty acids and lipids and foster interaction among all participants. These included the ‘meet the Professors breakfast’ and ‘young investigator social’ providing networking opportunities with people from different parts of the world. At that moment I realized that there is more to research than collecting data and writing articles, it’s all about being part of something, socializing with people who share similar interests and coming together to help improve the world we live in. 

The program for the congress covered three major topics: Biochemistry and Metabolism of Fatty Acids; Lipids in Health and Disease; and Lipids in Nutrition. These major themes encompassed all other aspects of lipids including but not limited to lipidomics and metabolomics, which are all important for understanding human physiology and pathophysiology. The actual scientific congress started on Monday, May 28 and ended on Thursday, May 31. Each day began with one plenary session in the morning, followed by three parallel break-out sessions, another plenary session soon after the lunch break and three parallel break-out sessions after the afternoon coffee break. All in all, there were six plenary sessions and 24 parallel break-out sessions. Presentations ranged from translational research to clinical studies. Most presentations provided evidence about the impact of lipids in different clinical diseases and a clear understanding of the role that dietary lipids play at all ages in preventing diseases related to lifestyle. 

Below are a few key learnings from my experience at ISSFAL:

Maternal and Infant Nutrition 

– Results from a randomized controlled trial showed that enteral DHA supplementation with 60mg per kilogram of DHA resulted in a greater risk of lung inflammation in very preterm infants. Therefore, these results did not support supplementing very preterm infants with DHA above levels currently available in breast milk and recommended in infant formula. 

– Other analyses highlighted the importance of controlling for environmental factors when evaluating nutritional interventions. Furthermore, differences in brain function and behavior were observed in children more than 5 years after in utero DHA supplementation. However, boys may be more vulnerable and tend to benefit more from early supplementation.

– The importance of long chain polyunsaturated fatty acids (LCPUFAs) in infant formula is still evolving. Polymorphisms add an entirely new dimension, particularly, the FADS status of the mother and infant should be considered when designing future studies. In addition, fortified infant formula milk should contain both DHA and AA, because there is insufficient clinical trial evidence for the safe removal of AA in infant formula milk containing DHA. 

Clinical Trial Methodology 

–  It is important to optimize the differences between the treatment and control groups to ensure that effects are detected, if any. The interpretation of results solely depends on the background diet, dose of fatty acid intervention and use of appropriate control diets or supplements. Research is important for assessing different trial outcomes, therefore, it is important to have realistic expectations and outcomes. 

– At the beginning of a trial, it is important to consider the design of tools to enable effective organisation of the study protocol with the aim of improving compliance. Of importance is a communication plan, study timeline, data management and monitoring plan as well as the establishment of appropriate committees. The full lifespan of the project must be examined, giving special attention to defining roles, training a skilled research team and creating a comprehensive manual of standard operating procedures. 

– Also critical is further refining relationships with institutional support sectors including institutional review boards, research institutes, and clinical stake holders. When conducting clinical trials, it is important to be vigilant and focus on the goal as well as to keep contact on the ground on the project’s routine needs thus allowing your team to not only keep momentum but also to anticipate a variety of road blocks at any stage of the trial. 

Dietary Fatty Acid Intake 

– In Canada, healthy toddlers are not meeting the recommended dietary intakes of DHA and AA. 

– Moreover, in the United States of America, the current recommendation of 2 servings of fish per week in adults is unlikely to result in a desirable omega 3 index. Thus, at least 3 servings of fish per week plus an EPA+DHA supplement appears to be necessary to achieve this target level. 

I also attended the Alexander Leaf award ceremony and had the privilege to listen to Maria Makrides’ (South Australian Health and Medical Research Institute & School of Medicine, University of Adelaide, Australia) lecture titled, “Standing on the shoulders on giants: Great women role models of my career”. From this speech I learnt that: 

– It is important to keep your eye on the horizon. Be clear about your destination and how you want to get there. Keep trying out new things, adjust and modify your journey accordingly. Sometimes you want to think that your career will be linear, always a step forward, but along the way you will find a lot of sharp turns. Even then, do not cut too many corners in the process because the value of the outcomes is strongly linked to the quality of the research process. 

– It’s all about creating opportunities and preparation. Learn from as many people as you can along the way. Be open to new possibilities and by so doing you will always have a runway for continuing to explore new areas of research and stretching yourself beyond limits. Also, remember to be kind to yourself and to others. Have fun and enjoy the journey. 

Congress report, DHA
Linda P. Siziba standing by her poster at the ISSFAL congress

Poster presentations were done every day during lunch and coffee breaks. I had the privilege of presenting my poster entitled “Associations of plasma total phospholipid fatty acid patterns with feeding practices, growth and psychomotor development in six-month old South African infants.”

Furthermore, some activities were organised to enable everyone to meet and socialize with other delegates at the congress. In addition to the welcome reception, I also had the privilege to attend the ‘DSM 1000 days award breakfast’, DSM Science and Technology Award reception, young investigator social and ‘meet the Professors breakfast’. Wednesday, May 30 was an ‘off-day’ and this was an opportunity for everyone to explore Las Vegas and surrounding areas. There was a variety of tours and activities to choose from which included but were not limited to a helicopter ride or a drive to the Grand Canyon. The congress officially ended on Thursday, May 31 with a gala dinner, where we had an amazing ‘German’ experience, while in Las Vegas, at the Hofbräuhaus. 

I would like to express my utmost gratitude to Sight and Life, DSM, Centre of Excellence for Nutrition and my promoters (Prof Marius Smuts and Prof Jeannine Baumgartner) for generously contributing towards making my ISSFAL congress attendance possible. It was indeed a unique opportunity for me as a budding researcher for personal branding, networking and learning even more about fatty acids from leading scientists in the field. 

