A Tale of Two Conferences, One Ultimate Goal

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The 2019 summer conference season opened in an intense way for me. With barely one intervening week, I had the privilege of attending two fascinating conferences that differed in most aspects but converged on the complementary pathways towards the common and ultimate goal of a better-nourished and healthier world.

Reflections from Baltimore

The first conference was Nutrition 2019, the annual meeting of the American Society for Nutrition, hosted in Baltimore, home to Johns Hopkins University, one of the leading nutrition research institutions in the world. Five intense days with hundreds of lectures, presentations, panels and posters organized in themes ranging from cellular and physiological metabolism to global and public health nutrition. As expected, great learning and networking, accompanied by the recurring wish one could multiply oneself so as not to miss one or more exciting parallel sessions. Nearly 3,500 participants from scores of countries, albeit with diminished participation from Africa and Asia compared to last year’s edition. I had the opportunity to present a poster on complementary food safety and quality in Rwanda (poster shown below), the detailed content of which was recently published in Maternal & Child Nutrition.

A few topics stood out. Perhaps the most emergent was the microbiome, a theme that has now migrated from the margins to the center of clinical and translational nutrition. The most thought-provoking microbiome presentation in my view was by Dan Knights from the University of Minnesota. In a panel titled “You Are What Your Microbes Eat” exploring the interplay between diets and the gut microbiome, he borrowed from physics the metaphor of dark matter to describe the countless compounds present in foods that are not captured on any nutrition label yet strongly influence microbiome composition and metabolism. Intriguingly, responses of specific gut microbes to the same foods are often different from person to person, pointing to the need for a personalized approach to the microbiome and nutrition and mirroring the emergence of nutrigenomics and personalized nutrition, another salient topic in the conference.

Sustainability was another theme on the move towards the mainstream of nutrition, certainly influenced by the EAT-Lancet Food in the Anthropocene report[i]. The challenges of nudging consumers and food systems towards healthy diets and sustainability, and the multiple tradeoffs involved, were highlighted in several sessions, including a dense panel discussion moderated by Klaus Kraemer, Managing Director of Sight and Life, and Eileen Kennedy, Dean of the Friedman School of Nutrition Science and Policy at Tufts University.

A special event, rich in historical perspective and fond memories, was the Kellogg Prize for Lifetime Achievements in International Nutrition Lectureship. Marie Ruel, Director of IFPRI’s Poverty, Health, and Nutrition Division, was this year’s prize recipient, recognized for her outstanding work of more than 25 years on policies and programs to alleviate poverty, food insecurity and malnutrition in developing countries. What made the ceremony particularly touching was the presence of many other leaders in the field who were mentors, colleagues, or mentees of Marie’s, a testimony to the expanse and depth of her contributions.

My overall perception of the field, partly from having attended both the 2018 and 2019 editions of ASN, is that it is currently in a stage of incremental and relatively modest advances; areas such as the microbiome and personalized nutrition show tantalizing promise, yet they involve complex science in its early stages, which likely implies a translational pathway a few years long, not to mention translational challenges to low-resource contexts.

Impressions from Hyderabad

The second conference was the Agriculture, Nutrition & Health (ANH) Academy Week 2019. Held in Hyderabad, the bustling and sprawling high tech hub of Southern India, this was a much smaller and more intimate event of about 400 participants from a broad array of food system-related disciplines. It was the Academy Week’s fourth edition, the previous ones having been held in Addis Ababa, Kathmandu and Accra. The first two days were dedicated to learning labs, followed by a three-day research conference. Overall, a superb interdisciplinary and cross-sectoral gathering that stretched participants’ world views and thinking across boundaries.

Srujith Lingala of Sight and Life participating during ANH.

And it was the progress in the interdisciplinary dialogue on food systems that impressed me the most. We have been talking about ag-nutrition integration for a few years now, but the road has been bumpy and uphill, with dissonances ranging from language to priorities and expectations. It felt so much smoother and fluid at this Academy Week. To me, this gathering was one among a number of signals that we are now reaching an upland in which we can switch gears towards more integrative thinking and holistic approaches to the food system. These refined approaches incorporate not just nutrition and health but also sustainability – now inextricably linked with agriculture –, equity and socioeconomic development, while acknowledging the need for inclusive governance to co-create win-wins and negotiate inevitable tradeoffs with fairness. The good research presented at the conference included innovative tools (such as Agrifood) to facilitate the complex and consequential decision-making involved.

ANH, Acedemic Week, India, Nutrition, Agriculture
Group photo from Agriculture, Nutrition & Health (ANH) Academy Week 2019 held in Hyderabad, India.

Final Thoughts

I thus stepped into the second half of 2019 with renewed optimism from these two conferences and the complementary and increasingly convergent learning agendas they represent. Health system-based approaches and the first thousand-day focus remain vital, but are insufficient to address the multiple burdens of malnutrition. Food system-based approaches can benefit the whole population from cradle to grave, spanning the food insecurity-malnutrition spectrum and addressing other dimensions also relevant to nutrition outcomes. With these two wings in tandem, we will be able rise faster towards a better-nourished, healthier, fairer, and more sustainable world.

For additional pictures from ASN visit here and for ANH visit here

[i] Willet et al., “Food in the Anthropocene: the EAT–Lancet Commission on healthy diets from sustainable food systems”. Lancet 2019; 393: 447–92.

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

Congress Report 

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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