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Can new developments in nutrition and its interaction with lifestyle help reduce the massive burden of some key non-communicable diseases including dementia, diabetes, and obesity? This year’s 6th annual Institute for Food Nutrition and Health (IFNH) Forum invited a panel of expert internal and external speakers to consider the issue.

Milk is an excellent source of essential nutrients and functional components. There is increasing evidence that some of these components are implicated in cognitive health and behaviour. The first of our external speakers, Dr Javier Fontecha, Head, Food Lipid Biomarkers and Health at the Institute of Food Science Research (CIAL,CSIC) Autónoma University of Madrid, discussed his research on the use of milk fat globule membrane (MFGM) supplementation. Studies have shown that supplementing baby milk formula with MGFM significantly increased the cognitive language and motor skills of babies and Dr Fontecha has tested whether adding MFGM supplements can improve mild cognitive impairment during aging. Results showed that there was an increase in long term memory and also a significant increase in short term memory, which is significant because the short term memory is most easily impaired as we age. But Dr Fontecha noted that people are consuming less and less MFGM – people are consuming less whole milk, and it is largely lost in the processing of semi- and skimmed milk. With cognitive impairment starting from around 40-50 years, increasing MFGM in diets before clinical symptoms manifest would be a good start.

The link between obesity and cardiovascular diseases and type-2 diabetes has long been established but more recently, it has become apparent that obesity drives at least thirteen different cancers, increases the risk of fatty liver disease and drives both dementia and poor mental health. Our second external speaker, John Mathers, Professor of Human Nutrition, Human Nutrition and Exercise Research Centre at Newcastle University, looked at how obesity risk is exacerbated by genotype. The fat mass and obesity associated gene (FTO) is the gene most commonly associated with obesity. However, actions can be taken to reduce the effects of that genetic predisposition. The good news is that for those people who are living with obesity or who are overweight, weight loss improves health and wellbeing and more specifically, physical activity reduces the effect of FTO genotype on body weight. The other good news is that the FTO gene does not make it more difficult to lose weight and restricting energy intake remains the key to losing weight. If a woman at age 40 who previously had an unhealthy diet, improves her diet to eat the kind of foods eaten by those with the longest longevity, and carefully manages energy intake, she could attain more than ten years of extra life expectancy. Similarly, a 70 year old female could attain a five year increase in life, and there are very similar expectations for men at both age 40 and 70.

IFNH Deputy Director, Professor Vimal Karani, showed how understanding the interaction between the genetic risk and the dietary consumption worked in practice. In collaboration with the Universiti Tunku Abdul Rahman, he has set up the Nutrigenetics and Nutrigenomics Research and Training Unit in Malaysia looking at how an optimum diet could be tailored according to an individual’s genetic makeup. Malaysia has got the highest prevalence of obesity among adults compared to all other Southeast Asian populations and nearly 50% of the adult population were reported to be overweight or obese. Professor Karani highlighted the importance of conveying the message that even if you have a really high genetic risk, by adopting healthy eating and doing more levels of physical activity, it can help you to overcome the risk of several non-communicable diseases such as obesity, diabetes and cardiovascular diseases.

Putting into context why people eat what they do is critical to changing dietary habits and changing the inequalities that arise from poor diet. We know what we should be doing, but actually persuading people to do something different, either for their own health or for the benefit of the planet in terms of reducing the burden of climate change is a substantial challenge. Dietary fibre is a really valuable component of the diet and is associated with a reduction in risk of all-cause mortality, coronary heart disease, type two diabetes, colorectal cancer incidence, and total cancer mortality, as well as reductions in body weight, total cholesterol and systolic blood pressure. Professor Julie Lovegrove, Hugh Sinclair Chair in Human Nutrition at the University of Reading, discussed how the UK population is not consuming the recommended 30 grams of fibre a day; in fact intake is exceptionally low, particularly in adolescents and women. This is particularly the case in those groups of low income. Although there are easy swaps to make to increase our fibre intake, such as substituting white spaghetti with wholegrain, people find it difficult to comply with recommendations for reasons such as accessibility of foods, cost and preferences. So innovative strategies are required to increase fibre intake for all groups of the population. One such project is ‘Raising the Pulse’, which is looking at replacing some of the nutrient poor wheat flour with nutrient rich fava bean flour in bread. 96% of the population purchase bread on a weekly basis and 90% of this is white. So by changing the flour component, people don’t have to change their diet in a significant way to get increased fibre, one of the benefits of pulses.