Correspondence: Linda P. Siziba, PhD student at Centre of Excellence for Nutrition, North West University, South Africa. Email: sizibalinda@gmail.com

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Expand your Knowledge

Recommended Reading on Behavior Change Communication

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At Sight and Life, we are pleased to share knowledge and recommend resources that we find useful in our work. This is certainly the case with behavior change communication (BCC).

To expand your knowledge about the steps in the Sight and Life BCC Process we shared during the webinar “Assessing the Situation: What you need to know” in our BCC webinar series, we have collated an array of books, websites, and papers that are valuable resources. This is just our opinion but we hope these recommendations can deepen your knowledge on BCC and provide though-provoking ideas and inspiration as it did for us.

During this second webinar in the series, we discussed Step 2 and Step 3 in the Sight and Life BCC Process; the desk review and client research.

Bcc Process Cycle, behavior change, nutrition

The key takeaways from this webinar are:
– The BCC principle ‘know your audience’ lies at the core of developing successful nutrition communication campaigns. 
– Defining your knowledge needs, or simply what you need to know, is the first critical consideration.
– Step 2 in the BCC process isabout assessment, analysis, and synthesis of information to effectively answer questions on the broader context, thedrivers and constraints for the target behavior and communication efforts previously employed to change the desired behavior.
– Client research, step 3 in the BCC process,involves gaining valuable insights from the target audience and communities that you seek to change. 

Watch the video of webinar 2 below and find the complete slide deck from the second Sight and Life webinar HERE.

Our Recommended Resources on BCC from Webinar 2

 

Research Paper
1.
Download the paper by Population Services International (PSI). A Qualitative Research for Consumer Insights: One Organization’s Journey to Improved Consumer Insight HERE

In this paper, PSI, a leading social marketing and behavioral change communication NGO describe how they improved the use of research to gain better consumer insights and plan better interventions. It offers a practical perspective through the lens of an organization where research is core of the business.

Why do we like this?
We think this paper is insightful for any organization wishing to strengthen their qualitative research capacity for improved target audience insight generation. The paper lays out how an organization focusing on behavioral change, has sophisticated their approach to qualitative research to improve their programmes over time.

Useful Websites
2.
The Health COMpass
The Health COMpass is a platform offering a wealth of useful resources from different proven sources, for researchers, from specific guides on data collection methodsfor the field to more comprehensive guides on how to conduct formative research. It is funded by USAID and managed by Johns Hopkins University Bloomberg School of Public Health.
 
Why do we like this?
The Health COMpass provides evidence based, easy to understand tools – ready to take and apply to a real-life context for beginner and specialists in behavioral change alike.
 
3. The UK National Social Marketing Center
This former non-profit and now agency offers a comprehensive step-by-step guide on developing a behavioral change intervention. Of specific interest is the section on generating insights, in their planning guide as well as the real-life examples of behavioral change interventions, in the show case section, you can learn how insights were derived from research to development. 

Blog
4.
Innovative Research Methods – Roleplay
As we often conduct research on topics that can be sensitive such as personal health or child feeding practices, creating an environment where the interviewee feels comfortable and at ease enough to open up to the interviewer is often a challenge. The choice of a research method which best fits the environment is key. Using roleplay for research is an innovative way to allow the interviewees to ‘act-out’ their behaviors, concerns, beliefs, and barriers with others rather than be interviewed. IDEO, a social innovation consultancy, uses this method successfully and provides free tools to download.

Another interesting blog post about the use of role play in research is “Candy Wrappers and Stethoscopes: Role-play in the user testing environment” written by Estee Liebenberg, a service design consultant.
 
Why do we like this?
Innovative research methods to tailor how we approach our audience and adhere to their needs and contexts is an important part of ‘knowing your audience’. Roleplay provides an applicable research method and in this blog post the author and practitioner of roleplay provides great insight into how this methodology works in practice.

Book
5.
Thinking Fast and Slow by Daniel Kahneman
 Drawing on decades of research in psychology that resulted in a Nobel Prize in Economic Sciences, Daniel Kahneman takes readers on an exploration of what influences thought example by example. System 1 and System 2, the fast and slow types of thinking, become characters that illustrate the psychology behind things we think we understand but really don’t, such as intuition.
 
Why do we like it?
In webinar 2 we talked a lot about the BCC principle ‘know your audience’ and this book is an interesting examination of human behavior and how we think. It is a comprehensive explanation of why we make decisions the way we do and how the decision-making process can be improved. An interesting tidbit is our decisions are strongly colored by how we frame questions in our minds. Simply re-framing a question can easily cause people to reverse decisions. We need to understand these framing issues in order to avoid bad decisions. This provides useful insights for BCC interventions aiming to influence the decision-making process.

Webinar 2 Sources
And lastly check out these great sources our experts referred to during webinar 2! 

6. Merritt, RK. Bsc, D.Phil  (2011). Developing your  Behaviour Change Strategy ‘How To’ Guide.  On behalf o f NHS East London & the city.  Tower Hamlets PCT. 
 
7. Dickin, Kate and Marcia Griffiths, The Manoff Group, and Ellen Piwoz, SARA/AED. Designing by Dialogue. Consultative Research to Improve Young Child Feeding. Support for Analysis and Research in Africa: Washington, D.C.: AED for the Health and Human Resources Analysis (HHRAA) Project, June 1997 
 
8. Focused Ethnographic Study of Infants and Young Children Feeding Manual

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Assessing the Situation

What you Need to Know 

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Recently listening to TEDxCSU Talk on behavior change led by Professor Jeni Cross from Colorado University, I was immediately struck by how we routinely rush the planning stage of a behavior change communication (BCC) intervention. Taking time to understand where we are, where we want to go, and what will enable us to reach our goal is essential in devising a successful nutrition communication campaign. Resonating with this topic is the second webinar in Sight and Life’s Webinar Series “Assessing the Situation: What you Need to Know.” It is a valuable and timely reminder on the importance of understanding your target audience during the BCC planning process. 

During this enlightening dialogue Professor Cross spoke candidly about the existing myths regarding behavior change. For example, does education change behavior? What we know about education is how the information is presented, rather than the information itself, creates behavior change. Making learning tangible, personalized, and incorporating social interaction provides the greatest impact in behavior change.  

Another misconception is that one needs to change attitudes to change behaviors. Attitudes do not predict behavior! A more effective strategy is to connect to people’s values to set behavior expectations. The last myth is that people know the triggers that motivate them. Professor Cross argues this is not the case, as social norms have, by far, the greatest influence on human behavior. For instance, if you see someone select a healthy option at lunch, then you are more likely to follow suit. Understanding these constructs in human behavior is important because they are the core of developing successful nutrition communication campaigns.  Watch the TEDxCSU Talk below: 

Keep this principle thought in mind as you embark on the next steps in the BCC process presented in Sight and Life’s second webinar in the BCC Webinar Series. 

The Journey to Understanding your Audience 

Here are the questions to ask as you embark on step 2 and 3 in the BCC process:   
– What is it that I really need to know about my audience and the environment in which they live? 
– What works and does not? 
– How do I get to the core of what matters to my target audience? 

Webinar 2 walks through the typical knowledge needs required for a BCC intervention in nutrition, examines how to get the most out of each knowledge source and suggests approaches that enable a deep understanding of the target audience.  

BCC Process Step 2. The Desk Review 

Before beginning the desk review, be sure to answer the question, what is the purpose of this information and how do you plan to use it?  

The desk review encompasses three elements: 
– Exploring the broader context
– Reviewing the effectiveness of past experiences
– Understanding program context (reaching your target audience) 

In summary, elements 1 through 3 of the desk review help define the scope of your communication strategy. These identify the broad parameters and constraints to use when designing and delivering the intervention while also supporting the critical decisions when creating a communication strategy.  

BCC Process Step 3. Client Research 

The next step in the BCC process involves acquiring valuable insights from the target audience and communities you seek to change. We are again reminded of the BCC principle; know your audience!  

BCC, Nutritional Status, conceptual Model, behavior communicationDuring webinar 2 we share three key components in client research which support the gathering of comprehensive information on the target audience and factors that influence behaviors and practices; the inquiry framework (what do you need to know about the behaviors), applicable research methods (how to extract that information), and insight generation (moving from understanding behavior to finding deep, shared truths). 
BCC, Nutritional Status, conceptual Model, behavior communication
Consider the questions posed at the start of this blog: what do I need to know about my audience and the environment in which they live, what works or does not, and how do I get to the core of what matters to my target audience? Steps 2 and 3 help you answer these questions.  

Key Takeaways from Webinar 2 

– The BCC principle ‘know your audience’ lies at the core of developing successful nutrition communication campaigns.  
– Defining your knowledge needs, or simply what you need to know, is the first critical consideration.  
– Step 2 in the BCC process is about assessment, analysis, and synthesis of information to effectively answer questions on the broader context, the drivers and constraints for the target behavior and communication efforts previously employed to change the desired behavior.
– Client research, step 3 in the BCC process, involves gaining valuable insights from the target audience and communities that you seek to change. 

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Essential Reading on Behavior Change Communication (BCC)

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At Sight and Life, we are pleased to share knowledge and recommend resources that we find useful in our work. This is certainly the case with behavior change communication (BCC)! To continue learning about BCC while waiting for the upcoming webinar, we have collated an array of books, websites, and e-learning modules that are valuable resources. This is just our opinion but we hope theses recommendations can deepen your knowledge on BCC and provide though-provoking ideas and inspiration as it did for us. 

During the first webinar in the Sight and Life Webinar Series focusing on behavior change communication (BCC), we examine integrating BCC into nutrition programs. The key learnings are:

– BCC is a communication approach with distinct underlying principles, which make it a valuable part of nutrition programming.
– It is complicated but can be managed by taking a systematic approach.
– Consider the Sight and Life BBC process cycle as a tool to support planning your nutrition communication campaign.

Find the video and the complete slide deck here from the first Sight and Life webinar People eat food not nutrition: Integrating BCC into nutrition programs HERE.
Behavior change communications, BCC, SBCC 
On May 15th we will be hosting our second webinar Assessing the situation: What you need to know (please register HERE). In this webinar we will identify the typical knowledge needs for BCC intervention in nutrition. We will discuss how to get the most out of the knowledge sources, including written material (program reports, scientific papers), experienced program stakeholders, knowledgeable service providers, and of course, your target audience. Additionally, learn tips for tailoring formative research to generate insights on the factors driving eating behaviors.

Our Recommendations on BCC

E- learning:

1. This interactive course by Strengthening Partnerships, Results, and Innovations in Nutrition Globally project (SPRING) will guide you through narrated slides, quizzes, exercises, handouts, videos, and links to helpful resources. This course will help you understand agriculture’s role in improving nutrition, learn how to use behavior change methods to prioritize and promote nutrition-sensitive agriculture practices, and develop a behavior change strategy for current and future agriculture projects. Find it HERE.

Reading

2. Read this work SPRING; Evidence of Effective Approaches to Social and Behavior Change for Preventing and Reducing Stunting and Anemia to learn the findings from a systematic literature review. 

Lamstein, S.,T. Stillman, P. Koniz-Booher, A.Aakesson, B. Collaiezzi,T.Williams, K. Beall, and M.Anson. 2014. Evidence of Effective Approaches to Social and Behavior Change Communication for Preventing and Reducing Stunting and Anemia: Report from a Systematic Literature Review. Arlington,VA: USAID/ Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) Project.