Challenges such as how effects of food cultures can impact the need to change dietary habits and how the needed dietary changes can be affected by social inequalities and climate change were also among the topics explored. Professor Henny Osbahr, Head, Department of International Development at the University of Reading outlined research projects in Ghana, India and Vietnam to highlight the need to better incorporate social-cultural dimensions in debates about food and nutritional security, recognising consumption patterns and choices at all levels from individual households to regional and national extension programmes.

Indigenous communities throughout the world are among the most vulnerable groups to the threat posed by the climate crisis. There are direct links between their society and economy to natural resource availability. Dr Vernica Escobar-Ruiz, Research Support Scientist in the Department of Meteorology at the University of Reading and Dr Oscar Martínez-Alvarado, Research Scientist at National Centre for Atmospheric Science, talked about communities they are working with – a llama farming community in Argentina and a fishing community in Mexico – looking at the effects of climate change on their health and lifestyle.

Key to both discussions was participation. There are calls for policy regarding the design of food and nutrition interventions to consider the cultural aspects of the uses of food by indigenous people when seeking to enhance the nutritional value of local foods. Similarly, any policy or research into increasing resilience and adaptation needs to incorporate their knowledge that those communities hold as opposed to imposing the views of “mainstream” scientific knowledge.

So can nutrition and lifestyle combine to make a really big impact on future health? Well, there is no doubt that they can help enormously and can even overcome genetic predisposition to obesity. The potential of components of the MFGM to improve neurodevelopment in children and reduce the risk of cognitive decline in later life is very exciting as is the possibility to increase dietary fibre intake. But as always further research is essential to maximise the ability to reduce diet-responsive chronic diseases which have substantial impacts on health, quality of life and on the costs of healthcare.

Professor Ian Givens is Director of the Institute for Food Nutrition and Health and Professor of Food Chain Nutrition.

We are pleased to announce our next Lunchtime Seminar showcasing 'Home-Grown School Feeding delivering nutritional and dietary diversity: Lessons from GIZ Afikepo NAPE programme, Malawi' presented by Gilbert Ngwaneh Miki, Early Career Researcher, School of Agriculture, Policy and Development. The seminar will take place Friday 16th February at 13.00 – 14.00 via Microsoft Teams. If you would like to join us please  Click here to join the meeting and share the invitation within your school/group.

Abstract

Currently the world is faced with global nutrition crisis, with overwhelming consequences of malnutrition. Many countries especially in the Global South experience multiple malnutrition burdens, with undernutrition threatening the health and future of school-aged children and their communities. The negative impact is more evident in poor, vulnerable and disadvantaged rural communities. Amidst these challenges, Home-Grown School Feeding (HGSF) stands out as an approach to significantly address issues related to nutrition and diets among poor, vulnerable, and disadvantaged communities. However, evidence is lacking on implementation of HGSF within multi-sectoral programmes and this study is partly an attempt to uncover the impact of HGSF on nutritional wellbeing and dietary practices among smallholder farmers and their households in Malawi. With School feeding linked to local food production (HGSF), this study explored the extent to which HGSF stimulate diversification of crop production for improved nutrition and dietary diversity. While various HGSF models were explored, this session focuses on the GIZ Afikepo NAPE programme which prioritised the community-based approach, with school feeding used as an entry point to influence behaviour change towards nutrition and dietary diversity in rural communities through nutrition-sensitive agriculture. The study utilised mixed methods with key interest on the changes resulting from the community-based HGSF intervention. This involved 153 household surveys, 40 in-depth interviews, 20 key informants and 6 focus group discussions. Findings from the study showed that HGSF especially the community-based approach contributed to stimulating crop production diversification and consequently the diversity of food consumed at the school and household levels. Smallholder farmers in particular reported increased food consumption scores, reduced coping strategies and increased household food basket. The study identified positive changes attributed to the GIZ Afikepo NAPE programme, with significant impact on nutrition and dietary diversity.