Toolkit

3. Behavior Change Toolkit  – for International Development Practitioners
This behavior change toolkit is a useful, well written and simple introduction to BCC. A great resource for those starting their learning journey on BCC. The toolkit can be downloaded HERE.

Books

4. Nudge: Improving Decisions about Health, Wealth, and Happiness, Richard H. Thaler, and Cass R. Sunstein.
A book from the winner of the 2017 Nobel Prize in Economics, Richard H. Thaler, and Cass R. Sunstein: it is a revelatory look at how we make decisions. The authors examine the process of how people think, and suggest that we can use sensible “choice architecture” to nudge people toward the best decisions for ourselves, our families, and our society, without restricting our freedom of choice. Nudge is really about the small, subtle pushes that our modern-day world makes to sway one’s opinion or real-world choices.

Why it’s on our Kindle’s
To succeed in behavioral change we must be able to offer people better, more favorable and less costly choices to what they are currently doing. To reduce the consumption of junk food in teenagers for example, we must be able to design alternatives that are equally desirable. Therefore, we must build an architecture that will encourage people to change their habits and follow our behavioral goals. We loved reading the real life examples in this book and learning how simple, thoughtful ‘nudges’ can help people change a variety of behaviors. Find it HERE
 
5. The Power of HabitWhy We Do What We Do in Life and Business, Charles Duhigg 
In The Power of Habit, award-winning New York Times business reporter Charles Duhigg takes us to the edge of scientific discoveries that explain why habits exist and how they can be changed. It uses research to explain how habits are formed and changed. At its core, The Power of Habit contains an exhilarating argument: The key to exercising regularly, losing weight, raising exceptional children, becoming more productive, building revolutionary companies and social movements, and achieving success is understanding how habits work. 

Why we think it’s an essential read for BCC
We recommend The Power of Habit as an easy and fun to read introduction into the science of habit formation and the art of attempting to change them. As nutrition program managers, most of the time, our challenges go beyond changing people’s behaviors. Changing what and how people eat requires us to understanding people’s daily habits and then help them to adopt new routines. This book an excellent foundation to understand the particulars of habits. Buy your copy HERE.  

6. The Tipping Point, Malcolm Gladwell
The tipping point is that magic moment when an idea, trend, or social behavior crosses a threshold, tips, and spreads like wildfire. The Tipping Point explains the phenomenon of why some products, businesses, authors, etc. become hugely successful (tip) while others never seem to break apart from the masses as anything special. Buy your copy HERE.

Why we think it’s relevant to BCC
We think The Tipping Point is a great read to understand how change happens and what makes a behavior tip. Successful interventions and campaigns aimed at changing people’s routines have certain critical characteristic in common: They manage to gain followers, naturally mobilize the audience, and make the behavior contagious instead of imposing it. These initiatives succeed in making the behavior desirable, the message exciting and memorable – like a jingle that naturally ‘sticks’ – and they understand that ‘little things’ in people’s lives matter.

Happy reading!

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The Vitamin A Supplementation (VAS) Controversy

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A recent report and podcast from the British Medical Journalhas revived the controversy on when to scale back high-dose vitamin A supplementation (VAS) to reduce child mortality.We believe only compelling evidence can justify scaling back this intervention for the reasons pointed out below.

VAS is a Safe and Cost-effective Strategy for Reducing Child Mortality

Estimates from the World Health Organization (WHO) indicate that still 190 million children aged under five (U5) are vitamin A deficient (VAD).VAD increases the risk of disease and death from severe infections, and is the leading cause of preventable blindness in children U5. Well-controlled randomized trials in different regions with a high prevalence of VAD have conclusively demonstrated that high-dose vitamin A supplementation (VAS) given every four to six months to children U5 is an efficient and cost-effective strategy for reducing child mortality. VAS programs have largely contributed to the reduction in U5 mortality rates over the last decades.

Vitamin A, VAS, DEVTA, Supplementation, Child mortality 
A 2011 Cochrane review of 17 randomized controlled trials (RCTs) in 9 countries concluded that VAS results in a 24% reduction in U5 child mortality rate.This reduction in all-cause mortality confirmed an earlier meta-analysis from 1993, in which WHO’soriginal VAS guidelines were based upon and adopted by over 80 countries. There is also strong evidence, from both community and clinical trials, that VA prophylaxis and treatment can reduce the severity and fatality from measles, diarrhoea, and reduce the risk of hearing loss following middle ear infections. The most recent 2017 Cochrane reviewof 47 RCTs conducted in 19 countries concluded that vitamin A supplementation to U5 results in a significant 12% reduction for both all-cause mortality and mortality due to diarrhoea.6

DEVTA Contradicts the Evidence of VAS on Child Mortality

Cutting in half VAS effect on mortality between the 2011 and 2017 Cochrane reviews differ due to the latter’s inclusion of the DEVTA (Deworming and Enhanced Vitamin A) study,a large-scale program evaluation in the state of Uttar Pradesh, India. The ‘DEVTA study’ was an attempt to evaluate a large supplementation program providing VAS every six months through routine services. Approximately two million preschool children were reportedly enrolled through the Anganwadi Centres of the Integrated Child Development Scheme (ICDS) for the study and comparisons were made between usual care, 6-monthly VAS, 6-monthly albendazole (for deworming), or both. The intervention continued for 5 years and concluded that VAS did not reduce child mortality, although there was a 4% non-significant decline.

The DEVTA Study Had Limitations in the Program Design, Implementation, and Evaluation

Certain elements in the program design may shed light on the lack of effect in DEVTA. The research activity was vastly under-staffed with only 18 monitors overseeing the work of over 8,300 Anganwadi workers and the participation of two million children. This lack of human resources required the number of children and their levels of compliance to be determined only from a mid-study census using anon-random opportunistic sample of 2,106 children out of two million, therefore leaving the estimate open to bias. Thus, this number represented ‘compliers’ at the time of the census, rather than the numbers of children and capsules taken throughout the intervention. The authors reported an overall compliance of 86%, raising questions about accuracy of record keeping. Finally,the DEVTA evaluation also did not include younger children between 6-12 months, who normally account for one-third of the deaths in children U5 and would have benefited most from VAS.

The DEVTA Results Should Not Be Combined with Other Trials

Delivering VA to children every six months is a well-established intervention to reduce child mortality. The DEVTA study represented an earnest attempt to assess a large VAS program run by the Government of India with only a non-significant reduction in child mortality. The evaluation was expected to have revealed a greater program impact. The reasons for this ineffective program were due to how it was run and evaluated, problems that commonly afflict most large intervention strategies. There are many lessons to be learned from this undertaking, both with respect to VA delivery and program design, implementation, and resources needed for running and evaluating programs. We encourage the global scientific community to resist combining the DEVTA findings (as done in the 2017 Cochrane review) with those of previous, rigorously conducted trials to reset the overall “efficacy” of VA in reducing child mortality. Doing so could send the wrong message that mixing program evaluation results with those of well-controlled randomized human trials is an acceptable strategy, when it is not, especially when millions of children lives are potentially at stake.

Scaling Back of VAS Requires Compelling Evidence

As VAS saves lives, eyesight, and hearing of children only irrefutable evidence can justify scaling back this intervention. While continuing VAS programs, it is also critical to address the direct and underlying causes of VAD through effective interventions (e.g., dietary diversity, breastfeeding, fortification, hygiene, etc.). According to the Global Alliance for Vitamin A (GAVA),9it would only be justifiable to scale back VAS if VAD were no longer a public health issue (<5% biochemical VAD at population level). Only evidence from regular data collection in countries (at least every 10 years for VA intake and status data in children), or other data indicating a reduction in VAD, shall inform decisions to phase out of VAS.10

WHO Recommendations

In settings where VAD is a public health problem (prevalence of night blindness is 1% or higher in children 24–59 months of age or where the prevalence of biochemical VAD (serum retinol 0.70 µmol/L or lower) is 20% or higher in infants and children 6–59 months of age), high-dose VAS (200,000 IU) is recommended for children 12–59 months of age (with a single half-dose for infants 6-11 months of age) every 4-6 months.5

References

1. Mason JB, Benn CS, Sachdev H, West KP Jr, Palmer AC, Sommer A. Should universal distribution of high dose vitamin A to children cease? BMJ. 2018 Mar 1;360:k927. doi: 10.1136/bmj.k927.

2. Mason JB, Sanders D, Greiner T, Shrimpton R, Yukich J. Vitamin A deficiency: policy implications of estimates of trends and mortality in children.Lancet Glob Health. 2016 Jan;4(1):e21. doi: 10.1016/S2214-109X(15)00246-6.

3. WHO. Global prevalence of vitamin A deficiency in populations at risk 1995–2005. WHO Global Database on Vitamin A Deficiency. Geneva, World Health Organization, 2009. (accessed 25 April 2018).

4. Mayo-Wilson E, Imdad A, Herzer K, Yakoob MY, Bhutta ZA. Vitamin A supplements for preventing mortality, illness, and blindness in children aged under 5: systematic review and meta-analysis. BMJ. 2011 Aug 25;343:d5094. doi: 10.1136/bmj.d5094.

5. WHO. Guideline: Vitamin A supplementation in infants and children 6–59 months of age. Geneva, World Health Organization, 2011. (accessed 25 April 2018).

6. Imdad A, Mayo-Wilson E, Herzer K, Bhutta ZA.Vitaminsupplementation for preventing morbidity and mortality in children from six months to five years of age. Cochrane Database Syst Rev. 2017 Mar 11;3:CD008524. doi: 10.1002/14651858.CD008524.pub3.

7. Awasthi S, Peto R, Read S, Clark S, Pande V, Bundy D; DEVTA (Deworming and Enhanced Vitamin A) team. Vitamin A supplementation every 6 months with retinol in 1 million pre-school children in north India: DEVTA, a cluster-randomised trial. Lancet2013 Apr 27;381(9876):1469-77. doi: 10.1016/S0140-6736(12)62125-4. Epub 2013 Mar 14.

8. Habicht JP, Victora C. Vitamin A supplementation in Indian children. Lancet. 2013 Aug 17;382(9892):592. doi: 10.1016/S0140-6736(13)61736-5.

9. The Global Alliance for Vitamin A (GAVA). Assessing vitamin A status in population based surveys. Draft statement, 2017.

10. Wirth JP, Petry N, Tanumihardjo SA, Rogers LM, McLean E, Greig A, Garrett GS, Klemm RD, Rohner F. Vitamin A Supplementation Programs and Country-Level Evidence of Vitamin A Deficiency.Nutrients. 2017 Feb 24;9(3). pii: E190. doi: 10.3390/nu9030190.

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Incorporating Behavior Change Communication (BCC) into Nutrition Programs

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If you are reading this blog then, in one way or another, you are interested in changing people’s behavior for better health outcomes. The Sight and Life Inaugural Webinar Series on behavior change communication (BCC) might be just the informative source you are looking for to expand your knowledge. 

What is BCC? 

BCC is a communication approach, one of many communication approaches available to nutrition professionals. It is distinct from other approaches, such as nutrition education or health promotion, for the following reasons:

– It is an emergent process that culminates with the implementation of a BCC strategy 
– The process draws heavily on research and evidence
– The BCC strategy is focused on what the audience needs to do (versus what the audience must know)
– The BCC strategy is integrated with programs and services.

Interested in learning further? Join our first webinar in the series “People eat food not nutrition: Integrating BCC into your nutrition program” to understand more about these principles underlying BCC.  

It’s a Process

For a program manager, BCC might seem like a complicated undertaking, and for many of you, it is about managing others to do this work. BCC is complicated but it can be mastered if you have a systematic approach. Throughout this webinar series we follow an 8-step process cycle for BCC and share tips, checklists, tools, and resources to help you succeed in managing BCC. Completing the webinar series will not make you a BCC expert, however, it will make you BCC literate.

Behavior change communications, BCC, SBCC, process cycle, nutrition

The first webinar introduces step one of the BCC process, setting your BCC goals and behavior objectives. Straightforward, right? An important learning, from our experience, is to separate your program goal from your BCC goal, as they are not necessarily the same. Your BCC goals will focus on practices or behaviors while program goals might focus on a specific health outcome, such as anemia.

Another learning has been to distinguish between “practices” and “behaviors”; practices consist of multiple behaviors and actions. Once you have distinguished practices from behaviors, setting your BCC goal and behavior objectives is easy. We have developed a behavior chain tool to help you detect the multiple behaviors in a practice.

Behavior chain is a simple tool used to identify the factors or activities required to achieve a target behavior. 

For example a micronutrient powder (MNP) intervention, where the BCC goal might be appropriate use of MNP (a practice), the behavior chain tool would look like this:

[START] 1. Aware of MNP 2. value the MNP 3. get to distribution point 4. ask for MNP at distribution point 5. mix MNP with child meal (at the right consistency) (as per frequency indicated on package) [FINISH]. 

Asking for MNP at a point of distribution would be a behavior, as would mix with meals. Voila – two behavior objectives emerge. The objectives are not set in stone. You can modify them as you gather evidence and clues about your target audience in steps 2 and 3. Remember- only set a few objectives because less is more!

Next Steps 

So how do you feel about BCC after reading this blog – empowered to tackle BCC? Eager to learn more? Register for the Sight and Life Webinar Series on BCC below:

Webinar 1 | Tuesday April, 24 at 14:00 CET
People eat food not nutrition: Integrating BCC into nutrition programs

Some key learnings as we begin our first webinar in the series: 

– BCC is a communication approach with distinct underlying principles, which make it a valuable part of nutrition programming. 
– It is complicated but can be managed by taking a systematic approach. 
– This series provides a high-level analysis of BCC that enables you, the participant, to become BCC literate. 

Webinar 2 | Tuesday, May 15 at 14:00 CET
Assessing the situation: What you need to know

Webinar 3 | Tuesday, June 5 at 14:00 CET
BCC Strategy and Roll out: The devil’s in the detail 

Webinar 4 | Tuesday, June 26 at 14:00 CET
Monitoring the Process: Does it work?

****Note you need to sign-up for each individual webinar. Therefore, if you would like to attend each of the four webinars in the series you must register four times. ****

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Introducing Selenium

An Important Mineral for Human Health

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selenium, nourish notesSelenium is an important component of the body’s antioxidant system, protecting the body against oxidative stress. Oxidative stress is a natural by-product of the body’s metabolism. There is now considerable evidence that selenium plays a key role in the functioning of the immune system, in thyroid hormone metabolism and oxidative reduction reactions of vitamin C. Selenium, along with vitamin E, work to reduce the free radicals that are generated through cellular processes.

The Primary Sources of Selenium

Selenium is found in seafood, meat, whole grains, dairy, fruits, and vegetables. The selenium concentration of plants is determined by the content and availability of the element in the soil in which they are grown. The selenium content of plant foods, therefore, varies from country to country and there are also regional variations. The amount of selenium in animal foods reflects the feeding patterns of livestock.

selenium, nourish notes

Bioavailability of Selenium

Selenium from food sources is highly bioavailable.

Risks Related to Inadequate or Excess Intake of Selenium

Overt selenium deficiency is very rare. Some endemic diseases in parts of Russia and China such as Keshan and Kashin-Beck disease are related to low selenium intakes. Individuals at risk for low selenium intakes are vegans who eat foods grown in low-selenium areas. Selenium is toxic in high doses and causes loss and brittleness of hair and nails, garlic breath odor and nervous system abnormalities.

Find more information on vitamins and micronutrient deficiencies though our partner, Vitamin Angels or download our complete vitamin and mineral guide here

Incorporate selenium into your next evening meal by trying the delicious recipe below…

Brown Soda Bread*

brown soda bread, recipe
Photo Credit: Liz Parsons

Ingredients

1-3/4 cups (225g) whole wheat (wholemeal) flour
1-3/4 cups (225g) all-purpose (plain) flour
1 teaspoon salt
1 teaspoon baking soda (bicarbonate of soda)
3 tablespoons (50g) mixed seeds, such as sesame, pumpkin, or sunflower, or golden flax seeds (linseeds) (optional)
2 tablespoons (25g) butter, softened (optional)
1 egg
About 1 2/3 cups (375–400ml) buttermilk or soured milk

Directions

Preheat the oven to 425°F (220°C).

Sift together the flours, salt, and baking soda in a large bowl and mix in the seeds (if using). Add the butter (if using), and rub into the flour mixture with your fingertips until it resembles bread crumbs. Make a well in the center. In another bowl, whisk the egg with the buttermilk and pour most of the liquid into the flour mixture. Using one hand with your fingers outstretched like a claw, bring the flour and liquid together, adding more of the buttermilk mixture, if necessary. The dough should be quite soft, but not too sticky. Turn onto a floured work surface and gently bring the dough together into a round about 1 1/2 inches (4cm) thick. Cut a deep cross on top and place on a baking sheet. Bake for 15 minutes. Turn down the heat to 400°F (200°C) and bake for 30 minutes more. When done, the loaf will sound slightly hollow when tapped on the bottom. Remove from the baking sheet and place on a wire rack to cool.

*Adapted from Rachel Allen Recipes

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Introducing Iodine

Are You Eating Enough Iodine-Rich Foods?

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Iodine, essential mineral, nourish notesThe body does not make iodine, so it is an essential part of your diet. In addition, this mineral  is needed for the production of thyroid hormones. As an integral part of thyroid hormones it regulates body temperature, metabolic rate, reproduction, growth, blood cell production, nerve and muscle function and more. By controlling the rate at which the cells use oxygen, these hormones influence the amount of energy released when the body is at total rest. Approximately 70 to 80% of the body’s iodine is found in the thyroid.

The Primary Sources of Iodine

Most foods have low iodine content however, iodized salt, seafood, plants grown in iodine-rich soil and animals fed those plants or feed containing iodine are good sources. Additional foods may be sources of iodine if iodized salt is used in their preparation (e.g. bread).

Iodine, nourish notes, primary sources, essentila mineral

Bioavailability of Iodine

Normally, the absorption of iodine from foods is very high (>90%). Some foods (e.g., cassava, millet, lima beans, cabbage) contain substances called goitrogens. These substances inhibit the transfer of iodine to the thyroid gland and disrupt the production of thyroid hormones. If foods containing goitrogens are consumed in large quantities, they may limit the absorption and use of iodine by the body. In general, most people can tolerate higher intakes of iodine from food and supplements.

Risks Related to Inadequate Intake of Iodine

Iodine deficiency has adverse effects at all stages of development but is most damaging to the developing brain. In addition to regulating many aspects of growth and development, thyroid hormone is important for myelination of the nerves, which is most active before and shortly after birth. Thus during pregnancy, diets deficient in iodine may result in higher risk for mental retardation. Thyroid enlargement, or goiter, is one of the most visible signs of iodine deficiency.

Find more information on vitamins and micronutrient deficiencies though our partner, Vitamin Angels or download our complete vitamin and mineral guide here

Incorporate iodine into your next evening meal by trying the delicious recipe below…

Garlic & Chilli Prawns*

Ingredients

Garlic, prawns, recipe, jamie Oliver8 large raw shell-on king prawns , from sustainable sources
3 cloves of garlic
1 fresh red chilli
a few sprigs of fresh flat-leaf parsley
50 ml olive oil , ideally Spanish
½ teaspoon smoked paprika
1 lemon

Method

Peel the prawns, removing the heads and leaving the tails on. Run the tip of a knife down the backs of the peeled prawns and pull out and discard the dark vein. Peel the garlic and finely chop with the chilli (deseed if you like). Pick and finely chop the parsley leaves. Next, drizzle the oil into a shallow heatproof terracotta dish or a small frying pan over a medium-high heat, add the garlic and chilli and fry for 30 seconds to flavour the oil, before stirring in the paprika. Add the prawns and fry for 2 minutes on each side, or until cooked through, adding most of the parsley when you turn the prawns.
Squeeze half the lemon juice into the dish, then remove from the heat and sprinkle over the remaining parsley and a pinch of sea salt.

*Adapted from Jamie Oliver Recipes

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Introducing Iron

An Important Role in the Body

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Iron, essential mineral, nourish notes, FeFeeling tired? No energy? Maybe you are not getting enough iron in your diet! Iron is essential for the formation of haemoglobin in red blood cells; haemoglobin binds oxygen and transports it around the body. Iron also serves as a cofactor to enzymes in oxidation/reduction reactions (i.e., accepts or donates electrons). These reactions are vital to cells’ energy metabolism. Iron requirements fluctuate throughout the life course. Iron needs increase during menstruation, pregnancy, and periods of rapid growth such as early childhood and adolescence.

The Primary Sources of Iron

Iron can be found in red meats, fish, poultry, shellfish, eggs, legumes, grains, and dried fruits.

Iron, nourish notes, primary sources, meat, mineral

Bioavailability of Iron

Iron is carefully regulated by the body and absorption rates vary by the size of a person’s iron stores. The more iron-deficient a person is, the better the absorption rates. Conversely, in healthy individuals iron absorption shuts down when iron stores have been maximized. Many factors affect the absorption of iron. Heme iron from animal-source foods is absorbed, on average, twice as well as inorganic iron (from plant sources). The absorption rates for inorganic iron are also influenced by the meal composition and the solubility of the iron form.

Factors that enhance absorption of inorganic iron are vitamin C and animal protein. Factors that inhibit inorganic iron absorption include phytates (found in grains), polyphenols (found in teas and red wine), vegetable protein, and calcium (which also affects the absorption of heme iron). Food processing techniques to reduce the phytate content of plant-based foods, such as thermal processing, milling, soaking, fermentation, and germination, improve the bioavailability of inorganic iron from these foods.

Risks Related to Inadequate Intake of Iron

A lack of dietary iron depletes iron stores in the liver, spleen and bone marrow. Severe depletion or exhaustion of iron stores can lead to iron deficiency anemia. Certain life-stages require greater iron intake and if these are not met, the risk for iron deficiency is increased. For example, pregnancy demands additional iron to support the added blood volume, growth of the fetus and blood loss during childbirth. Infants and young children need extra iron to support their rapid growth and brain development. Because breast milk is low in iron, infants exclusively fed breastmilk may also be at risk for iron deficiency. Similarly, the rapid growth of adolescence also demands extra iron.

Due to iron’s role in energy metabolism, depletion of body iron stores may result in reductions of the available energy in the cell. The physical signs of iron deficiency include fatigue, weakness, headaches, apathy, susceptibility to infections, and poor resistance to cold temperatures.

Find more information on vitamins and micronutrient deficiencies though our partner, Vitamin Angels or download our complete vitamin and mineral guide here.

Incorporate iron into your next evening meal by trying the delicious recipe below…

Fillet Steak with Peppercorn Sauce*

Steak, Jamie Oliver, recipe, nourish notes

Ingredients 

175 g fillet steak , ideally 3-4cm thick
olive oil
1 teaspoon unsalted butter
Peppercorn Sauce (enough sauce for 2 steaks)
1 teaspoon white peppercorns
40 ml brandy
125 ml dry white wine
100 ml concentrated organic beef stock
30 ml double cream
1 teaspoon unsalted butter

Method

Place a medium frying pan over a high heat to warm-up. Season the steak with sea salt and drizzle with a little oil, then rub all over. Place the steak into the hot pan and cook for 3 to 4 minutes on each side for medium-rare, searing it on its edges for an even crust. If you prefer your steak medium (5 to 6 minutes) or well done (8 to 10 minutes), adjust the cooking time to your liking. Remove the steak to a plate, reserving the pan of juices. Top the steak with the butter, cover with tin foil, then leave to rest for 10 minutes.

Meanwhile, crush the peppercorns in a pestle and mortar, then sieve and remove the powder, leaving the chunker bits to cook with. Add the chunky white peppercorns to the pan of meat juices and cook over a low heat for 30 seconds. Pour in the brandy to deglaze the pan, then carefully tilt the pan to catch the flame (or light with a match) and let it flambé for 30 seconds – stand back! When the flames subside, add the wine, turn the heat up to high and reduce by half, then add the beef stock and continue cooking for 3 to 4 minutes, or until thick and delicious. Turn off the heat, stir in the cream, add the butter and any resting juices, and stir to combine. Serve the steak with a drizzle of peppercorn sauce.

*Adapted from Jamie Oliver recipes

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Introducing Zinc

Playing Key Roles in Human Body Function

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ZincThat cut on your finger not healing? Maybe you are not getting enough zinc? Zinc plays a vital role in wound healing as it is required for the functioning of the immune system and in the structure and function of the skin. Almost all cells in our body contain zinc and it is a vital nutrient for growth and development. The highest concentrations are found in muscle and bone. The body tightly regulates zinc levels. For example, stress and infections cause plasma zinc levels to fall. 

Zinc has a key role as a catalyst in a wide range of reactions and is, in fact, a catalyst for about 100 enzymes. It is important in the structure of cell transport proteins such as vitamins A and D. Zinc regulates gene expression; stabilizes cell membranes, helping to strengthen their defense against oxidative stress; participates in the synthesis, storage, and release of insulin; interacts with platelets in blood clotting; and influences thyroid hormone function. It is necessary for visual pigments; normal taste perception; sperm production; fetal development; and behavior and learning performance.

The Primary Sources of Zinc

Zinc can be found in meats, a selection of  shellfish, legumes, mushrooms whole grains, and some fortified cereals.

Zinc Sources

Bioavailability of Zinc

Like iron, zinc absorption will depend on the zinc body pool, with those having poorer zinc status able to absorb zinc more efficiently in the gut. Foods rich in phytate lead to previously absorbed zinc being lost in the feces. High intakes of calcium, phosphorus, or iron also decrease the absorption of zinc. Protein may enhance absorption of zinc.

Risks Related to Inadequate Intake of Zinc

Individuals consuming unprocessed or minimally processed diets consisting of unrefined whole grains or unleavened whole bread and little animal-source foods are at greater risk for zinc deficiency. Zinc needs are higher in periods of growth and development, such as infancy, childhood, pregnancy and lactation. Zinc deficiency can occur even with only modest restrictions to zinc intake. Impaired growth velocity is the main clinical feature of zinc deficiency. Immune system functions and pregnancy outcomes improve with zinc supplementation. For example, zinc is often given as an adjunct therapy for diarrhea.

Find more information on vitamins and micronutrient deficiencies though our partner, Vitamin Angels or download our complete vitamin and mineral guide here

Incorporate zinc into your next evening meal by trying the delicious recipe below…

Beef stroganoff with herby pasta*

Ingredients

Beef Stroganoff4 tbsp olive oil
500 g mushrooms, sliced
1.5 kg stewing beef, cut into 3cm cubes
350 ml beef stock
3 onions, sliced
2 cloves garlic, crushed
150 ml dry white wine
100 ml brandy
300 ml double cream

For the beurre manié
3 tbsp butter, softened
3 tbsp plain flour

Method

Preheat the oven to 150C/130C fan/gas 3. Then, heat 2 tablespoons of olive oil in a large ovenproof casserole and lightly fry the mushrooms in batches in the olive oil until golden brown. Tip onto a plate and set aside. Brown the meat in the same pan in small batches, adding more oil as necessary and removing each batch from the pan. Now fry the onions until softened and lightly coloured, adding the garlic towards the end and using a little more oil, if necessary. Next, pour 150ml of the stock into the pan and bring to the boil, stirring to deglaze. Return the mushrooms and meat to the pan, then pour in the wine, brandy and remaining stock. Add seasoning to taste, stir well and bring to a simmer. Cover with the lid, transfer to the oven and cook for 2-2½ hours or until the meat is tender. Make the beurre manié by putting the butter and flour onto a plate and mixing to a paste. Set aside. When the meat is cooked, carefully strain the cooking liquid into a saucepan. Keep the meat and mushrooms warm in the covered casserole. Pour the cream into the cooking liquid and boil, uncovered, for a few minutes until the sauce has reduced slightly and has a good flavour. Adjust the seasoning to taste, if necessary. With the liquid still boiling, add the beurre manié 1 teaspoon at a time and whisk vigorously until the sauce thickens slightly. Now pour the sauce over the meat and mushrooms and stir gently to mix. Keep the stroganoff warm until you are ready to serve. 

*Adapted from the BCC Good Food website. 

 

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